Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial

Child & Adolescent Psychiatry, University of Göttingen, Germany.
Journal of Child Psychology and Psychiatry (Impact Factor: 6.46). 02/2009; 50(7):780-9. DOI: 10.1111/j.1469-7610.2008.02033.x
Source: PubMed


For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention, impulsivity and hyperactivity by neurofeedback (NF) has been reported in several studies. But so far, unspecific training effects have not been adequately controlled for and/or studies do not provide sufficient statistical power. To overcome these methodological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite randomised controlled study using a computerised attention skills training as a control condition.
102 children with ADHD, aged 8 to 12 years, participated in the study. Children performed either 36 sessions of NF training or a computerised attention skills training within two blocks of about four weeks each (randomised group assignment). The combined NF treatment consisted of one block of theta/beta training and one block of slow cortical potential (SCP) training. Pre-training, intermediate and post-training assessment encompassed several behaviour rating scales (e.g., the German ADHD rating scale, FBB-HKS) completed by parents and teachers. Evaluation ('placebo') scales were applied to control for parental expectations and satisfaction with the treatment.
For parent and teacher ratings, improvements in the NF group were superior to those of the control group. For the parent-rated FBB-HKS total score (primary outcome measure), the effect size was .60. Comparable effects were obtained for the two NF protocols (theta/beta training, SCP training). Parental attitude towards the treatment did not differ between NF and control group.
Superiority of the combined NF training indicates clinical efficacy of NF in children with ADHD. Future studies should further address the specificity of effects and how to optimise the benefit of NF as treatment module for ADHD.

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Available from: Hartmut Heinrich, Feb 24, 2015
    • "On the basis of these principles, they concluded that neurofeedback is ''probably an efficacious instrument'' for treatment of ADHD, as clinically significant improvement is observed in approximately 75 % of the cases treated in each one of the investigations analyzed. Gevensleben et al. (2009), after studying 102 participants (8–12 years) who received 36 sessions of neurofeedback, concluded that the instrument shows contrasted clinical efficacy in the treatment of ADHD. Previously, Thompson and Thompson (1998) carried out a study with 111 participants (98 boys and 13 adults) with ADHD during 40 training sessions combining neurofeedback and metacognitive strategies. "
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    ABSTRACT: Behavioral training in neurofeedback has proven to be an essential complement to generalize the effects of pharmacological support in subjects who have attention deficit with hyperactivity disorder (ADHD). Therefore, this investigation attempts to analyze the efficacy of neurofeedback compared with pharmacological support and the combination of both. Participants were 131 students, classified into four groups: control (did not receive neurofeedback or pharmacological support), neurofeedback group, pharmacological support group, and combined group (neurofeedback + pharmacological support). Participants' executive control and cortical activation were assessed before and after treatment. Results indicate that the combined group obtained more benefits and that the neurofeedback group improved to a greater extent in executive control than the pharmacological support group. It is concluded that this kind of training may be an alternative to stimulate activation in subjects with ADHD.
    Applied Psychophysiology and Biofeedback 08/2015; DOI:10.1007/s10484-015-9299-4 · 1.13 Impact Factor
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    • "So far, health insurance carriers and government regulatory agencies have generally refrained from granting wider approval of EEG-based diagnosis and treatment despite the existence of certification procedures for NFB providers and even dedicated quantitative EEG interpretation services. Notable exceptions are the recent FDA approvals of the NEBA device as an adjunct for diagnosing ADHD in children and adolescents, and the Brainscope device for assessing traumatic brain injury [20] [9] [8] [5]. "
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    ABSTRACT: Therapeutic Neurofeedback (NFB) using real-time electro-encephalography (EEG) data works by reinforcing desired brainwave patterns. Although EEG is a well-established diagnostic tool and EEG-NFB shows great promise for enhancing cognitive performance and treating neurological disorders , proof of its efficacy has been limited. Here we characterize a novel Self-Calibrating Protocol (SCP) method coupled to five standard machine learning algorithms to classify brain states corresponding to the experience of " pain " or " no pain ". Our results indicate that commercially available, wearable EEG sensors provide sufficient data fidelity to robustly differentiate the two " perceptually opposite " brain states. Crucially , use of SCP allows us for the first time to bypass the pitfalls associated with trying to force an individual's brain wave patterns to match " normed " target patterns obtained over population averages. These are necessary steps towards personalized NFB therapies and bespoke Brain-Computer Interfaces and brain training suitable to a wide variety of individual needs.
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    • "The Fourier transformation was carried out for 600 s consisting of one EEG record in each patient. According to the international 10–20 Electrode Placement System, Cz [10] [11] is the standard placement sites, which is the most sensitive EEG area between ADHD and normal children. Active (record) electrode was placed at site Cz in order to collect EEG activity signals easily. "

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