Self-reported efficacy of neurofeedback treatment in a clinical randomized controlled study of ADHD children and adolescents

Figures & data

Table 1 Comparisons between ADHD core symptoms, school performance, age, IQ, and sociodemographic characteristics between the three experimental groups before treatments began

	Total (N=80) mean (SD)	MPHa group (N=27) mean (SD)	NF/MPHa group (N=25) mean (SD)	NF group (N=28) mean (SD)	P-value
Age (years)	11.2 (2.8)	10.9 (2.4)	11.2 (2.8)	11.4 (3.1)	0.770d
Sex
Boys	65 (81%)
IQ	87 (14)	87 (15)	85 (13)	89 (14)	0.750d
ADHD core symptomsc
Attention	5.0 (2.1)	5.4 (2.5)	5.0 (1.7)	4.6 (2.0)	0.370d
Hyperactivity	5.0 (2.3)	5.1 (2.1)	6.0 (2.5)	4.2 (2.1)	0.011d
School performance	6.6 (2.8)	6.7 (2.6)	7.3 (2.7)	5.8 (2.8)	0.143d
Parents’ educationb	73 (91%)				0.951e
Higher education (college or higher)	25 (34%)	8 (31%)	8 (38%)	9 (35%)
Lower education	48 (66%)	18 (69%)	13 (62%)	17 (65%)
Parents’ employmentb	71 (89%)				0.101e
Home	3 (4%)	2 (7%)	1 (6%)	0 (0%)
Unemployed	3 (4%)	2 (7%)	1 (6%)	0 (0%)
Part-time	12 (17%)	8 (30%)	1 (6%)	3 (12%)
Fulltime	53 (75%)	15 (56%)	15 (82%)	23 (88%)
Income typeb	59 (73%)				0.184e
Fixed wage	43 (73%)	11 (58%)	13 (77%)	19 (83%)
Other	16 (27%)	8 (42%)	4 (23%)	4 (17%)
Social functioningb	59 (73%)				0.754e
No/moderate problems	35 (59%)	15 (65%)	9 (53%)	11 (58%)
Severe problems	24 (41%)	8 (35%)	8 (47%)	8 (42%)
Siblingsb	61 (76%)				0.309e
<2 siblings	32 (53%)	8 (38%)	10 (59%)	14 (61%)
≥2 siblings	29 (47%)	13 (62%)	7 (41%)	9 (39%)
Child welfare supportb	73 (91%)				0.105e
No support	48 (66%)	14 (52%)	15 (83%)	19 (68%)
Support	25 (34%)	13 (48%)	3 (17%)	9 (32%)

Notes:

a Medication dosage: 1 mg/kg MPH, twice per day (total daily doses ranging from 20 to 60 mg)

b N (%)

c Self report questionnaire, scale 1–10

d ANOVA

e Exact χ²-test.

Abbreviations: ANOVA, analyses of variance; ADHD, attention-deficit/hyperactivity disorder; NF, neurofeedback; MPH, methylphenidate; SD, standard deviation.

Table 2 ADHD core symptoms (attention, hyperactivity, total score) regarding the treatments (NF, MED, combined) reported from children and adolescents

	N	Pre-treatment		Post-treatment		Pre–post change (T2–T1)a					Treatment effectb
		Mean	95% CI	Mean	95% CI	Mean	95% CI	Effect sizec	P-valued	P-valuee	P-valued	P-valuee
Attention									<0.001	0.545	0.705	0.524
Medication	27	5.4	(4.4, 6.4)	6.8	(6.0, 7.7)	1.4	(0.3, 2.5)	0.50
Neurofeedback + medication	25	5.1	(4.4, 6.0)	6.3	(5.5, 7.2)	1.2	(0.2, 2.3)	0.49
Neurofeedback	25	4.5	(3.7, 5.4)	6.4	(5.6, 7.1)	1.8	(0.9, 2.8)	0.90
Hyperactivity									0.001	0.244	0.892	0.861
Medication	27	5.1	(4.3, 6.0)	6.4	(5.4, 7.5)	1.3	(0.2, 2.4)	0.55
Neurofeedback + medication	25	6.0	(5.0, 7.1)	7.1	(6.1, 8.0)	1.0	(−0.3, 2.4)	0.31
Neurofeedback	25	4.1	(3.2, 5.1)	5.6	(4.4, 6.7)	1.4	(0.2, 2.7)	0.57
School performance									0.568	0.576	0.042	0.042
Medication	27	6.7	(5.7, 7.8)	6.9	(5.9, 7.8)	0.1	(−1.2, 1.4)	0.03
Neurofeedback + medication	22	7.2	(6.1, 8.4)	6.3	(5.1, 7.5)	−1.0	(−2.3, 0.3)	−0.42
Neurofeedback	24	5.7	(4.3, 7.0)	7.2	(6.1, 8.2)	1.5	(0.1, 2.9)	0.55

Notes:

a Tests for within-subject-contrast in the GLM

b Between-groups-effect in the GLM

c Effect size measure δRM;⁴³

d Unadjusted model

e Model adjusted for age and sex. T₁-period before the treatment, T₂-1 week after the treatment, T_3–6 months after the treatment.

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; NF, neurofeedback; MED, medication; CI, confidence interval; GLM, general linear model.

Table 3 Characteristics of 130 randomized participants in the neurofeedback treatment study of ADHD children and adolescents

	Completed (91) N (%)	Dropout (39) N (%)
Sex – male	106 (82%)	24 (62%)
Age*	11.5 [6–17]	12.0 [7–17]
Family (both parents)	49 (52%)	18 (46%)
Foster family	2 (5%)	15 (56%)
Two or more siblings	48 (58%)	18 (46%)
Father employed full time	45 (50%)	18 (46%)
Mother employed full time	42 (46%)	17 (45%)
CW support	5 (5%)	2 (5%)
Number of IQ-tested	70 (77%)	29 (74%)
Mean IQ, full scale*	87 [14]	89 [11]
Comorbidity
– Total	73 (80%)	27 (69%)
– ODD	49 (67%)	15 (56%)
– Anxiety	24 (33%)	12 (44%)
– Others	12 (14%)	2 (7%)
Subtypes
– Combined	72 (79%)	35 (90%)
– Hyperactivity	14 (4%)	3 (8%)
– Inattention	5 (5%)	1 (3%)

Notes:

* Mean ± SD median [min, max].

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; SD, standard deviation; CW, child welfare; ODD, oppositional-defiant disorder.

Table

ID NR:
Self-report form for T1 □ T2 □ T3 □
Answered by the patient in the scale of 1–10.
	Scale 1–10:	Comments:
1. Can you concentrate?	(1= bad, 10= good)
2. Can you sit quietly?	(1= bad, 10= good)
3. What is your academic development at school?	(1= bad, 10= good)
How can you	(1= bad, 10= good)
– Read
– Write
– Calculate

Notes: T₁-period before the treatment, T₂-1 week after the treatment, T_3–6 months after the treatment.

MorrisSBDeShonRPCombining effect size estimates in meta-analysis with repeated measures and independent-groups designsPsychol Methods20027110512511928886

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