A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD

Katleen Geladé, Tieme W.P. Janssen, Marleen Bink, Jos W.R. Twisk, Rosa van Mourik, Athanasios Maras, Jaap Oosterlaan

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

To assess the long-term effects of neurofeedback (NFB) in children with attention deficit hyperactivity disorder (ADHD), we compared behavioral and neurocognitive outcomes at a 6-month naturalistic follow-up of a randomized controlled trial on NFB, methylphenidate (MPH), and physical activity (PA). Ninety-two children with a DSM-IV-TR ADHD diagnosis, aged 7–13, receiving NFB (n = 33), MPH (n = 28), or PA (n = 31), were re-assessed 6-months after the interventions. NFB comprised theta/beta training on the vertex (cortical zero). PA comprised moderate to vigorous intensity exercises. Outcome measures included parent and teacher behavioral reports, and neurocognitive measures (auditory oddball, stop-signal, and visual spatial working memory tasks). At follow-up, longitudinal hierarchical multilevel model analyses revealed no significant group differences for parent reports and neurocognitive measures (p = .058–.997), except for improved inhibition in MPH compared to NFB (p = .040) and faster response speed in NFB compared to PA (p = .012) during the stop-signal task. These effects, however, disappeared after controlling for medication use at follow-up. Interestingly, teacher reports showed less inattention and hyperactivity/impulsivity at follow-up for NFB than PA (p = .004–.010), even after controlling for medication use (p = .013–.036). Our findings indicate that the superior results previously found for parent reports and neurocognitive outcome measures obtained with MPH compared to NFB and PA post intervention became smaller or non-significant at follow-up. Teacher reports suggested superior effects of NFB over PA; however, some children had different teachers at follow-up. Therefore, this finding should be interpreted with caution. Clinical trial registration Train your brain and exercise your heart? Advancing the treatment for Attention Deficit Hyperactivity Disorder (ADHD), Ref. no. NCT01363544, https://clinicaltrials.gov/show/NCT01363544.

LanguageEnglish
Pages581-593
Number of pages13
JournalEuropean Child and Adolescent Psychiatry
Volume27
Issue number5
Early online date2 Nov 2017
DOIs
StatePublished - May 2018

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Neurofeedback
Attention Deficit Disorder with Hyperactivity
Exercise
Methylphenidate
Outcome Assessment (Health Care)
Multilevel Analysis
Impulsive Behavior
Short-Term Memory
Diagnostic and Statistical Manual of Mental Disorders
Randomized Controlled Trials
Clinical Trials

Keywords

  • ADHD
  • Behavior
  • Cognition
  • Naturalistic follow-up
  • Neurofeedback

Cite this

Geladé, Katleen ; Janssen, Tieme W.P. ; Bink, Marleen ; Twisk, Jos W.R. ; van Mourik, Rosa ; Maras, Athanasios ; Oosterlaan, Jaap. / A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD. In: European Child and Adolescent Psychiatry. 2018 ; Vol. 27, No. 5. pp. 581-593
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A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD. / Geladé, Katleen; Janssen, Tieme W.P.; Bink, Marleen; Twisk, Jos W.R.; van Mourik, Rosa; Maras, Athanasios; Oosterlaan, Jaap.

In: European Child and Adolescent Psychiatry, Vol. 27, No. 5, 05.2018, p. 581-593.

Research output: Contribution to JournalArticleAcademicpeer-review

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AU - Geladé,Katleen

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AU - Maras,Athanasios

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AB - To assess the long-term effects of neurofeedback (NFB) in children with attention deficit hyperactivity disorder (ADHD), we compared behavioral and neurocognitive outcomes at a 6-month naturalistic follow-up of a randomized controlled trial on NFB, methylphenidate (MPH), and physical activity (PA). Ninety-two children with a DSM-IV-TR ADHD diagnosis, aged 7–13, receiving NFB (n = 33), MPH (n = 28), or PA (n = 31), were re-assessed 6-months after the interventions. NFB comprised theta/beta training on the vertex (cortical zero). PA comprised moderate to vigorous intensity exercises. Outcome measures included parent and teacher behavioral reports, and neurocognitive measures (auditory oddball, stop-signal, and visual spatial working memory tasks). At follow-up, longitudinal hierarchical multilevel model analyses revealed no significant group differences for parent reports and neurocognitive measures (p = .058–.997), except for improved inhibition in MPH compared to NFB (p = .040) and faster response speed in NFB compared to PA (p = .012) during the stop-signal task. These effects, however, disappeared after controlling for medication use at follow-up. Interestingly, teacher reports showed less inattention and hyperactivity/impulsivity at follow-up for NFB than PA (p = .004–.010), even after controlling for medication use (p = .013–.036). Our findings indicate that the superior results previously found for parent reports and neurocognitive outcome measures obtained with MPH compared to NFB and PA post intervention became smaller or non-significant at follow-up. Teacher reports suggested superior effects of NFB over PA; however, some children had different teachers at follow-up. Therefore, this finding should be interpreted with caution. Clinical trial registration Train your brain and exercise your heart? Advancing the treatment for Attention Deficit Hyperactivity Disorder (ADHD), Ref. no. NCT01363544, https://clinicaltrials.gov/show/NCT01363544.

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