A Randomized Controlled Trial Investigating the Effects of Neurofeedback, Methylphenidate, and Physical Activity on Event-Related Potentials in Children with Attention-Deficit/Hyperactivity Disorder. Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports Neurofeedback and Cognitive Attention Training for Children with Attention-Deficit Hyperactivity Disorder in Schools Neurofeedback Treatment for Attention-Deficit/Hyperactivity Disorder in Children: A Comparison with Methylphenidate Self-reported efficacy of neurofeedback treatment in a clinical randomized controlled study of ADHD children and adolescents Neurofeedback and standard pharmacological intervention in ADHD: A randomized controlled trial with six-month follow-up What future research should bring to help resolving the debate about the efficacy of EEG-neurofeedback in children with ADHD Neurofeedback in ADHD: a single-blind randomized controlled trial Reprint of “Neurofeedback and standard pharmacological intervention in ADHD: A randomized controlled trial with six-month follow-up” The Effectiveness of Neurofeedback and Stimulant Drugs in Treating AD/HD: Part II. Replication 1-year follow-up of neurofeedback treatment in adolescents with attention-deficit hyperactivity disorder: randomised controlled trial Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder. Additive effects of neurofeedback on the treatment of ADHD: A randomized controlled study. Slow cortical potential neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial In-School Neurofeedback Training for ADHD: Sustained Improvements From a Randomized Control Trial Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial
OBJECTIVE Electroencephalographic ( EEG ) neurofeedback ( NF ) is considered a nonpharmacological alternative for medication in attention-deficit/hyperactivity disorder ( ADHD ) . Comparisons of the behavioral efficacy of NF and medication have produced inconsistent results . EEG measures can provide insight into treatment mechanisms , but have received little consideration . In this r and omized controlled trial ( RCT ) , effects of NF were compared with methylpheni date ( MPH ) , and physical activity ( PA ) in children with ADHD on event-related potential ( ERP ) indices of response inhibition , which are involved in ADHD psychopathology . METHODS Using a multicenter three way parallel group RCT design , 112 children with a Diagnostic and Statistical Manual of Mental Disorders , 4th ed . ( DSM-IV ) ( American Psychiatric Association 1994 ) diagnosis of ADHD , between 7 and 13 years of age , were initially included .  NF training consisted of 30 sessions of theta/beta training at Cz over a 10 week period . PA training was a semiactive control group , matched in frequency and duration . MPH was titrated using a double-blind placebo controlled procedure in 6 weeks , followed by a stable dose for 4 weeks . ERP measures of response inhibition , N2 and P3 , were available for 81 children at pre- and postintervention ( n = 32 NF , n = 25 MPH , n = 24 PA ) . RESULTS Only the medication group showed a specific increase in P3 amplitude compared with NF ( partial eta-squared [ ηp(2 ) ] = 0.121 ) and PA ( ηp(2 ) = 0.283 ) , which was related to improved response inhibition . Source localization of medication effects on P3 amplitude indicated increased activation primarily in thalamic and striatal nuclei . CONCLUSIONS This is the first study that simultaneously compared NF with stimulant treatment and a semiactive control group . Only stimulant treatment demonstrated specific improvements in brain function related to response inhibition . These results are in line with recent doubts on the efficacy and specificity of NF as treatment for ADHD . CLINICAL TRIALS REGISTRATION Train Your Brain ? Exercise and Neurofeedback Intervention for ADHD , https:// clinical trials.gov/show/NCT01363544 , Ref . No. NCT01363544 Background A r and omized and controlled clinical study was performed to evaluate the use of neurofeedback ( NF ) to treat  attention-deficit/hyperactivity disorder ( ADHD ) in children and adolescents . Methods The 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 r and omized into three groups , with 30 in the NF group , 31 controls in a group that was given methylpheni date , and 30 in a group that received NF and methylpheni date .  ADHD core symptoms were reported by parents using the parent form of the Clinician ’s Manual for Assessment by Russell A. Barkley . Results Ninety-one children and adolescents were effectively r and omized 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 . Conclusions NF was as effective as methylpheni date at treating the attentional and hyperactivity symptoms of ADHD , based on parental reports . Trial registration Current Controlled Trials Objective : To evaluate the efficacy of 2 computer attention training systems administered in school for children with attention-deficit hyperactivity disorder ( ADHD ) . Method : Children in second and fourth grade with a diagnosis of ADHD ( n = 104 ) were r and omly assigned to neurofeedback ( NF ) ( n = 34 ) , cognitive training ( CT ) ( n = 34 ) , or control ( n = 36 ) conditions . A 2-point growth model assessed change from pre-post intervention on parent reports ( Conners 3-Parent [ Conners 3-P ] ; Behavior Rating Inventory of Executive Function [ BRIEF ] rating scale ) , teacher reports ( Swanson , Kotkin , Agler , M-Flynn and Pelham scale [ SKAMP ] ; Conners 3-Teacher [ Conners 3-T ] ) , and systematic classroom observations ( Behavioral Observation of Students in Schools [ BOSS ] ) . Paired t tests and an analysis of covariance assessed change in medication . Results : Children who received NF showed significant improvement compared with those in the control condition on the Conners 3-P Attention , Executive Functioning and Global Index , on all BRIEF summary indices , and on BOSS motor/verbal off-task behavior . Children who received CT showed no improvement compared to the control condition . Children in the NF condition showed significant improvements compared to those in the CT condition on Conners 3-P Executive Functioning , all BRIEF summary indices , SKAMP Attention , and Conners 3-T Inattention subscales . Stimulant medication dosage in methylpheni date equivalencies significantly increased for children in the CT ( 8.54 mg ) and control ( 7.05 mg ) conditions but not for those in the NF condition ( 0.29 mg ) . Conclusion : Neurofeedback made greater improvements in ADHD symptoms compared to both the control and CT conditions . Thus , NF is a promising attention training treatment intervention for children with ADHD Clinical trials have suggested that neurofeedback may be efficient in treating attention-deficit/hyperactivity disorder ( ADHD ) . We compared the effects of a 3-month electroencephalographic feedback program providing reinforcement contingent on the production of cortical sensorimotor rhythm ( 12–15 Hz ) and beta1 activity ( 15–18 Hz ) with stimulant medication . Participants were N = 34 children aged 8–12 years , 22 of which were assigned to the neurofeedback group and 12 to the methylpheni date group according to their parents ' preference . Both neurofeedback and methylpheni date were associated with improvements on all subscales of the Test of Variables of Attention , and on the speed and accuracy measures of the d2 Attention Endurance Test . Furthermore , behaviors related to the disorder were rated as significantly reduced in both groups by both teachers and parents on the IOWA-Conners Behavior Rating Scale . These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored a nonpharmacological treatment Background Many non-pharmacological treatments for children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) have been attempted , but reports indicate that most are ineffective . Although neurofeedback ( NF ) is a treatment approach for children with ADHD that remains promising , a variety of appropriate measures have been used in reporting and evaluating its effect . Objective To report the self-evaluations of NF treatment by children and adolescents with ADHD . Methods R and omized controlled trial in 91 children and adolescents with ADHD , aged less than 18 years ( mean , 11.2 years ) participated in a 30-session program of intensive NF treatment .  Participants were r and omized and allocated by sequentially numbered sealed envelopes into three groups : methylpheni date ( MPH ) as an active control group , and two trial groups NF with MPH , and NF alone .  ADHD core symptoms and school performance were given on a scale of 1 to 10 using a self-reporting question naire , and the changes in these scores after treatment were used as the self-reported evaluation . Basic statistical methods ( descriptive , analyses of variance , exact χ2 test , and paired t-test ) were used to investigate the baseline data . Changes in ADHD core symptoms and treatment effects were investigated using a general linear model for repeated measures . Results Eighty participants completed the treatment study and 73 ( 91 % ) responded sufficiently on the self-reporting question naires . The treatment groups were comparable in age , sex , and cognition as well as in the baseline levels of core ADHD symptoms . All treatments result ed in significant improvements regarding attention and hyperactivity ( P<0.001 ) , and did not differ from each other in effectiveness . However , a significant treatment effect in school performance was observed ( P=0.042 ) , in which only the NF group showed a significant improvement . Conclusion The self-reported improvements in ADHD core symptoms and school performance shortly after treatment indicate NF treatment being promising in comparison with medication , suggesting NF as an alternative treatment for children and adolescents who do not respond to MPH , or who suffer side effects . Further long-term follow-up is needed The present study is a r and omized controlled trial that aims to evaluate the efficacy of Neurofeedback compared to st and ard pharmacological intervention in the treatment of attention deficit/hyperactivity disorder ( ADHD ) . The final sample consisted of 23 children with ADHD ( 11 boys and 12 girls , 7 - 14 years old ) . Participants carried out 40 theta/beta training sessions or received methylpheni date .  Behavioral rating scales were completed by fathers , mothers , and teachers at pre- , post-treatment , two- , and six-month naturalistic follow-up . In both groups , similar significant reductions were reported in ADHD functional impairment by parents ; and in primary ADHD symptoms by parents and teachers . However , significant academic performance improvements were only detected in the Neurofeedback group . Our findings provide new evidence for the efficacy of Neurofeedback , and contribute to enlarge the range of non-pharmacological ADHD intervention choices . To our knowledge , this is the first r and omized controlled trial with a six-month follow-up that compares Neurofeedback and stimulant medication in ADHD In recent years a rising amount of r and omized controlled trials , review s , and meta-analyses relating to the efficacy of electroencephalographic-neurofeedback ( EEG-NF ) in children with attention-deficit/hyperactivity disorder ( ADHD ) have been published . Although clinical reports and open treatment studies suggest EEG-NF to be effective , double blind placebo-controlled studies as well as a rigorous meta- analysis failed to find support for the efficacy of EEG-NF . Since absence of evidence does not equate with evidence of absence , we will outline how future research might overcome the present method ological limitations . To provide conclusive evidence for the presence or absence of the efficacy of EEG-NF  in the treatment of ADHD , there is a need to set up a well- design ed study that ensures optimal implementation and embedding of the training , and possibly incorporates different forms of neurofeedback Neurofeedback treatment has been demonstrated to reduce inattention , impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder ( ADHD ) . However , previous studies did not adequately control confounding variables or did not employ a r and omized reinforcer-controlled design . This study addresses those method ological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD : EEG neurofeedback ( NF ) aim ing at theta/beta ratio reduction and EMG biofeedback ( BF ) aim ing at forehead muscle relaxation . Thirty-five children with ADHD ( 26 boys , 9 girls ; 6–14 years old ) were r and omly assigned to either the therapy group ( NF ; n = 18 ) or the control group ( BF ; n = 17 ) . Treatment for both groups consisted of 30 sessions . Pre- and post-treatment assessment consisted of psychophysiological measures , behavioural rating scales completed by parents and teachers , as well as psychometric measures . Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups , respectively . Parents reported significant reductions in primary ADHD symptoms , and inattention improvements in the NF group were higher compared to the control intervention ( BF , dcorr = −.94 ) . NF training also improved attention and reaction times on the psychometric measures . The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests . However , regarding hyperactivity and impulsivity symptoms , the results imply that non-specific factors , such as behavioural contingencies , self-efficacy , structured learning environment and feed-forward processes , may also contribute to the positive behavioural effects induced by neurofeedback training The present study is a r and omized controlled trial that aims to evaluate the efficacy of Neurofeedback compared to st and ard pharmacological intervention in the treatment of attention deficit/hyperactivity disorder ( ADHD ) . The final sample consisted of 23 children with ADHD ( 11 boys and 12 girls , 7 - 14 years old ) . Participants carried out 40 theta/beta training sessions or received methylpheni date .  Behavioral rating scales were completed by fathers , mothers , and teachers at pre- , post-treatment , two- , and six-month naturalistic follow-up . In both groups , similar significant reductions were reported in ADHD functional impairment by parents ; and in primary ADHD symptoms by parents and teachers . However , significant academic performance improvements were only detected in the Neurofeedback group . Our findings provide new evidence for the efficacy of Neurofeedback , and contribute to enlarge the range of non-pharmacological ADHD intervention choices . To our knowledge , this is the first r and omized controlled trial with a six-month follow-up that compares Neurofeedback and stimulant medication in ADHD This study replicated T. R. Rossiter and T. J. La Vaque ( 1995 ) with a larger sample , exp and ed age range , and improved statistical analysis . Thirty-one AD/HD patients who chose stimulant drug ( MED ) treatment were matched with 31 patients who chose a neurofeedback ( EEG ) treatment program . EEG patients received either office ( n = 14 ) or home ( n = 17 ) neurofeedback . Stimulants for MED patients were titrated using the Test of Variables of Attention ( TOVA ) .  EEG ( effect size [ ES ] = 1.01–1.71 ) and MED ( ES = 0.80–1.80 ) groups showed statistically and clinical ly significant improvement on TOVA measures of attention , impulse control , processing speed , and variability in attention . The EEG group demonstrated statistically and clinical ly significant improvement on behavioral measures ( Behavior Assessment System for Children , ES = 1.16–1.78 , and Brown Attention Deficit Disorder Scales , ES = 1.59 ) . TOVA gain scores for the EEG and MED groups were not significantly different . More importantly , confidence interval and nonequivalence null hypothesis testing confirmed that the neurofeedback program produced patient outcomes equivalent to those obtained with stimulant drugs . An effectiveness research design places some limitations on the conclusions that can be drawn Background Estimates of the effectiveness of neurofeedback as a treatment for attention-deficit hyperactivity disorder ( ADHD ) are mixed . Aims To investigate the long-term additional effects of neurofeedback ( NFB ) compared with treatment as usual ( TAU ) for adolescents with ADHD . Method Using a multicentre parallel-r and omised controlled trial design , 60 adolescents with a DSM-IV-TR diagnosis of ADHD receiving NFB+TAU ( n=41 ) or TAU ( n=19 ) were followed up .  Neurofeedback treatment consisted of approximately 37 sessions of theta/sensorimotor rhythm (SMR)-training on the vertex ( Cz ) . Outcome measures included behavioural self-reports and neurocognitive measures . Allocation to the conditions was unmasked . Results At 1-year follow-up , inattention as reported by adolescents was decreased ( range ηp2=0.23–0.36 , P<0.01 ) and performance on neurocognitive tasks was faster ( range ηp2=0.20–0.67 , P<0.005 ) irrespective of treatment group . Conclusions Overall , NFB+TAU was as effective as TAU . Given the absence of robust additional effects of neurofeedback in the current study , results do not support the use of theta/SMR neurofeedback as a treatment for adolescents with ADHD and comorbid disorders in clinical practice . Declaration of interest None . Copyright and usage © The Royal College of Psychiatrists 2016 . This is an open access article distributed under the terms of the Creative Commons Non-Commercial , No Derivatives ( CC BY-NC-ND ) licence BACKGROUND 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 method ological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite r and omised controlled study using a computerised attention skills training as a control condition . METHODS 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 ( r and omised 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 . RESULTS 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 protocol s ( theta/beta training , SCP training ) . Parental attitude towards the treatment did not differ between NF and control group . CONCLUSIONS 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 OBJECTIVE A double-blind , r and omized , placebo-controlled study was design ed to assess the efficacy and safety of electroencephalographic ( EEG ) neurofeedback in children with attention-deficit/hyperactivity disorder ( ADHD ) . The study started in August 2008 and ended in July 2012 and was conducted at Karakter Child and Adolescent Psychiatry University Centre in Nijmegen , The Netherl and s. METHOD Forty-one children ( aged 8 - 15 years ) with a DSM-IV-TR diagnosis of ADHD were r and omly assigned to treatment with either EEG neurofeedback ( n = 22 ) or placebo neurofeedback ( n = 19 ) for 30 sessions , given as 2 sessions per week . The children were stratified by age , electrophysiologic state of arousal , and medication use . Everyone involved in the study , except the neurofeedback therapist and the principal investigator , was blinded to treatment assignment . The primary outcome was severity of ADHD symptoms on the ADHD Rating Scale IV , scored at baseline , during treatment , and at study end . Clinical improvement as measured by the Clinical Global Impressions-Improvement scale ( CGI-I ) was a secondary outcome . RESULTS While total ADHD symptoms improved over time in both groups ( F1,39 = 26.56 , P < .001 ) , there was no significant treatment effect , ie , group × time interaction ( F1,39 = 0.36 , P = .554 ) ; the same was true for clinical improvement as measured by the CGI-I ( P = .092 ) . No clinical ly relevant side effects were observed . Among the children and their parents , guessing treatment assignment was not better than chance level ( P = .224 for children , P = .643 for parents ) . CONCLUSION EEG neurofeedback was not superior to placebo neurofeedback in improving ADHD symptoms in children with ADHD . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT00723684 Neurofeedback ( NF ) has been identified as a " possibly efficacious " treatment in current evidence -based review s ; therefore , more research is needed to determine its effects . The current study examined the potential additive effect of NF for children diagnosed with ADHD beginning a medication trial first . Thirty-six children ( 6 - 12 years ) with a DSM-IV-TR diagnosis of ADHD were r and omly assigned to an NF with medication ( NF condition ) or a medication only condition . Children in the NF group attended 20 twice-weekly sessions . Outcome measures included individual cognitive performance scores ( ADS , K-WISC-III ) , ADHD rating scores completed by their parents ( ARS , CRS ) and brainwave indices of left and right hemispheres before and after NF treatment . Significant additive treatment effect in any of the symptom variables was found and a reduction of theta waves in both the right and left hemispheres was recorded in NF condition participants . However our r and omized controlled study could not demonstrate superior effects of combined NF on intelligent functioning compared to the medication treatment only . This study suggested any possible evidence of positive and additive treatment effects of NF on brainwaves and ADHD symptomatology Background : Treatment for children with attention deficit/hyperactivity disorder ( ADHD ) today is predominantly pharmacological . While it is the most common treatment , it might not always be the most appropriate one . Moreover , long term effects remain unclear . Behavior therapy ( BT ) and non-pharmacological treatments such as neurofeedback ( NF ) are promising alternatives , though there are no routine outpatient care/effectiveness studies yet that have included children with medication or changes in medication . Methods / design : This paper presents the protocol of a r and omized controlled trial to compare the effectiveness of a Slow Cortical Potential ( SCP ) NF protocol with self-management ( SM ) in a high frequent outpatient care setting . Both groups ( NF/SM ) receive a total of 30 high frequent therapy sessions . Additionally , 6 sessions are reserved for comorbid problems . The primary outcome measure is the reduction of ADHD core symptoms according to parent and teacher ratings . Preliminary Results : Untill now 58 children were included in the study ( 48 males ) , with a mean age of 8.42 ( 1.34 ) years , and a mean IQ of 110 ( 13.37 ) . Conners-3 parent and teacher ratings were used to estimate core symptom change . Since the study is still ongoing , and children are in different study stages , pre-post and follow-up results are not yet available for all children included . Preliminary results suggest overall good pre-post effects , though . For parent and teacher ratings an ANOVA with repeated measures yielded overall satisfying pre-post effects ( η2 0.175–0.513 ) . Differences between groups ( NF vs. SM ) could not yet be established ( p = 0.81 ) . Discussion : This is the first r and omized controlled trial to test the effectiveness of a NF protocol in a high frequent outpatient care setting that does not exclude children on or with changes in medication . First preliminary results show positive effects . The rationale for the trial , the design , and the strengths and limitations of the study are discussed . Trial registration : This trial is registered in www . clinical trials.gov as NCT01879644 OBJECTIVE : To evaluate sustained improvements 6 months after a 40-session , in-school computer attention training intervention using neurofeedback or cognitive training ( CT ) administered to 7- to 11-year-olds with attention-deficit/hyperactivity disorder ( ADHD ) . METHODS : One hundred four children were r and omly assigned to receive neurofeedback , CT , or a control condition and were evaluated 6 months postintervention . A 3-point growth model assessed change over time across the conditions on the Conners 3–Parent Assessment Report ( Conners 3-P ) , the Behavior Rating Inventory of Executive Function Parent Form ( BRIEF ) , and a systematic double-blinded classroom observation ( Behavioral Observation of Students in Schools ) . Analysis of variance assessed community-initiated changes in stimulant medication . RESULTS : Parent response rates were 90 % at the 6-month follow-up . Six months postintervention , neurofeedback participants maintained significant gains on Conners 3-P ( Inattention effect size [ ES ] = 0.34 , Executive Functioning ES = 0.25 , Hyperactivity/Impulsivity ES = 0.23 ) and BRIEF subscales including the Global Executive Composite ( ES = 0.31 ) , which remained significantly greater than gains found among children in CT and control conditions . Children in the CT condition showed delayed improvement over immediate postintervention ratings only on Conners 3-P Executive Functioning ( ES = 0.18 ) and 2 BRIEF subscales . At the 6-month follow-up , neurofeedback participants maintained the same stimulant medication dosage , whereas participants in both CT and control conditions showed statistically and clinical ly significant increases ( 9 mg [ P = .002 ] and 13 mg [ P < .001 ] , respectively ) . CONCLUSIONS : Neurofeedback participants made more prompt and greater improvements in ADHD symptoms , which were sustained at the 6-month follow-up , than did CT participants or those in the control group . This finding suggests that neurofeedback is a promising attention training treatment for children with ADHD Neurofeedback ( NF ) could help to improve attentional and self-management capabilities in children with attention-deficit/hyperactivity disorder ( ADHD ) . In a r and omised controlled trial , NF training was found to be superior to a computerised attention skills training ( AST ) ( Gevensleben et al. in J Child Psychol Psychiatry 50(7):780–789 , 2009 ) . In the present paper , treatment effects at 6-month follow-up were studied . 94 children with ADHD , aged 8–12 years , completed either 36 sessions of NF training ( n = 59 ) or a computerised AST ( n = 35 ) . Pre-training , post-training and follow-up assessment encompassed several behaviour rating scales ( e.g. , the German ADHD rating scale , FBB-HKS ) completed by parents . Follow-up information was analysed in 61 children ( ca . 65 % ) on a per- protocol basis . 17 children ( of 33 dropouts ) had started a medication after the end of the training or early in the follow-up period . Improvements in the NF group ( n = 38 ) at follow-up were superior to those of the control group ( n = 23 ) and comparable to the effects at the end of the training . For the FBB-HKS total score ( primary outcome measure ) , a medium effect size of 0.71 was obtained at follow-up . A reduction of at least 25 % in the primary outcome measure ( responder criterion ) was observed in 50 % of the children in the NF group . In conclusion , behavioural improvements induced by NF training in children with ADHD were maintained at a 6-month follow-up . Though treatment effects appear to be limited , the results confirm the notion that NF is a clinical ly efficacious module in the treatment of children with ADHD
When only trials are considered that include probably blinded ratings or those that are sham-NF or semi-active controlled or those that employed optimally titration procedures , the findings do not support theta/beta NF as a st and alone treatment for children or adolescents with ADHD .
This review concludes that the present role of NF in treating children diagnosed with ADHD should be considered as complementary in a multimodal treatment approach , individualized to the needs of the child , and may be considered a viable alternative to stimulants for a specific group of patients .
This systematic review aim ed to evaluate the efficacy of neurofeedback ( NF ) compared to stimulant medication in treating children and adolescents with attention-deficit/hyperactivity disorder ( ADHD ) .