Neurofeedback in children with ADHD: Validation and challenges

Expert Review of Neurotherapeutics

Volumn 12, Issue 4, 2012, Pages 447-460

  Gevensleben, Holger ^a   Rothenberger, Aribert ^a   Moll, Gunther H ^b   Heinrich, Hartmut ^b,c  

^a UNIVERSITY OF GÖTTINGEN   (Germany)

^b UNIVERSITY OF ERLANGEN NUREMBERG   (Germany)

^c Heckscher Klinikum   (Germany)

Author keywords

training; ADHD; attention deficit hyperactivity disorder; evaluation; mediators; moderators; neurofeedback; SCPs; self regulation; slow cortical potentials; specificity

Indexed keywords

METHYLPHENIDATE; PLACEBO;

ATTENTION; ATTENTION DEFICIT DISORDER; CHILD; CHILD BEHAVIOR; CLINICAL PROTOCOL; COGNITION; CONTINGENT NEGATIVE VARIATION; ELECTROENCEPHALOGRAM; ELECTROMYOGRAM; EVENT RELATED POTENTIAL; EXECUTIVE FUNCTION; HUMAN; INSTRUMENTAL CONDITIONING; MOTIVATION; NEUROFEEDBACK; NEUROPHYSIOLOGY; NEUROPSYCHOLOGY; PERSONALITY; RANDOMIZED CONTROLLED TRIAL (TOPIC); REINFORCEMENT; RELAXATION TRAINING; REVIEW; SELF CONCEPT; SELF CONTROL; SENSORIMOTOR FUNCTION; SKILL; SOCIAL PSYCHOLOGY; THERAPY EFFECT; TREATMENT OUTCOME;

ATTENTION DEFICIT DISORDER WITH HYPERACTIVITY; BIOFEEDBACK, PSYCHOLOGY; CHILD; HUMANS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; REPRODUCIBILITY OF RESULTS; TREATMENT OUTCOME;

EID: 84860272253     PISSN: 14737175     EISSN: 17448360     Source Type: Journal    
DOI: 10.1586/ern.12.22     Document Type: Review

References (79)

1. Heinrich H, Gevensleben H, Strehl U. Annotation: Neurofeedback - train your brain to train behaviour. J. Child Psychol. Psychiatry 48(1), 3-16 (2007). Our previous review published in 2007. (Pubitemid 46140509)
2. American Psychological Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). American Psychiatric Association, DC, USA (2000).
3. Barkley RA. ADHD and the Nature of Self-Control. Guilford Press, NY, USA (1997).
4. Barry RJ, Clarke AR, Johnstone SJ. A review of electrophysiology in attention-deficit/hyperactivity disorder: I. Qualitative and quantitative electroencephalography. Clin. Neurophysiol. 114(2), 171-183 (2003). (Pubitemid 36136088)
5. Sergeant JA. Modeling attention-deficit/ hyperactivity disorder: A critical appraisal of the cognitive-energetic model. Biol. Psychiatry 57(11), 1248-1255 (2005). (Pubitemid 40798542)
6. Sagvolden T, Johansen EB, Aase H, Russell VA. A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/ impulsive and combined subtypes. Behav. Brain Sci. 28(3), 397-419, discussion 419-368 (2005). (Pubitemid 41440193)
7. Sonuga-Barke EJ, Castellanos FX. Spontaneous attentional fluctuations in impaired states and pathological conditions: A neurobiological hypothesis. Neurosci. Biobehav. Rev. 31(7), 977-986 (2007). (Pubitemid 47332617)
8. Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult outcome of hyperactive children: Adaptive functioning in major life activities. J. Am. Acad. Child Adolesc. Psychiatry 45(2), 192-202 (2006). (Pubitemid 43151524)
9. Pingault JB, Tremblay RE, Vitaro F et al. Childhood trajectories of inattention and hyperactivity and prediction of educational attainment in early adulthood: A 16-year longitudinal population-based study. Am. J. Psychiatry 168(11), 1164-1170 (2011).
10. Danckaerts M, Sonuga-Barke EJ, Banaschewski T et al. The quality of life of children with attention deficit/ hyperactivity disorder: A systematic review. Eur. Child Adolesc. Psychiatry 19(2), 83-105 (2010).
11. Pelham WE, Fabiano GA. Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. J. Clin. Child Adolesc. Psychol. 37(1), 184-214 (2008).
12. Banaschewski T, Coghill D, Santosh P et al. Long-acting medications for the hyperkinetic disorders. A systematic review and European treatment guideline. Eur. Child Adolesc. Psychiatry 15(8), 476-495 (2006). (Pubitemid 46020533)
13. Faraone SV, Buitelaar J. Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis. Eur. Child Adolesc. Psychiatry 19(4), 353-364 (2009).
14. Graham J, Banaschewski T, Buitelaar J et al. European guidelines on managing adverse effects of medication for ADHD. Eur. Child Adolesc. Psychiatry 20(1), 17-37 (2011).
15. Pliszka SR. Pharmacologic treatment of attention-deficit/hyperactivity disorder: Efficacy, safety and mechanisms of action. Neuropsychol. Rev. 17(1), 61-72 (2007). (Pubitemid 46355006)
16. Taylor E, Dopfner M, Sergeant J et al. European clinical guidelines for hyperkinetic disorder - first upgrade. Eur. Child Adolesc. Psychiatry 13(Suppl. 1), 17-30 (2004).
17. Vitiello B. Improving decision making in the treatment of ADHD. Am. J. Psychiatry 165(6), 666-667 (2008). (Pubitemid 351810531)
18. Babiloni C, Del Percio C, Iacoboni M et al. Golf putt outcomes are predicted by sensorimotor cerebral EEG rhythms. J. Physiol. 586(1), 131-139 (2008).
19. Del Percio C, Marzano N, Tilgher S et al. Pre-stimulus a rhythms are correlated with post-stimulus sensorimotor performance in athletes and non-athletes: A high-resolution EEG study. Clin. Neurophysiol. 118(8), 1711-1720 (2007). (Pubitemid 47039310)
20. Sherlin LA, Arns M, Lubar J et al. Neurofeedback and basic learning theory: Implications for research and practice. J. Neurother. 15, 292-304 (2011).
21. Drechsler R, Straub M, Doehnert M, Heinrich H, Steinhausen HC, Brandeis D. Controlled evaluation of a neurofeedback training of slow cortical potentials in children with attention deficit/ hyperactivity disorder (ADHD). Behav. Brain Funct. 3, 35 (2007).
22. Leins U, Hinterberger T, Kaller S, Schober F, Weber C, Strehl U. Neurofeedback for children with ADHD: A comparison of SCP - and q/b-protocols. Prax. Kinderpsychol. Kinderpsychiatr. 55(5), 384-407 (2006). (Pubitemid 43990003)
23. El-Sayed E, Larsson JO, Persson HE, Rydelius PA. Altered cortical activity in children with attention-deficit/ hyperactivity disorder during attentional load task. J. Am. Acad. Child Adolesc. Psychiatry 41(7), 811-819 (2002). (Pubitemid 38338097)
24. Hagemann D, Hewig J, Seifert J, Naumann E, Bartussek D. The latent state-trait structure of resting EEG asymmetry: Replication and extension. Psychophysiol. 42(6), 740-752 (2005). (Pubitemid 43943078)
25. Egner T, Zech TF, Gruzelier JH. The effects of neurofeedback training on the spectral topography of the electroencephalogram. Clin. Neurophysiol. 115(11), 2452-2460 (2004). (Pubitemid 39304137)
26. Birbaumer N, Elbert T, Canavan AG, Rockstroh B. Slow potentials of the cerebral cortex and behavior. Physiol. Rev. 70(1), 1-41 (1990). Excellent review of slow cortical potentials. (Pubitemid 20037280)
27. Hinterberger T, Veit R, Strehl U et al. Brain areas activated in fMRI during self-regulation of slow cortical potentials (SCPs). Exp. Brain Res. 152(1), 113-122 (2003). (Pubitemid 37100339)
28. Kleemeyer M. Self-regulation of slow cortical potentials in children with attention-deficit/hyperactivity disorder: A tomographic analysis over the course of a neurofeedback training. Master Thesis, University of Bremen, Bremen, Germany (2010).
29. Elbert T, Rockstroh B, Lutzenberger W, Birbaumer N. Self-Regulation of the Brain and Behavior. Springer, NY, USA (1984).
30. Banaschewski T, Brandeis D. Annotation: What electrical brain activity tells us about brain function that other techniques cannot tell us - A child psychiatric perspective. J. Child Psychol. Psychiatry 48(5), 415-435 (2007). Comprehensive review of neurophysiological basics and EEG/event-related potentials studies in child and adolescent psychiatry. (Pubitemid 46901219)
31. Rockstroh B, Elbert T, Lutzenberger W, Birbaumer N. Biofeedback: Evaluation and therapy in children with attentional dysfunctions. In:Brain and Behavior in Child Psychiatry. Rothenberger A (Ed.). Springer, Berlin, Germany, 345-357 (1990).
32. Strehl U, Leins U, Goth G, Klinger C, Hinterberger T, Birbaumer N. Self-regulation of slow cortical potentials: A new treatment for children with attention-deficit/hyperactivity disorder. Pediatrics 118(5), e1530-e1540 (2006). (Pubitemid 46393658)
33. Heinrich H, Gevensleben H, Freisleder FJ, Moll GH, Rothenberger A. Training of slow cortical potentials in attention-deficit/ hyperactivity disorder: Evidence for positive behavioral and neurophysiological effects. Biol. Psychiatry 55(7), 772-775 (2004). (Pubitemid 38376191)
34. Doehnert M, Brandeis D, Straub M, Steinhausen HC, Drechsler R. Slow cortical potential neurofeedback in attention deficit hyperactivity disorder: Is there neurophysiological evidence for specific effects? J. Neural. Transm. 115(10), 1445-1456 (2008).
35. Clarke AR, Barry RJ, Mccarthy R, Selikowitz M. EEG-defined subtypes of children with attention-deficit/ hyperactivity disorder. Clin. Neurophysiol. 112(11), 2098-2105 (2001). (Pubitemid 32995977)
36. Arns M, De Ridder S, Strehl U, Breteler M, Coenen A. Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clin. EEG Neurosci. 40(3), 180-189 (2009).
37. Fuchs T, Birbaumer N, Lutzenberger W, Gruzelier JH, Kaiser J. Neurofeedback treatment for attention-deficit/ hyperactivity disorder in children: A comparison with methylphenidate. Appl. Psychophysiol. Biofeedback 28(1), 1-12 (2003). (Pubitemid 36397232)
38. Monastra VJ, Monastra DM, George S. The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/ hyperactivity disorder. Appl. Psychophysiol. Biofeedback 27(4), 231-249 (2002). (Pubitemid 36008111)
39. Loo SK, Barkley RA. Clinical utility of EEG in attention deficit hyperactivity disorder. Appl. Neuropsychol. 12(2), 64-76 (2005). (Pubitemid 41008922)
40. Levesque J, Beauregard M, Mensour B. Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/ hyperactivity disorder: A functional magnetic resonance imaging study. Neurosci. Lett. 394(3), 216-221 (2006). (Pubitemid 43144853)
41. Döpfner M, Lehmkuhl G. DISYPS-KJ - Diagnostik-System für Psychische Störungen im Kindes- und Jugendalter. Hans Huber, Bern, Germany (2000).
42. Gevensleben H, Holl B, Albrecht B et al. Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. J. Child Psychol. Psychiatry 50(7), 780-789 (2009).
43. Gevensleben H, Holl B, Albrecht B et al. Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial. Eur. Child Adolesc. Psychiatry 19(9), 715-724 (2010). The first randomized controlled neurofeedback trial in children with ADHD that allowed reliable detection of at least a medium effect size.
44. Fan J, Mccandliss BD, Sommer T, Raz A, Posner MI. Testing the efficiency and independence of attentional networks. J. Cogn. Neurosci. 14(3), 340-347 (2002). (Pubitemid 34267537)
45. Gevensleben H, Holl B, Albrecht B et al. Distinct EEG effects related to neurofeedback training in children with ADHD: A randomized controlled trial. Int. J. Psychophysiol. 74(2), 149-157 (2009).
46. Ros T, Munneke MA, Ruge D, Gruzelier JH, Rothwell JC. Endogenous control of waking brain rhythms induces neuroplasticity in humans. Eur. J. Neurosci. 31(4), 770-778 (2010).
47. Wangler S, Gevensleben H, Albrecht B et al. Neurofeedback in children with ADHD: Specific event-related potential findings of a randomized controlled trial. Clin. Neurophysiol. 122(5), 942-950 (2011).
48. Holtmann M, Grasmann D, Cionek-Szpak E et al. Spezifische wirksamkeit von neurofeedback auf die impulsivität bei ADHS. Kindheit Entwicklung 18(2), 95-104 (2009).
49. Lansbergen MM, Van Dongen-Boomsma M, Buitelaar JK, Slaats-Willemse D. ADHD and EEG-neurofeedback: A double-blind randomized placebo-controlled feasibility study. J. Neural Transm. 118(2), 275-284 (2011).
50. Thatcher RW. EEG normative databases and EEG biofeedback. J. Neurother. 2(4), 8-39 (1998).
51. Omer H, London P. Signal and noise in psychotherapy. The role and control of non-specific factors. Br. J. Psychiatry 155, 239-245 (1989). (Pubitemid 19204909)
52. Bakhshayesh AR, Hansch S, Wyschkon A, Rezai MJ, Esser G. Neurofeedback in ADHD: A single-blind randomized controlled trial. Eur. Child Adolesc. Psychiatry 20(9), 481-491 (2011).
53. Arnold LE. Alternative treatments for adults with attention-deficit hyperactivity disorder (ADHD). Ann. NY Acad. Sci. 931, 310-341 (2001).
54. Chambless DL, Hollon SD. Defining empirically supported therapies. J. Consult. Clin. Psychol. 66(1), 7-18 (1998). (Pubitemid 28086807)
55. La Vaque T, Hammond DC. Template for developing guidelines for the evaluation of the clinical efficacy of psychophysiological interventions. Appl. Psychophysiol. Biofeedback 27(4), 273-281 (2002). Guidelines on the evaluation of empirically supported treatments.
56. Hibbs ED. Evaluating empirically based psychotherapy research for children and adolescents. Eur. Child Adolesc. Psychiatry 10(Suppl. 1), 3-11 (2001).
57. Sherlin L, Arns M, Lubar J, Sokhadze E. A position paper on neurofeedback for the treatment of ADHD. J. Neurotherapy 14(2), 66-78 (2010).
58. Chambless DL, Ollendick TH. Empirically supported psychological interventions: Controversies and evidence. Annu. Rev. Psychol. 52, 685-716 (2001). (Pubitemid 33705589)
59. Lofthouse N, Arnold L, Hurt E. A comment on Sherlin, Arns, Lubar, and Sokhadze. J. Neurother. 14(4), 301-306 (2010).
60. American Psychological Association. Criteria for evaluating treatment guidelines. Am. Psychol. 57(12), 1052-1059 (2002).
61. Borkovec TD, Sibrava NJ. Problems with the use of placebo conditions in psychotherapy research, suggested alternatives, and some strategies for the pursuit of the placebo phenomenon. J. Clin. Psychol. 61(7), 805-818 (2005). (Pubitemid 41153532)
62. Heinrich H, Goetze O, Menne D et al. Effect on gastric function and symptoms of drinking wine, black tea, or schnapps with a Swiss cheese fondue: Randomised controlled crossover trial. BMJ 341, c6731 (2010).
63. Margraf J, Ehlers A, Roth WT et al. How "blind" are double-blind studies? J. Consult. Clin. Psychol. 59(1), 184-187 (1991).
64. Herbert JD, Gaudiano BA. Moving from empirically supported treatment lists to practice guidelines in psychotherapy: The role of the placebo concept. J. Clin. Psychol. 61(7), 893-908 (2005). Critical discussion on placebo control in psychotherapy research. (Pubitemid 41153538)
65. Logemann HN, Lansbergen MM, Van Os TW, Bocker KB, Kenemans JL. The effectiveness of EEG-feedback on attention, impulsivity and EEG: A sham feedback controlled study. Neurosci. Lett. 479(1), 49-53 (2010).
66. Kendall PC. Clinical significance. J. Consult. Clin. Psychol. 67(3), 283-284 (1999). (Pubitemid 29266497)
67. Kazdin AE. The meanings and measurement of clinical significance. J. Consult. Clin. Psychol. 67(3), 332-339 (1999). (Pubitemid 29266502)
68. Kazdin AE. Mediators and mechanisms of change in psychotherapy research. Annu. Rev. Clin. Psychol. 3, 1-27 (2007). Outline of the necessity to evaluate mechanisms, moderators and mediators in psychotherapy research. (Pubitemid 46651119)
69. Pine DS. Editorial: Evaluating new and old treatments for ADHD. J. Child Psychol. Psychiatry 50(7), 767-768 (2009).
70. Schafer RJ, Moore T. Selective attention from voluntary control of neurons in prefrontal cortex. Science 332(6037), 1568-1571 (2011).
71. Barry RJ, Clarke AR, McCarthy R, Selikowitz M. EEG coherence in attention-deficit/hyperactivity disorder: A comparative study of two DSM-IV types. Clin. Neurophysiol. 113(4), 579-585 (2002). (Pubitemid 34327391)
72. Strehl U, Kotchoubey B, Trevorrow T, Birbaumer N. Predictors of seizure reduction after self-regulation of slow cortical potentials as a treatment of drug-resistant epilepsy. Epilepsy Behav. 6(2), 156-166 (2005). (Pubitemid 40247147)
73. Neumann N, Birbaumer N. Predictors of successful self control during brain-computer communication. J. Neurol. Neurosurg. Psychiatry 74(8), 1117-1121 (2003).
74. Hinshaw SP. Moderators and mediators of treatment outcome for youth with ADHD: Understanding for whom and how interventions work. J. Pediatr. Psychol. 32(6), 664-675 (2007). (Pubitemid 47356043)
75. Wood R, Bandura A. Impact of conceptions of ability on self-regulatory mechanisms and complex decision making. J. Pers. Soc. Psychol. 56(3), 407-415 (1989).
76. Bandura A. Social cognitive theory of self-regulation. Organizat. Behav. Hum. Deci. Process 50, 248-287 (1991).
77. Caria A, Sitaram R, Birbaumer N. Real-time fMRI: A tool for local brain regulation. Neuroscientist doi:10.1177/1073858411407205 (2011) (Epub ahead of print).
78. Obrig H, Wenzel R, Kohl M et al. Near-infrared spectroscopy: Does it function in functional activation studies of the adult brain? Int. J. Psychophysiol. 35(2-3), 125-142 (2000). (Pubitemid 30085585)
79. Congedo M, Lubar JF, Joffe D. Low-resolution electromagnetic tomography neurofeedback. IEEE Trans. Neural. Syst. Rehabil. Eng. 12(4), 387-397 (2004). (Pubitemid 39620263)