Pandawan Classroom

Pandawan Classroom is an innovative therapeutic tool that blends neurofeedback* with virtual reality.  

It empowers children to immerse themselves in a 3D replica of a classroom environment, with the primary goal of mitigating the symptoms associated with attention deficit disorders. 

• Enhance a child's capacity for focused concentration.

• Minimize vulnerability to distractions from the surrounding environment.

• Promote the application of acquired skills in real-life situations, especially in the demanding classroom setting.

• Potentially decrease or suppress the need for medication.

Attention is a crucial cognitive function that helps us filter and process relevant information while suppressing irrelevant distractions in our daily lives. However, the demands of modern life can place significant pressure on our ability to maintain focus, leading to occasional lapses in attention. While most of these lapses are minor and inconsequential, in certain pathological conditions, attention deficits can become markedly pronounced.

One such condition is Attention Deficit Hyperactivity Disorder (ADHD), a developmental syndrome characterized by persistently high levels of impulsivity and inattentiveness. This disorder affects approximately 7% of school-age children, and its impact can extend beyond childhood. ADHD often leads to academic difficulties, anxiety, depression, disruptive behavior, strained relationships, and an increased risk of substance abuse.

Traditionally, the primary approach to managing ADHD has been through the use of stimulant medications like methylphenidate (commonly known as Ritalin®). However, it's worth noting that 20-30% of individuals with ADHD do not respond to methylphenidate treatment, while others may experience unwelcome side effects such as sleep disturbances, reduced appetite, and increased tics. 

EEG neurofeedback (EEG-NFB) offers a compelling alternative, allowing patients to acquire the skills to self-regulate specific aspects of their brain's electrical activity. This is achieved by providing real-time feedback derived from their electro-encephalogram (EEG). 

However, the existing literature reveals that the effectiveness of this approach hinges on extensive training involving repetitive sessions, often necessitating 30 to 40 sessions before achieving stable and positive outcomes. This intensive training regimen may not be well-suited for children, particularly those dealing with attention deficit and hyperactivity disorders.

The goal of our project is to develop more economical and effective strategies for EEG-NFB using playful virtual reality environment and appealing exercises combined with an artificial intelligence algorithm to continuously adapt the difficulty of the task in real-time according to the performance and attentional level of the children.

We have demonstrated the feasibility of this groundbreaking protocol on a small group of healthy children aged 6 to 11 years. Once enrolled, the full rate of engagement in the intervention program also shows that the children largely accepted and enjoyed the program. While the efficacy of the protocol has yet to be validated, the preliminary findings are promising.

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We have submitted two funding applications to initiate a comprehensive randomized controlled study involving a cohort of children diagnosed with ADHD.

1. Changes in fronto-parietal network connectivity at rest

Using two different approaches, we demonstrated that NFB induce changes in the fronto-parietal attention network. In particular, we found an increased expansion connectivity in parietal areas at rest (such as the postcentral gyrus and precuneus). This suggests an enhancement of attentional processes related to a better integration of sensory and visuo-spatial stimuli.

2. Changes in brain activity during NFB periods (i.e. transfer run in MRI scanner)

During the transfer run, i.e. when children are asked to reproduce the brain state similar as during the NFB training runs, we found a deactivation in sensorimotor cortices as well as in the pulvinar nucleus.

This result suggests a decrease in reactivity to salient environmental stimuli and therefore potentially an increase in goal-directed behavior.