An RCT into the effects of neurofeedback on neurocognitive functioning compared to stimulant medication and physical activity in children with ADHD.
An RCT into the effects of neurofeedback on neurocognitive functioning compared to stimulant medication and physical activity in children with ADHD.
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DOI：
10.1007/s00787-016-0902-x
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发表时间：
2017-04
影响因子：
6.4
通讯作者：
Oosterlaan J
中科院分区：
文献类型：
--
作者：
Geladé K;Bink M;Janssen TW;van Mourik R;Maras A;Oosterlaan J
神经反馈（NFB）是ADHD儿童的潜在替代治疗方法，旨在优化大脑活动。虽然大多数研究NFB的行为影响，较少关注的神经认知功能的影响。本随机对照试验（RCT）比较了NFB与（1）最佳滴定哌甲酯（MPH）和（2）半主动对照干预（体力活动（PA））的神经认知效应，以控制非特异性效应。采用多中心三向平行组RCT设计，将7-13岁ADHD儿童随机分配到NFB（n = 39），MPH（n = 36）或PA（n = 37），为期10-12周。NFB包括在CZ的theta/beta培训。PA干预的频率和持续时间与NFB相匹配。使用双盲安慰剂对照程序滴定MPH以确定最佳剂量。神经认知功能进行了评估，使用来自听觉oddball，停止信号和视觉空间工作记忆任务的参数。数据收集时间为2010年9月至2014年3月。意向治疗分析显示，与NFB和PA相比，MPH的注意力得到改善，这反映在古怪任务期间反应速度降低[η p2 = 0.21，p < 0.001]，以及抑制、冲动和注意力得到改善，这反映在更快的停止信号反应时间上，在停止信号任务期间较低的执行和遗漏错误率（范围η p2 = 0.09-0.18，p值<0.008）。工作记忆随时间改善，与接受治疗无关（η p2 = 0.17，p < 0.001）。总的来说，兴奋剂药物在改善神经认知功能方面表现出上级效果。因此，研究结果不支持theta/beta训练作为ADHD儿童的独立治疗。本文的在线版本（doi：10.1007/s 00787 -016-0902-x）包含补充材料，可供授权用户使用。
Neurofeedback (NFB) is a potential alternative treatment for children with ADHD that aims to optimize brain activity. Whereas most studies into NFB have investigated behavioral effects, less attention has been paid to the effects on neurocognitive functioning. The present randomized controlled trial (RCT) compared neurocognitive effects of NFB to (1) optimally titrated methylphenidate (MPH) and (2) a semi-active control intervention, physical activity (PA), to control for non-specific effects. Using a multicentre three-way parallel group RCT design, children with ADHD, aged 7–13, were randomly allocated to NFB (n = 39), MPH (n = 36) or PA (n = 37) over a period of 10–12 weeks. NFB comprised theta/beta training at CZ. The PA intervention was matched in frequency and duration to NFB. MPH was titrated using a double-blind placebo controlled procedure to determine the optimal dose. Neurocognitive functioning was assessed using parameters derived from the auditory oddball-, stop-signal- and visual spatial working memory task. Data collection took place between September 2010 and March 2014. Intention-to-treat analyses showed improved attention for MPH compared to NFB and PA, as reflected by decreased response speed during the oddball task [η p2 = 0.21, p < 0.001], as well as improved inhibition, impulsivity and attention, as reflected by faster stop signal reaction times, lower commission and omission error rates during the stop-signal task (range η p2 = 0.09–0.18, p values <0.008). Working memory improved over time, irrespective of received treatment (η p2 = 0.17, p < 0.001). Overall, stimulant medication showed superior effects over NFB to improve neurocognitive functioning. Hence, the findings do not support theta/beta training applied as a stand-alone treatment in children with ADHD. The online version of this article (doi:10.1007/s00787-016-0902-x) contains supplementary material, which is available to authorized users.