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A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD

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Abstract

To assess the long-term effects of neurofeedback (NFB) in children with attention deficit hyperactivity disorder (ADHD), we compared behavioral and neurocognitive outcomes at a 6-month naturalistic follow-up of a randomized controlled trial on NFB, methylphenidate (MPH), and physical activity (PA). Ninety-two children with a DSM-IV-TR ADHD diagnosis, aged 7–13, receiving NFB (n = 33), MPH (n = 28), or PA (n = 31), were re-assessed 6-months after the interventions. NFB comprised theta/beta training on the vertex (cortical zero). PA comprised moderate to vigorous intensity exercises. Outcome measures included parent and teacher behavioral reports, and neurocognitive measures (auditory oddball, stop-signal, and visual spatial working memory tasks). At follow-up, longitudinal hierarchical multilevel model analyses revealed no significant group differences for parent reports and neurocognitive measures (p = .058–.997), except for improved inhibition in MPH compared to NFB (p = .040) and faster response speed in NFB compared to PA (p = .012) during the stop-signal task. These effects, however, disappeared after controlling for medication use at follow-up. Interestingly, teacher reports showed less inattention and hyperactivity/impulsivity at follow-up for NFB than PA (p = .004–.010), even after controlling for medication use (p = .013–.036). Our findings indicate that the superior results previously found for parent reports and neurocognitive outcome measures obtained with MPH compared to NFB and PA post intervention became smaller or non-significant at follow-up. Teacher reports suggested superior effects of NFB over PA; however, some children had different teachers at follow-up. Therefore, this finding should be interpreted with caution.

Clinical trial registration Train your brain and exercise your heart? Advancing the treatment for Attention Deficit Hyperactivity Disorder (ADHD), Ref. no. NCT01363544, https://clinicaltrials.gov/show/NCT01363544.

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Acknowledgements

We wish to thank all participating children and their families for their contribution, as well as all research interns for their valuable support. Furthermore, we would like to thank the participating centers of child and adolescent psychiatry: Yulius Academie, Groene Hart ziekenhuis, Lucertis, Alles Kits, GGZ Delfland, Maasstad ziekenhuis, RIAGG Schiedam, Kinderpraktijk Zoetermeer, Albert Schweitzer ziekenhuis, Groos Mentaal Beter Jong, ADHD behandelcentrum, GGZ inGeest, and PuntP.

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Authors and Affiliations

  1. Clinical Neuropsychology section, Vrije Universiteit Amsterdam, Van der Boechorstraat 1, 1081 BT, Amsterdam, The Netherlands

    Katleen Geladé, Tieme W. P. Janssen, Marleen Bink, Rosa van Mourik & Jaap Oosterlaan

  2. Department of Epidemiology and Biostatistics, VUmc, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands

    Jos W. R. Twisk

  3. Department of Research and Monitoring, Mental Health Care Organisation Noord-Holland-Noord, Stationsplein 138, 1703 WC, Heerhugowaard, The Netherlands

    Rosa van Mourik

  4. Yulius Academy, Yulius Mental Health Organization, Dennenhout 1, 2994 GC, Barendrecht, The Netherlands

    Athanasios Maras

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  1. Katleen Geladé
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Correspondence to Katleen Geladé.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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This trial was funded by the Netherlands Organization for Health Research and Development (ZonMw): 157 003 012. ZonMw funded the trial, but had no role in the data analysis, manuscript preparation or decision to publish.

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Geladé, K., Janssen, T.W.P., Bink, M. et al. A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD. Eur Child Adolesc Psychiatry 27, 581–593 (2018). https://doi.org/10.1007/s00787-017-1072-1

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