Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial

Holger Gevensleben, Birgit Holl, Björn Albrecht, Dieter Schlamp, Oliver Kratz, Petra Studer, Aribert Rothenberger, Gunther H Moll, Hartmut Heinrich, Holger Gevensleben, Birgit Holl, Björn Albrecht, Dieter Schlamp, Oliver Kratz, Petra Studer, Aribert Rothenberger, Gunther H Moll, Hartmut Heinrich

Abstract

Neurofeedback (NF) could help to improve attentional and self-management capabilities in children with attention-deficit/hyperactivity disorder (ADHD). In a randomised controlled trial, NF training was found to be superior to a computerised attention skills training (AST) (Gevensleben et al. in J Child Psychol Psychiatry 50(7):780-789, 2009). In the present paper, treatment effects at 6-month follow-up were studied. 94 children with ADHD, aged 8-12 years, completed either 36 sessions of NF training (n = 59) or a computerised AST (n = 35). Pre-training, post-training and follow-up assessment encompassed several behaviour rating scales (e.g., the German ADHD rating scale, FBB-HKS) completed by parents. Follow-up information was analysed in 61 children (ca. 65%) on a per-protocol basis. 17 children (of 33 dropouts) had started a medication after the end of the training or early in the follow-up period. Improvements in the NF group (n = 38) at follow-up were superior to those of the control group (n = 23) and comparable to the effects at the end of the training. For the FBB-HKS total score (primary outcome measure), a medium effect size of 0.71 was obtained at follow-up. A reduction of at least 25% in the primary outcome measure (responder criterion) was observed in 50% of the children in the NF group. In conclusion, behavioural improvements induced by NF training in children with ADHD were maintained at a 6-month follow-up. Though treatment effects appear to be limited, the results confirm the notion that NF is a clinically efficacious module in the treatment of children with ADHD.

Figures

Fig. 1
Fig. 1
Schematic illustration of the design of the randomised trial in children with ADHD. The training (neurofeedback, NF; attention skills training) was divided into two blocks. Children of the NF group conducted theta/beta training in one block and SCP training in the other block (balanced order). Behavioural ratings used for follow-up evaluation were assessed before the training started, directly after the end of the training and 6 months after the end of the training
Fig. 2
Fig. 2
Patient flow diagram

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