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Attention and Motivation

February 3, 2014

Cognitive Neuroscience of Attention and Motivation

By Masud Husain, Wellcome Trust Principal Fellow, University of Oxford.    

Recent developments in the neuroscience of attention and motivation have moved forward at a rapid pace. We now understand a great deal about the brain systems, networks and neurotransmitters that underpin the deployment of attention and human motivation, two fundamental processes that are widely considered to play key roles in learning and educational outcome. However, application of these findings to education and improved performance is still in its infancy.

Neurofeedback is perhaps the technique which is closest to being used in educational settings. In this relatively new approach students are given real-time feedback on their own neurological state. This is typically achieved by visualising brainwaves using electroencephalography (EEG; Gruzelier, 2013), although neurofeedback has also been attempted with real-time functional magnetic resonance imaging (Weiskopf, 2012) in adults. It is proposed that by monitoring their brain activity through the use of neurofeedback, students are able to train their brains to produce specific patterns of activity that are optimal for learning (Enriquez-Geppert et al., 2013).

Several studies and, more recently, randomized trials have been conducted using  EEG in children with attention deficit hyperactivity disorder (ADHD) (Loo, et al, 2012Lofthouse, et al, 2012Moriyama, et al, 2012Gevensleben, et al, 2012). One recent six month study has even reported that neurofeedback outperformed standard drug treatment (methylphenidate) for ADHD in terms of academic outcome (Meisel, et al, 2013).

Other potential interventions include transcranial magnetic stimulation (TMS) (Demirtas­‐Tatlidede, et al, 2013), transcranial direct current stimulation (tDCS) (Kuo, et al, 2013) and cognitive enhancement using drugs (Husain & Mehta, 2011). The use of these techniques to enhance cognitive function has been explored, to varying extents, in adults. For example, tDCS has been reported to improve numerical abilities in adults (Cohen Kadosh, et al, 2010) but the use of such techniques in children, in particular, raises both safety and ethical issues (Cohen Kadosh, et al, 2012).  Similarly, studies of cognitive enhancement using drugs in adults have shown signs that the individuals most likely to benefit are those who have the lowest performance (Husain & Mehta, 2011), but these studies have not been systematically tested. For most drugs, the long-­term safety profile and effects on cognition have not been established in children.

In order for techniques to be translated effectively into the classroom, to become useful and safe, they need much further testing, considering both ethical and safety issues. Obtaining regulatory and ethics committee permissions for such studies would not be straightforward, but a case could be made, particularly if there is an unmet need, for instance, for students with different types of learning disability.

Potential benefits

The potential benefits of applying interventions based upon neuroscience to education will depend upon the magnitude of effects – which is still unknown. Nevertheless, one might speculate, that even relatively small effects of cognitive enhancement in a population might have significant consequences on long-­term outcome, particularly if the impact of an intervention could be maintained over time. It is theoretically possible that developing good learning habits at young ages, such as sustaining attention for longer and improving motivation, might have positive long-­term consequences even when the intervention is withdrawn.

Evidence that the interventions described above, when directed towards improving attention or decision‐making, have a direct impact on educational outcome, are difficult to find, apart perhaps from the case of children affected by ADHD. Here, there is some evidence that drug treatment (Powers, et al, 2008) and, more recently, neurofeedback (Meisel, et al, 2013), might have a significant positive effects on academic outcome. However, the findings are variable and some studies suggest that although performance might be improved on tests in the laboratory, these might not generalize to everyday improvement (Epstein, et al, 2010Currie, et al, 2013). Thus, even for a long-­studied disorder such as ADHD, the data on long-­term effects on educational outcome remain unclear.

It needs to be appreciated, though, that costs of delivering an intervention and the risks of any possible side effects might be weighed up against the benefits of reducing societal costs of academic under-performance and disengagement from education. ADHD is a significant factor that leads to drop‐out from school and UK government data published in 2008 revealed that more than forty per cent of young offenders have a diagnosis of ADHD (UK Home Office, 2008).

Prospects for the future

Realistically, on current trends, future development is likely to be slow, especially given the ethical and safety concerns. Also, even if one of these interventions is shown to be successful in enhancing one particular cognitive function, say, attention, it might have negative effects on another aspect of cognitive performance (see Husain & Mehta, 2011, for further discussion).

Perhaps the technique that might have greatest potential for rapid development in children is neurofeedback. EEG is relatively inexpensive and widely available in many centres across the world, although widespread application to education is still likely to be some way in the future.

References

1. Gruzelier, J. H. (2013). EEG-neurofeedback for optimising performance. I: A review of cognitive and affective outcome in healthy participants. Neuroscience and Biobehavioral Reviews doi:10.1016/j.neubiorev.2013.09.015

2. Weiskopf, N. (2012). Real‐time fMRI and its application to neurofeedback. Neuroimage, 62, 682– 692.

3. Enriquez-Geppert, S., Huster, R. J., Scharfenort, R., Mokom, Z. N., Zimmermann, J. and Hermann, C. S. (2014). Modulation of frontal-midline theta by neurofeedback.  Biological Psychology doi:10.1016/j.biopsycho.2013.02.019

4. Loo, S. K. & Makeig, S. (2012). Clinical utility of EEG in attention-­deficit/hyperactivity disorder: a research update. Neurotherapeutics, 9, 569–587.

5. Lofthouse, N., Arnold, L. E. & Hurt, E. (2012). Current status of neurofeedback for attention-deficit/hyperactivity disorder. Current Psychiatry Reports, 14, 536–542.

6. Moriyama, T. S., Polanczyk, J., Caye, A., Banaschewski, T., Brandeis, D. & Rohde, L. A. (2012). Evidence-­based information on the clinical use of neurofeedback for ADHD. Neurotherapeutics, 9, 588–598.

7. Gevensleben, H., Rothenberger, A., Moll, G. H. & Heinrich, H. (2012). Neurofeedback in children with ADHD: validation and challenges. Expert Review of Neurotherapeutics, 12, 447–460.

8. Meisel, V., Servera, M., Garcia-­‐Banda, G., Cardo, E. & Moreno, I. (2013). Neurofeedback and standard pharmacological intervention in ADHD: A randomized controlled trial with six-­‐ month follow-­‐up. Biological Psychology, 94, 12–21.

9. Demirtas­‐Tatlidede, A., Vahabzadeh‐Hagh, A. M. & Pascual­‐Leone, A. (2013). Can noninvasive brain stimulation enhance cognition in neuropsychiatric disorders? Neuropharmacology 64, 566–578.

10. Kuo, M.­‐F. & Nitsche, M. A. (2012). Effects of transcranial electrical stimulation on cognition. Clinical EEG and Neuroscience, 43, 192–199.

11. Husain, M. & Mehta, M. A. (2011). Cognitive enhancement by drugs in health and disease. Trends in Cognitive Science, 15, 28–36.

12. Cohen Kadosh, R., Soskic, S., Iuculano, T., Kanai, R. & Walsh, V. (2010). Modulating neuronal activity produces specific and long-­‐lasting changes in numerical competence. Current Biology, 20, 2016–2020.

13. Cohen Kadosh, R., Levy, N., O’Shea, J., Shea, N. & Savulescu, J. (2012). The neuroethics of non‐invasive brain stimulation. Current Biology, 22, R108–111.

14. Powers, R. L., Marks, D. J., Miller, C. J., Newcorn, J. H. & Halperin, J. M. (2008). Stimulant treatment in children with attention-­‐deficit/hyperactivity disorder moderates adolescent academic outcome. Journal of Child and Adolescent Psychopharmacology, 18, 449–459.

15. Epstein, J. N., Langberg, J. M., Lichtenstein, P. K., Altaye, M., Brinkman, W. B., House, K. & Stark, L. J. (2010). Attention‐deficit/hyperactivity disorder outcomes for children treated in community-­based pediatric settings. JAMA Pediatrics, 164, 160-165.

16. Currie, J., Stabile, M. & Jones, L. E. Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with ADHD? (National Bureau of Economic Research, 2013)

17. UK Home Office. Youth Crime Action Plan 2008. (HM Government, 2008).

 

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One Comment leave one →
  1. July 16, 2014 5:16 pm

    My aunt treats patients with this technique for ADHD and has told it is very effective. Along with a particular diet it may be the best combination possible to help us focus better.

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