EEG neurofeedback for ADHD: double-blind sham-controlled randomized pilot feasibility trial

Area of Science:

• Neuroscience
• Clinical Psychology
• Pediatrics

Background:

• Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder.
• Neurofeedback (NF) is a potential non-pharmacological treatment for ADHD.
• A definitive randomized clinical trial (RCT) is needed to establish NF's efficacy.

Purpose of the Study:

• To assess the feasibility of a double-blind, sham-controlled design for an ADHD neurofeedback trial.
• To evaluate treatment adherence, palatability, and relative effects of two versus three weekly NF sessions.
• To inform the design of a larger, definitive RCT.

Main Methods:

• Pilot randomized controlled trial with a double-blind, sham-controlled design.
• Participants: 39 unmedicated children aged 6-12 with DSM-IV ADHD.
• Randomization to active NF vs. sham-NF and 2x/week vs. 3x/week frequency; frequency switch allowed.
• Outcome measures included feasibility, adherence, palatability, and pre-post symptom ratings.

Main Results:

• High recruitment (39 participants) and retention (87% completion of 40 treatments) were achieved.
• Participant and parent guessing of treatment allocation was no better than chance, indicating successful blinding.
• Both active NF and sham treatments showed significant pre-post improvement, with no significant difference between them.
• A higher frequency of 3x/week was preferred (62%) over 2x/week (38%) and was equally effective.

Conclusions:

• A double-blind, sham-controlled RCT for ADHD neurofeedback is feasible.
• Sham neurofeedback does not impede recruitment or retention.
• A treatment frequency of 3x/week is preferred and as effective as 2x/week.
• Further research with a large-scale RCT is necessary to determine the specific effectiveness of neurofeedback for ADHD.