1Controlled evaluation of a neurofeedback training of slow cortical potentials in children with Attention Deficit/Hyperactivity Disorder (ADHD).

Renate Drechsler,Daniel Brandeis,Hans-Christoph Steinhausen,Hartmut Heinrich,Mirko Doehnert,Marc Straub

doi:10.1186/1744-9081-3-35

Abstract

BackgroundAlthough several promising studies on neurofeedback training in Attention Deficit/Hyperactivity Disorder (ADHD) have been performed in recent years, the specificity of positive treatment effects continues to be challenged.MethodsTo evaluate the specificity of a neurofeedback training of slow cortical potentials, a twofold strategy was pursued: First, the efficacy of neurofeedback training was compared to a group training program for children with ADHD. Secondly, the extent of improvements observed in the neurofeedback group in relation to successful regulation of cortical activation was examined. Parents and teachers rated children's behaviour and executive functions before and after treatment. In addition, children underwent neuropsychological testing before and after training.ResultsAccording to parents' and teachers' ratings, children of the neurofeedback training group improved more than children who had participated in a group therapy program, particularly in attention and cognition related domains. On neuropsychological measures children of both groups showed similar improvements. However, only about half of the neurofeedback group learned to regulate cortical activation during a transfer condition without direct feedback. Behavioural improvements of this subgroup were moderately related to neurofeedback training performance, whereas effective parental support accounted better for some advantages of neurofeedback training compared to group therapy according to parents' and teachers' ratings.ConclusionThere is a specific training effect of neurofeedback of slow cortical potentials due to enhanced cortical control. However, non-specific factors, such as parental support, may also contribute to the positive behavioural effects induced by the neurofeedback training.

Highlights

Several promising studies on neurofeedback training in Attention Deficit/ Hyperactivity Disorder (ADHD) have been performed in recent years, the specificity of positive treatment effects continues to be challenged
Effects of neurofeedback training compared to group therapy Behavioural ratings Composite scores of three behavioural scales rated by parents were entered into a repeated measures MANOVA
When effects sizes of changes on the Conners' Parent Rating Scale (CPRS) Global Score were calculated separately for both groups, it could be shown that changes within the neurofeedback group were responsible for the improvement on the CPRS Gobal Index

Summary

Introduction

Several promising studies on neurofeedback training in Attention Deficit/ Hyperactivity Disorder (ADHD) have been performed in recent years, the specificity of positive treatment effects continues to be challenged. Clinical trials have been described since the seventies [2], but controlled studies on the effectiveness of neurofeedback training in children with ADHD have only been published in recent years (see [1,3,4], for reviews). On trials where the change in the desired direction reaches a critical threshold, a positive reinforcement signal is fed back to the participant. This type of training is aiming more directly at the control of cortical regulation and at the efficient allocation of resources, which is supposed to be impaired in ADHD [13,14]. Studies on SCP neurofeedback training with children with ADHD have been published with encouraging results [7,8,10]

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