Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder

Abstract Background Aberrant resting state electroencephalography (rsEEG) is a well-established indicator of psychopathological brain activity in clinical disorders. In Autism Spectrum Disorder (ASD), a substantial body of research reports reduced Alpha activity in the electrocortical resting state...

Full description

Saved in:
Bibliographic Details
Main Authors: Gabriel Anton Auer, Paul Lukas Plener, Luise Poustka, Lilian Konicar
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Child and Adolescent Psychiatry and Mental Health
Subjects:
Online Access:https://doi.org/10.1186/s13034-025-00909-1
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849325911938170880
author Gabriel Anton Auer
Paul Lukas Plener
Luise Poustka
Lilian Konicar
author_facet Gabriel Anton Auer
Paul Lukas Plener
Luise Poustka
Lilian Konicar
author_sort Gabriel Anton Auer
collection DOAJ
description Abstract Background Aberrant resting state electroencephalography (rsEEG) is a well-established indicator of psychopathological brain activity in clinical disorders. In Autism Spectrum Disorder (ASD), a substantial body of research reports reduced Alpha activity in the electrocortical resting state of affected individuals. However, effective interventions based on neurophysiological patterns and objective biological markers of treatment outcome remain scarce. Methods In this randomized controlled trial, the primary objective was to examine rsEEG changes in adolescents with ASD following 24 sessions of slow cortical potential neurofeedback training (n = 21) compared to a treatment-as-usual control group (n = 20). A repeated-measures analysis of variance was used to assess group differences over time. Additionally, Pearson correlation analyses were conducted to exploratorily investigate associations between rsEEG measures and clinical psychopathology and affective well-being, as assessed via parental and self-report questionnaires at baseline and post-intervention. Results Analyses revealed significant differences in the development of rsEEG between the intervention groups: while Alpha activity increased in the experimental neurofeedback group, it decreased in the control group, demonstrating an opposite trend. Exploratory analyses showed that Delta activity decreased in both groups, with a more pronounced decrease in the experimental group. Correlational analyses revealed significant associations between subjective-psychological and electrocortical levels: lower alpha power at baseline was related to greater severity of ASD symptoms, while both lower alpha and higher delta power were associated with greater negative affect at baseline. Increases in alpha power after NF-training were linked with enhanced positive affect, whereas reductions in delta power corresponded to decreases in negative affect. Conclusions This study provides insights into changes in resting-state neural activity before and after clinical interventions alongside clinical-psychological assessment, overcoming single-level assessments and emphasizing the need for multi-level outcome measures for a more comprehensive treatment evaluation. Clinical Trial Registration: DRKS00012339.
format Article
id doaj-art-7b34b330cda2492fb0d49346592eda6e
institution Kabale University
issn 1753-2000
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series Child and Adolescent Psychiatry and Mental Health
spelling doaj-art-7b34b330cda2492fb0d49346592eda6e2025-08-20T03:48:18ZengBMCChild and Adolescent Psychiatry and Mental Health1753-20002025-05-0119111310.1186/s13034-025-00909-1Multi-level treatment outcome evaluation in adolescents with autism spectrum disorderGabriel Anton Auer0Paul Lukas Plener1Luise Poustka2Lilian Konicar3Department of Child and Adolescent Psychiatry, Medical University of ViennaDepartment of Child and Adolescent Psychiatry, Medical University of ViennaDepartment of Child and Adolescent Psychiatry, University Hospital HeidelbergDepartment of Child and Adolescent Psychiatry, Medical University of ViennaAbstract Background Aberrant resting state electroencephalography (rsEEG) is a well-established indicator of psychopathological brain activity in clinical disorders. In Autism Spectrum Disorder (ASD), a substantial body of research reports reduced Alpha activity in the electrocortical resting state of affected individuals. However, effective interventions based on neurophysiological patterns and objective biological markers of treatment outcome remain scarce. Methods In this randomized controlled trial, the primary objective was to examine rsEEG changes in adolescents with ASD following 24 sessions of slow cortical potential neurofeedback training (n = 21) compared to a treatment-as-usual control group (n = 20). A repeated-measures analysis of variance was used to assess group differences over time. Additionally, Pearson correlation analyses were conducted to exploratorily investigate associations between rsEEG measures and clinical psychopathology and affective well-being, as assessed via parental and self-report questionnaires at baseline and post-intervention. Results Analyses revealed significant differences in the development of rsEEG between the intervention groups: while Alpha activity increased in the experimental neurofeedback group, it decreased in the control group, demonstrating an opposite trend. Exploratory analyses showed that Delta activity decreased in both groups, with a more pronounced decrease in the experimental group. Correlational analyses revealed significant associations between subjective-psychological and electrocortical levels: lower alpha power at baseline was related to greater severity of ASD symptoms, while both lower alpha and higher delta power were associated with greater negative affect at baseline. Increases in alpha power after NF-training were linked with enhanced positive affect, whereas reductions in delta power corresponded to decreases in negative affect. Conclusions This study provides insights into changes in resting-state neural activity before and after clinical interventions alongside clinical-psychological assessment, overcoming single-level assessments and emphasizing the need for multi-level outcome measures for a more comprehensive treatment evaluation. Clinical Trial Registration: DRKS00012339.https://doi.org/10.1186/s13034-025-00909-1Resting state EEGAlpha brain activityAutism spectrum disorderNeurofeedbackBrain regulation training
spellingShingle Gabriel Anton Auer
Paul Lukas Plener
Luise Poustka
Lilian Konicar
Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder
Child and Adolescent Psychiatry and Mental Health
Resting state EEG
Alpha brain activity
Autism spectrum disorder
Neurofeedback
Brain regulation training
title Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder
title_full Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder
title_fullStr Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder
title_full_unstemmed Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder
title_short Multi-level treatment outcome evaluation in adolescents with autism spectrum disorder
title_sort multi level treatment outcome evaluation in adolescents with autism spectrum disorder
topic Resting state EEG
Alpha brain activity
Autism spectrum disorder
Neurofeedback
Brain regulation training
url https://doi.org/10.1186/s13034-025-00909-1
work_keys_str_mv AT gabrielantonauer multileveltreatmentoutcomeevaluationinadolescentswithautismspectrumdisorder
AT paullukasplener multileveltreatmentoutcomeevaluationinadolescentswithautismspectrumdisorder
AT luisepoustka multileveltreatmentoutcomeevaluationinadolescentswithautismspectrumdisorder
AT liliankonicar multileveltreatmentoutcomeevaluationinadolescentswithautismspectrumdisorder