Nonpharmacological Interventions for ADHD: Systematic Review and Meta-Analyses of Randomized Controlled Trials of Dietary and Psychological Treatments

Sonuga‐Barke, Edmund; Brandeis, Daniel; Cortese, Samuele; Daley, David; Ferrín, Maite; Holtmann, Martin; Stevenson, Jim; Danckaerts, Marina; Oord, Saskia Van der; Döpfner, Manfred; Dittmann, Ralf W.; Simonoff, Emily; Zuddas, Alessandro; Banaschewski, Tobias; Buitelaar, Jan K.; Coghill, David; Hollis, Chris; Konofal, Éric; Lecendreux, Michel; Wong, Ian C. K.; Sergeant, Joseph A.

doi:10.1176/appi.ajp.2012.12070991

Cited by 986 publications

(1,052 citation statements)

References 83 publications

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“…A number of reviews and meta-analyses have addressed the literature regarding EEG-nf treatment for ADHD (Arns et al, 2014;Arns, Ridder, & Strehl, 2009;Lofthouse et al, 2012;Sonuga-Barke et al, 2013), epilepsy (Tan et al, 2009), depression and anxiety (Hammond, 2005), Parkinson's disease (Esmail & Linden, 2014), and a slew of other disorders (Hammond, 2011). Some of these accounts highlight the dearth of convincing evidence (Esmail & Linden, 2014;Lofthouse et al, 2012;Sonuga-Barke et al, 2013) while others rely on single-blinding, subpar control groups, non-peer-reviewed publications, and case studies to support EEG-nf (see Thibault et al, 2015 for a more in-depth exposition).…”

Section: Introductionmentioning

confidence: 99%

The self-regulating brain and neurofeedback: Experimental science and clinical promise

Thibault

Lifshitz

Raz

2016

Cortex

215

198

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Neurofeedback, one of the primary examples of self-regulation, designates a collection of techniques that train the brain and help to improve its function. Since coming on the scene in the 1960s, electroencephalography-neurofeedback has become a treatment vehicle for a host of mental disorders; however, its clinical effectiveness remains controversial. Modern imaging technologies of the living human brain (e.g., real-time functional magnetic resonance imaging) and increasingly rigorous research protocols that utilize such methodologies begin to shed light on the underlying mechanisms that may facilitate more effective clinical applications. In this paper we focus on recent technological advances in the field of human brain imaging and discuss how these modern methods may influence the field of neurofeedback. Toward this end, we outline the state of the evidence and sketch out future directions to further explore the potential merits of this contentious therapeutic prospect.

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Section: Introductionmentioning

confidence: 99%

The self-regulating brain and neurofeedback: Experimental science and clinical promise

Thibault

Lifshitz

Raz

2016

Cortex

215

198

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“…Although superior to behavioral treatments in the short‐term, longer‐term efficacy has not been demonstrated [Cunill et al, 2016; Molina et al, 2009], which may be related to evidence from positron emission tomography studies for dopaminergic brain adaptation to psychostimulant medication [Fusar‐Poli et al, 2012; Wang et al, 2013]. Moreover, because of their potential for abuse and diversion, adverse effects, and unknown longer‐term brain effects, non‐pharmacological treatments are preferred, but have limited efficacy [Sonuga‐Barke et al, 2013]. …”

Section: Introductionmentioning

confidence: 99%

“…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].…”

Section: Introductionmentioning

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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103

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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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“…Extant research has demonstrated support for the efficacy of cognitive training programs in improving individual cognitive skills (Holmes, Gathercole, & Dunning, 2009; Klingberg et al, 2005; Melby‐Lervag & Hulme, 2013; Sonuga‐Barke et al, 2013; Wegrzyn, Hearrington, Martin, & Randolph, 2012). However, because each training program described in the literature targets different cognitive skills, the results are as diverse and varied as the programs themselves.…”

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confidence: 99%

LearningRx Cognitive Training Effects in Children Ages 8–14: A Randomized Controlled Trial

Carpenter

Ledbetter

Moore

2016

Applied Cognitive Psychology

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SummaryIn a randomized controlled study, we examined the effects of a one‐on‐one cognitive training program on memory, visual and auditory processing, processing speed, reasoning, attention, and General Intellectual Ability (GIA) score for students ages 8–14. Participants were randomly assigned to either an experimental group to complete 60 h of cognitive training or to a wait‐list control group. The purpose of the study was to examine changes in multiple cognitive skills after completing cognitive training with ThinkRx, a LearningRx program. Results showed statistically significant differences between groups on all outcome measures except for attention. Implications, limitations, and suggestions for future research are examined. © 2016 The Authors Applied Cognitive Psychology Published by John Wiley & Sons Ltd.

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Nonpharmacological Interventions for ADHD: Systematic Review and Meta-Analyses of Randomized Controlled Trials of Dietary and Psychological Treatments

Cited by 986 publications

References 83 publications

The self-regulating brain and neurofeedback: Experimental science and clinical promise

The self-regulating brain and neurofeedback: Experimental science and clinical promise

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

LearningRx Cognitive Training Effects in Children Ages 8–14: A Randomized Controlled Trial

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