Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports

BackgroundA randomized and controlled clinical study was performed to evaluate the use of neurofeedback (NF) to treat attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.MethodsThe ADHD population was selected from an outpatient clinic for Child and Adolescent Mental Health in Norway. Ninety-one of the 275 children and adolescents ranging in age from 6 to 18 years (10.5 years) participated in 30 sessions of an intensive NF program. The reinforcement contingency was based on the subjects’ production of cortical beta1 activity (15–18 Hz). The ADHD participants were randomized into three groups, with 30 in the NF group, 31 controls in a group that was given methylphenidate, and 30 in a group that received NF and methylphenidate. ADHD core symptoms were reported by parents using the parent form of the Clinician’s Manual for Assessment by Russell A. Barkley.ResultsNinety-one children and adolescents were effectively randomized by age, sex, intelligence and distribution of ADHD core symptoms. The parents reported significant effects of the treatments, but no significant differences between the treatment groups were observed.ConclusionsNF was as effective as methylphenidate at treating the attentional and hyperactivity symptoms of ADHD, based on parental reports.Trial registrationCurrent Controlled Trials NCT01252446

[1]  Robert D Gibbons,et al.  3-year follow-up of the NIMH MTA study. , 2007, Journal of the American Academy of Child and Adolescent Psychiatry.

[2]  Michael Linden,et al.  A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities , 1996, Biofeedback and self-regulation.

[3]  D. Kaiser,et al.  Effect of Neurofeedback on Variables of Attention in a Large Multi-Center Trial , 2000 .

[4]  Susan Sprich,et al.  Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: a randomized controlled trial. , 2010, JAMA.

[5]  J. Lubar,et al.  Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting , 1984, Biofeedback and self-regulation.

[6]  S. Faraone,et al.  Novel treatments for attention-deficit/hyperactivity disorder in children. , 2002, The Journal of clinical psychiatry.

[7]  Ann York,et al.  Parent training interventions for Attention Deficit Hyperactivity Disorder (ADHD) in children aged 5 to 18 years. , 2011, The Cochrane database of systematic reviews.

[8]  Daniel J Fox,et al.  Neurofeedback: An Alternative and Efficacious Treatment for Attention Deficit Hyperactivity Disorder , 2005, Applied psychophysiology and biofeedback.

[9]  Vincent J Monastra,et al.  Electroencephalographic Biofeedback in the Treatment of Attention-Deficit/Hyperactivity Disorder , 2005, Applied psychophysiology and biofeedback.

[10]  Joel F. Lubar,et al.  Neurofeedback Assessment and Treatment for Attention Deficit/Hyperactivity Disorders , 1999 .

[11]  Thomas R. Rossiter The Effectiveness of Neurofeedback and Stimulant Drugs in Treating AD/HD: Part II. Replication , 2004, Applied psychophysiology and biofeedback.

[12]  Morton L Perel,et al.  On research. , 2013, Implant dentistry.

[13]  Werner Lutzenberger,et al.  Neurofeedback Treatment for Attention-Deficit/Hyperactivity Disorder in Children: A Comparison with Methylphenidate , 2003, Applied psychophysiology and biofeedback.

[14]  V. Monastra EEG and Neurofeedback Findings in ADHD: An Empirical Response , 2004 .

[15]  J. Leon Kenemans,et al.  The effectiveness of EEG-feedback on attention, impulsivity and EEG: A sham feedback controlled study , 2010, Neuroscience Letters.

[16]  S. Othmer Interhemispheric EEG Training , 2005 .

[17]  A. Sandler How common is attention-deficit/hyperactivity disorder? Incidence in a population-based birth cohort in Rochester, Minnesota , 2002 .

[18]  Thilo Hinterberger,et al.  Neurofeedback for Children with ADHD: A Comparison of SCP and Theta/Beta Protocols , 2007, Applied psychophysiology and biofeedback.

[19]  Norwegian Children and Adolescents with ADHD - A Retrospective Clinical Study: Subtypes and Comorbid Conditions and Aspects of Cognitive Performance and Social Skills , 2011 .

[20]  H. Heinrich,et al.  Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. , 2009, Journal of child psychology and psychiatry, and allied disciplines.

[21]  P. Friel,et al.  EEG biofeedback in the treatment of attention deficit hyperactivity disorder. , 2007, Alternative medicine review : a journal of clinical therapeutic.

[22]  Vincent J Monastra,et al.  The Effects of Stimulant Therapy, EEG Biofeedback, and Parenting Style on the Primary Symptoms of Attention-Deficit/Hyperactivity Disorder , 2002, Applied psychophysiology and biofeedback.

[23]  Russell A. Barkley,et al.  Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment, 2nd ed. , 1998 .

[24]  Valery A Ponomarev,et al.  ERPs correlates of EEG relative beta training in ADHD children. , 2005, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[25]  Sandra K Loo,et al.  Clinical Utility of EEG in Attention-Deficit/Hyperactivity Disorder: A Research Update , 2005, Neurotherapeutics.

[26]  W. Barbaresi,et al.  How common is attention-deficit/hyperactivity disorder? Incidence in a population-based birth cohort in Rochester, Minn. , 2002, Archives of pediatrics & adolescent medicine.

[27]  Richard P. DeShon,et al.  Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. , 2002, Psychological methods.

[28]  T. Tinius Quantitative Electroencephalographic Analysis (Qeeg) Databases for Neurotherapy: Description, Validation, and Application , 2004 .

[29]  K. Wagner Management of treatment refractory attention-deficit/hyperactivity disorder in children and adolescents. , 2002, Psychopharmacology bulletin.

[30]  L. Thompson,et al.  Neurofeedback Combined with Training in Metacognitive Strategies: Effectiveness in Students with ADD , 1998, Applied psychophysiology and biofeedback.

[31]  Mohammad Javad Rezai,et al.  Neurofeedback in ADHD: a single-blind randomized controlled trial , 2011, European Child & Adolescent Psychiatry.

[32]  David Wechsler,et al.  Manual for the Wechsler intelligence scale for children , 1974 .

[33]  T. Egner,et al.  The effects of neurofeedback training on the spectral topography of the electroencephalogram , 2004, Clinical Neurophysiology.

[34]  W. Barbaresi,et al.  How common is attention‐deficit/hyperactivity disorder? Towards resolution of the controversy: results from a population‐based study , 2004, Acta paediatrica (Oslo, Norway : 1992). Supplement.

[35]  M. Arns,et al.  Efficacy of Neurofeedback Treatment in ADHD: The Effects on Inattention, Impulsivity and Hyperactivity: A Meta-Analysis , 2009, Clinical EEG and neuroscience.

[36]  Joshua M. Langberg,et al.  Parent-Reported Homework Problems in the MTA Study: Evidence for Sustained Improvement with Behavioral Treatment , 2010, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[37]  R. Barkley Defiant Children: A Clinician's Manual for Assessment and Parent Training. Second Edition. , 1997 .

[38]  D. Wechsler Wechsler Intelligence Scale for Children , 2020, Definitions.

[39]  I. Elgen,et al.  Characteristics of Norwegian children suffering from ADHD symptoms: ADHD and primary health care , 2011, Psychiatry Research.

[40]  B. Anthony,et al.  Multimodal Treatments versus Pharmacotherapy Alone in Children with Psychiatric Disorders , 2009, Paediatric drugs.