Skip to main content
SpringerLink
Log in

The efficacy of Ritalin in ADHD children under neurofeedback training

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Current research has shown that neurofeedback (NF) is a viable treatment for attention deficit hyperactivity disorder (ADHD), however having pharmacological approach alongside such stimulants is still inevitable. Therefore, the purpose of this study is the comparison of neurofeedback with Ritalin and without Ritalin in treating children with ADHD. This study was causal-comparative in design. Participants were children aged 5–10 years with ADHD; seven participants were in neurofeedback group with Ritalin and seven in neurofeedback without Ritalin group according to random split and parent’s conformation. Clinical Q, Conner’s continuous performance test (CPT), and WISC-R were used before and after treatment. For analyzing data, we used descriptive statistical and Mann Whitney U tests. Results showed that even if the two groups were modified in all components, modifications of commission and reaction time of the CPT and F4 theta/alpha of the clinical Q were more accurate in NF with Ritalin treatment rather than the other group. These findings suggest that neurofeedback is efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored non-pharmacological treatment, but Ritalin and neurofeedback combination is more efficient. So, multimodal approach is strongly recommended for ADHD treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ho Y, Gwan L, Song G (2014) Genome-wide pathway analysis in attention-deficit/hyperactivity disorder

  2. Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP et al (2012) Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. Am J Psychiatry [Internet] 169(10):1038–1055 Available from: http://www.ncbi.nlm.nih.gov/pubmed/22983386

    Article  Google Scholar 

  3. Koziol LF, Budding DE, Chidekel D (2013) ADHD as a model of brain-behavior relationships [internet]. Available from: doi: https://doi.org/10.1007/978-1-4614-8382-3

  4. Merwood A, Chen W, Rijsdijk F, Skirrow C, Larsson H, Thapar A, et al. (2014) Genetic associations between the symptoms of attention-deficit/hyperactivity disorder and emotional lability in child and adolescent twins. J Am Acad Child Adolesc Psychiatry 53(2)

  5. McLoughlin G, Palmer JA, Rijsdijk F, Makeig S (2014) Genetic overlap between evoked frontocentral theta-band phase variability, reaction time variability, and attention-deficit/hyperactivity disorder symptoms in a twin study. Biol Psychiatry 75(3):238–247

    Article  PubMed  Google Scholar 

  6. Baumeister S, Wolf I, Holz N, Boecker-Schlier R, Adamo N, Holtmann M, et al. (2016) Neurofeedback training effects on inhibitory brain activation in ADHD: a matter of learning? Neuroscience [internet]. https://doi.org/10.1016/j.neuroscience.2016.09.025

  7. Siqueira CM, Gurge-Giannetti J (2011) Poor school performance: an updated review. Rev da Assoc Médica Bras (English Ed) [Internet] 57(1):78–86 Available from: http://www.sciencedirect.com/science/article/pii/S2255482311700212

    Google Scholar 

  8. Nevels RM, Dehon EE, Alexander K, Gontkovsky ST (2010) Psychopharmacology of aggression in children and adolescents with primary neuropsychiatric disorders: a review of current and potentially promising treatment options. Exp Clin Psychopharmacol 18(2):184–201

    Article  PubMed  Google Scholar 

  9. Catalá-López F, Hutton B, Núñez-Beltrán A, Page MJ, Ridao M, Saint-Gerons DM et al (2017) The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: a systematic review with network meta-analyses of randomised trials. PLoS One 12:1–31

  10. Felthous AR, Stanford MS (2015) A proposed algorithm for the pharmacotherapy of impulsive aggression. J Am Acad Psychiatry Law 43(4):456–467

    PubMed  Google Scholar 

  11. Prado-Lima PA (2009) Pharmacological treatment of impulsivity and aggressive behavior. Rev Bras Psiquiatr [Internet] 31(Suppl 2):S58–S65 Available from: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19967201

    Article  Google Scholar 

  12. Dalsgaard S, Nielsen HS, Simonsen M (2012) Long-term consequences of ADHD medication for children’s human capital development

  13. Lee EJ, Jung CH (2017) Additive effects of neurofeedback on the treatment of ADHD: a randomized controlled study. Asian J Psychiatr [Internet] 25:16–21. https://doi.org/10.1016/j.ajp.2016.09.002

    Article  Google Scholar 

  14. Meijer WM, Faber A, den Ban E, Tobi H (2009) Current issues around the pharmacotherapy of ADHD in children and adults. Pharm World Sci [Internet] 31(5):509–516. Available from. https://doi.org/10.1007/s11096-009-9302-3

    Article  Google Scholar 

  15. Graham J, Banaschewski T, Buitelaar J, Coghill D, Danckaerts M, Dittmann RW et al (2011) European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry 20(1):17–37

    Article  CAS  PubMed  Google Scholar 

  16. Holtmann M, Sonuga-Barke E, Cortese S, Brandeis D (2014) Neurofeedback for ADHD: a review of current evidence. Child Adolesc Psychiatr Clin N Am 23:789–806

    Article  PubMed  Google Scholar 

  17. Hofmann SG, Asnaani A, Vonk IJJ, Sawyer AT, Fang A (2012) The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cogn Ther Res 36:427–440

    Article  Google Scholar 

  18. Delgado-Rodríguez M (2006) Systematic reviews of meta-analyses: applications and limitations. J Epidemiol Community Health 60:90–92

    Article  PubMed  PubMed Central  Google Scholar 

  19. Arns M, Heinrich H, Strehl U (2014) Evaluation of neurofeedback in ADHD: the long and winding road. Biol Psychol [Internet] 95(1):108–115. Available from. https://doi.org/10.1016/j.biopsycho.2013.11.013

    Article  Google Scholar 

  20. Zuberer A, Brandeis D, Drechsler R (2015) Are treatment effects of neurofeedback training in children with ADHD related to the successful regulation of brain activity? A review on the learning of regulation of brain activity and a contribution to the discussion on specificity. Front Hum Neurosci [Internet] 9(March):1–15. Available from. https://doi.org/10.3389/fnhum.2015.00135/abstract

    Article  Google Scholar 

  21. Searight HR, Robertson K, Smith T, Perkins S, Searight BK (2012) Complementary and alternative therapies for pediatric attention deficit hyperactivity disorder: a descriptive review. ISRN Psychiatry [Internet] 2012:1–8 Available from: http://www.hindawi.com/journals/isrn/2012/804127/

    Article  CAS  Google Scholar 

  22. Wechsler D (2004) The Wechsler intelligence scale for children—fourth edition. The Wechsler intelligence scale for children—fourth edition. 153–190

  23. Achenbach TM, Dumenci L, Rescorla LA (2001) Ratings of relations between DSM-IV diagnostic categories and items of the CBCL/6-18, TRF, and YSR. Vermont Res [Internet] 1–9. Available from: http://www.childbehaviorchecklist.com/research/DSM6-18ratings.pdf

  24. Lubar JF, Swartwood MO, Swartwood JN, O’Donnell PH (1995) Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings, and WISC-R performance. Biofeedback Self Regul 20(1):83–99

    Article  CAS  PubMed  Google Scholar 

  25. Jasper HH (1958) Report of the committee on methods of clinical examination in electroencephalography. Electroencephalogr Clin Neurophysiol Suppl [Internet] 10(2):370–375 Available from: http://www.ncbi.nlm.nih.gov/pubmed/10590970

    Article  Google Scholar 

  26. Sterman MB, Wyrwicka W, Howe R (1969) Behavioral and neurophysiological studies of the sensorimotor rhythm in the cat. Electroencephalogr Clin Neurophysiol [Internet] 27(7):678–679 Available from: http://europepmc.org/abstract/MED/4187331

    CAS  Google Scholar 

  27. Epstein JN, Erkanli A, Conners CK, Klaric J, Costello JE, Angold A (2003) Relations between continuous performance test performance measures and ADHD behaviors. J Abnorm Child Psychol 31(5):543–554

    Article  PubMed  Google Scholar 

  28. Frazier PA, Tix AP, Barron KE (2004) Testing moderator and mediator effects in counseling psychology research. J Couns Psychol 51:115–134

    Article  Google Scholar 

  29. Riccio CA, Reynolds CR, Lowe P, Moore JJ (2002) The continuous performance test: a window on the neural substrates for attention? Arch Clin Neuropsychol 17:235–272

    Article  PubMed  Google Scholar 

  30. Losier BJ, McGrath PJ, Klein RM (1996) Error patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: a meta-analytic review. J Child Psychol Psychiatry 37(8):971–987

    Article  CAS  PubMed  Google Scholar 

  31. Swingle PG (2015) Adding neurotherapy to your practice: clinician’s guide to the ClinicalQ, neurofeedback, and braindriving. [Internet]. Adding neurotherapy to your practice: Clinician’s guide to the ClinicalQ, neurofeedback, and braindriving. Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=psyc11&NEWS=N&AN=2015-18569-000

  32. Leard Statistics (2016) Mann Whitney U test using SPSS statistics. Leard Statistics

  33. Rosner B, Grove D (1999) Use of the Mann-Whitney U-test for clustered data. Stat Med 18(11):1387–1400

    Article  CAS  PubMed  Google Scholar 

  34. Nachar N (2008) The Mann-Whitney U: a test for assessing whether two independent samples come from the same distribution. Tutor Quant Methods Psychol [Internet] 4(1):13–20 Available from: http://www.tqmp.org/RegularArticles/vol04-1/p013

    Article  Google Scholar 

  35. McKnight PE, Najab J (2010) Mann-Whitney U test. In: The Corsini encyclopedia of psychology [Internet]. Available from: doi: https://doi.org/10.1002/9780470479216.corpsy0524

  36. van Doren J, Arns M, Heinrich H, Vollebregt MA, Strehl UK, Loo S (2018) Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry [Internet] (123456789):1–13. Available from. https://doi.org/10.1007/s00787-018-1121-4

  37. Arns M, De Ridder S, Strehl U, Breteler M, Coenen A (2009) Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clin EEG Neurosci 40(3):180–189

    Article  PubMed  Google Scholar 

  38. Steiner NJ, Frenette EC, Rene KM, Brennan RT (2015) Neurofeedback and cognitive attention training for children with ADHD in schools [Internet]. ADHD Attention Deficit and Hyperactivity Disorders 7:S16 Available from: http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed17&NEWS=N&AN=72018033

    Google Scholar 

  39. Janssen TWP, Bink M, Geladé K, van Mourik R, Maras A, Oosterlaan J (2016) A randomized controlled trial investigating the effects of neurofeedback, methylphenidate, and physical activity on event-related potentials in children with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol [Internet] 26(4):344–353. Available from. https://doi.org/10.1089/cap.2015.0144

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mehr Brain Clinic, Tehran, Iran

    Fatemeh Pakdaman

  2. Psychology and Center for Interdisciplinary Brain Research, Jyvaskyla University, Jyvaskyla, Finland

    Fatemeh Irani

  3. Clinical Psychology, Shiraz University, Shiraz, Iran

    Fakhri Tajikzadeh

  4. Department of Clinical Psychology, Tehran University of Medical Sciences, Tehran, Iran

    Samaneh Amani Jabalkandi

Authors
  1. Fatemeh Pakdaman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fatemeh Irani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fakhri Tajikzadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Samaneh Amani Jabalkandi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fatemeh Irani.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pakdaman, F., Irani, F., Tajikzadeh, F. et al. The efficacy of Ritalin in ADHD children under neurofeedback training. Neurol Sci 39, 2071–2078 (2018). https://doi.org/10.1007/s10072-018-3539-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10072-018-3539-3

Keywords

Search

Navigation