Neurofeedback for ADHD

Abstract

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

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

“…However, this is unlikely for the active group, given that the clinical improvements correlated with the trained brain activation changes in their ROI. While the active control condition controlled for region‐specificity, which is rarely addressed in rtfMRI‐NF [Thibault et al, 2015, 2016] or EEG‐NF [Holtmann et al, 2014] studies, the inclusion of a sham‐rtfMRI‐NF condition would have enabled us to rule out potential placebo effects (but not nonspecific learning effects [Baumeister et al, 2016]).…”

“…Given that ADHD is typified by poor self‐control [Schachar et al, 1993], and enhancing brain‐self‐control is the target of NF, ADHD is the psychiatric disorder where NF has been most applied, using electrophysiological neurofeedback (EEG‐NF) targeting abnormal EEG biomarkers. Meta‐analyses of randomized controlled trials (RCT) of EEG‐NF show medium effect sizes for symptom improvements [Arns et al, 2009], reduced to trends when only “probably” blinded raters are included [Holtmann et al, 2014; Sonuga‐Barke et al, 2013]. Crucially, unlike psychostimulant treatment, NF effects seem stable and longer‐lasting (up to 2 years), with no side effects [Arns and Kenemans, 2014; Gani et al, 2008; Gevensleben et al, 2010; Leins et al, 2007; Mayer et al, 2016; Steiner et al, 2014; Strehl et al, 2006].…”

Efficacy of Neurofeedback Versus Pharmacological Support in Subjects with ADHD

“…Previous studies justify the increase in activation by neurofeedback training, not only due to the immediate feedback provided by the instrument (Mayer et al 2015), but also due to the establishment of new neural pathways and connections (Toomim et al 2004). In this sense, clinicians commonly utilize three basic types of neurofeedback training protocols, based on the alterations in ADHD (Holtmann et al 2014). First, a conventional protocol to reduce inattention and impulsivity, which consists on operant suppressing of theta activity and enhancement of beta activity (Bakhshayesh et al 2011;Lubar et al 1995).…”

“…Historically, pharmacological supports have been considered the only efficacious treatment. However, in recent years, diverse studies have shown the effectiveness of neurofeedback training because as levels of cortical activation increase, symptoms of inattention, impulsivity, and hyperactivity decrease (Fuchs et al 2003;Holtmann et al 2014;Maurizio et al 2013;Mayer et al 2015;Monastra et al 2005).…”

Brain–Computer Interface and Neurofeedback Technologies: Current State, Problems and Clinical Prospects (Review)

“…It manifested, primarily, in a great number of reviews analytical reviews on various aspects of neurointerfaces [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. In addition, over the last 5 years, the publications on BCI and NFB in PubMed have increased by 2-3 times.…”