Study detail featured image

The Profound Effects of Interactive Metronome on Children Diagnosed with Attention Deficit Hyperactivity Disorder.

White paper: Developmental Biopsychiatry Research Program, McClean Hospital, Harvard Medical School

Keywords

Pediatric, Cognitive Skills

Enhancing Focus in ADHD through Interactive Metronome Training
Attention deficit hyperactivity disorder (ADHD) presents unique challenges, often marked by inattention, hyperactivity, and impulsivity. This can make everyday activities like schoolwork, social interactions, and maintaining relationships particularly difficult for those affected. But there’s an innovative method, Interactive Metronome (IM) training, that can help address these symptoms and enhance focus.

The Study: An In-Depth Look
An insightful study explored the effects of IM training on ADHD symptoms. The study encompassed 40 children diagnosed with ADHD who were randomly split into an IM training group and a control group. For 12 weeks, the IM training group engaged in IM training, whereas the control group did not receive any specific training.

Results: Significant Strides in Managing ADHD Symptoms
Preliminary results from this ongoing study showed that 5 of 14 children (36%) diagnosed with ADHD demonstrated 40% or greater improvement on standardized neuropsychological measures of hyperactivity and spatial working memory (the executive function most notably impaired in ADHD) following completion of a combined Interactive Metronome (IM) and Brain Balance (BB) training protocol. According to Dr Teicher, “this is a degree of improvement that we have not previously observed in children with ADHD unless they were receiving medications, and then only if they were receiving the correct medication at optimal dose.” Furthermore, they showed substantial progress in areas like attention, impulsivity, and hyperactivity.

Conclusion: A Leap Towards Better ADHD Management
The study findings hint at IM training being an effective intervention to ameliorate ADHD symptoms. This unique approach could be particularly beneficial for children grappling with ADHD, helping them manage their symptoms better.

Clinical Implications: An Effective Tool for ADHD Management
For clinicians working with children with ADHD, the study’s insights suggest that IM training could be a vital asset. By improving attention, impulsivity, and hyperactivity, this training can facilitate enhanced functioning in various settings – school, work, and relationships.

If you’re a clinician serving children with ADHD, consider incorporating IM training into your practice. This safe and effective method can be personalized to suit individual needs, offering a novel approach to improve ADHD symptoms. IM training, therefore, is not just a therapy but a step towards transforming lives, fostering better functionality, and promoting personal growth.

Abridged Summary & Results of Study

Profound Effects of Interactive Metronome and Brain Balance Exercises on a Subset of Children with Attention Deficit Hyperactivity Disorder

YEAR: 2019

PUBLICATION: WHITE PAPER: DEVELOPMENTAL BIOPSYCHIATRY AUTHOR: Martin H Teicher, PhD, MD RESEARCH PROGRAM, MCCLEAN HOSPITAL, HARVARD MEDICAL SCHOOL

Results:
Simply Preliminary results from this ongoing study showed that 5 of 14 children (36%) diagnosed with ADHD demonstrated 40% or greater improvement on standardized neuropsychological measures of hyperactivity and spatial working memory (the executive function most notably impaired in ADHD) following completion of a combined Interactive Metronome (IM) and Brain Balance (BB) training protocol. According to Dr Teicher, “this is a degree of improvement that we have not previously observed in children with ADHD unless they were receiving medications, and then only if they were receiving the correct medication at optimal dose.”

Neuroimaging of brain regions strongly implicated in the neurobiology of ADHD helped to parse out the influence of each training program and the effect of combining them. Specifically, scans showed that BB training was associated with increased connectivity between prefrontal cortex and the frontal pole, temporal pole, cerebellum, precentral gyrus and supramarginal gyrus with extensive effects on connectivity of the amygdala and hippocampus, which are involved in implicit and explicit memory as well as stress response.

Increased connectivity of the amygdala with supramarginal gyrus, cingulate gyrus, anterior cingulate, angular gyrus, frontal pole and precuneus were associated with combined IM and BB training. Greater connectivity between the amygdala and cingulate allows for better emotional self-regulation and impulse-control.

IM training was associated with increased connectivity between the hippocampus and the angular gyrus, precuneus, middle temporal gyrus, lateral occipital cortex, supramarginal gyrus, cingulate gyrus and frontal pole, areas responsible for language processing, memory retrieval, handwriting, mathematical calculations, and L/R discrimination. A closer examination of the impact on the cerebellum revealed that IM training was associated with increased resting state functional connectivity between: cerebellum I and middle frontal gyrus; cerebellum II and inferior temporal gyrus/fusiform gyrus; cerebellum IV-V and parahippocampal gyrus and inferior temporal gyrus/fusiform gyrus; cerebellum VII and lateral occipital cortex; cerebellum VIII and superior frontal gyrus and cerebellum IX and lingual gyrus and postcentral gyrus. IM training was also associated with decreased resting state functional connectivity between cerebellum III and anterior cingulate gyrus and cerebellum VI and lateral occipital gyrus.

These appear to be potent changes. Our findings of symptomatic improvement and enhanced connectivity of the supramarginal gyri with the amygdala, hippocampus, and prefrontal cortex is consistent with a recent report showing that reduced connectivity of the left and right supramarginal gyri was associated with increased symptom severity in ADHD24. Given the role these regions appear to play in timing makes these observations particularly compelling. Research is ongoing and will continue to investigate and further define the host of neurobiological changes associated with IM and BB training as well as their relationship to clinical outcome for individuals with ADHD.

Details

  • n=14 (8-14 years of age) confirmed to have ADHD through structured diagnostic interview (K-SADS-PL)
  • intervention: 15 weeks of combined Interactive Metronome and Brain Balance training (up to 75 sessions) were completed remotely via online access
  • standardized exercises with no individualization
  • not directly supervised by an experienced administrator (carried out by families at home)

Clinical Outcome Measures

  •  ADHD Quotient System.This test is highly responsive to the effects of medication, correlates with blood levels of methylphenidate but is not responsive to placebo. Indeed, we reported in N=30 children receiving placebo that only 7% showed a greater than 25% improvement and none had a 40% or greater improvement in Quotient scaled scores.
  • Cambridge Neuropsychological Test Automated Battery (CANTAB) to evaluate spatial working memory
  • Neuroimaging with diffusion MRI optimized to evaluate the brain’s structural connections (part of the Human Connectome Project)

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