National Institute of Developmental Psychiatry for Children and Adolescents-INCT-CNPq, São Paulo, Brazil.
Neurotherapeutics. 2012 Jul;9(3):588-98. doi: 10.1007/s13311-012-0136-7.
Neurofeedback (NF) is a training to enhance self-regulatory capacity over brain activity patterns and consequently over brain mental states. Recent findings suggest that NF is a promising alternative for the treatment of attention-deficit/hyperactivity disorder (ADHD). We comprehensively reviewed literature searching for studies on the effectiveness and specificity of NF for the treatment of ADHD. In addition, clinically informative evidence-based data are discussed. We found 3 systematic review on the use of NF for ADHD and 6 randomized controlled trials that have not been included in these reviews. Most nonrandomized controlled trials found positive results with medium-to-large effect sizes, but the evidence for effectiveness are less robust when only randomized controlled studies are considered. The direct comparison of NF and sham-NF in 3 published studies have found no group differences, nevertheless methodological caveats, such as the quality of the training protocol used, sample size, and sample selection may have contributed to the negative results. Further data on specificity comes from electrophysiological studies reporting that NF effectively changes brain activity patterns. No safety issues have emerged from clinical trials and NF seems to be well tolerated and accepted. Follow-up studies support long-term effects of NF. Currently there is no available data to guide clinicians on the predictors of response to NF and on optimal treatment protocol. In conclusion, NF is a valid option for the treatment for ADHD, but further evidence is required to guide its use.
神经反馈（NF）是一种训练，旨在增强对大脑活动模式和大脑心理状态的自我调节能力。最近的发现表明，NF 是治疗注意力缺陷/多动障碍（ADHD）的一种很有前途的替代方法。我们全面回顾了文献，寻找关于 NF 治疗 ADHD 的有效性和特异性的研究。此外，还讨论了基于临床信息的循证数据。我们发现了 3 项关于 NF 治疗 ADHD 的系统评价和 6 项未包含在这些评价中的随机对照试验。大多数非随机对照试验发现了具有中到大效应量的积极结果，但当仅考虑随机对照研究时，有效性的证据就不那么可靠了。在 3 项已发表的研究中，NF 与假 NF 的直接比较未发现组间差异，但方法上的注意事项，如使用的训练方案的质量、样本量和样本选择，可能导致了阴性结果。来自报告 NF 有效改变大脑活动模式的电生理学研究的特异性进一步数据。临床试验没有出现安全问题，NF 似乎耐受性良好且被接受。随访研究支持 NF 的长期效果。目前没有可用的数据来指导临床医生关于 NF 反应的预测因素和最佳治疗方案。总之，NF 是治疗 ADHD 的有效选择，但需要更多的证据来指导其使用。
