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Effectiveness of EEG Biofeedback as Compared with Methylphenidate in the Treatment of Attention-Deficit/Hyperactivity Disorder: A Cinical Out-Come Study

Authors:
  • Centre Hospitalier Universitaire d'Amiens-Picardie, Amiens, France
  • Centre Hospitalier Universitaire d'Amiens - University hospital

Abstract

Operant conditioning of the electroencephalographic rhythm (EEG biofeedback) is argued to be an effective method for treating children with ADHD. This study was designed to evaluate whether this method, compared to methylphenidate, achieves an equally effective outcome. Participants were 39 children aged between 7 -12 years. Thirteen children with attention-deficit/hyperactivity disorder (ADHD) were trained to enhance the amplitude of the beta1 activity (15 -18 Hz) and decrease the amplitude of the theta activity (4 -8 Hz), and 13 of which were treated with methylphenidate alone. Thirteen healthy children did not receive intervention. Several behavioral, neuropsychological and experimental tests were administered before and after intervention. While behavioral measures were improved by both types of method, methylphenidate was significantly more effective than EEG biofeedback. Response inhibition was improved only by EEG biofeedback. Both EEG biofeedback and methylphenidate were associated with improvements on the variability and accuracy measures of computerized tests. Intellectual ability increased also by both methods. Although averaged effect size for methylphenidate seems to be greater than for EEG biofeedback, the difference was not significant. In conjunction with other studies, these findings demonstrate that EEG biofeedback can significantly improve several be-havioral and cognitive functions in children with ADHD, and it might be an alternative treatment for non-responders or incomplete responders to medication as well as for those their parents favor a non-pharmacological treatment.
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... On the other hand, there is a vast amount of research regarding the possibility of improving several aspects of cognitive performance through EEG biofeedback training, also known as neurofeedback (Dessy et al. 2018;Naas et al. 2019;Norris and Currieri 1999;Vernon et al. 2003;Yamashita et al. 2017). It is reported that SMR-Beta1 (in the range of 12-18 Hz frequency bands) neurofeedback (NFB) training improves attentional processes in ADHD (Arns et al. 2015;Kaiser and Othmer 2000;Nazari et al. 2011), traumatic brain injury (Keller 2001), autistic (Holtmann et al. 2011) and healthy populations (Gruzelier 2014). Furthermore, it has been suggested that arousal levels might also be increased after SMR-Beta1 neurofeedback training (Faller et al. 2019; Communicated by Francesca Frassinetti. ...
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... Also, nonpharmacological treatment has always been welcomed by practitioners who are looking for ways to change steadily and have more lasting effects. Among nonpharmacological treatments, neurofeedback treatment (NFB) has been utilized as a potentially successful intervention for years (Aggensteiner et al., 2019;Alegria et al., 2017;Bakhshayesh et al., 2011;Geladé et al., 2018;Gevensleben et al., 2009;Lansbergen et al., 2011;Lévesque et al., 2006;Liechti et al., 2012;Lofthouse et al., 2012;Maurizio et al., 2014;Meisel et al., 2014;Minder et al., 2018;Mohammad Ali et al., 2011;Mohammadi et al., 2015;Rubia et al., 2019;Shereena et al., 2019;Strehl et al., 2006). Maurizio et al., 2014 provide evidence for some specific effects in their research sample. ...
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... 83 Stimulants have been shown to reduce certain risk-prone behaviors, 84 enhance working memory in children 85 and adults, 86 and improve inhibitory control, performance accuracy and intellectual function. 87,88 Another important clinical sign of this subject was her mental retardation. EEG abnormalities in subjects with intellectual disability with a frequency ranging from 23% to 50% depending on the degree of severity of mental retardation is found quite frequently. ...
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Book
Recent years have seen tremendous advances in understanding and treating Attention-Deficit/Hyperactivity Disorder (ADHD). Now in a revised and expanded third edition, this authoritative handbook brings the field up to date with current, practical information on nearly every aspect of the disorder. Drawing on his own and others' ongoing, influential research - and the wisdom gleaned from decades of front-line clinical experience - Russell A. Barkley provides insights and tools for professionals working with children, adolescents, or adults. Part I presents foundational knowledge about the nature and developmental course of ADHD and its neurological, genetic, and environmental underpinnings. The symptoms and subtypes of the disorder are discussed, as are associated cognitive and developmental challenges and psychiatric comorbidities. In Parts II and III, Barkley is joined by other leading experts who offer state-of-the-art guidelines for clinical management. Assessment instruments and procedures are described in detail, with expanded coverage of adult assessment. Treatment chapters then review the full array of available approaches - parent training programs, family-focused intervention for teens, school- and classroom-based approaches, psychological counseling, and pharmacotherapy - integrating findings from hundreds of new studies. The volume also addresses such developments as once-daily sustained delivery systems for stimulant medications and a new medication, atomoxetine. Of special note, a new chapter has been added on combined therapies. Chapters in the third edition now conclude with user-friendly Key Clinical Points. This comprehensive volume is intended for a broad range of professionals, including child and adult clinical psychologists and psychiatrists, school psychologists, and pediatricians. It serves as a scholarly yet accessible text for graduate-level courses. Note: Practitioners wishing to implement the assessment and treatment recommendations in the Handbook are advised to purchase the companion Workbook, which contains a complete set of forms, questionnaires, and handouts, in a large-size format with permission to photocopy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(jacket)