Neurofeedback Requires Better Evidence of Efficacy Before It Should Be Considered a Legitimate Treatment for ADHD: What is the Evidence for this Claim?

Authors

  • H. Edmund Pigott Brain Treatment Centers of South Florida
  • Rex Cannon Brain Treatment Centers of South Florida

DOI:

https://doi.org/10.15540/nr.1.1.25

Keywords:

neurofeedback, ADHD

Abstract

The article reviews the evidence for the claim that neurofeedback lacks sufficient evidence of efficacy and, therefore, cannot be considered a legitimate treatment for ADHD.

References

Arnold, L. E., Arns, M., Conners, K., deBeus, R., Hirshberg, L., & Monastra, V. (2013a). A

proposed multisite double-blind randomized clinical trial of neurofeedback for ADHD:

Need, rationale, and strategy. Journal of Attention Disorders, 17, 420–436.

http://dx.doi.org/10.1177/1087054713482580

Arnold, L. E., Lofthouse, N., Hersch, S., Pan, X., Hurt, E., Bates, B . . . Grantier, C. (2013b).

EEG neurofeedback for ADHD: Double-blind sham-controlled randomized pilot

feasibility trial. Journal of Attention Disorders, 17(5), 410–9.

http://dx.doi.org/10.1177/1087054712446173

Arns, M., Heinrich, H., & Strehl, U. (2014). Evaluation of neurofeedback in ADHD: The long

and winding road. Biological Psychology, 95, 108–115.

http://dx.doi.org/10.1016/j.biopsycho.2013.11.013

Arns, M., & Strehl, U. (2013). Evidence for efficacy of neurofeedback in ADHD? (letter).

American Journal of Psychiatry, 170, 799. http://dx.doi.org/10.1176/appi.ajp.2013.13020208

Bakhshayesh, A. R., Hansch, S., Wyschkon, A., Rezai, M. J., & Esser, G. (2011).

Neurofeedback in ADHD: A single-blind randomized controlled trial. European Child

& Adolescent Psychiatry, 20, 481–491. http://dx.doi.org/10.1007/s00787-011-0208-y

Barkley, R. A. (1987). Defiant children: A clinician’s manual for parent training. New York,

NY: Guilford Press.

Barkley, R. A. (1992). Is EEG biofeedback treatment effective for ADHD children? Proceed

with much caution. Attention Deficit Disorder Advocacy Group newsletter.

Barkley, R. website accessed April 29, 2014: http://www.russellbarkley.org/factsheets/adhdfacts.pdf.

Cannon, R. L. (in press). Parietal foci for Attention Deficit/Hyperactivity Disorder: Targets

for LORETA neurofeedback with outcomes. Biofeedback Magazine: Special issue on

QEEG and Treatment Approaches for ADHD, June 2014.

Cannon, R. L., Baldwin, D., Diloreto, D., Phillips, S., Shaw, T. L., Levy, J. J. (2014). LORETA

neurofeedback in the precuneus: Operant conditioning in basic mechanisms of selfregulation.

Clinical EEG and Neuroscience, DOI: 10.1177/1550059413512796.

http://dx.doi.org/10.1177/1550059413512796

ENHD website accessed April 29, 2014: http://adhd-adduce.org/page/view/55/What+nondrug+treatments+help

FDA website accessed April 29, 2014:

http://www.accessdata.fda.gov/drugsatfda_docs/label/2003/21475_methylin_lbl.pdf.

Gani, C., Birbaumer, N., & Strehl, U. (2008). Long term effects after feedback of slow cortical

potentials and of theta-beta-amplitudes in children with attention-deficit/hyperactivity

disorder (ADHD). International Journal of Bioelectromagnetism, 10(4), 209–232.

Gevensleben, H., Holl, B., Albrecht, B., Vogel, C., Schlamp, D., Kratz, O., . . . Heinrich, H.

(2009). Is neurofeedback an efficacious treatment for ADHD? A randomized

controlled clinical trial. Journal of Child Psychology and Psychiatry, 50(7), 780–789.

http://dx.doi.org/10.1111/j.1469-7610.2008.02033.x

Gevensleben, H., Holl, B., Albrecht, B., Schlamp, D., Kratz, O., Studer, P., & Heinrich H.

(2010). Neurofeedback training in children with ADHD: 6-Month follow-up of a

randomized controlled trial. European Child & Adolescent Psychiatry, 19, 715–724.

http://dx.doi.org/10.1007/s00787-010-0109-5

Heinrich, H., Gevensleben, H., Freisleder, F. J., Moll, G. H., & Rothenberger, A. (2004).

Training of slow cortical potentials in attention-deficit/hyperactivity disorder: Evidence

for positive behavioral and neurophysiological effects. Biological Psychiatry, 55(7),

–775. http://dx.doi.org/10.1016/j.biopsych.2003.11.013

Holtmann, M., Grasmann, D., Cionek-Szpak, E., Hager, V., Panzer, N., Beyer, A., & Stadler,

C. (2009). Specific effects of neurofeedback on impulsivity in ADHD. Kindheit und

Entwicklung, 18, 95–104. http://dx.doi.org/10.1026/0942-5403.18.2.95

Lansbergen, M. M., van Dongen-Boomsma, M., Buitelaar, J. K., & Slaats-Willemse, D.

(2011). ADHD and EEG-neurofeedback: A double-blind randomized placebocontrolled

feasibility study. Journal of Neural Transmission, 118(2), 275–84.

http://dx.doi.org/10.1007/s00702-010-0524-2

Leins, U., Goth, G., Hinterberger, T., Klinger, C., Rumpf, N., & Strehl, U. (2007).

Neurofeedback for children with ADHD: A comparison of SCP and Theta/Beta

protocols. Applied Psychophysiology and Biofeedback, 32, 73–88.

http://dx.doi.org/10.1007/s10484-007-9031-0

Levesque, J., Beauregard, M., & Mensour, B. (2006). Effect of neurofeedback training on the

neural substrates of selective attention in children with attention-deficit/hyperactivity

disorder: A functional magnetic resonance imaging study. Neuroscience Letters, 394,

–221. http://dx.doi.org/10.1016/j.neulet.2005.10.100

Molina, B. S., Hinshaw, S. P., Swanson, J. M., Arnold, L. E., Vitiello B., Jensen, P. S., . . .

MTA Cooperative Group. (2009). The MTA at 8 years: Prospective follow-up of

children treated for combined-type ADHD in a multisite study. Journal of the

American Academy of Child & Adolescent Psychiatry, 48(5), 484–500.

http://dx.doi.org/10.1097/chi.0b013e31819c23d0

Olfson, M., Blanco, C., Liu, S. M., Wang, S., & Correll, C. U. (2012). National trends in the

office-based treatment of children, adolescents, and adults with antipsychotics.

Archives of General Psychiatry, 69(12), 1247–56.

http://dx.doi.org/10.1001/archgenpsychiatry.2012.647

Ogrim,G., & Hestad, K.A. (2013). Effects of neurofeedback versus stimulant medication in

attention-deficit/hyperactivity disorder: A randomized pilot study. Journal of Child and

Adolescent Psychopharmacology, 23(7), 448–457.

http://dx.doi.org/10.1089/cap.2012.0090

Perreau-Linck, E., Lessard, N., Levesque, J., & Beauregard, M. (2010). Effects of

neurofeedback training on inhibitory capacities in ADHD children: A single-blind,

randomized, placebo-controlled study. Journal of Neurotherapy, 14, 229–242.

http://dx.doi.org/10.1080/10874208.2010.501514

Riddle, M., Yershova, K., Lazzaretto, D., Paykina, N., Yenokyan, G., Greenhill, L., & Posner,

K. (2013). The preschool attention-deficit/hyperactivity disorder treatment study

(PATS) 6-year follow-up. Journal of the American Academy of Child & Adolescent

Psychiatry, 52(3), 264–278. http://dx.doi.org/10.1016/j.jaac.2012.12.007

Sherlin, L. H., Arns, M., Lubar, J., Heinrich, H., Kerson, C., Strehl, U., & Sterman, M. B.

(2011). Neurofeedback and basic learning theory: Implications for research and

practice. Journal of Neurotherapy, 15, 292–304.

http://dx.doi.org/10.1080/10874208.2011.623089

Smith, G., Jongeling, B., Hartmann, P., Russell, C., & Landu, L. (2010). Raine ADHD study:

Long-term outcomes associated with stimulant medication in the treatment of ADHD

in children. Department of Heath, Western Government of Australia.

Snyder, S. M., Quintana, H., Sexson, S. B., Knott, P., Haque, A. F., Reynolds, D. A. (2008).

Blinded, multi-center validation of EEG and rating scales in identifying ADHD within a

clinical sample. Psychiatry Research, 159, 346–358.

http://dx.doi.org/10.1016/j.psychres.2007.05.006

Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., . . .

Sergeant, J. (2013a). Nonpharmacological interventions for ADHD: Systematic

review and meta-analyses of randomized controlled trials of dietary and

psychological treatments. American Journal of Psychiatry, 170(3), 275–289.

http://dx.doi.org/10.1176/appi.ajp.2012.12070991

Sonuga-Barke, E. J., Brandeis, D., Cortese, S., Daley, D., Ferrin, M., Holtmann, M., . . .

Sergeant, J. (2013b). Response to Chronis-Tuscano et al. and Arns and Strehl

(letter). American Journal of Psychiatry, 170, 800–802.

http://dx.doi.org/10.1176/appi.ajp.2013.13020208r

Steiner, N. J., Sheldrick, R. C., Gotthelf, D., & Perrin, E. C. (2011). Computer-based attention

training in the schools for children with attention deficit/hyperactivity disorder: A

preliminary trial. Clinical Pediatrics, 50, 615–622.

http://dx.doi.org/10.1177/0009922810397887

Steiner, N. J., Frenette, E. C., Rene, K. M., Brennan, R. T., & Perrin, E. C. (2014a).

Neurofeedback and cognitive attention training for children with attention-deficit

hyperactivity disorder in schools. Journal of Developmental & Behavioral Pediatrics,

, 18–27. http://dx.doi.org/10.1097/dbp.0000000000000009

Steiner, N. J., Frenette, E. C., Rene, K. M., Brennan, R. T., & Perrin, E. C. (2014b). In-school

neurofeedback training for ADHD: Sustained improvements from a randomized

control trial. Pediatrics, 133, 483–492. http://dx.doi.org/10.1542/peds.2013-2059d

Thorndike, E. L. (1932). Reward and punishment in animal learning. Comparative

Psychology Monographs, 8(39), 1–23.

van Dongen-Boomsma, M., Vollebregt, M. A., Slaats-Willemse, D., Buitelaar, J. K. (2013). A

randomized placebo-controlled trial of electroencephalographic (EEG)

neurofeedback in children with attention deficit/hyperactivity disorder. Journal of

Clinical Psychiatry, 74(8), 821–827. http://dx.doi.org/10.4088/jcp.12m08321

Vollebregt, M. A., van Dongen-Boomsma, M., Buitelaar, J. K., & Slaats-Willemse, D. (2013).

Does EEG-neurofeedback improve neurocognitive functioning in children with

attention-deficit/hyperactivity disorder? A systematic review and a double-blind

placebo-controlled study. Journal of Child Psychology and Psychiatry, 55(5), 460–

http://dx.doi.org/10.1111/jcpp.12143

Vollebregt, M. A., van Dongen-Boomsma, M., Slaats-Willemse, D. & Buitelaar, J. K. (2014).

What future research should bring to help resolving the debate about the efficacy of

EEG-neurofeedback in children with ADHD. Frontiers in Human Neuroscience, 8,

http://dx.doi.org/10.3389/fnhum.2014.00321

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