Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials
Objective: We performed meta-analyses of randomized controlled trials to examine the effects of neurofeedback on attention-deficit/hyperactivity disorder (ADHD) symptoms and neuropsychological deficits in children and adolescents with ADHD. Method: We searched PubMed, Ovid, Web of Science, ERIC...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Published: |
Elsevier
2016
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| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/39737/ |
| _version_ | 1848795901818044416 |
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| author | Cortese, Samuel Ferrin, Maite Brandeis, Daniel Holtmann, Martin Aggensteiner, Pascal Daley, David Santosh, Paramala Simonoff, Emily Stevenson, Jim Stringaris, Argyris Sonuga-Barke, Edmund J.S. |
| author_facet | Cortese, Samuel Ferrin, Maite Brandeis, Daniel Holtmann, Martin Aggensteiner, Pascal Daley, David Santosh, Paramala Simonoff, Emily Stevenson, Jim Stringaris, Argyris Sonuga-Barke, Edmund J.S. |
| author_sort | Cortese, Samuel |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objective:
We performed meta-analyses of randomized controlled trials to examine the effects of neurofeedback on attention-deficit/hyperactivity disorder (ADHD) symptoms and neuropsychological deficits in children and adolescents with ADHD.
Method:
We searched PubMed, Ovid, Web of Science, ERIC, and CINAHAL through August 30, 2015. Random-effects models were employed. Studies were evaluated with the Cochrane Risk of Bias tool.
Results:
We included 13 trials (520 participants with ADHD). Significant effects were found on ADHD symptoms rated by assessors most proximal to the treatment setting, that is, the least blinded outcome measure (standardized mean difference [SMD]: ADHD total symptoms = 0.35, 95% CI = 0.11−0.59; inattention = 0.36, 95% CI = 0.09−0.63; hyperactivity/impulsivity = 0.26, 95% CI = 0.08−0.43). Effects were not significant when probably blinded ratings were the outcome or in trials with active/sham controls. Results were similar when only frequency band training trials, the most common neurofeedback approach, were analyzed separately. Effects on laboratory measures of inhibition (SMD = 0.30, 95% CI = −0.10 to 0.70) and attention (SMD = 0.13, 95% CI = −0.09 to 0.36) were not significant. Only 4 studies directly assessed whether learning occurred after neurofeedback training. The risk of bias was unclear for many Cochrane Risk of Bias domains in most studies.
Conclusion:
Evidence from well-controlled trials with probably blinded outcomes currently fails to support neurofeedback as an effective treatment for ADHD. Future efforts should focus on implementing standard neurofeedback protocols, ensuring learning, and optimizing clinically relevant transfer. |
| first_indexed | 2025-11-14T19:39:27Z |
| format | Article |
| id | nottingham-39737 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:39:27Z |
| publishDate | 2016 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-397372020-05-04T17:38:39Z https://eprints.nottingham.ac.uk/39737/ Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials Cortese, Samuel Ferrin, Maite Brandeis, Daniel Holtmann, Martin Aggensteiner, Pascal Daley, David Santosh, Paramala Simonoff, Emily Stevenson, Jim Stringaris, Argyris Sonuga-Barke, Edmund J.S. Objective: We performed meta-analyses of randomized controlled trials to examine the effects of neurofeedback on attention-deficit/hyperactivity disorder (ADHD) symptoms and neuropsychological deficits in children and adolescents with ADHD. Method: We searched PubMed, Ovid, Web of Science, ERIC, and CINAHAL through August 30, 2015. Random-effects models were employed. Studies were evaluated with the Cochrane Risk of Bias tool. Results: We included 13 trials (520 participants with ADHD). Significant effects were found on ADHD symptoms rated by assessors most proximal to the treatment setting, that is, the least blinded outcome measure (standardized mean difference [SMD]: ADHD total symptoms = 0.35, 95% CI = 0.11−0.59; inattention = 0.36, 95% CI = 0.09−0.63; hyperactivity/impulsivity = 0.26, 95% CI = 0.08−0.43). Effects were not significant when probably blinded ratings were the outcome or in trials with active/sham controls. Results were similar when only frequency band training trials, the most common neurofeedback approach, were analyzed separately. Effects on laboratory measures of inhibition (SMD = 0.30, 95% CI = −0.10 to 0.70) and attention (SMD = 0.13, 95% CI = −0.09 to 0.36) were not significant. Only 4 studies directly assessed whether learning occurred after neurofeedback training. The risk of bias was unclear for many Cochrane Risk of Bias domains in most studies. Conclusion: Evidence from well-controlled trials with probably blinded outcomes currently fails to support neurofeedback as an effective treatment for ADHD. Future efforts should focus on implementing standard neurofeedback protocols, ensuring learning, and optimizing clinically relevant transfer. Elsevier 2016-04-01 Article PeerReviewed Cortese, Samuel, Ferrin, Maite, Brandeis, Daniel, Holtmann, Martin, Aggensteiner, Pascal, Daley, David, Santosh, Paramala, Simonoff, Emily, Stevenson, Jim, Stringaris, Argyris and Sonuga-Barke, Edmund J.S. (2016) Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 55 (6). pp. 444-455. ISSN 0890-8567 ADHD neurofeedback nonpharmacological treatment meta-analysis risk of bias http://www.sciencedirect.com/science/article/pii/S0890856716300958 doi:10.1016/j.jaac.2016.03.007 doi:10.1016/j.jaac.2016.03.007 |
| spellingShingle | ADHD neurofeedback nonpharmacological treatment meta-analysis risk of bias Cortese, Samuel Ferrin, Maite Brandeis, Daniel Holtmann, Martin Aggensteiner, Pascal Daley, David Santosh, Paramala Simonoff, Emily Stevenson, Jim Stringaris, Argyris Sonuga-Barke, Edmund J.S. Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| title | Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| title_full | Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| title_fullStr | Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| title_full_unstemmed | Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| title_short | Neurofeedback for attention-deficit/hyperactivity disorder: meta-Analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| title_sort | neurofeedback for attention-deficit/hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials |
| topic | ADHD neurofeedback nonpharmacological treatment meta-analysis risk of bias |
| url | https://eprints.nottingham.ac.uk/39737/ https://eprints.nottingham.ac.uk/39737/ https://eprints.nottingham.ac.uk/39737/ |