[Neurofeedback and attention deficit hyperactivity disorder: what is it and is it working?].

Tijdschrift voor psychiatrie 01/2010; 52(1):41-50.
Source: PubMed


BACKGROUND Neurofeedback (nf) is a method of treatment that is being used increasingly in the Netherlands, particularly in psychological practices. Many psychiatric and somatic symptoms are currently being treated with the help of nf. In particular, nf is being used more and more to treat attention deficit hyperactivity disorder (adhd). Despite its growing popularity, nf is still a relatively unknown treatment method in psychiatric practices.
To investigate the scientific evidence for treating adhd with nf.
We searched the literature for reports on controlled trials that investigated the effectiveness of nf on adhd. results Six controlled trials were located. The studies reported that nf had a positive effect on adhd, but all the studies were marred by methodological shortcomings.
On the basis of currently available research results, no firm conclusion can be drawn about the effectiveness of treating adhd by means of nf. In view of the fact that nf is being used more and more as a method of treatment, there is an urgent need for scientific research in this field to be well planned and carefully executed.

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    ABSTRACT: Gedragsproblemen bijadhd blijken vaak samen te gaan met een afwijkend activatieniveau in de hersenen. Neurofeedback is een trainingsmethode die, door het geven van directe feedback aan de hersenen, de regulatie van de hersenenactiviteit gedeeltelijk kan corrigeren. Het aanleren van een aangepast activatieniveau kan daarmee leiden tot verbeterd gedrag. Onderzoek naar de effecten van neurofeedback laat vooruitgang zien op gedragsmaten. Er wordt met name een effect gevonden op aandacht; fysiologische maten laten nog geen consistente veranderingen zien. De wijze waarop deze gedragsveranderingen tot stand komen, blijft daarmee vooralsnog onduidelijk.
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    ABSTRACT: As conventional treatments offer incomplete benefit for over 33 % of children with attention-deficit/hyperactivity disorder (ADHD) and many refuse to try them, additional treatments are needed. One of the most promising is neurofeedback (NF, EEG biofeedback), which trains the brain with real-time video/audio information about its electrical activity measured from scalp electrodes. Since 2010, data from 8 randomized controlled studies of NF have been published with overall mean effect sizes of: 0.40 (all measures), 0.42 (ADHD measures), 0.56 (inattention), and 0.54 (hyperactivity/ impulsivity). Unfortunately, the benefit reported from randomized studies has not been observed in the few small blinded studies conducted. Main study strengths include randomization, evidence-based diagnostic assessments, multi-domain treatment outcomes, use of some type of blinding, and sham control conditions. Main study limitations include lack of large samples, abnormal EEG participant selection, double-blinding, and testing of blind validity and sham inertness. Most recently, a collaborative NF research group has been planning a definitive double-blind well-controlled trial.
    No preview · Article · Aug 2012 · Current Psychiatry Reports
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    ABSTRACT: Objective: The purpose of this pilot study was to compare the effects of 30 sessions of neurofeedback (NF) with stimulant medication on attention-deficit/hyperactivity disorder (ADHD) patients. Methods: Thirty-two medication-naïve ADHD patients, ages 7-16, from a neuropsychiatric clinic, were randomized to NF (n=16) or drug treatment (n=16). Other actions, such as parent management training, information, or support in school were given as needed, with no differences between the groups. All participants were assessed before treatment on two rating scales, each with parent and teacher forms. In addition, quantitative electroencephalogram (QEEG) and event-related potentials (ERPs), which included behavioral data from a go/no go test were administered. NF training took place in the clinic over a period of 7-11 months, and was followed by a repeat of the same assessment tools. The mean time interval between pre- and postassesment was not significantly different in the two groups. The 18 symptoms of ADHD (American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV)) were used as the primary outcome measure. Results: Analysis of covariance revealed a significant difference between the groups at evaluation in favor of medication, with a large effect size. This picture was confirmed by other outcome measures. The QEEG spectral power in the theta and beta bands did not change in either group. In ERP, the P3 no go component increased significantly in 8 of 12 patients who had a clinically relevant medication effect, but did not increase in the medication nonresponders or the NF group. Conclusions: Our study supports effects for stimulants, but not for NF. Effects of NF may require thorough patient selection, frequent training sessions, a system for excluding nonresponders, and active transfer training. The P3 no go ERP component may be a marker for treatment response.
    No preview · Article · Jun 2013 · Journal of child and adolescent psychopharmacology
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