Study Finds Limited Evidence for Neurofeedback in ADHD

- The meta-analysis included 38 randomized controlled trials involving 2,472 participants, making it a large and comprehensive review of the existing research. - Neurofeedback is a non-invasive technique that uses real-time displays of brain activity, typically from an electroencephalogram (EEG), to teach individuals how to self-regulate their brain function. The theory for ADHD treatment is that individuals can learn to increase the activity of beta brain waves (associated with focus) and decrease theta waves (associated with inattention). - When researchers analyzed only the studies using the most established, standardized neurofeedback protocols, they found a small but statistically significant improvement in overall ADHD symptoms. However, the analysis found no benefits for newer neurofeedback techniques that use fMRI or fNIRS. - The one area where neurofeedback showed a small but significant positive effect was in processing speed, which is a measure of cognitive performance. It did not, however, show meaningful improvement in other neuropsychological areas like attention, inhibition, or working memory. - The study was conducted on behalf of the European ADHD Guidelines Group (EAGG), a body that helps establish clinical practice recommendations, suggesting the findings will likely influence future treatment guidelines. - Treatment with neurofeedback can be a significant financial commitment, often requiring 20-40 sessions at an average cost of $120-$200 per in-clinic session, and it is frequently not covered by insurance. - The call for "blinded" outcomes is a response to a known weakness in prior research where parent or teacher ratings could be influenced by their knowledge of whether a child was receiving the active treatment or a placebo. This potential for placebo effect is why comparing neurofeedback to a sham or control treatment is considered critical. - Evidence-based treatments with more established track records for ADHD include stimulant medications, non-stimulant medications like atomoxetine, and behavioral therapies such as Cognitive Behavioral Therapy (CBT). Research shows a combination of medication and psychotherapy often yields the most improvement.