What is Neurofeedback?
21 April 2020
Neurofeedback (NF), or electroencephalogram (EEG) biofeedback, is a relatively new, noninvasive approach for treating multiple brain-related conditions.

To date, EEG - NF has the most supportive evidence for the treatment of ADHD in children.

NF works via the classical operant conditioning mechanisms of learning which train participants to regulate their brain activity by providing them with real-time feedback about their EEG.

The changes in brain wave patterns are presented on a computer screen for visual or auditory feedback. Participants learn to alter their brainwaves to achieve a goal, reinforcing the state of attention.

Most NF protocols for children with ADHD focus on two types of training: theta/beta training to lower the theta /beta ratio, and slow cortical potential training (SCP) to gain control over cortical activation and deactivation.
NF (theta/beta training) is based on the theoretical foundation that EEG of children with ADHD usually show an increased theta /beta ratio compared to children without ADHD.
The theta wave reflects the inattentive state, while the beta wave reflects an attentive state. Repeated training is thought to foster automatization of the learned process with subsequent changes at the behavioral level.

Finally, a recent meta-analysis that included RCTs and specifically looked at long-term effects of neurofeedback, compared to active treatments (including psychostimulants) and semi-active treatments (e.g., cognitive training), found that after on average 6 months followup, the effects of neurofeedback were superior to semiactive control groups and no different from active treatments including methylphenidate. Interestingly, this meta-analysis confirmed the trend for medication effects to diminish with time, and the effects of neurofeedback— without additional sessions being conducted — to increase with time.

Noninvasive, the treatment involves attaching electrodes to the head.

It's important to note that there'll be no pain.

If your child is not independent enough, he needs trainer assistance. By the way, children can receive remote supervising through an online platform that connects them with neurofeedback trainers.

It is estimated that in the US around 10% of children and adolescents with ADHD have received neurofeedback interventions

Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2018). Treatment strategies for ADHD: an evidence-based guide to select optimal treatment. Molecular Psychiatry. doi:10.1038/s41380-018-0116-3
Razoki, B. (2018). Neurofeedback versus psychostimulants in the treatment of children and adolescents with attention-deficit/hyperactivity disorder: a systematic review. Neuropsychiatric Disease and Treatment, Volume 14, 2905–2913. doi:10.2147/ndt.s178839
Enriquez-Geppert, S., Smit, D., Pimenta, M. G., & Arns, M. (2019). Neurofeedback as a Treatment Intervention in ADHD: Current Evidence and Practice. Current Psychiatry Reports, 21(6). doi:10.1007/s11920-019-1021-4

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