Comparison of the Effectiveness of Neurofeedback and LORETA Neurofeedback in Improving Executive Functions and Sustained Attention in Children with Attention-Deficit/Hyperactivity Disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood, characterized by deficits in sustained attention and executive functions. In recent years, neurofeedback has gained attention as a non-invasive method for improving cognitive performance in children with ADHD. The present study aimed to compare the effectiveness of traditional neurofeedback and LORETA neurofeedback in improving sustained attention and components of executive functioning in this group of children. This study employed a quasi-experimental pretest-posttest design with a control group. The statistical population consisted of all children aged 8 to 12 years diagnosed with ADHD who attended Mehrdoostan Psychological and Counseling Clinic in Tehran in 2024. Sixty children were randomly selected and assigned into three groups of 20 participants each: traditional neurofeedback, LORETA neurofeedback, and control. The measurement instruments included the Continuous Performance Test (CPT), Stroop Test, Tower of London Test (TOL), NEPSY-II, and the Conners’ Parent Rating Scale. The neurofeedback interventions were conducted over 20 sessions of 45 minutes each. Data were analyzed using analysis of variance (ANOVA), post-hoc tests, and within-group t-tests. The results indicated that both interventions led to significant improvements in sustained attention, working memory, response inhibition, and cognitive flexibility (p < .001); however, LORETA neurofeedback demonstrated greater effectiveness compared to traditional neurofeedback. The therapeutic effects were sustained during the three-month follow-up period. Post-hoc analyses confirmed significant differences between the LORETA group and the other groups across all variables (p < .05). The findings suggest that LORETA neurofeedback can serve as an effective and lasting method for enhancing executive functions and sustained attention in children with ADHD. It is recommended that this approach be incorporated alongside other interventions in comprehensive treatment programs.