This study took a new look at existing data from adolescents with ADHD who trained with fMRI neurofeedback. Sixteen trained on a brain area called the right inferior frontal cortex. A comparison group of 11 trained on the left parahippocampal gyrus. Both groups did the same stop task in the scanner. Most of the patients were taking ADHD medication (70%).
After training, the right frontal group was slower to respond after making an error. The authors read this as a stronger adjustment to mistakes. This group also showed more activity in left-side error monitoring areas: the inferior frontal cortex, insula, putamen and premotor cortex.
Both groups had fewer ADHD symptoms afterward. Both also became less variable in their responses, which may have been a practice effect. The brain and performance changes were seen only in the right frontal group.
Larger brain changes tended to go with greater symptom improvement. This link became significant only once extreme outliers were removed, and the authors urge caution. They found no link between the slower post-error responses and the brain changes.
The study was small and preliminary. It lacked the power to test performance and brain behavior links, and the behavior analyses were not corrected for multiple tests. Medication did not differ significantly between groups, but it was not identical. It is not known whether the results would hold in patients never treated with ADHD medication. Further studies are needed to see if the findings repeat.
Source: Marion Criaud, Melanie Wulff, Analucía A. Alegría, et al.. Increased left inferior fronto-striatal activation during error monitoring after fMRI neurofeedback of right inferior frontal cortex in adolescents with attention deficit hyperactivity disorder. NeuroImage Clinical (2020). doi:10.1016/j.nicl.2020.102311