Sudnawa Khemika Khemakanok, Chirdkiatgumchai Vilawan, Ruangdaraganon Nichara, Khongkhatithum Chaiyos, Udomsubpayakul Umaporn, Jirayucharoensak Suwicha, Israsena Pasin
Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pediatr Int. 2018 Sep;60(9):828-834. doi: 10.1111/ped.13641. Epub 2018 Sep 5.
Neurofeedback (NF) is an operant conditioning procedure that trains participants to self-regulate brain activity. NF is a promising treatment for attention-deficit/hyperactivity disorder (ADHD), but there have been only a few randomized controlled trials comparing the effectiveness of NF with medication with various NF protocols. The aim of this study was therefore to evaluate the effectiveness of unipolar electrode NF using theta/beta protocol compared with methylphenidate (MPH) for ADHD.
Children with newly diagnosed ADHD were randomly organized into NF and MPH groups. The NF group received 30 sessions of NF. Children in the MPH group were prescribed MPH for 12 weeks. Vanderbilt ADHD rating scales were completed by parents and teachers to evaluate ADHD symptoms before and after treatment. Student's t-test and Cohen's d were used to compare symptoms between groups and evaluate the effect size (ES) of each treatment, respectively.
Forty children participated in the study. No differences in ADHD baseline symptoms were found between groups. After treatment, teachers reported significantly lower ADHD symptoms in the MPH group (P = 0.01), but there were no differences between groups on parent report (P = 0.55). MPH had a large ES (Cohen's d, 1.30-1.69), while NF had a moderate ES (Cohen's d, 0.49-0.68) for treatment of ADHD symptoms.
Neurofeedback is a promising alternative treatment for ADHD in children who do not respond to or experience significant adverse effects from ADHD medication.
神经反馈（NF）是一种操作性条件反射程序，可训练参与者自我调节大脑活动。NF是治疗注意力缺陷多动障碍（ADHD）的一种有前景的方法，但仅有少数随机对照试验比较了不同NF方案与药物治疗ADHD的有效性。因此，本研究旨在评估与哌甲酯（MPH）相比，采用θ/β方案的单极电极NF治疗ADHD的有效性。
将新诊断的ADHD儿童随机分为NF组和MPH组。NF组接受30次NF治疗。MPH组儿童接受12周的MPH治疗。治疗前后，由家长和教师完成范德比尔特ADHD评定量表，以评估ADHD症状。分别采用学生t检验和科恩d值比较两组症状，并评估每种治疗方法的效应大小（ES）。
40名儿童参与了本研究。两组间ADHD基线症状无差异。治疗后，教师报告MPH组的ADHD症状显著减轻（P = 0.01），但家长报告的两组间无差异（P = 0.55）。MPH治疗ADHD症状的ES较大（科恩d值，1.30 - 1.69），而NF的ES中等（科恩d值，0.49 - 0.68）。
对于对ADHD药物无反应或出现明显不良反应的儿童，神经反馈是一种有前景的ADHD替代治疗方法。
