Efficacy of Neurofeedback Treatment in ADHD
Link to Meta-Analysis showing strong effect size for neurofeedback.
Clinical EEG and Neuroscience. 2009 Vol. 40 No. 3
Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity:
Martijn Arns 1,2,*, Sabine de Ridder 2, Ute Strehl 3, Marinus Breteler 4, 5 & Anton Coenen 5
1 Brainclinics Diagnostics, Nijmegen, The Netherlands
2 Brainclinics Treatment, Nijmegen, The Netherlands
3 University of Tuebingen, Germany
4 EEG Resource Institute, Nijmegen, The Netherlands
5 Radboud University, Nijmegen, The Netherlands
of Neurofeedback treatment in ADHD: The effects on Inattention,
Impulsivity and Hyperactivity: A meta-analysis (In Press). Martijn Arns,
Sabine de Ridder, Ute Strehl, Marinus Breteler & Anton Coenen. EEG and Clinical Neuroscience, 40: 180-189.
the first reports of neurofeedback treatment in ADHD in 1976 many
studies have been carried out investigating the effects of neurofeedback
on different symptoms of ADHD such as inattention, impulsivity and
hyperactivity. This technique is also used by many practitioners, but
the question as to the evidence-based level of this treatment is still
unclear. In this study selected research on neurofeedback treatment for
ADHD was collected and a meta-analysis was performed.
prospective controlled studies and studies employing a pre- and
post-design found large effect sizes (ES) for neurofeedback on
impulsivity and inattention and a medium ES for hyperactivity.
Randomized studies demonstrated a lower ES for hyperactivity suggesting
that hyperactivity is probably most sensitive to non-specific treatment
Due to the inclusion of some very recent and sound
methodological studies in this meta-analysis potential confounding
factors such as small studies, lack of randomization in previous studies
and a lack of adequate control groups have been addressed and the
clinical effects of neurofeedback in the treatment of ADHD can be
regarded as clinically meaningful. Three randomized studies have
employed a semi-active control group which can be regarded as a credible
sham control providing an equal level of cognitive training and
client-therapist interaction. Therefore, in line with the AAPB and ISNR
guidelines for rating clinical efficacy, we conclude that neurofeedback
treatment for ADHD can be considered ‘Efficacious and Specific’ (Level
5) with a large ES for inattention and impulsivity and a medium ES for
Keywords: Neurofeedback, EEG Biofeedback, ADHD, meta-analysis, inattention, impulsivity, hyperactivity.
wish to acknowledge the following people for providing us with
additional information for the meta-analysis : Hartmut Heinrich, Petra
Studer, Jochen Kaiser, David Kaiser, Michael Linden, Johanne Lévesque,
Martin Holtmann, Ulrike Leins, Domenic Greco, André Achim, Geneviève
Moreau and Ali Reza Bakhshayesh. We also wish to acknowledge the support
of Desiree Spronk in the preparation of this manuscript.