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February 9, 2024

Neurofeedback For ADHD - Is it Effective?

A growing number of parents of children with attention deficit hyperactivity disorder ADHD are seeking alternatives to medication. Many of them turn to neurofeedback, a practice that claims to teach brain waves to improve focus. But the treatment is expensive, time consuming and still scientifically unproven.

A 2013 study compared the effects of neurofeedback to those of stimulant drugs, a commonly used ADHD medication. The results suggested that neurofeedback produced a similar reduction in symptoms.

But the studies have been small, and they did not use double-blind designs. As a result, it's not clear whether the benefits actually reflect changes in a person's brain, or simply a placebo effect.

More research is needed to establish the efficacy of neurofeedback, but some experts are optimistic. In one recent study, researchers analyzed data from four multi-centre RCTs using standard neurofeedback protocols. The results showed that remission rates for neurofeedback were comparable to those of medications and similar to those of other psychological treatments, including psychoeducational therapy and cognitive behaviour therapy.

During a neurofeedback session, people wear a cap with 19 sensors on their head, like a swimmer's cap. These sensors record the electrical activity of the brain, which is then transmitted to a laptop that displays a visual representation of the brain's activity on a screen. The person tries to make their brain wave patterns match the pattern on the screen. The goal is to increase the speed of fast brain waves and decrease the amplitude of slow brain waves, which are associated with anxiety and depression.

As the results are shown on the screen, the practitioner uses a device that emits sounds to stimulate certain areas of the brain, which helps encourage the desired change in the EEG pattern. The goal is to teach the brain to regulate itself without the need for medication or other therapies.

Some researchers also believe that neurofeedback might improve attention by helping to normalize the cortical activity profile, which is characterized by slower waves than those found in healthy adults. The slow waves might be a contributing factor to the difficulties with attention and impulsivity in individuals with ADHD.

Some of the RCTs examining Neurofeedback for ADHD reported relatively large pre-post effect sizes and demonstrated remission rates that were comparable to those of medication and other psychological interventions. However, a number of studies did not report these outcomes, and the results of several other RCTs were mixed or negative. In addition, open label data from the iSPOT-A study Tolin et al., 2018 showed that the benefits of neurofeedback were not sustained over long-term follow-up. Consequently, further research is needed to establish the efficacy and safety of neurofeedback in ADHD treatment.

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