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

Micoulaud-Franchi JA, Geoffroy PA, Fond G, Lopez R, Bioulac S, Philip P - Front Hum Neurosci (2014)

Bottom Line: 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]).Future investigations should pay greater attention to adequately blinded studies and EEG-NF protocols that carefully control the implementation and embedding of training.

View Article: PubMed Central - PubMed

Affiliation: Solaris, Unité de Neurophysiologie, Pôle de Psychiatrie Universitaire, Hôpital Sainte-Marguerite Marseille, France ; Institut de Neurosciences Cognitives de la Méditerranée, INCM-CNRS UMR 6193 Marseille, France.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Forest plots with Standardized Mean Difference (SMD), effect size, and homogeneity statistics for the meta-analysis examining total scores of ADHD symptoms, inattention dimension and hyperactivity/Impulsivity dimension assessed by parent (left) and by teacher (right).
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Figure 1: Forest plots with Standardized Mean Difference (SMD), effect size, and homogeneity statistics for the meta-analysis examining total scores of ADHD symptoms, inattention dimension and hyperactivity/Impulsivity dimension assessed by parent (left) and by teacher (right).

Mentions: The overall ADHD score (SMD = −0.49 [−0.74, −0.24], CLR = 3.08, p < 0.001), the inattention score (SMD = −0.46 [−0.76, −0.15], CLR = 3.04, p = 0.003) and the hyperactivity/impulsivity score (SMD = −0.34 [−0.59, −0.09], CLR = 6.55, p = 0.007) were significantly improved in patients receiving EEG-NF compared to controls. The three associated funnel plots were reasonably symmetrical excluding publication biases (Figure 1).


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

Micoulaud-Franchi JA, Geoffroy PA, Fond G, Lopez R, Bioulac S, Philip P - Front Hum Neurosci (2014)

Forest plots with Standardized Mean Difference (SMD), effect size, and homogeneity statistics for the meta-analysis examining total scores of ADHD symptoms, inattention dimension and hyperactivity/Impulsivity dimension assessed by parent (left) and by teacher (right).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230047&req=5

Figure 1: Forest plots with Standardized Mean Difference (SMD), effect size, and homogeneity statistics for the meta-analysis examining total scores of ADHD symptoms, inattention dimension and hyperactivity/Impulsivity dimension assessed by parent (left) and by teacher (right).
Mentions: The overall ADHD score (SMD = −0.49 [−0.74, −0.24], CLR = 3.08, p < 0.001), the inattention score (SMD = −0.46 [−0.76, −0.15], CLR = 3.04, p = 0.003) and the hyperactivity/impulsivity score (SMD = −0.34 [−0.59, −0.09], CLR = 6.55, p = 0.007) were significantly improved in patients receiving EEG-NF compared to controls. The three associated funnel plots were reasonably symmetrical excluding publication biases (Figure 1).

Bottom Line: 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]).Future investigations should pay greater attention to adequately blinded studies and EEG-NF protocols that carefully control the implementation and embedding of training.

View Article: PubMed Central - PubMed

Affiliation: Solaris, Unité de Neurophysiologie, Pôle de Psychiatrie Universitaire, Hôpital Sainte-Marguerite Marseille, France ; Institut de Neurosciences Cognitives de la Méditerranée, INCM-CNRS UMR 6193 Marseille, France.

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus