Gevensleben Holger, Holl Birgit, Albrecht Björn, Vogel Claudia, Schlamp Dieter, Kratz Oliver, Studer Petra, Rothenberger Aribert, Moll Gunther H, Heinrich Hartmut
Child & Adolescent Psychiatry, University of Göttingen, Germany.
J Child Psychol Psychiatry. 2009 Jul;50(7):780-9. doi: 10.1111/j.1469-7610.2008.02033.x. Epub 2009 Jan 12.
For children with attention deficit/hyperactivity disorder (ADHD), a reduction of inattention, impulsivity and hyperactivity by neurofeedback (NF) has been reported in several studies. But so far, unspecific training effects have not been adequately controlled for and/or studies do not provide sufficient statistical power. To overcome these methodological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite randomised controlled study using a computerised attention skills training as a control condition.
102 children with ADHD, aged 8 to 12 years, participated in the study. Children performed either 36 sessions of NF training or a computerised attention skills training within two blocks of about four weeks each (randomised group assignment). The combined NF treatment consisted of one block of theta/beta training and one block of slow cortical potential (SCP) training. Pre-training, intermediate and post-training assessment encompassed several behaviour rating scales (e.g., the German ADHD rating scale, FBB-HKS) completed by parents and teachers. Evaluation ('placebo') scales were applied to control for parental expectations and satisfaction with the treatment.
For parent and teacher ratings, improvements in the NF group were superior to those of the control group. For the parent-rated FBB-HKS total score (primary outcome measure), the effect size was .60. Comparable effects were obtained for the two NF protocols (theta/beta training, SCP training). Parental attitude towards the treatment did not differ between NF and control group.
Superiority of the combined NF training indicates clinical efficacy of NF in children with ADHD. Future studies should further address the specificity of effects and how to optimise the benefit of NF as treatment module for ADHD.
多项研究报告称,对于患有注意力缺陷多动障碍(ADHD)的儿童,神经反馈(NF)可减少其注意力不集中、冲动和多动症状。但到目前为止,尚未充分控制非特异性训练效果,且/或研究没有提供足够的统计效力。为克服这些方法学上的缺点,我们在一项多中心随机对照研究中评估了神经反馈对ADHD儿童的临床疗效,该研究使用计算机化注意力技能训练作为对照条件。
102名8至12岁的ADHD儿童参与了该研究。儿童在两个约四周的时间段内分别进行36次NF训练或计算机化注意力技能训练(随机分组)。联合NF治疗包括一个theta/β训练模块和一个慢皮层电位(SCP)训练模块。训练前、训练中期和训练后的评估包括由家长和教师完成的多个行为评定量表(如德国ADHD评定量表,FBB-HKS)。使用评估(“安慰剂”)量表来控制家长的期望和对治疗的满意度。
对于家长和教师的评分,NF组的改善情况优于对照组。对于家长评定的FBB-HKS总分(主要结局指标),效应大小为0.60。两种NF方案(theta/β训练、SCP训练)均获得了类似的效果。NF组和对照组家长对治疗的态度没有差异。
联合NF训练的优越性表明NF对ADHD儿童具有临床疗效。未来的研究应进一步探讨效果的特异性,以及如何优化NF作为ADHD治疗模块的益处。