title: Neurocognitive effects of neurofeedback in adolescents with ADHD: a randomized controlled trial.
abstract: OBJECTIVE
  Neurofeedback aims to reduce symptoms of attention-deficit/hyperactivity disorder (ADHD), mainly attention problems. However, the additional influence of neurofeedback over treatment as usual (TAU) on neurocognitive functioning for adolescents with ADHD remains unclear.
  
  
  METHODS
  By using a multicenter parallel randomized controlled trial (RCT) design, male adolescents with a DSM-IV-TR diagnosis of ADHD (mean age = 16.1 years; range, 12-24) were randomized to receive either a combination of TAU and neurofeedback (n = 45) or TAU (n = 26). Randomization was computer generated and stratified by age group (ages 12 through 15, 16 through 20, and 21 through 24 years). The neurofeedback intervention consisted of approximately 37 sessions over a period of 25 weeks of theta/sensorimotor rhythm training on the vertex (Cz). Primary neurocognitive outcomes included performance parameters derived from the D2 Test of Attention, the Digit Span backward, the Stroop Color-Word Test and the Tower of London, all assessed preintervention and postintervention. Data were collected between December 2009 and July 2012.
  
  
  RESULTS
  At postintervention, outcomes of attention and/or motor speed were improved, with faster processing times for both intervention conditions and with medium to large effect sizes (range, ηp2 = .08-.54; P values < .023). In both groups, no improvements for higher executive functions were observed. Results might partly resemble practice effects.
  
  
  CONCLUSIONS
  Although neurocognitive outcomes improved in all adolescents receiving treatment for ADHD, no additional value for neurofeedback over TAU was observed. Hence, this study does not provide evidence for using theta/sensorimotor rhythm neurofeedback to enhance neurocognitive performance as additional intervention to TAU for adolescents with ADHD symptoms.
  
  
  BACKGROUND
  Trialregister.nl identifier: 1759.
authors.affiliation: Tilburg University, Scientific Center for Care & Welfare (Tranzo), PO Box 90153 (T618), 5000 LE, Tilburg, the Netherlands m.bink@ggze.nl.
authors.forename: Marleen
authors.initials: M
authors.lastname: Bink
authors.forename: Chijs
authors.initials: C
authors.lastname: van Nieuwenhuizen
authors.forename: Arne
authors.initials: A
authors.lastname: Popma
authors.forename: Ilja L
authors.initials: IL
authors.lastname: Bongers
authors.forename: Geert J M
authors.initials: GJ
authors.lastname: van Boxtel
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods*; D003913:Dextroamphetamine / Q000627:therapeutic use; D004569:Electroencephalography / Q000295:instrumentation / Q000379:methods*; D005196:Family Therapy / Q000379:methods; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use; D058765:Neurofeedback / Q000295:instrumentation / Q000379:methods*; D009483:Neuropsychological Tests; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D003913:Dextroamphetamine