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Clin Psychopharmacol Neurosci. 2016 Nov 30;14(4):357-364. doi: 10.9758/cpn.2016.14.4.357.

The Effects of Equine-assisted Activities and Therapy on Resting-state Brain Function in Attention-deficit/Hyperactivity Disorder: A Pilot Study.

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Laboratory of Clinical Neuroscience and Development, Graduate School of Medical Science and Engineering, KAIST, Daejeon, Korea.
KAIST Institute for Health Science and Technology, KAIST, Daejeon, Korea.
Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hae-sol Psychiatric Clinic, Dongtan, Korea.
Hae-sol Psychiatric Clinic, Seoul, Korea.
Samsung Biomedical Research Institute, Seoul, Korea.
Samsung Research & Development Center, Samsung Equestrian Team, Gunpo, Korea.
Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.



Equine-assisted activities and therapy (EAA/T) have been used as adjunct treatment options for physical and psychosocial rehabilitation. However, the therapeutic effects on resting-state brain function have not yet been studied. The aim of this study is to investigate the effects of EAA/T on participants with attention-deficit/hyperactivity disorder (ADHD) by comparing resting-state functional magnetic resonance imaging (rs-fMRI) signals and their clinical correlates.


Ten participants with ADHD participated in a 12-week EAA/T program without any medication. Two rs-fMRIs were acquired for all participants before and after EAA/T. For estimating therapeutic effect, the regional homogeneity (ReHo) method was applied to capture the changes in the regional synchronization of functional signals.


After the EAA/T program, clear symptom improvement was found even without medication. Surface-based pairwise comparisons revealed that ReHo in the right precuneus and right pars orbitalis clusters had significantly diminished after the program. Reduced ReHo in the right precuneus cluster was positively correlated with changes in the scores on DuPaul's ADHD Rating Scale-Korean version.


Our results indicate that EAA/T is associated with short-range functional connectivity in the regions related to the default mode network and the behavioral inhibition system, which are associated with symptom improvement.


Attention deficit hyperactivity disorder; Default mode network; Equine-assisted therapy; Functional magnetic resonance imaging; Regional homogeneity; Resting state

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