Effectiveness of Brain-Computer Interface (BCI)-Based Attention Training Game System for Symptom Reduction, Behavioral Enhancement, and Brain Function Modulation in Children With ADHD: A Systematic Review and Single-Arm Meta-Analysis

Authors

  • Muhammad Zain Raza KEMU
  • Muhammad Omais
  • Hafiz Muhammad Ehsan Arshad
  • Musab Maqsood
  • Ali Ahmad Nadeem

DOI:

https://doi.org/10.15540/nr.12.1.51

Keywords:

Attention-deficit/hyperactivity disorder (ADHD), Brain-Computer Interface, Gaming, Neurofeedback

Abstract

Introduction. Brain-computer interface (BCI)-based games have been developed as an adjunct to conventional ADHD therapy. This review aims to assess the effectiveness of these systems. Methodology. ADHD Rating Scale (ADHD-RS) and Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) scores were analyzed, while other outcomes were assessed qualitatively. Results. Eleven studies with a total of 421 subjects were included, which utilized seven unique BCI-based games. There was a significant reduction in parent-reported (MD = 2.20; 95% CI: 0.91–3.49) and clinician-reported (MD = 1.60; 95% CI: 0.32–2.88) inattention (IA) scores in the intervention group versus control. There was a statistically significant reduction in parent-reported (MD = 3.70; 95% CI: 2.11–5.29) and clinician-reported (MD = 3.20; 95% CI: 1.82–4.58) IA scores and parent-reported hyperactive/impulsivity (HI) scores (MD = 3.88; 95% CI: 1.88–5.87) in a pre–post intervention analysis. IVA-CPT visual and auditory scores showed a statistically significant increase in the response control (MD = 12.85; 95% CI: 6.01–19.68) and attention (MD = 22.93; 95% CI: 15.44–30.43) quotients. Three studies reported a statistically significant reduction in Child Behavior Checklist (CBCL) scores. One study found a significant change in small-worldness over time (P = .045), indicating altered brain network structure after BCI-based attention training. Conclusion. BCI-based interventions show promise in controlling inattentive, hyperactive-impulsive, behavioral, and learning disability symptoms of ADHD, but further research is needed on a more holistic approach targeting both inattention and learning symptoms simultaneously.

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2025-03-24

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Vol. 12 No. 1 (2025)

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Copyright (c) 2025 Muhammad Zain Raza, Muhammad Omais, Hafiz Muhammad Ehsan Arshad, Musab Maqsood, Ali Ahmad Nadeem

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