Neurofeedback, pharmacological treatment and behavioral therapy in hyperactivity: Multilevel analysis of treatment effects on electroencephalography

Abstract

The purpose of this study was to investigate the efficacy of neurofeedback, pharmacological treatment and behavioral therapy in Attention Deficit Hyperactivity Disorder (ADHD) through a controlled, randomized, multigroup design, with pre-, post- and follow-up treatment phases. The objectives of this study are: a) to analyze individual trajectories over time of each child in treatment, from specific measures of EEG (theta/beta ratio/TBR) considering age and sex and b) to determine the therapeutic effect on attentional and behavioral variables evaluated through the Integrated Visual and Auditory Continuous Performance Test. A total of 57 children (7-14 years) diagnosed with ADHD, were randomly assigned to one of the following experimental conditions: 1) 30 Theta/Beta training sessions, 2) Methylphenidate treatment and, 3) Behavior therapy administered according to a cognitive-behavioral protocol based on manuals. Data were analyzed using a Multilevel Longitudinal Regression Model. Results show that administered treatments are effective and cause similar effects on TBR variable, with no differences between them. However, significant differences were observed in the global attention (p=.002), auditory attention (p=.017) and visual attention (p=.028).

Nonpharmacologic Treatments for Attention-Deficit/Hyperactivity Disorder: A Systematic Review

“…Findings for neurofeedback interventions versus nonpharmacologic or pharmacologic or placebo, usual care, or waitlist are described in Supplemental Table 18. In 4 randomized controlled trials (RCTs), 19,34,55,68,69 in which a total of 353 participants were enrolled, researchers examined neurofeedback as an intervention versus a nonpharmacologic intervention (n = 3), pharmacologic intervention (n = 1), or placebo, usual care, or waitlist (n = 3).…”

“…In 3 studies, researchers examined neurofeedback as the primary intervention and evaluated standardized symptoms scores or progress toward patient-identified goals. 34,55,68,69 All 3 studies were RCTs: 2 were of good quality 34, 68,69 and 1 was of fair quality. 55 Follow-up times were either not reported or short-term (2 months).…”

“…34,55,68,69 All 3 studies were RCTs: 2 were of good quality 34, 68,69 and 1 was of fair quality. 55 Follow-up times were either not reported or short-term (2 months). In 1 study, researchers found a statistically significant decrease in ADHD symptoms using a standard scale comparing neurofeedback with an attention skills control condition.…”

“…A third study compared neurofeedback to behavioral treatment and found that the group treated with neurofeedback showed greater improvement in a continuous performance test score. 55…”

Initial Study on Implementation of the Low-Frequency Wave Markers for the Purpose of Diagnostic Tests’ Performance and Neurofeedback Therapy

“…The Neurofeedback-based therapy in ADHD treatment is still a controversial method compared to pharmacological or behavioral ones; however, it is becoming more and more popular due to the increasing number of publications describing its positive results (Bluschke et al, 2016;Moreno-Garcia et al, 2015;Moreno-Garcia et al, 2019). The vast body of literature in the Neurofeedback field suggests that specific bandwidths are associated with particular cognitive functions.…”