Personalized at-home neurofeedback compared to long-acting methylphenidate in children with ADHD: NEWROFEED, a
Diane Purper-Ouakil1,2, Hilario Blasco-Fontecilla3, Tomas Ros4
1Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, University of Montpellier, Montpellier, France.
Insights
At-home neurofeedback (NF) did not prove non-inferior to methylphenidate for treating ADHD in children. While both interventions improved symptoms, methylphenidate showed superior efficacy in this trial.
Area of Science:
- Neuroscience
- Pediatrics
- Psychiatry
Background:
- Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
- Neurofeedback (NF) is explored as a potential non-pharmacological treatment for ADHD.
- The NEWROFEED trial investigated personalized at-home NF versus methylphenidate in children with ADHD.
Purpose of the Study:
- To demonstrate the non-inferiority of personalized at-home neurofeedback (NF) training compared to methylphenidate.
- To evaluate the efficacy of NF as a treatment for ADHD in children aged 7-13 years.
- To compare the effectiveness of at-home NF with a standard pharmacological intervention.
Main Methods:
- A prospective, multicentre, randomized controlled trial (RCT) comparing NF to methylphenidate.
- Participants (7-13 years) received either at-home NF (down-training theta/beta ratio or enhancing SMR) or titrated long-acting methylphenidate.
- The primary outcome was the change in the Clinician ADHD Rating Scale (ADHD-RS-IV) total score.
Main Results:
- The study failed to demonstrate non-inferiority of NF compared to methylphenidate (mean difference 8.09).
- Both groups showed significant pre-post improvements in ADHD symptoms.
- Methylphenidate demonstrated a greater reduction in ADHD-RS-IV scores (46.9%) than NF (26.7%).
Conclusions:
- Personalized at-home NF was found to be inferior to methylphenidate as a standalone ADHD treatment.
- While NF showed some benefits, methylphenidate yielded more substantial improvements in ADHD symptoms.
- Further research may explore combined or alternative NF protocols.
Background:
Neurofeedback is considered a promising intervention for the treatment of attention-deficit hyperactivity disorder (ADHD). NEWROFEED is a prospective, multicentre, randomized (3:2), reference drug-controlled trial in children with ADHD aged between 7 and 13 years. The main objective of NEWROFEED was to demonstrate the noninferiority of personalized at-home neurofeedback (NF) training versus methylphenidate in the treatment of children with ADHD.
Methods:
The NF group (n = 111) underwent eight visits and two treatment phases of 16 to 20 at-home sessions with down-training of the theta/beta ratio (TBR) for children with high TBR and enhancing the sensorimotor rhythm (SMR) for the others. The control group (n = 67) received optimally titrated long-acting methylphenidate. The primary endpoint was the change between baseline and endpoint in the Clinician ADHD-RS-IV total score in the per-protocol population (90 NF/59 controls).
Trial Registration:
US National Institute of Health, ClinicalTrials.gov #NCT02778360.
Results:
Our study failed to demonstrate noninferiority of NF versus methylphenidate (mean between-group difference 8.09 90% CI [8.09; 10.56]). However, both treatment groups showed significant pre-post improvements in core ADHD symptoms and in a broader range of problems. Reduction in the Clinician ADHD-RS-IV total score between baseline and final visit (D90) was 26.7% (SMD = 0.89) in the NF and 46.9% (SMD = 2.03) in the control group. NF effects increased whereas those of methylphenidate were stable between intermediate and final visit.
Conclusions:
Based on clinicians' reports, the effects of at-home NF were inferior to those of methylphenidate as a stand-alone treatment.
More Related Videos
13:09Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol
Published on: April 1, 2018
05:48The Adventures of Fundi Intervention Based on the Cognitive and Emotional Processing in Attention Deficit Hyperactive Disorder Patients
Published on: June 12, 2020
