Effects of Neurofeedback in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review

Abstract

Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental disorders in childhood and adolescence. Choosing the right treatment is critical to controlling and improving symptoms. An innovative ADHD treatment is neurofeedback (NF) that trains participants to self-regulate brain activity. The aim of the study was to analyze the effects of NF interventions in children with ADHD. A systematic review was carried out in the CINAHL, Medline (PubMed), Proquest, and Scopus databases, following the PRISMA recommendations. Nine articles were found. The NF improved behavior, allowed greater control of impulsivity, and increased sustained attention. In addition, it improved motor control, bimanual coordination and was associated with a reduction in theta waves. NF combined with other interventions such as medication, physical activity, behavioral therapy training, or attention training with brain–computer interaction, reduced primary ADHD symptoms. Furthermore, more randomized controlled trials would be necessary to determine the significant effects.

Neurological Mechanisms of Diagnosis and Therapy in School Children with ADHD in Poland

“…Improving self-monitoring of brain activity patterns permits slowing down of brain activity in the Theta band and accelerating it in the Beta band. High-frequency waves associated with concentration and neuronal excitability are upregulated [20][21][22]. The research findings presented here support the conclusion that the use of Theta/Beta training in ADHD is valid [63] because it translates into a reduction in the disruptive symptoms of ADHD.…”

“…The image of the signal on the screen that results from brainwave activity takes the form of a line consisting of various waves. When studying the electrical activity of the brain, diverse types and ranges of waves are distinguished: Delta wave with frequency (0.5-4 Hz), Theta (4-8 Hz), Alpha (8-12 Hz), SMR (12-15 Hz), Beta (15-20 Hz) and Beta2 (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34). Delta waves are responsible for efficient brain function and regeneration during sleep.…”

“…These are guidelines for parents, teachers, psychiatrists, as well as for child psychotherapists [17]. Noteworthy are methods that help diagnose ADHD using tools applied in neurology, such as neurofeedback [18][19][20]. These tools can be used both at the stage of diagnosis and therapy.…”

Results of Neurofeedback in Treatment of Children with ADHD: A Systematic Review of Randomized Controlled Trials

“…Concerning evidence of neurofeedback as a treatment for ADHD, some studies have concluded that neurofeedback is "effective" as a treatment for ADHD (Arns et al, 2009), "probably effective" (Lofthouse et al, 2012) or "possibly effective" (Storebø et al, 2011). Along the same line as Monastra et al (2005), the review by Sampedro-Baena et al (2021) suggested that as there is no conclusive RCT research, more RCTs need to be published.…”

Effects of Trainer Continuity and Experience on Neurofeedback Treatment of ADHD in Children

“…Theta/Beta ratio is often elevated in ADHD patients and is a marker of unfocused attention, so theta/beta neurofeedback consists of reinforcing lower theta/beta ratios as informed by real-time EEG feedback during the session (Arns et al, 2013). There has historically been a lack of consensus among the medical community as to the efficacy of this treatment, as many studies have proved contradictory (Baena et al, 2021; Louthrenoo et al, 2021). Past unblinded randomized controlled trials of theta/beta NF reported it to equal methylphenidate in efficacy when treating ADHD (Duric et al, 2012), and in some cases surpass it (Meisel et al, 2013), but these studies have lacked a double-blind placebo-controlled design.…”