Children, young people and adults are increasingly being diagnosed with Attention deficit hyperactivity disorder (ADHD) has been raised. At the same time, interest in alternative and complementary treatment methods is growing. In particular, the Neurofeedback has become much more widely recognised in recent years. This blog post provides a clear overview of how neurofeedback is used to treat ADHD and how it can be integrated into a holistic treatment programme.
What is neurofeedback?
Neurofeedback is a specialised form of Biofeedback, in which brain activity is measured byEEG sensoris measured and visually fed back. Whilst traditional biofeedback involves monitoring physiological signals such as heart rate or skin conductance, neurofeedback focuses on the brain.
The aim of neurofeedback training is to specifically enhance or inhibit certain brain waves in order to improve the brain’s self-regulation. To this end, EEG signals are broken down into different frequency ranges. In the treatment of ADHD, the focus is often on enhancing beta activity (12–30 Hz), which is associated with concentration and attention, and on reducing theta activity (4–8 Hz), which is linked to daydreaming and low alertness.
How does neurofeedback work for ADHD?
In people with ADHD, an imbalance in certain brainwave patterns is usually observed. For example, theta waves – which are associated with daydreaming and a relaxed waking state, amongst other things – are often overactive, whilst beta waves, which occur during concentration and focused attention, may show reduced activity. With the help of neurofeedback, those affected can work specifically and actively to consciously influence their brain activity in the desired direction, which can lead to improved concentration and emotional control.
People with ADHD often exhibit an imbalance in their brainwave patterns: the slow theta waves are frequently overactive, whilst the faster beta waves – which are responsible for focused attention – are underactive. This is precisely where neurofeedback comes in: through targeted training, children and adults learn to consciously regulate their brain activity, which can lead to improved concentration and emotional control.
The use of neurofeedback in therapy and occupational therapy
Neurofeedback for ADHD can be used both as an alternative to medication and as a complementary therapy – for children as well as adults. At the start of therapeutic treatment for ADHD, neurofeedback can be used as a diagnostic tool to guide future (multimodal) treatment planning. Twenty to forty sessions are generally recommended, ideally two to three times a week. The exact number depends on the individual’s progress and how the treatment is going.
Studies on effectiveness: What does the research say?
Numerous studies have demonstrated the effectiveness of neurofeedback in ADHD:
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Improvements in attention, working memory and [1,3]
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Positive effects on everyday school and social life [2]
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Long-term benefits – even 6 to 12 months after the end of treatment [4,5,8]
When used in combination with medication, neurofeedback can bring about further improvements in ADHD symptoms. Studies show, for example, that:
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Greater reduction in core ADHD symptoms [6,7]
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Long-term stability of treatment effects [8]
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Particularly good results have been achieved with children with severe or very mild cognitive deficits [9]
Key success factors are:
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High frequency of meetings
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Professional EEG analysis [10]
Conclusion: Neurofeedback as a modern treatment option for ADHD
Neurofeedback is a scientifically proven method with no side effects that can be used with both children and adults with ADHD. By training brain activity, it is possible to bring about lasting improvements in concentration, self-regulation and everyday coping skills.
Whether used on its own or as a complement to medication, neurofeedback is particularly valuable when the aim is to achieve a long-term, personalised solution. It is when neurofeedback is combined with other therapeutic approaches – such as behavioural therapy or occupational therapy – that it realises its full potential.
It is important to note that training should always be supervised by qualified professionals be carried out in order to ensure long-term success.
Sources
[1] Shereena, E. A., Gupta, R. K., Bennett, C. N., Sagar, K. J. V. & Rajeswaran, J. (2018). EEG Neurofeedback Training in Children with Attention Deficit/Hyperactivity Disorder: A Study of Cognitive and Behavioural Outcomes. Clinical EEG and Neuroscience, 50(4), 242–255. https://doi.org/10.1177/1550059418813034
[2] Moreno-García, I., Cano-Crespo, A. & Rivera, F. (2022). Results of Neurofeedback in the Treatment of Children with ADHD: A Systematic Review of Randomised Controlled Trials. Applied Psychophysiology And Biofeedback, 47(3), 145–181. https://doi.org/10.1007/s10484-022-09547-1
[3] Moradi, N., Rajabi, S. & Nejad, A. M. (2022b). The effect of neurofeedback training combined with computer-based cognitive games on time perception, attention and working memory in children with ADHD. Applied Neuropsychology: Child, 13(1), 24–36. https://doi.org/10.1080/21622965.2022.2112679
[4] Dobrakowski, P. & Łebecka, G. (2019). Individualised neurofeedback training may help achieve long-term improvement in working memory in children with ADHD. Clinical EEG and Neuroscience, 51(2), 94–101. https://doi.org/10.1177/1550059419879020
[5] Van Doren, J., Arns, M., Heinrich, H., Vollebregt, M. A., Strehl, U. & Loo, S. K. (2018). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European Child and Adolescent Psychiatry, 28(3), 293–305. https://doi.org/10.1007/s00787-018-1121-4
[6] Pakdaman, F., Irani, F., Tajikzadeh, F. & Jabalkandi, S. A. (2018). The efficacy of Ritalin in children with ADHD undergoing neurofeedback training. Neurological Sciences, 39(12), 2071–2078. https://doi.org/10.1007/s10072-018-3539-3
[7] Lin, F., Sun, C., Cheng, Y., Wang, M. Y., Chung, W., Tzang, R., Chiu, H., Cheng, Y. & Tu, K. (2022). Additive effects of EEG neurofeedback on medications for ADHD: a systematic review and meta-analysis. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-23015-0
[8] Arns, M., Clark, C. R., Trullinger, M., deBeus, R., Mack, M. & Aniftos, M. (2020). Neurofeedback and Attention-Deficit/Hyperactivity Disorder (ADHD) in Children: Assessing the Evidence and Proposed Guidelines. Applied Psychophysiology And Biofeedback, 45(2), 39–48. https://doi.org/10.1007/s10484-020-09455-2
[9] Ging-Jehli, N. R., Kraemer, H. C., Arnold, L. E., Roley-Roberts, M. E. & deBeus, R. (2023). Cognitive markers for the efficacy of neurofeedback in attention-deficit hyperactivity disorder – personalised medicine using computational psychiatry in a randomised clinical trial. Journal of Clinical and Experimental Neuropsychology, 45(2), 118–131. https://doi.org/10.1080/13803395.2023.2206637
[10] Bussalb, A., Congedo, M., Barthélemy, Q., Ojeda, D., Acquaviva, E., Delorme, R. & Mayaud, L. (2019). Clinical and Experimental Factors Influencing the Efficacy of Neurofeedback in ADHD: A Meta-Analysis. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00035
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