REVIEW PAPERS AND META-ANALYSES
Efficacy of Neurofeedback Treatment in ADHD: The Effects on Inattention, Impulsivity and Hyperactivity: a Meta-Analysis [pdf]
by Arns M, de Ridder S, Strehl U, Breteler M and Coenen A
Journal of Clinical EEG & Neuroscience, July, 2009
Since the first reports of neurofeedback treatment in Attention Deficit Hyperactivity Disorder (ADHD) in 1976, many studies have investigated the effects of neurofeedback on different symptoms of ADHD such as inattention, impulsivity and hyperactivity. This technique is also used by many practitioners, but the question as to the evidence-based level of this treatment is still unclear. In this study selected research on neurofeedback treatment for ADHD was collected and a meta-analysis was performed.
Both prospective controlled studies and studies employing a pre- and post-design found large effect sizes (ES) for neurofeedback on impulsivity and inattention and a medium ES for hyperactivity. Randomized studies demonstrated a lower ES for hyperactivity suggesting that hyperactivity is probably most sensitive to nonspecific treatment factors.
Due to the inclusion of some very recent and sound methodological studies in this meta-analysis, potential confounding factors such as small studies, lack of randomization in previous studies and a lack of adequate control groups have been addressed, and the clinical effects of neurofeedback in the treatment of ADHD can be regarded as clinically meaningful. Three randomized studies have employed a semi-active control group which can be regarded as a credible sham control providing an equal level of cognitive training and client-therapist interaction. Therefore, in line with the AAPB and ISNR guidelines for rating clinical efficacy, we conclude that neurofeedback treatment for ADHD can be considered "Efficacious and Specific" (Level 5) with a large ES for inattention and impulsivity and a medium ES for hyperactivity.
Place of EEG Biofeedback for ADHD [pdf]
by Hirshberg LM
Expert Review Neurotherapeutics, 7(4), 315-319
Although methodological weaknesses limited early research into electroencephalograpic (EEG) biofeedback (EBF) for treatment of attention-deficit/hyperacticity disorder (ADHD), recent stronger randomized controlled trials have provided substantial, but not yet conclusive, empirical support. Additional support is found in research on functional magnetic resonance imaging (fMRI) feedback and brain-computer interface (BCI) models which involve feedback-guided learning to achieve control over neural activation.
EEG Biofeedback in the Treatment of Attention Deficit Hyperactivity Disorder [abs.]
by Friel PN
Alternative Medicine Review, Volume 12, #2, June, 2007, pp146-151
Electroencephalogram (EEG) biofeedback, also known as neurofeedback, is a promising alternative treatment for patients with attention deficit/hyperactivity disorder (AD/HD). EEG biofeedback therapy rewards scalp EEG frequencies that are associated with relaxed attention, and suppresses frequencies associated with under- or over-arousal.
Electroencephalographic Biofeedback in the Treatment of Attention-Deficit/Hyperactivity Disorder [abs.]
by Monastra VJ, Lynn S, Linden M, Lubar JF, Gruzelier J, LaVaque TJ
Historically, pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) have been considered to be the only type of interventions effective for reducing the core symptoms of this condition. However, during the past three decades, a series of case and controlled group studies examining the effects of EEG biofeedback have reported improved attention and behavioral control, increased cortical activation on quantitative electroencephalographic examination, and gains on tests of intelligence and academic achievement in response to this type of treatment.
Electroencephalographic Biofeedback (Neurotherapy) as a Treatment for Attention Deficit Hyperactivity Disorder: Rationale and Empirical Foundation [abs.]
by Monastra VJ
During the past three decades, electroencephalographic (EEG) biofeedback has emerged as a nonpharmacologic treatment for attention-deficit/hyperactivity disorder (ADHD). This intervention was derived from operant conditioning studies that demonstrated capacity for neurophysiologic training in humans and other mammals and targets atypical patterns of cortical activation that have been identified consistently in neuroimaging and quantitative EEG studies of patients diagnosed with ADHD.
Treatment of Attention Deficit Hyperactivity Disorder with Neurotherapy [abs.]
by Nash JK
Significant public health concerns exist regarding our current level of success in treating ADHD. Medication management is very helpful in 60-70% of patients. Side effects, lack of compliance and the fact that stimulant medications cannot be given late in the day limit the benefits largely to school hours.
Review of the Literature Regarding the Efficacy of Neurofeedback in the Treatment of Attention Deficit Hyperactivity Disorder [abs.]
by Lingenfelter JE
The following is a review of the most recent literature regarding the efficacy of EEG Neurofeedback in the treatment of attention deficit hyperactivity disorders.
Update on Attention-Deficit/Hyperactivity Disorder [abs.]
by Campbell Daley K
In her recent paper, Update on Attention-Deficit/Hyperactivity Disorder, published in Current Opinion in Pediatrics, Katie Campbell Daley reviewed the research and practice standards on treatment of ADHD. Dr. Campbell is on the staff of the Department of Medicine, Children's Hospital Boston and in the Department of Pediatrics of the Harvard Medical School. Her conclusion: "Overall, these findings support the use of multi-modal treatment, including medication, parent/school counseling, and EEG biofeedback, in the long term management of ADHD, with EEG biofeedback in particular providing a sustained effect even without stimulant treatment... Parents interested in non-psychopharmacologic treatment can pursue the use of complementary and alternative therapy. The therapy most promising by recent clinical trials appears to be EEG biofeedback."
Comparisons of Neurofeedback with Stimulant Medication
Neurofeedback Treatment for Attention Deficit/Hyperactivity Disorder in Children: A Comparison with Methylphenidate [abs.]
by Fuchs T, Birbaumer N, Lutzenberger W, Gruzelier J. H., & Kaiser J
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 betal activity (15-18 Hz) with stimulant medication.
The Effectiveness of Neurofeedback and Stimulant Drugs in Treating AD/HD: Part I. Review of Methodological Issues [abs.]
by Rossiter T.R.
The paper examines major criticisms of AD/HD (Attention Deficit/Hyperactivity Disorder) neurofeedback research using T. R. Rossiter and T. J. La Vaque (1995) as an exemplar and discusses relevant aspects of research methodology.
The Effectiveness of Neurofeedback and Stimulant Drugs in Treating AD/HD: Part II. Replication [abs.]
by Rossiter T.R.
This study replicated T. R. Rossiter and T. J. La Vaque (1995) with a larger sample, expanded age range, and improved statistical analysis. Thirty-one ADIHD patients who chose stimulant drug (MED) treatment were matched with 31 patients who chose a neurofeedback (EEG) treatment program.
A Comparison of EEG Biofeedback and Psychostimulants in Treating Attention Deficit/Hyperactivity Disorders
by Rossiter TR and La Vaque TJ
The study compared treatment programs with EEG biofeedback or stimulants as their primary components. An EEG group (EEG) was matched with a stimulant group (MED) by age, IQ, gender and diagnosis. The Test of Variables of Attention (TOVA) was administered pre and post treatment.
The Effects of Stimulant Therapy, EEG Biofeedback, and Parenting Style on the Primary Symptoms of Attention-Deficit/Hyperactivity Disorder [abs.]
by Monastra VJ, Monastra DM, George S
One hundred children, ages 6-19, who were diagnosed with attention-deficit/hyperactivity disorder (ADHD), either inattentive or combined types, participated in a study examining the effects of Ritalin, EEG biofeedback, and parenting style on the primary symptoms of ADHD.
Neurofeedback for ADHD using Slow Cortical Potentials
Is Neurofeedback an Efficacious Treatment for ADHD? A Randomised Controlled Clinical Trial [abs.]
by Gevensleben H, Holl B, Albrecht B, Vogel C, Schlamp D, Kratz O, Studer P, Rothenberger A, Moll GH, Heinrich H
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 methodological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite randomised controlled study using a computerised attention skills training as a control condition.