Efficacy of Neurofeedback Treatment in ADHD: the Effects on Inattention, Impulsivity and Hyperactivity: a Meta-Analysis
Efficacy of Neurofeedback Treatment in ADHD: the Effects on Inattention, Impulsivity and Hyperactivity: a Meta-Analysis
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DOI：
10.1177/155005940904000311
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发表时间：
2009-07-01
影响因子：
2
通讯作者：
Coenen, Anton
中科院分区：
文献类型：
--
作者：
Arns, Martijn;de Ridder, Sabine;Coenen, Anton
自1976年首次报道神经反馈治疗注意缺陷多动障碍（ADHD）以来，许多研究调查了神经反馈对ADHD不同症状的影响，如注意力不集中，冲动和多动。这种技术也被许多医生使用，但这种治疗的循证水平问题仍不清楚。在这项研究中，选择了神经反馈治疗ADHD的研究，并进行了荟萃分析，前瞻性对照研究和研究采用前和后设计发现大的影响大小（ES）的神经反馈冲动和注意力不集中和中等的ES多动。随机研究表明，多动的ES较低，表明多动可能对非特异性治疗因素最敏感。由于在本荟萃分析中纳入了一些最近和合理的方法学研究，潜在的混杂因素，如小型研究，既往研究缺乏随机化和缺乏足够的对照组，神经反馈治疗ADHD的临床效果具有临床意义。三项随机研究采用了半主动对照组，该对照组可被视为可信的假对照组，提供了同等水平的认知训练和客户-治疗师互动。因此，根据AAPB和ISNR的临床疗效评定指南，我们得出结论，ADHD的神经反馈治疗可以被认为是“有效和特异性的”（5级），注意力不集中和冲动的ES较大，多动的ES中等。
Since the first reports of neurofeedback treatment in Attention Deficit Hyperactivity Disorder (ADHD) in 1976, many studies have investigated the effects of neurofeedback on different symptoms of ADHD such as inattention, impulsivity and hyperactivity. This technique is also used by many practitioners, but the question as to the evidence-based level of this treatment is still unclear. In this study selected research on neurofeedback treatment for ADHD was collected and a meta-analysis was performed.Both prospective controlled studies and studies employing a pre- and post-design found large effect sizes (ES) for neurofeedback on impulsivity and inattention and a medium ES for hyperactivity. Randomized studies demonstrated a lower ES for hyperactivity suggesting that hyperactivity is probably most sensitive to nonspecific treatment factors.Due to the inclusion of some very recent and sound methodological studies in this meta-analysis, potential confounding factors such as small studies, lack of randomization in previous studies and a lack of adequate control groups have been addressed, and the clinical effects of neurofeedback in the treatment of ADHD can be regarded as clinically meaningful. Three randomized studies have employed a semi-active control group which can be regarded as a credible sham control providing an equal level of cognitive training and client-therapist interaction. Therefore, in line with the AAPB and ISNR guidelines for rating clinical efficacy, we conclude that neurofeedback treatment for ADHD can be considered "Efficacious and Specific" (Level 5) with a large ES for inattention and impulsivity and a medium ES for hyperactivity.