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Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD

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Summary

Neurofeedback (NF) is a training to enhance self-regulatory capacity over brain activity patterns and consequently over brain mental states. Recent findings suggest that NF is a promising alternative for the treatment of attention-deficit/hyperactivity disorder (ADHD). We comprehensively reviewed literature searching for studies on the effectiveness and specificity of NF for the treatment of ADHD. In addition, clinically informative evidence-based data are discussed. We found 3 systematic review on the use of NF for ADHD and 6 randomized controlled trials that have not been included in these reviews. Most nonrandomized controlled trials found positive results with medium-to-large effect sizes, but the evidence for effectiveness are less robust when only randomized controlled studies are considered. The direct comparison of NF and sham-NF in 3 published studies have found no group differences, nevertheless methodological caveats, such as the quality of the training protocol used, sample size, and sample selection may have contributed to the negative results. Further data on specificity comes from electrophysiological studies reporting that NF effectively changes brain activity patterns. No safety issues have emerged from clinical trials and NF seems to be well tolerated and accepted. Follow-up studies support long-term effects of NF. Currently there is no available data to guide clinicians on the predictors of response to NF and on optimal treatment protocol. In conclusion, NF is a valid option for the treatment for ADHD, but further evidence is required to guide its use.

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Acknowledgments

This review is part of the formative phase for a research project financed by the Brazilian National Counsel of Technological and Scientific Development (process no. 483934/2010-0). Dr. Tais S. Moriyama receives financial support from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil. Authors declare no real or perceived conflict of interest, full conflict of interest disclosure is available in the electronic supplementary material for this article.

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Authors and Affiliations

  1. National Institute of Developmental Psychiatry for Children and Adolescents, (INCT-CNPq), São Paulo, Brazil

    Tais S. Moriyama, Guilherme Polanczyk & Luis A. Rohde

  2. Early Intervention Program, Division of Child and Adolescent Psychiatry, Institute of Psychiatry, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil

    Tais S. Moriyama & Guilherme Polanczyk

  3. Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil

    Guilherme Polanczyk

  4. Child Psychiatric Division, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Brazil

    Arthur Caye

  5. Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany

    Tobias Banaschewski & Daniel Brandeis

  6. Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland

    Daniel Brandeis

  7. Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland

    Daniel Brandeis

  8. Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, Rio Grande do Sul, Brazil

    Luis A. Rohde

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  1. Tais S. Moriyama
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  2. Guilherme Polanczyk
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  3. Arthur Caye
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  4. Tobias Banaschewski
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  5. Daniel Brandeis
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  6. Luis A. Rohde
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Correspondence to Luis A. Rohde.

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Moriyama, T.S., Polanczyk, G., Caye, A. et al. Evidence-Based Information on the Clinical Use of Neurofeedback for ADHD. Neurotherapeutics 9, 588–598 (2012). https://doi.org/10.1007/s13311-012-0136-7

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