An RCT into the effects of neurofeedback on neurocognitive functioning compared to stimulant medication and physical activity in children with ADHD

K. Gelade, M. Bink, T.W.P. Janssen, R. van Mourik, A. Maras, J. Oosterlaan

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Abstract

Neurofeedback (NFB) is a potential alternative treatment for children with ADHD that aims to optimize brain activity. Whereas most studies into NFB have
investigated behavioral effects, less attention has been paid to the effects on neurocognitive functioning. The present randomized controlled trial (RCT) compared neurocognitive effects of NFB to (1) optimally titrated methylphenidate (MPH) and (2) a semi-active control intervention, physical activity (PA), to control for non-specific effects. Using a multicentre three-way parallel group RCT design, children with ADHD, aged 7–13, were randomly allocated to NFB (n = 39), MPH (n = 36) or PA (n = 37) over a period of 10–12 weeks. NFB comprised theta/beta training at CZ. The PA intervention was matched in frequency and duration to NFB. MPH was titrated using a doubleblind placebo controlled procedure to determine the optimal dose. Neurocognitive functioning was assessed using parameters derived from the auditory oddball-, stop-signal- and visual spatial working memory task. Data collection took place between September 2010 and March 2014. Intention-to-treat analyses showed improved attention for MPH compared to NFB and PA, as reflected by decreased
response speed during the oddball task [ηp 2 = 0.21, p < 0.001], as well as improved inhibition, impulsivity and attention, as reflected by faster stop signal reaction times, lower commission and omission error rates during the stopsignal task (range ηp 2 = 0.09–0.18, p values <0.008). Working memory improved over time, irrespective of received treatment (ηp 2 = 0.17, p < 0.001). Overall, stimulant medication showed superior effects over NFB to improve neurocognitive functioning. Hence, the findings do not support theta/beta training applied as a stand-alone treatment in children with ADHD.
Original languageEnglish
Pages (from-to)457-468
Number of pages12
JournalEuropean Child and Adolescent Psychiatry
Volume26
Issue number4
Early online date24 Sept 2016
DOIs
Publication statusPublished - Apr 2017

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