EEG neurofeedback treatments in children with ADHD: an updated meta-analysis of randomized controlled trials

OBJECTIVE: We undertook a meta-analysis of published Randomized Controlled Trials (RCT) with semi-active control and sham-NF groups to determine whether Electroencephalogram-neurofeedback (EEG-NF) significantly improves the overall symptoms, inattention and hyperactivity/impulsivity dimensions for probably unblinded assessment (parent assessment) and probably blinded assessment (teacher assessment) in children with Attention Deficit Hyperactivity Disorder (ADHD). DATA SOURCES: A systematic review identified independent studies that were eligible for inclusion in a random effects meta-analysis. DATA EXTRACTION: Effect sizes for ADHD symptoms were expressed as standardized mean differences (SMD) with 95% confidence intervals. RESULTS: Five identified studies met eligibility criteria, 263 patients with ADHD were included, 146 patients were trained with EEG-NF. On parent assessment (probably unblinded assessment), the overall ADHD score (SMD = -0.49 -0.74, -0.24), the inattention score (SMD = -0.46 -0.76, -0.15) and the hyperactivity/impulsivity score (SMD = -0.34 -0.59, -0.09) were significantly improved in patients receiving EEG-NF compared to controls. On teacher assessment (probably blinded assessment), only the inattention score was significantly improved in patients receiving EEG-NF compared to controls (SMD = -0.30 -0.58, -0.03). CONCLUSIONS: This meta-analysis of EEG-NF in children with ADHD highlights improvement in the inattention dimension of ADHD symptoms. Future investigations should pay greater attention to adequately blinded studies and EEG-NF protocols that carefully control the implementation and embedding of training.