Clinical and Experimental Factors Influencing the Efficacy of Neurofeedback in ADHD

A Meta-Analysis

Bibliographic Data

ID15525187
AuthorsAurore Bussalb (0000-0002-8531-701X, Hôpital Robert-Debré, corresponding author), Marco Congedo (0000-0003-2196-0409, Institut polytechnique de Grenoble), Quentin Barthélemy (0000-0002-7059-6028, Mensia (France)), David Ojeda (0000-0001-5379-8069, Mensia (France)), Éric Acquaviva (0000-0001-7664-5313, Hôpital Robert-Debré), Richard Delorme (0000-0002-5614-3663, Hôpital Robert-Debré), Louis Mayaud (0000-0002-3187-8030, Mensia (France))
Year2019
Volume10
Pages35-35
Publication date2019-02-18
Open AccessYes
TypeARTICLE
VenueFrontiers in Psychiatry (JOURNAL)
Journal identifiersISSN: 1664-0640 • E-ISSN: 1664-0640
PublisherFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2019.00035
PMID30833909
OpenAlexW2917154121
LanguageEN
Citations received2
References cited95

Meta-analyses have been extensively used to evaluate the efficacy of neurofeedback (NFB) treatment for Attention Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. However, each meta-analysis published in the past decade has contradicted the methods and results from the previous one, thus making it difficult to determine a consensus of opinion on the effectiveness of NFB. This works brings continuity to the field by extending and discussing the last and much controversial meta-analysis by Cortese et al. (1). The extension comprises an update of that work including the latest control trials, which have since been published and, most importantly, offers a novel methodology. Specifically, NFB literature is characterized by a high technical and methodological heterogeneity, which partly explains the current lack of consensus on the efficacy of NFB. This work takes advantage of this by performing a Systematic Analysis of Biases (SAOB) in studies included in the previous meta-analysis. Our extended meta-analysis (k = 16 studies) confirmed the previously obtained results of effect sizes in favor of NFB efficacy as being significant when clinical scales of ADHD are rated by parents (non-blind, p -value = 0.0014), but not when they are rated by teachers (probably blind, p -value = 0.27). The effect size is significant according to both raters for the subset of studies meeting the definition of "standard NFB protocols" (parents' p -value = 0.0054; teachers' p -value = 0.043, k = 4). Following this, the SAOB performed on k = 33 trials identified three main factors that have an impact on NFB efficacy: first, a more intensive treatment, but not treatment duration, is associated with higher efficacy; second, teachers report a lower improvement compared to parents; third, using high-quality EEG equipment improves the effectiveness of the NFB treatment. The identification of biases relating to an appropriate technical implementation of NFB certainly supports the efficacy of NFB as an intervention. The data presented also suggest that the probably blind assessment of teachers may not be considered a good proxy for blind assessments, therefore stressing the need for studies with placebo-controlled intervention as well as carefully reported neuromarker changes in relation to clinical response

Meta-analysis · Neurofeedback · Psychiatry · Publication bias · Value (mathematics · Attention Deficit Hyperactivity Disorder · Clinical Psychology · Computer Science · EEG and Brain-Computer Interfaces · Medicine · Neural and Behavioral Psychology Studies · Psychology · Internal Medicine

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