Neurofeedback as a treatment for ADHD: A methodological review with implications for future research

Journal of Neurotherapy

Volumn 8, Issue 2, 2004, Pages 53-82

  Vernon, David ^a   Frick, Ann ^b   Gruzelier, John ^b  

^a CANTERBURY CHRIST CHURCH UNIVERSITY   (United Kingdom)

^b CHARING CROSS HOSPITAL   (United Kingdom)

Author keywords

ADHD; EEG; Methodology; Neurofeedback; Quantitative EEG

Indexed keywords

CENTRAL STIMULANT AGENT; DEXAMPHETAMINE; METHYLPHENIDATE; PLACEBO;

AGITATION; ANXIETY; ATTENTION DEFICIT DISORDER; BEHAVIOR THERAPY; BETA RHYTHM; CLINICAL PROTOCOL; CLINICAL TRIAL; COGNITION; DIAGNOSTIC PROCEDURE; DIAGNOSTIC VALUE; DRUG EFFICACY; DYSLEXIA; EEG ABNORMALITY; ELECTROENCEPHALOGRAM; FEEDBACK SYSTEM; FOLLOW UP; HUMAN; INSTRUMENTAL CONDITIONING; MENTAL PERFORMANCE; PREVALENCE; PRIORITY JOURNAL; QUANTITATIVE ANALYSIS; REVIEW; SEIZURE; SENSORIMOTOR FUNCTION; SLEEP DISORDER; THETA RHYTHM;

EID: 7244226394     PISSN: 10874208     EISSN: None     Source Type: Journal    
DOI: 10.1300/J184v08n02_04     Document Type: Review

References (102)

1. Achenbach, T. M. (1999). The child behavior checklist and related instruments. In M. E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment (2 ed., pp. 429-466). Mahwah, New Jersey: Lawrence Erlbaum Associates.
2. Alhambra, M. A.. Fowler, T. P., & Alhambra, A. A. (1995). EEG biofeedback: A new treatment option for ADD/ADHD. Journal of Neurotherapy, 1 (2), 39-43.
3. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
4. Ayers, M. A. (2001). Have you seen any negative effects associated with EEG neurofeedback? Journal of Neurotherapy, 4 (4), 63-65.
5. Barkley, R. A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press.
6. Barry, R. J., Clarke, A. R., & Johnstone, S. J. (2003). A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. Clinical Neurophysiology, 114 (2), 171-183.
7. Baydala, L., & Wikman, E. (2001). The efficacy of neurofeedback in the management of children with attention deficit/hyperactivity disorder. Paediatric Child Health, 6 (7), 451-455.
8. Bellak, L., & Black, R. B. (1992). Attention-deficit hyperactivity disorder in adults. Clinical Therapy, 14 (2), 138-147.
9. Benninger, C., Matthis, P., & Scheffner, D. (1984). EEG development of healthy boys and girls. Results of a longitudinal study. Electroencephalography and Clinical Neurophysiology, 57 (1), 1-12.
10. Boyd, W. D., & Campbell, S. E. (1998). EEG biofeedback in schools: The use of EEG biofeedback to treat ADHD in a school setting. Journal of Neurotherapy, 2 (4), 65-71.
11. Capute, A. J., Niedermeyer, E. F., & Richardson, F. (1968). The electroencephalogram in children with minimal cerebral dysfunction. Pediatrics, 41 (6), 1104-1114.
12. Carmody, D. P., Radvanski, D. C., Wadhwani, S., Sabo, M. J., & Vergara, L. (2001). EEG biofeedback training and attention-deficit/hyperactivity disorder in elementary school setting. Journal of Neurotherapy, 4 (3), 5-27.
13. Chabot, R. J., di Michele, F., Prichep, L., & John, E. R. (2001). The clinical role of computerized EEG in the evaluation and treatment of learning and attention disorders in children and adolescents. Journal of Neuropsychiatry and Clinical Neuroscience, 13 (2), 171-186.
14. Chabot, R. J., Merkin, H., Wood, L. M., Davenport, T. L., & Serfontein, G. (1996). Sensitivity and specificity of QEEG in children with attention deficit or specific developmental learning disorders. Clinical Electroencephalography, 27 (1), 26-34.
15. Chabot, R. J., Orgill, A. A., Crawford, G., Harris, M. J., & Serfontein, G. (1999). Behavioral and electrophysiologic predictors of treatment response to stimulants in children with attention disorders. Journal of Child Neurology, 14 (6), 343-351.
16. Chabot, R. J., & Serfontein, G. (1996). Quantitative electroencephalographic profiles of children with attention deficit disorder. Biological Psychiatry, 40, 951-963.
17. Chartier, D. (2001). An adverse neurofeedback reaction, or, there is no such thing as a neurofeedback demo. Journal of Neurotherapy, 5 (3), 68.
18. Clarke, A. R., Barry, R. J., McCarthy, R., & Selikowitz, M. (1998). EEG analysis in Attention-Deficit/Hyperactivity Disorder: A comparative study of two subtypes. Psychiatry Research, 81 (1), 19-29.
19. Clarke, A. R., Barry, R. J., McCarthy, R., & Selikowitz, M. (2001a). Age and sex effects in the EEG: Differences in two subtypes of attention-deficit/hyperactivity disorder. Clinical Neurophysiology, 112 (5), 815-826.
20. Clarke, A. R., Barry, R. J., McCarthy, R., & Selikowitz, M. (2001b). Electroencephalogram differences in two subtypes of attention-deficit/hyperactivity disorder. Psychophysiology, 38 (2 , 212-221.
21. Clarke, A. R., Barry, R. J., McCarthy, R., Selikowitz, M., & Brown, C. R. (2002). EEG evidence for a new conceptualisation of attention deficit hyperactivity disorder. Clinical Neurophysiology, 113 (7), 1036-1044.
22. Clarke, A. R., Barry, R. J., McCarthy, R., Selikowitz, M., Brown, C. R., & Croft, R. J. (2003). Effects of stimulant medications on the EEG of children with attention-deficit/hyperactivity disorder predominantly inattentive type. International Journal of Psychophysiology, 47 (2), 129-137.
23. Cohen, H. D., Graham, C., Fotopoulos, S. S., & Cook, M. R. (1977). A double-blind methodology for biofeedback research. Psychophysiology, 14 (6), 603-608.
24. Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998a). The revised Conners' parent rating scale (CPRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26 (4), 257-268.
25. Conners, C. K., Sitarenios, G., Parker, J. D., & Epstein, J. N. (1998b). Revision and restandardization of the Conners' teacher rating scale (CTRS-R): Factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26 (4), 279-291.
26. Cook, I. A., O'Hara, R., Uijtdehaage, S. H., Mandelkern, M., & Leuchter, A. F. (1998). Assessing the accuracy of topographic EEG mapping for determining local brain function. Electroencephalography and Clinical Neurophysiology, 107 (6), 408-414.
27. Cox, D. J., Kovatchev, B. P., Morris, J. B., Phillips, C., Hill, R. J., & Merkel, L. (1998). Electroencephalographic and psychometric differences between boys with and without attention-deficit/hyperactivity disorder (ADHD): A pilot study. Applied Psychophysiology and Biofeedback, 23 (3), 179-188.
28. Diamond, J. M. (1997). ADHD and EEG. Journal of the American Academy of Child and Adolescent Psychiatry, 36 (5), 575-577.
29. Egner, T., & Gruzelier, J. H. (2001). Learned self-regulation of EEG frequency components affects attention and event-related brain potentials in humans. Neuroreport, 12 (18), 4155-4159.
30. Farone, S. V., & Beiderman, J. (1998). Neurobiology of attention-deficit hyperactivity disorder. Biological Psychiatry, 44, 951-958.
31. Fuchs, T., Birbaumer, N., Lutzenberger, W., Gruzelier, J. H., & Kaiser, J. (2003). Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: A comparison with methylphenidate. Applied Psychophysiology and Biofeedback, 28 (1), 1-12.
32. Gasser, T., Verleger, R., Bacher, P., & Sroka, L. (1988). Development of the EEG of school-age children and adolescents. I. Analysis of band power. Electroencephalography and Clinical Neurophysiology, 69, 91-99.
33. Giray, M., & Ulrich, R. (1993). Motor coactivation revealed by response force in divided and focused attention. Journal of Experimental Psychology, Human Perception and Performance, 19 (6), 1278-1291.
34. Gomez, C. M., Vazquez, M., Vaquero, E., Lopez-Mendoza, D., & Cardoso, M. J. (1998). Frequency analysis of the EEG during spatial selective attention. International Journal of Neuroscience, 95 (1-2), 17-32.
35. Goodman, R. (1997). The strengths and difficulties questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38 (5), 581-586.
36. Greenberg, L. (1987). An objective measure of methylphenidate response: Clinical use of the MCA. Psychopharmacology Bulletin, 23 (2), 279-282.
37. Gruzelier, J., Hardman, E., Wild, J., & Zaman, R. (1999). Learned control of slow potential interhemispheric asymmetry in schizophrenia. International Journal of Psychophysiology, 34 (3), 341-348.
38. Guyatt, G. H., Sackett, D. L., & Cook, D. J. (1993). Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group. Journal of the American Medical Association, 270 (21), 2598-2601.
39. Hammond, D. C. (2001a). Adverse reactions and potential iatrogenic effects in neurofeedback training. Journal of Neurotherapy, 4 (4), 57-62.
40. Hammond, D. C. (2001b). Comprehensive neurofeedback bibliography. Journal of Neurotherapy, 5, 113-128.
41. Heilman, K. M., Voeller, K. K., & Nadeau, S. E. (1991). A possible pathophysiologic substrate of attention deficit hyperactivity disorder. Journal of Child Neurology, 6 Supplement, S76-81.
42. Hoza, B., & Pelham, W. E. (1993). Attention-deficit hyperactivity disorder. In R. T. Ammerman, C. G. Last & J. Hersen (Eds.), Handbook of prescriptive treatments for children and adolescents (pp. 64-84). Boston: Allyn and Bacon.
43. Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSM-V. Journal of the American Academy of Child and Adolescent Psychiatry, 36 (8), 1065-1079.
44. John, E. R., Ahn, H., Prichep, L., Trepetin, M., Brown, D., & Kaye, H. (1980). Developmental equations for the electroencephalogram. Science, 210 (4475), 1255-1258.
45. Kaiser, D. A. (2001). Rethinking standard bands. Journal of Neurotherapy, 5 (1/2), 87-96.
46. Katznelson, R. D. (1981). Normal modes of the brain: Neuroanatomical basis and a physiological theoretical model. In P. L. Nunez (Ed.), Electric fields of the brain: The neurophysics of EEG (pp. 401-442). New York: Oxford University Press.
47. Klimesch, W. (1999). EEG alpha and theta oscillations reflect cognitive and memory performance: A review and analysis. Brain Research Reviews, 29 (2-3), 169-195.
48. Klimesch, W., Doppelmayr, M., Pachinger, T., & Russegger, H. (1997). Event-related desynchronization in the alpha band and the processing of semantic information. Cognitive Brain Research, 6 (2), 83-94.
49. Klimesch, W., Doppelmayr, M., Russegger, H., Pachinger, T., & Schwaiger, J. (1998). Induced alpha band power changes in the human EEG and attention. Neuroscience Letters, 244 (2), 73-76.
50. Klimesch, W., Schimke, H., & Pfurtscheller, G. (1993). Alpha frequency, cognitive load and memory performance. Brain Topography, 5 (3), 241-251.
51. Klimesch, W., Schimke, H., & Schwaiger, J. (1994). Episodic and semantic memory: An analysis in the EEG theta and alpha band. Electroencephalography and Clinical Neurophysiology, 91 (6), 428-441.
52. Kristeva-Feige, R., Fritsch, C., Timmer, J., & Lucking, C. H. (2002). Effects of attention and precision of exerted force on beta range EEG-EMG synchronization during a maintained motor contraction task. Clinical Neurophysiology, 113 (1), 124-131.
53. Kuperman, S., Johnson, B., Arndt, S., Lindgren, S., & Wolraich, M. (1996). Quantitative EEG differences in a non-clinical sample of children with ADHD and undifferentiated ADD. Journal of the American Academy of Child and Adolescent Psychiatry, 35 (8), 1009-1017.
54. La Vaque, T. J., & Rossiter, T. (2001). The ethical use of placebo controls in clinical research: The Declaration of Helsinki. Applied Psychophysiology and Biofeedback, 26 (1), 23-37; discussion 61-65.
55. Lal, S. K., Henderson, R. J., Carter, N., Bath, A., Hart, M. G., Langeluddecke, P., et al. (1998). Effect of feedback signal and psychological characteristics on blood pressure self-manipulation capability. Psychophysiology, 35 (4), 405-412.
56. Linden, M., Habib, T., & Radojevic, V. (1996). A controlled study of the effects of EEG biofeedback on cognition and behaviour of children with ADD and LD. Biofeedback and Self Regulation, 21 (1), 35-49.
57. Lubar, J. F. (1995). Neurofeedback for the management of attention-deficit/hyperactivity disorders. In M. S. Schwartz (Ed.), Biofeedback: A practitioner's guide (pp. 493-522). New York: Guilford Press.
58. Lubar, J. F. (2001). Rationale for choosing bipolar versus referential training. Journal of Neurotherapy, 4 (3), 94-97.
59. Lubar, J. F., & Lubar, J. O. (1999). Neurofeedback assessment and treatment for attention deficit/hyperactivity disorders. In J. R. Evans & A. Abarbanel (Eds.), Introduction to quantitative EEG and neurofeedback (pp. 103-143). San Diego: Academic Press.
60. Lubar, J. F., & Shouse, M. N. (1976). EEG and behavioral changes in a hyperkinetic child concurrent with training of the sensorimotor rhythm (SMR): A preliminary report. Biofeedback and Self Regulation, 1 (3), 293-306.
61. Lubar, J. F., Swartwood, M. O., Swartwood, J. N., & O'Donnell, P. H. (1995). Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in TOVA scores, behavioural ratings, and WISC-R performance. Biofeedback and Self Regulation, 20 (1), 83-99.
62. Lubar, J. F., Swartwood, M. O., Swartwood, J. N., & Timmerman, D. L. (1995). Quantitative EEG and auditory event related potentials in the evaluation of attention deficit/hyperactivity disorder: Effects of methylphenidate and implications for neurofeedback training. Journal of Psychoeducational Assessment, (Monograph Series, Special ADHD issue), 143-160.
63. Lubar, J. O., & Lubar, J. F. (1984). Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting. Biofeedback and Self Regulation, 9 (1), 1-23.
64. Mann, C. A., Lubar, J. F., Zimmerman, A. W., Miller, C. A., & Muenchen, R. A. (1992). Quantitative analysis of EEG in boys with attention-deficit-hyperactivity disorder: Controlled study with clinical implications. Pediatric Neurology, 8 (1), 30-36.
65. McCarney, S. B. (1995). Attention deficit disorders evaluation scale. Columbia, MO: Hawthorne Press.
66. McGee, R., Williams, S., & Feehan, M. (1992). Attention deficit disorder and age of onset of problem behaviors. Journal of Abnormal Psychology, 20 (5), 487-502.
67. Monastra, V. J., Lubar, J. F., & Linden, M. (2001). The development of a quantitative electroencephalographic scanning process for attention deficit-hyperactivity disorder: Reliability and validity studies. Neuropsychology, 15 (1), 136-144.
68. Monastra, V. J., Lubar, J. F., Linden, M., VanDeusen, P., Green, G., Wing, W., et al. (1999). Assessing attention deficit hyperactivity disorder via quantitative electroencephalography: An initial validation study. Neuropsychology, 13 (3), 424-433.
69. Monastra, V. J., Monastra, D. M., & George, S. (2002). The effects of stimulant therapy, EEG biofeedback and parenting style on the primary symptoms of attention deficit/hyperactivity disorder. Applied Psychophysiology and Biofeedback, 27 (4), 231-249.
70. Murphy, K. R., Barkley, R. A., & Bush, T. (2002). Young adults with attention deficit hyperactivity disorder: Subtype differences in comorbidity, educational and clinical history. The Journal of Nervous and Mental Disease, 190 (3), 147-157.
71. Nash, J. K. (2000). Treatment of attention deficit hyperactivity disorder with neurotherapy. Clinical Electroencephalography, 31 (1), 30-37.
72. Nash, J. K. (2001). Have you seen any negative effects associated with EEG neurofeedback? Journal of Neurotherapy, 4 (4), 65-69.
73. Nunez, P. L. (1981). Electric fields of the brain: The neurophysics of EEG. New York: Oxford University Press.
74. Pary, R., Lewis, S., Arnp, C. S., Matuschka, P. R., & Lippmann, S. (2002). Attention-deficit/hyperactivity disorder: An update. Southern Medical Journal, 95 (7), 743-749.
75. Pliszka, S. R. (1998). Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: An overview. Journal of Clinical Psychiatry, 59 Suppl 7, 50-58.
76. Pollard, G., & Ashton, R. (1982). Heart rate decrease: A comparison of feedback modalities and biofeedback with other procedures. Biological Psychiatry, 14 (3-4), 245-257.
77. Putman, J. A. (2001). Technical issues involving bipolar EEG training protocols. Journal of Neurotherapy, 5 (3), 51-58.
78. Qualls, P. J., & Sheehan, P. W. (1981). Role of the feedback signal in electromyograph biofeedback: The relevance of attention. Journal of Experimental Psychology, General, 110 (2), 204-216.
79. Rossiter, T. R. (1998). Patient directed neurofeedback for AD/HD. Journal of Neurotherapy, 2 (4), 54-64.
80. Rossiter, T. R., & La Vaque, T. J. (1995). A comparison of EEG biofeedback and psychostimulants in treating attention deficit hyperactivity disorders. Journal of Neurotherapy, 1 (1), 48-59.
81. Shaywitz, B. A., Fletcher, J. M., Pugh, K. R., Klorman, R., & Shaywitz, S. E. (1999). Progress in imaging attention deficit hyperactivity disorder. Mental Retardation and Developmental Disabilities Research Reviews, 5, 185-190.
82. Shouse, M. N., & Lubar, J. F. (1979). Operant conditioning of EEG rhythms and Ritalin in the treatment of hyperkinesis. Biofeedback and Self Regulation, 4 (4), 299-312.
83. Steriade, M., Gloor, P., Llinas, R. R., Lopes da Silva, F. H., & Mesulam, M. M. (1990). Basic mechanisms of cerebral rhythmic activities. Electroencephalography and Clinical Neurophysiology, 76, 481-508.
84. Sterman, M. B., & Macdonald, L. R. (1978). Effects of central cortical EEG feedback training on incidence of poorly controlled seizures. Epilepsia, 19 (3), 207-222.
85. Sterman, M. B., Macdonald, L. R., & Stone, R. K. (1974). Biofeedback training of the sensorimotor electroencephalogram rhythm in man: Effects on epilepsy. Epilepsia, 15 (3), 395-416.
86. Sterman, M. B., & Wyrwicka, W. (1967). EEG correlates of sleep: Evidence for separate forebrain substrates. Brain Research, 6 (1), 143-163.
87. Stockdale, S. (2001). Have you seen any negative effects associated with EEG neurofeedback? Journal of Neurotherapy, 4 (4), 62-63.
88. Striefel, S. (2001). Ethical research issues: Going beyond the Declaration of Helsinki. Applied Psychophysiology and Biofeedback, 26 (1), 39-59; discussion 67-71.
89. Swanson, J. M., Sergeant, J. A., Taylor, E., Sonuga-Barke, E. J., Jensen, P. S., & Cantwell, D. P. (1998). Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet, 351 (9100), 429-433.
90. Tansey, M. A. (1993). Ten-year stability of EEG biofeedback results for hyperactive boy who failed fourth grade perceptually impaired class. Biofeedback and Self Regulation, 18 (1), 33-44.
91. Tansey, M. A., & Bruner, R. L. (1983). EMG and EEG biofeedback training in the treatment of a 10-year-old hyperactive boy with a developmental reading disorder. Biofeedback and Self Regulation, 8 (1), 25-37.
92. Thatcher, R. W. (1998). Normative EEG databases and EEG biofeedback. Journal of Neurotherapy, 2 (4), 8-39.
93. Thatcher, R. W. (1999). EEG database-guided neurotherapy. In J. R. Evans & A. Abarbanel (Eds.), Introduction to quantitative EEG and neurofeedback (pp. 29-64). San Diego, California: Academic Press.
94. Thompson, L., & Thompson, M. (1998). Neurofeedback combined with training in metacognitive strategies: Effectiveness in students with ADD. Applied Psychophysiology and Biofeedback, 23 (4), 243-263.
95. Thornton, K. (2000). Improvement/rehabilitation of memory functioning with neurotherapy/QEEG biofeedback. Journal of Head Trauma and Rehabilitation, 15 (6), 1285-1296.
96. Tinius, T. P., & Tinius, K. A. (2000). Changes after EEG biofeedback and cognitive retraining in adults with mild traumatic brain injury and attention deficit hyperactivity disorder. Journal of Neurotherapy, 4 (2), 27-41.
97. Uhlmann, C., & Froscher, W. (2001). Biofeedback treatment in patients with refractory epilepsy: Changes in depression and control orientation. Seizure, 10 (1), 34-38.
98. Vazquez Marrufo, M., Vaquero, E., Cardoso, M. J., & Gomez, C. M. (2001). Temporal evolution of alpha and beta bands during visual spatial attention. Cognitive Brain Research, 12 (2), 315-320.
99. Vernon, D., Egner, T., Cooper, N., Compton, T., Neilands, C., Sheri, A., et al. (2003). The effect of training distinct neurofeedback protocols on aspects of cognitive performance. International Journal of Psychophysiology, 47 (1), 75-85.
100. Wadhwani, S., Radvanski, D. C., & Carmody, D. P. (1998). Neurofeedback training in a case of attention deficit hyperactivity disorder. Journal of Neurotherapy, 3 (1), 42-49.
101. World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.
102. Wolraich, M. L. (1999). Attention deficit hyperactivity disorder: The most studied and yet most controversial diagnosis. Mental Retardation and Developmental Disabilities Research Reviews, 5, 163-168.