The Problem of Patient Heterogeneity and Lack of Proper Training in a Study of EEG Neurofeedback in Children

Abstract

1. The percentage of reward (80%) utilized in this study precludes a significant learning effect in an operant conditioning paradigm. This article failed to demonstrate acquisition at the neural level for the stimulus being trained, which is the most basic principle of operant learning. 2–6 In both respondent and operant conditioning, an individual acquires a behavior that was not previously possessed. 7–9 2. Importantly, pre-quantitative and post-quantitative EEG at the group level would have also been desired given the comorbidity 10 and medication issues in addition to reward parameters. 11 It would also be advantageous to examine the EEG changes in the placebo group as a result of the procedure to better understand the nature of self-regulation and its global effects. To this end, we have calculated the effect size for each of the study variables shown in Table 2 of the article. The effect sizes range from 0.63 to 0.36; the highest effect sizes are shown for the inattention symptoms at 0.63. 3. The current work includes patients with ADHD) with comorbid oppositional defiant disorder (ODD), anxiety, and learning disorders. Thus, approximately 39% of this study population may not have received proper training with known protocols utilized for treatment of ADHD, anxiety, ODD, or learning disorders; 12–14 such protocols with differential features to address these particular