Abstract：
Attention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task.
Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed.
While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients.
Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD.
drks.de (identifier: DRKS00022370).
Eighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed.
While patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients.
Our findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD.
drks.de (identifier: DRKS00022370).
摘要：
背景：注意缺陷/多动障碍（ADHD）的特征是个体间的异质性，这对系统评估和治疗提出了挑战。考虑到先前神经反馈研究的混合证据，我们提出了一种新颖的反馈系统，该系统依靠凝视行为来检测注意力不集中的迹象，同时在虚拟研讨室中执行神经心理学注意力任务。更具体地说,每当参与者将目光从给定任务移开时，就会给出视听反馈。
方法：18名患有ADHD的成年人和18名健康对照者在虚拟现实中在三种平衡条件下进行了连续表现任务（CPT），虚假反馈，或未提供反馈。在所有条件下,高和低虚拟分心的阶段交替。CPT错误和反应时间，凝视停留时间的比例(例如，任务焦点或分心焦点)，扫视特征，脑电图θ/β比值，头部运动,并分析了多动症症状的经验抽样。
结果：虽然可以很好地区分患者与健康对照组，因为他们表现出更多的遗漏错误，更高的反应时间，与分心相关的停留时间更高，和更多的头部运动，反馈并没有立即提高任务绩效。还表明，假反馈与患者症状的加重有关。
结论：我们的研究结果证明了这种整体ADHD症状评估的足够适用性和特异性。关于反馈,基于所提出的元认知策略,一次单节训练不足以达到学习效果.未来纵向，多节试验应最终检查基于凝视的虚拟现实注意力训练在ADHD中的疗效.
背景：drks。de（标识符：DRKS00022370）。
方法：18名患有ADHD的成年人和18名健康对照者在虚拟现实中在三种平衡条件下进行了连续表现任务（CPT），虚假反馈，或未提供反馈。在所有条件下,高和低虚拟分心的阶段交替。CPT错误和反应时间，凝视停留时间的比例(例如，任务焦点或分心焦点)，扫视特征，脑电图θ/β比值，头部运动,并分析了多动症症状的经验抽样。
结果：虽然可以很好地区分患者与健康对照组，因为他们表现出更多的遗漏错误，更高的反应时间，与分心相关的停留时间更高，和更多的头部运动，反馈并没有立即提高任务绩效。还表明，假反馈与患者症状的加重有关。
结论：我们的研究结果证明了这种整体ADHD症状评估的足够适用性和特异性。关于反馈,基于所提出的元认知策略,一次单节训练不足以达到学习效果.未来纵向，多节试验应最终检查基于凝视的虚拟现实注意力训练在ADHD中的疗效.
背景：drks。de（标识符：DRKS00022370）。
