Efficacy of Mobile Neurofeedback for Adult Attention-Deficit/Hyperactivity Disorder (ADHD)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Tamir Epstein, MD
- Phone Number: +972-50-640-8442
- Email: tamir.epstein@sheba.health.gov.il
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- willingness to provide consent
- diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) of any type as ascertained by clinical interview conducted by a board-certified psychiatrist
- at the time of enrollment, not receiving treatment for symptoms of ADHD
Exclusion Criteria:
- comorbid psychotic or bipolar disorder or an active affective disorder
- medical disorder with potentially confounding psychiatric effects (either due to direct effects of the condition or medication effects)
- diagnosis of substance abuse disorder (SUD), sleep apnea, restless legs syndrome (RLS), or borderline intellectual functioning
- unable to attend in-clinic follow-up assessment
- antipsychotic agent in the three months prior to baseline assessment
- any selective serotonin reuptake inhibitor (SSRI) treatment in the four weeks prior to baseline
- other psychiatric medication in the two weeks prior to baseline that the principal investigator deems to be confounding
- experimental group only: plans to start stimulant medication during the course of the study (use of nutritional supplements including "prescription medical foods" is not exclusionary)
- neurofeedback treatment in the two years prior to baseline
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Treatment as Usual
|
Treatment plan as part of regular care at the ADHD clinic, which may include pharmacological intervention, cognitive behavioral therapy (CBT), a combination of pharmacological intervention and CBT, or no intervention.
Care will often include pharmacological intervention, with the specifics (e.g., type of medication, dosage) determined by psychiatrist recommendation considering such factors as response to previous interventions, participant characteristics, and practical constraints.
Most pharmacological interventions will be stimulants (e.g., methylphenidate) with various release mechanisms.
Each participant will receive an individualized dose titration and follow-up plan, including clinic visits as needed (generally 1-2 visits over the 10-week intervention period); interventions may be switched in accord with clinical judgment.
|
|
Experimental: Home-Based Neurofeedback Training
|
Home-based neurofeedback training (downtrain theta, uptrain beta; training site: Cz) 4 times weekly for a 40 of total sessions over the ten-week training period.
Session duration of 21 minutes for the first 20 sessions to 30 minutes for the last 20 sessions.
Positive visual and auditory feedback when brainwaves are within the desired range.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Continuous Performance Task (CPT) Response Time
Time Frame: baseline, immediately after 10-week intervention period
|
mean response time for correct responses on a computerized CPT
|
baseline, immediately after 10-week intervention period
|
|
Change in Continuous Performance Task (CPT) Response Time Variability
Time Frame: baseline, immediately after 10-week intervention period
|
standard deviation of response time for correct responses on a computerized CPT
|
baseline, immediately after 10-week intervention period
|
|
Change in Self-Reported ADHD Symptoms
Time Frame: baseline, immediately after 10-week intervention period
|
total score on the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1)
|
baseline, immediately after 10-week intervention period
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
EEG Theta Amplitude
Time Frame: baseline, immediately after 10-week intervention period
|
resting state fronto-central theta amplitude
|
baseline, immediately after 10-week intervention period
|
|
EEG Beta Amplitude
Time Frame: baseline, immediately after 10-week intervention period
|
resting state fronto-central beta amplitude
|
baseline, immediately after 10-week intervention period
|
|
EEG Theta/Beta Ratio
Time Frame: baseline, immediately after 10-week intervention period
|
resting state fronto-central theta/beta ratio
|
baseline, immediately after 10-week intervention period
|
|
Continuous Performance Task (CPT) Accuracy
Time Frame: baseline, immediately after 10-week intervention period
|
percent correct on a computerized CPT
|
baseline, immediately after 10-week intervention period
|
|
Continuous Performance Task (CPT) Commission Errors
Time Frame: baseline, immediately after 10-week intervention period
|
number of commission errors on a computerized CPT
|
baseline, immediately after 10-week intervention period
|
|
Continuous Performance Task (CPT) Omission Errors
Time Frame: baseline, immediately after 10-week intervention period
|
number of commission errors on a computerized CPT
|
baseline, immediately after 10-week intervention period
|
|
ADHD Screener Score
Time Frame: baseline, immediately after 10-week intervention period
|
sum of item scores for the first 6 items (Part A) of the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1);
item ratings: 0=never, 1=rarely, 2=sometimes, 3=often, 4=very often; scoring: for items 1-3, ratings of sometimes, often, or very often are assigned one point; for items 4-6 ratings of often or very often are assigned one point; a higher score reflects a worse outcome
|
baseline, immediately after 10-week intervention period
|
|
ADHD Symptom Inattention Subtype Score
Time Frame: baseline, immediately after 10-week intervention period
|
sum of item scores for the 9 inattention items from the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1):
items 1-4 & 7-11; item ratings: 0=never, 1=rarely, 2=sometimes, 3=often, 4=very often; scoring: for items 1-3 & 9, ratings of sometimes, often, or very often are assigned one point; for items 4, 7, 8, 10 & 11, ratings of often or very often are assigned one point; a higher score reflects a worse outcome
|
baseline, immediately after 10-week intervention period
|
|
ADHD Symptom Hyperactivity/Impulsivity Subtype Score
Time Frame: baseline, immediately after 10-week intervention period
|
sum of item scores for the 9 hyperactivity/impulsivity items from the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1):
items 5-6 & 12-18; item ratings: 0=never, 1=rarely, 2=sometimes, 3=often, 4=very often; scoring: for items 12 & 18, ratings of sometimes, often, or very often are assigned one point; for items 5-6 & 13-17, ratings of often or very often are assigned one point; a higher score reflects a worse outcome
|
baseline, immediately after 10-week intervention period
|
|
Global Cognitive Score from Cognitive Battery
Time Frame: baseline, immediately after 10-week intervention period
|
global cognitive score (average of standardized domain scores) from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation: 15
|
baseline, immediately after 10-week intervention period
|
|
Attention Domain Score from Cognitive Battery
Time Frame: baseline, immediately after 10-week intervention period
|
standardized attention domain score from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation 15
|
baseline, immediately after 10-week intervention period
|
|
Executive Function Domain Score from Cognitive Battery
Time Frame: baseline, immediately after 10-week intervention period
|
standardized executive function domain score from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation 15
|
baseline, immediately after 10-week intervention period
|
|
Information Processing Speed Domain Score from Cognitive Battery
Time Frame: baseline, immediately after 10-week intervention period
|
standardized information processing speed domain score from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation 15
|
baseline, immediately after 10-week intervention period
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Quality of Life Scores for Adult ADHD
Time Frame: baseline, immediately after 10-week intervention period
|
Adult ADHD Quality-of-Life Scale (AAQoL) overall score (29 items); life productivity (11 items), psychological health (6 items), life outlook (7 items), relationships (5 items) subscores from Adult ADHD Quality-of-Life Scale (AAQoL); items rated on five-point Likert scale from 'not at all/never' (1) to 'extremely/very often' (5); overall and subscale scores computed by reversing item scores for negatively worded items and transforming item scores to a 0-100 point scale; item scores summed and divided by item count; a higher score reflects a better outcome
|
baseline, immediately after 10-week intervention period
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Tamir Epstein, MD, Sheba Medical Center
Publications and helpful links
General Publications
- Brod M, Johnston J, Able S, Swindle R. Validation of the adult attention-deficit/hyperactivity disorder quality-of-life Scale (AAQoL): a disease-specific quality-of-life measure. Qual Life Res. 2006 Feb;15(1):117-29. doi: 10.1007/s11136-005-8325-z.
- Adler LA, Spencer T, Faraone SV, Kessler RC, Howes MJ, Biederman J, Secnik K. Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms. Ann Clin Psychiatry. 2006 Jul-Sep;18(3):145-8. doi: 10.1080/10401230600801077.
- Schweiger A, Abramovitch A, Doniger GM, Simon ES. A clinical construct validity study of a novel computerized battery for the diagnosis of ADHD in young adults. J Clin Exp Neuropsychol. 2007 Jan;29(1):100-11. doi: 10.1080/13803390500519738.
- Micoulaud-Franchi JA, Geoffroy PA, Fond G, Lopez R, Bioulac S, Philip P. EEG neurofeedback treatments in children with ADHD: an updated meta-analysis of randomized controlled trials. Front Hum Neurosci. 2014 Nov 13;8:906. doi: 10.3389/fnhum.2014.00906. eCollection 2014.
- 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. 2009 Jul;40(3):180-9. doi: 10.1177/155005940904000311.
- Riesco-Matias P, Yela-Bernabe JR, Crego A, Sanchez-Zaballos E. What Do Meta-Analyses Have to Say About the Efficacy of Neurofeedback Applied to Children With ADHD? Review of Previous Meta-Analyses and a New Meta-Analysis. J Atten Disord. 2021 Feb;25(4):473-485. doi: 10.1177/1087054718821731. Epub 2019 Jan 15.
Study record dates
Study Major Dates
Study Start (Anticipated)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 6362-19-SMC
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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