Project Attention Deficit Hyperactivity Disorder (ADHD) and Electroencephalography (EEG)-Neurofeedback THERapy (PANther)

ADHD and EEG-neurofeedback. A Single-blind Randomized Placebo-controlled Treatment Study.

Background:

Electroencephalography (EEG)-neurofeedback has been shown to offer therapeutic benefits to patients with ADHD in several mostly uncontrolled studies with relatively small sample sizes. It is unknown how EEG-neurofeedback affects brain functioning and exerts therapeutic effects in ADHD. This study is designed to examine the efficacy and safety of EEG-neurofeedback in a scientific rigorously way and to study the underlying neurobiological mechanisms of EEG-neurofeedback.

Objectives:

1. To investigate the efficacy of EEG-neurofeedback in reducing behavioral symptoms of ADHD.
2. To investigate whether EEG-neurofeedback is able to improve neurocognitive functioning.
3. To investigate whether EEG-neurofeedback is able to improve neural functioning.

Study design:

Double-blind randomized placebo-controlled treatment study.Study population: 120 subjects with ADHD (age 8-15, IQ of 80 or more). Intervention: 60 subjects with ADHD receive 30 sessions EEG-neurofeedback, and 60 subjects with ADHD receive placebo EEG-neurofeedback.

Main study parameter: ADHD-DSM-IV rating scale, rated by the investigator.

Hypothesis:

The hypothesis is EEG-Neurofeedback can reduce symptoms of ADHD.

Study Overview

• Status: Completed
• Conditions: ADHD
• Intervention / Treatment: Other: Placebo EEG Neurofeedback; Other: EEG-Neurofeedback

• Study Type: Interventional
• Enrollment (Actual): 63
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Gelderland
    • Nijmegen, Gelderland, Netherlands, 6500 HB
      • FC Donders Centre for Cognitive Neuroimaging
    • Nijmegen, Gelderland, Netherlands, 6525 GC
      • Karakter Nijmegen

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years to 13 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Diagnosis ADHD, classified by the (Diagnostic and Statistical Manual of Mental Disorders, 2000)
• Age between 8 and 15
• A full scale IQ of more than 80
• Psychopharmaca- naïve or -free, or using a stable dosage of psychostimulants or atomoxetine but still with room for improvement (defined by an average score of more than 1 on ADHD-DSM-IV rating scale).
• Deviant EEG of more than 1.5 standard deviation compared to the database

Exclusion criteria:

• Currently intensive (i.e. weekly) individual or group psychotherapy
• Regular use of medication other than psychostimulants or atomoxetine
• Diagnosis of one or more of the following comorbid psychiatric disorders:
• Major depression
• Bipolar disorder
• Psychotic disorder
• Chronically motor tic disorder or Gilles de la Tourette
• Conduct disorder
• Autism spectrum disorders
• Eating disorders
• Neurological disorders (e.g. epilepsy) currently or in the past
• Cardiovascular disease currently or in the past
• Participation in another clinical trial simultaneously
• EEG-neurofeedback training in the past
• Use of alcohol or drugs

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo group; This group will receive no real EEG-Neurofeedback.	Other: Placebo EEG Neurofeedback; The placebo EEG-neurofeedback group will get an identical procedure as the real EEG-Neurofeedback, but with feedback on a EEG signal simulation. The placebo group will not be rewarded on their real-time EEG but on a random, simulated EEG; known to be effective for this purpose (Utrecht University, study in progress). In the protocol selection the electrode position and rewarding versus inhibition of the treatment frequency band or bands will be individually created. The first 30 seconds of the treatment will start on a predetermined fixed threshold value for all treatment subjects.
Experimental: NF group; This group will receive real EEG-Neurofeedback	Other: EEG-Neurofeedback; The EEG-neurofeedback group will receive feedback on their real-time EEG-signal (brain activity). The treatment group will be rewarded, by brightening (i.e. not being blackened of) the feedback screen. Rewards will be given to the subjects when their digitally filtered frequency EEG activity meets the criteria in the 'percentage time over threshold' parameter. The 'percentage time over threshold' parameter will be auto-adjusted on the digitally filtered real-time EEG every 30 seconds, and the percentage parameter will be kept as a constant over all participants during the entire study (i.e. not adjusted during treatment based on individual capabilities).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
ADHD criteria according to the DSM-IV-TR rated by the investigator.	before, after 10, 20, 30 sessions and after half a year

Secondary Outcome Measures

Outcome Measure	Time Frame
side-effects by Score on the adapted Pittsburgh side effects rating scale	before, after 10, 20, 30 sessions

Collaborators and Investigators

• Sponsor: Radboud University Medical Center
• Investigators: Principal Investigator: J.K. Buitelaar, Professor, UMC St. Radboud and Karakter

Publications and helpful links

General Publications

• Vollebregt MA, van Dongen-Boomsma M, Buitelaar JK, Slaats-Willemse D. Does EEG-neurofeedback improve neurocognitive functioning in children with attention-deficit/hyperactivity disorder? A systematic review and a double-blind placebo-controlled study. J Child Psychol Psychiatry. 2014 May;55(5):460-72. doi: 10.1111/jcpp.12143. Epub 2013 Oct 30. Erratum In: J Child Psychol Psychiatry. 2014 Aug;55(8):954-5. J Child Psychol Psychiatry. 2014 Aug;55(8):954-955.
• van Dongen-Boomsma M, Vollebregt MA, Slaats-Willemse D, Buitelaar JK. A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2013 Aug;74(8):821-7. doi: 10.4088/JCP.12m08321.

Study record dates

Study Major Dates

• Study Start: July 1, 2008
• Primary Completion (Actual): July 1, 2012
• Study Completion (Actual): February 1, 2013

Study Registration Dates

• First Submitted: July 28, 2008
• First Submitted That Met QC Criteria: July 28, 2008
• First Posted (Estimate): July 29, 2008

Study Record Updates

• Last Update Posted (Estimate): March 8, 2013
• Last Update Submitted That Met QC Criteria: March 7, 2013
• Last Verified: March 1, 2013

More Information

Terms related to this study

• Keywords: Children; ADHD; EEG-Neurofeedback
• Other Study ID Numbers: NF1