Neurofeedback training shows no benefit for attention and inhibition in adults with ADHD
Photo by Peter Burdon / Unsplash
Key Takeaway
Note: Neurofeedback showed no clear benefit for attention or inhibition in adults with ADHD in this small trial.
This randomized controlled trial evaluated neurofeedback (NFB) training versus a waitlist control in 44 adults with ADHD (NFB group n=23; waitlist group n=21). The study did not report a primary outcome and was a secondary analysis. Assessments were conducted before and after the NFB training period.
The main analyses focused on TOVA behavioral performance and neural indices, including event-related potentials and power spectral density. The investigators reported no meaningful evidence for NFB-specific improvements in TOVA performance over time. They also found no evidence that NFB modulated event-related potentials or spectral indices relative to the ADHD-W group.
No adverse events, serious adverse events, discontinuations, or tolerability data were reported. Key limitations include the absence of a prespecified primary outcome, a small sample size, and the use of secondary analyses. Bayesian linear mixed models were used, but no effect sizes or confidence intervals were reported.
Given these limitations, the study does not demonstrate causal efficacy for NFB treatment. The practice relevance is limited, as there was no evidence that NFB meaningfully benefits sustained attention or inhibitory control in this adult ADHD population.
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View Original Abstract ↓
Attention-deficit/hyperactivity disorder (ADHD) is associated with impairments in sustained attention and inhibitory control. Neurofeedback (NFB) is a widely used non-pharmacological treatment for ADHD and is generally well tolerated, but evidence for its efficacy remains mixed. Here we report results from secondary analysis of a randomized controlled trial of NFB training for adult ADHD, analysing behaviour and neural data from attention testing in both test-retest and treatment-vs-waiting list control group contrasts. We used electroencephalography (EEG) to investigate event-related cortical dynamics during the Test of Variables of Attention (TOVA), administered before and after NFB treatment. 44 adults with ADHD (NFB treatment, ADHD-T: n = 23; waitlist control, ADHD-W: n = 21) completed the TOVA before and after the NFB training period, while 128-channel EEG was recorded. Treatment-related change was examined through analyses based on behavioural TOVA performance, power spectral density, and event-related potentials, analysed with Bayesian linear mixed models. We found no meaningful evidence for NFB-specific improvements in TOVA behavioural performance over time, and no evidence that NFB modulated ERP or spectral indices relative to the ADHD-W group. Overall, we found no evidence that NFB treatment meaningfully benefited sustained attention or inhibitory control in adults with ADHD.
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