1Controlled evaluation of a neurofeedback training of slow cortical potentials in children with Attention Deficit/Hyperactivity Disorder (ADHD)

Drechsler, Renate; Straub, Marc; Doehnert, Mirko; Heinrich, Hartmut; Steinhausen, Hans-Christoph; Brandeis, Daniel

doi:10.1186/1744-9081-3-35

Cited by 134 publications

(192 citation statements)

References 34 publications

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“…Evidence from Ref. 57 points in a similar direction. Although only half the children in their neurofeedback condition learned to regulate cortical activation during a transfer condition (without direct feedback), the neurofeedback training performance of these good performers was closely related to clinical improvement in hyperactivity (r 5 0.81) and impulsivity (r 5 0.75).…”

Section: Relation Between Training Performance and Clinical Improvementmentioning

confidence: 71%

Neurofeedback for ADHD

Holtmann

Sonuga‐Barke

Cortese

et al. 2014

Child and Adolescent Psychiatric Clinics of North America

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109

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KEYWORDS ADHD Treatment Neurofeedback Slow cortical potentials Frequency bands Reward KEY POINTSAmong alternative treatment approaches for attention-deficit/hyperactivity disorder (ADHD), neurofeedback has gained empirical support in recent years.Via neurofeedback, children with ADHD are trained to regulate their neurophysiologic profile or to bring it closer to that of nonaffected children; learning of self-regulation is thus a key mechanism.According to recent meta-analytic evidence, neurofeedback leads to significant decreases of ADHD core symptoms; however, if only probably blinded ratings are applied, these effects were reduced to a statistical trend. The evidence remains inconclusive because subsequent studies could demonstrate neither learning of self-regulation nor significant effects for the best blinded assessments.There is a strong need for more evidence from well-blinded, methodologically sound, and sensitive trials demonstrating also learning of self-regulation, before neurofeedback can be assigned the highest level of evidence as a front-line treatment of ADHD. ContinuedChild Adolesc Psychiatric Clin N Am -(2014) ---http://dx

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Section: Relation Between Training Performance and Clinical Improvementmentioning

confidence: 71%

Neurofeedback for ADHD

Holtmann

Sonuga‐Barke

Cortese

et al. 2014

Child and Adolescent Psychiatric Clinics of North America

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109

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“…After the last rtfMRI‐NF run, a 5‐minute fMRI transfer run was conducted, which was identical to the NF training runs, using the same stimuli, but without the feedback (the rocket did not move), consisting of four rest and three activation blocks. Transfer runs measure retention of learning and are considered a proximal measure of successful transfer of training strategies to everyday life [Drechsler et al, 2007]. …”

Section: Methodsmentioning

confidence: 99%

Real‐time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder

Alegría

Wulff

Brinson

et al. 2017

Human Brain Mapping

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Attention Deficit Hyperactivity Disorder (ADHD) is associated with poor self‐control, underpinned by inferior fronto‐striatal deficits. Real‐time functional magnetic resonance neurofeedback (rtfMRI‐NF) allows participants to gain self‐control over dysregulated brain regions. Despite evidence for beneficial effects of electrophysiological‐NF on ADHD symptoms, no study has applied the spatially superior rtfMRI‐NF neurotherapy to ADHD. A randomized controlled trial tested the efficacy of rtfMRI‐NF of right inferior prefrontal cortex (rIFG), a key region that is compromised in ADHD and upregulated with psychostimulants, on improvement of ADHD symptoms, cognition, and inhibitory fMRI activation. To control for region‐specificity, an active control group received rtfMRI‐NF of the left parahippocampal gyrus (lPHG). Thirty‐one ADHD boys were randomly allocated and had to learn to upregulate their target brain region in an average of 11 rtfMRI‐NF runs over 2 weeks. Feedback was provided through a video‐clip of a rocket that had to be moved up into space. A transfer session without feedback tested learning retention as a proximal measure of transfer to everyday life. Both NF groups showed significant linear activation increases with increasing number of runs in their respective target regions and significant reduction in ADHD symptoms after neurotherapy and at 11‐month follow‐up. Only the group targeting rIFG, however, showed a transfer effect, which correlated with ADHD symptom reductions, improved at trend level in sustained attention, and showed increased IFG activation during an inhibitory fMRI task. This proof‐of‐concept study demonstrates for the first time feasibility, safety, and shorter‐ and longer‐term efficacy of rtfMRI‐NF of rIFG in adolescents with ADHD. Hum Brain Mapp 38:3190–3209, 2017. © 2017 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

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“…Almost unequivocally, uncontrolled within subjects' pre-to post-treatment analyses indicate positive results with medium-to-large effect sizes (ES) [16,18,21,35,[38][39][40][41][42][43][44][45][46][47].…”

Section: Brain Electric Activity and Its Relation To Brain Functionmentioning

confidence: 99%

“…None of these studies found NF to be inferior to medication, but comparison was restricted to neuropsychological measurements in 2 of them. Drechsler et al [45] compared NF to cognitive behavioral therapy and found NF to be superior to psychotherapy according to parents and teachers ratings for inattention and metacognition, but not according to objective neuropsychological measurements. The 3 studies comparing NF to computerized attention skills training (CAST) yielded conflicting results.…”

Section: Brain Electric Activity and Its Relation To Brain Functionmentioning

confidence: 99%

“…Several trials also evaluated the effect of NF on the EEG, and on learning EEG control during training. Frequency training NF compared to sham-NF has been found to effectively reduce Theta/Beta ratio during NF training and in a resting state baseline [18], and both SCP and frequency training can increase intentional control over brain electrical activity [38], although this may only hold for a subgroup of the ADHD children training with NF [45]. In a large randomized trial, the authors found SCP (when compared to CAST) to significantly decrease theta activity after training, and increase both participants capacity to modulate SCP, and Contingent Negative Variation (CNV) [54][55][56].…”

Section: Brain Electric Activity and Its Relation To Brain Functionmentioning

confidence: 99%

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Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

et al. 2012

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Summary Neurofeedback (NF) is a training to enhance selfregulatory capacity over brain activity patterns and consequently over brain mental states. Recent findings suggest that NF is a promising alternative for the treatment of attention-deficit/hyperactivity disorder (ADHD). We comprehensively reviewed literature searching for studies on the effectiveness and specificity of NF for the treatment of ADHD. In addition, clinically informative evidence-based data are discussed. We found 3 systematic review on the use of NF for ADHD and 6 randomized controlled trials that have not been included in these reviews. Most nonrandomized controlled trials found positive results with medium-to-large effect sizes, but the evidence for effectiveness are less robust when only randomized controlled studies are considered. The direct comparison of NF and sham-NF in 3 published studies have found no group differences, nevertheless methodological caveats, such as the quality of the training protocol used, sample size, and sample selection may have contributed to the negative results. Further data on specificity comes from electrophysiological studies reporting that NF effectively changes brain activity patterns. No safety issues have emerged from clinical trials and NF seems to be well tolerated and accepted. Follow-up studies support long-term effects of NF. Currently there is no available data to guide clinicians on the predictors of response to NF and on optimal treatment protocol. In conclusion, NF is a valid option for the treatment for ADHD, but further evidence is required to guide its use.

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1Controlled evaluation of a neurofeedback training of slow cortical potentials in children with Attention Deficit/Hyperactivity Disorder (ADHD)

Cited by 134 publications

References 34 publications

Neurofeedback for ADHD

Neurofeedback for ADHD

Real‐time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder

Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

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