ADHD is a common condition that causes suffering for those affected and economic loss for society at large. The current standard treatment for ADHD includes stimulant medications, which are not effective for all patients, may include side effects, and can be non-medically misused. Z-score neurofeedback (NFB) and heart rate variability (HRV) biofeedback are alternative treatment strategies that have been associated with Attention-Deficit/Hyperactivity Disorder (ADHD) symptom improvement. We utilized a retrospective pre-post study design to quantify the change in clients’ ADHD symptoms after combined NFB + HRV treatment (which included simultaneous z-score training at four sites). We also assessed whether relevant physiological measures changed in accordance with the protocol, which would be consistent with effective NFB + HRV training. Adults (n = 39) and children (n = 100) with Borderline or Clinical ADHD classifications by the Achenbach System of Empirically Based Assessment (ASEBA) received 30 sessions of NFB + HRV training. Measures were compared before and after treatment for the ASEBA, the Integrated Visual and Auditory Continuous Performance Test (IVA), ADHD medication use, HRV and breathing parameters, and quantitative electroencephalogram (QEEG) parameters. Average ASEBA Attention-Deficit/Hyperactive Problems score improved after treatment for adults and children (p < 0.0001), with Cohen effect sizes (d_z) of −1.21 and −1.17, respectively. 87.2% of adults and 80.0% of children experienced improvements of a magnitude greater than or equal to the Minimal Clinically Important Difference. After treatment, 70.8% of adults and 52.8% of children who began in the ASEBA Clinical range, and 80.0% of adults and 63.8% of children who began in the ASEBA Borderline range, were classified in the Normal range. IVA scores also improved after treatment. Changes in HRV and breathing pattern after treatment were consistent with the protocol. QEEG parameters after treatment were closer to the age-based normative mean, which is consistent with effective z-score NFB training.

中文翻译：

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针对患有注意力缺陷/多动症症状的成人和儿童的 Z 分数神经反馈和心率变异性训练：一项回顾性研究。

多动症是一种常见疾病，会给受影响的人带来痛苦，并给整个社会带来经济损失。目前 ADHD 的标准治疗包括兴奋剂药物，但并非对所有患者都有效，可能会产生副作用，并且可能会被非医疗滥用。Z 分数神经反馈 (NFB) 和心率变异性 (HRV) 生物反馈是替代治疗策略，与注意力缺陷/多动障碍 (ADHD) 症状改善相关。我们采用回顾性前后研究设计来量化 NFB + HRV 联合治疗（包括在四个地点同时进行 z 评分训练）后客户 ADHD 症状的变化。我们还评估了相关生理测量是否根据方案发生变化，这与有效的 NFB + HRV 训练一致。根据阿亨巴赫经验评估系统 (ASEBA) 分类为边缘或临床 ADHD 的成人 (n = 39) 和儿童 (n = 100) 接受了 30 次 NFB + HRV 培训。比较治疗前后的 ASEBA、综合视觉和听觉连续性能测试 (IVA)、ADHD 药物使用、HRV 和呼吸参数以及定量脑电图 (QEEG) 参数。成人和儿童治疗后平均 ASEBA 注意力缺陷/多动问题评分有所改善 ( p  < 0.0001)，科恩效应量 ( d _z ) 分别为 -1.21 和 -1.17。87.2% 的成人和 80.0% 的儿童的改善幅度大于或等于最小临床重要差异。治疗后，开始进入 ASEBA 临床范围的成人和儿童的 70.8% 和 52.8%，以及开始进入 ASEBA 边缘范围的成人和儿童的 80.0% 和 63.8% 被归入正常范围。治疗后 IVA 评分也有所改善。治疗后 HRV 和呼吸模式的变化与方案一致。治疗后的 QEEG 参数更接近基于年龄的正常平均值，这与有效的 z 评分 NFB 训练一致。