Neurofeedback and ADHD
Reference books on ADHD and neurofeedback
Key Studies which demonstrate the effects of Neurofeedback in ADHD
Van Doren et al. (2018). Sustained effects of neurofeedback in ADHD: A systematic review and meta-analysis. European Child & Adolescent Psychiatry.
This is a systematic review and meta-analysis which looks at data from more than 500 children with ADHD from 10 randomised controlled trials, comparing the effects of Neurofeedback with ‘active treatments - including medication - and 'non-active' (no treatment) conditions. To critically interpret the data, researchers with different views on Neurofeedback contributed to this study. They concluded that Neurofeedback had long lasting effects after an average of 6 months, with no ongoing therapy sessions needed after the initial program compared to the group which was still taking medication at follow-up, and at follow-up the effects of neurofeedback were comparable to the effects of medication.
Strehl et al. (2017) Neurofeedback of Slow Cortical Potentials in Children with Attention-Deficit/Hyperactivtiy Disorder (ADHD): A Multicenter Randomized Trial Controlling for Unspecific Effects. Frontier in Human Neuroscience, 11.
This is (to-date) the largest multi-center randomised study on SCP Neurofeedback, in 150 children with ADHD. The study confirms the specific efficacy of SCP neurofeedback on the core symptoms of ADHD compared to a semi-active control group. This demonstrates the feasibility and, above all, the efficacy of SCP neurofeedback in children with ADHD, controlling for specific and unspecific effects.
Arns et al. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180-9.
This first meta-analysis on neurofeedback in ADHD demonstrates large effect sizes for the domains of inattention and impulsivity in ADHD. Most of the studies included in this meta-analysis concern ‘standard’ neurofeedback protocols such as Theta/Beta (TBR) or Slow Cortical Potential (SCP) Neurofeedback.
Arns et al. (2014). Evaluation of neurofeedback in ADHD: The long and winding road. Biological Psychology, 95, 108-15.
This review is an update to the above meta-analysis which includes studies published since 2009. Furthermore, this review better contextualises the evaluation of neurofeedback, also discussing differences between various neurofeedback approaches and methodological issues.
Arns et al. (2012). The effects of QEEG-informed neurofeedback in ADHD: An open-label pilot study. Applied Psychophysiology and Biofeedback, 37(3), 171-80
This paper demonstrates the results of the ‘individualized’ neurofeedback approach – also called QEEG informed neurofeedback – which is employed within neuroCare Clinics / Brainclinics. This manuscript also summarises how personalization of neurofeedback treatment, both within this study and in an earlier study by an independent group, potentially doubles clinical treatment effects.
Several independent mile-stone studies which have been conducted by independent research groups, demonstrating the effects of Neurofeedback in the treatment of ADHD
Heinrich et al. (2004) Training of Slow Cortical Potentials in Attention-Deficit/Hyperactivity Disorder: Evidence for Positive Behavioural and Neurophysiological Effects. Biological Psychiatry, 55(7), 772-5
This is a milestone study looking at the effects of Slow Cortical Potentials (SCP) Neurofeedback in ADHD.
Strehl et al. (2006) Self-Regulation of Slow Cortial Potentials: A New Treatment for Children with Attention-Deficit/Hyperactivity Disorder. Pediatrics, 118(5)
This is a second independant controlled study looking at the effects of SCP Neurofeedback in ADHD.
Gani et al. (2008) Long Term Effects after Feedback of Slow Cortical Potentials and of Theta-Beta-Amplitudes in Children with Attention Deficit/Hyperactivity Disorder (ADHD). Int J Bioelectromagn, 10(4)
This study is a two-year follow-up from results from the previous SCP neurofeedback study in ADHD children. The findings shows clinical effects are maintained after follow-up.
Gevensleben et al. (2009) Is Neurofeedback an Efficacious Treatment for ADHD? A Randomised Controlled Clinical Trial. Journal of Child Psychology and Psychiatry, And Allied Disciplines, 50(7), 780-9
This is the first large multi-centre Randomised Controlled Trial which demonstrates the effects of SCP (Slow Cortical Potentials) and TBR (Theta/Beta Ratio) Neurofeedback in ADHD, compared with a semi-active conrol group consisting of attention training.
Gevensleben et al. (2010). Neurofeedback Training in Children with ADHD: 6-Month Follow-Up of a Randomised Controlled Trial. European Child & Adolescent Psychiatry, 19(9), 715-24
The 6-month follow-up data from the above Gevensleben et al. (2009) study demonstrating clinical effects are maintained after 6-month follow-up.
Steiner et al. (2014) In-School Neurofeedback Training for ADHD: Sustained Improvements From A Randomized Control Trial. Pediatrics, 133(3), 483 - 92
Clinical results from another multi-centre randomized controlled study from the United States, which looks at Theta/Beta Ratio Neurofeedback, demonstrating clinical effects sustained after follow-up.
Mayer et al. (2015) Neurofeedback of Slow Cortical Potentials as a Treatment For Adults with Attention Deficit-Hyperactivity Disorder. Clinical Neurophysiology.
The first results from a controlled study on SCP neurofeedback in adults with ADHD.
Holtmann et al. (2014) Neurofeedback in Children With Attention-Deficit/Hyperactivity Disorder (ADHD) - A Controlled Multi-centre Study of a Non-Pharmalogical Treatment Approach. BMC Pediatrics. 14, 202
Design of the largest multicentre study to date (using TheraPrax) on SCP Neurofeedback in Children with ADHD: Based on conference reports, clinical results are positive and are in the process of being published.
Comparisons of treatment with Neurofeedback and Medication
Duric, N. S., Assmus, J., Gundersen, D. I., & Elgen, I. B. (2012). Neurofeedback for the treatment of children and adolescents with ADHD: A randomized and controlled clinical trial using parental reports. BMC Psychiatry, 12(1), 107. doi:10.1186/1471-244X-12-107
An independent Randomised Controlled Trial which compares the effects of neurofeedback with methylphenidate where neurofeedback demonstrates comparable efficacy as compared to methylphenidate.
Meisel, V., Servera, M., Garcia-Banda, G., Cardo, E., & Moreno, I. (2013). Neurofeedback and standard pharmacological intervention in ADHD: A randomized controlled trial with six-month follow-up. Biological Psychology, 94(1), 12-21. doi:10.1016/j.biopsycho.2013.04.015
Another independent Randomised Controlled Trial comparing neurofeedback with methylphenidate where neurofeedback demonstrates comparable efficacy as compared to methylphenidate.
Further Reviews on the efficacy of Neurofeedback in ADHD
Mayer, K., & Arns, M. (2016). Electroencephalogram Neurofeedback: Application in ADHD and Epilepsy. Psychiatric Annals, 46(10), 594-600.
This article reviews the evidence for the efficacy of neurofeedback in psychiatric disorders and also discusses the specific neurofeedback protocols that have been found effective in the treatment of ADHD.
Gevensleben et al. (2012). Neurofeedback in children with ADHD: Validation and challenges. Expert Review of Neurotherapeutics, 12(4), 447-60. doi:10.1586/ern.12.22
This article by Gevensleben and colleagues reviews the efficacy of Neurofeedback in ADHD
Mayer et al. (2013) One size fits all? Slow Cortical Potentials Neurofeedback: A Review. Journals of Attention Disorders, 17(5), 393 - 409
This is a review of the standardised protocols of Slow Cortical Potentials (SCP) Neurofeedback by Dr. Kerstin Mayer, Dr. Ute Strehl and others.
Cortese et al. (2016) Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child and Adolescent Psychiatry
A critical review and meta-analysis by the European ADHD-Guidelines group about neurofeedback in ADHD. This review relied mainly on teacher ratings as more objective indicators for improvement. In consideration of all studies – including some approaches that are known to be ineffective – there were no significant effects based on teacher ratings. However, when limiting the meta-analysis to ‘standard neurofeedback protocols’ as proposed by Arns, Heinrich & Strehl (2014), clinical effects for both parent and teacher rated symptoms were found to be significant, further supporting the neuroCare Group's focus on advocating well-researched neurofeedback protocols such as SCP, TBR and SMR neurofeedback.