title: EEG neurofeedback treatments in children with ADHD: an updated meta-analysis of randomized controlled trials.
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).
  
  
  METHODS
  A systematic review identified independent studies that were eligible for inclusion in a random effects meta-analysis.
  
  
  METHODS
  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.
authors.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.
authors.forename: Jean-Arthur
authors.initials: JA
authors.lastname: Micoulaud-Franchi
authors.affiliation: Inserm, UMR-S 1144 Paris, France ; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, Pôle Neurosciences Paris, France ; UMR-S 1144, Université Paris Descartes and Université Paris Diderot Paris, France ; Fondation FondaMental Créteil, France.
authors.forename: Pierre Alexis
authors.initials: PA
authors.lastname: Geoffroy
authors.affiliation: Fondation FondaMental Créteil, France ; Université Paris Est-Créteil, Pôle de Psychiatrie du Groupe des Hôpitaux Universitaires de Mondor, DHU Pe-psy, INSERM U955, Eq Psychiatrie Génétique, Réseau des Centres Experts Schizophrénie de France Créteil, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Fond
authors.affiliation: Centre de Référence National Narcolepsie-hypersomnie Idiopathique, Unité des Troubles du Sommeil, CHU Gui de Chauliac Montpellier, France ; NSERM U1061 Montpellier, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Centre Hospitalier Charles Perrens, Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent Bordeaux, France ; USR CNRS 3413 SANPSY, Clinique du Sommeil, CHU Pellegrin, Université de Bordeaux Bordeaux, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Bioulac
authors.affiliation: USR CNRS 3413 SANPSY, Clinique du Sommeil, CHU Pellegrin, Université de Bordeaux Bordeaux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Philip
keywords: attention deficit hyperactivity disorder; learning; neurofeedback; practice guidelines; randomized controlled trial