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Neurofeedback in ADHD
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Neurofeedback in ADHD

By Hartmut Heinrich (editor)
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Book Description

Neurofeedback is an operant learning procedure where participants learn to gain self-control over specific aspects of neural activity. Thus, depending on the neurofeedback protocol applied behavioural, cognitive and / or emotional effects can be induced. Different assumptions about mechanisms, moderators and mediators of neurofeedback exist, associated with different ways of application. 



EEG-based neurofeedback is used as a therapeutic approach in attention-deficit / hyperactivity disorder (ADHD), a clinically and pathophysiologically heterogeneous child psychiatric disorder. There is increasing evidence for specific effects of neurofeedback when applying 'standard' protocols (slow cortical potentials, theta/beta, SMR). Knowledge about underlying mechanisms and moderating variables is increasing. Nevertheless, further well-controlled and conducted trials are needed to answer open questions concerning optimisation and individualisation of neurofeedback training. Further improvements may be expected from new methodical and technical developments (e.g., tomographic neurofeedback) and new concepts (integrated ADHD treatment). 



The Frontiers Reserach Topic intends to provide answers to the following questions concerning neurofeedback in ADHD: 

• How efficacious is neurofeedback / does a certain neurofeedback protocol work? 

• What is the rationale of applying a certain neurofeedback protocol in ADHD? 

• What are central mechanisms and which moderating variables may affect training outcome? 

• How to optimise treatment? What are new developments and which benefits may be expected?

Table of Contents
  • Cover
  • Frontiers Copyright Statement
  • Neurofeedback in ADHD
  • Table of Contents
  • Editorial: Neurofeedback in ADHD
    • References
  • Pathophysiology of ADHD and associated problems—starting points for NF interventions?
    • Introduction
    • Characteristics of Attention Deficit Hyperactivity Disorder
    • ADHD and its Neuronal Background
      • Cognitive Functions
        • Action Monitoring and Response Inhibition
        • Preparation
      • Reward Processing
      • Resting State Brain Activity
    • Heterogeniety in ADHD
      • Clinical Heterogeneity—Hyperactive/Impulsive and Inattentive Subtypes
      • Similarities and Differences Between Boys and Girls with ADHD
      • ADHD and Conduct Disorder
      • ADHD and Tic Disorder
    • Conclusion
    • Acknowledgments
    • References
  • Neurofeedback in attention-deficit/hyperactivity disorder – different models, different ways of application
    • Introduction
    • Mechanisms and applications – models of nf in children with adhd
      • Competing assumptions about nf
        • What is the indication for nf: repairing a neural dysfunction vs. strengthening resources/compensatory mechanisms on different levels
        • The effect of nf: is there a change of “eeg trait3” or a change in ``eeg state''?
        • Neuro-regulation – implicit vs. explicit learning?
        • Generalization – does it occur automatically or is special effort needed to achieve transfer into daily life?
      • Implications for the application of nf
        • Indication – “repairing'' a neural dysfunction vs. strengthening neural resources
        • Acquisition of (neuro-)regulation: mechanisms of learning, mechanisms of change
        • How to assure generalization?
      • “conditioning-and-repairing” vs. “skill-acquisition” model
        • Annotations about specificity of treatments
    • Implications for the evaluation of nf
      • How to evaluate efficacy of nf? which variables account for the efficacy of nf? which variables should be considered “specific” or “unspecific”? can the fidelity of the nf treatment be ensured under placebo-control conditions?
    • Empirical evidence
      • Indication for nf and effects/results of nf
        • What is the evidence for distinct neurophysiological deficits in adhd?
        • Does nf repair this neurophysiological deficit or strengthen compensatory mechanisms? is there a change of ``eeg trait'' or a change in ``eeg state''?
      • Acquisition of neuro-regulation capability – learning during nf sessions
        • Implicit or explicit learning of neuro-regulation?
      • Generalization
        • Automatic generalization
        • Effortful transfer
    • Conclusion and implications
    • References
  • What learning theories can teach us in designing neurofeedback treatments
    • Introduction
    • Basics from learning theories to be considered in designing a neurofeedback protocol
      • Feedback, reinforcement and knowledge of results
      • Shaping and the question of threshold regulation
      • Transfer
      • Automation: practice makes perfect
        • Strategies and instructions
        • Practice schedules, how much practice and skill decay?
      • Individual variables
        • Motivation
        • Cognition
        • Disease
    • Neuronal basis of neurofeedback learning
    • Conclusion: neurofeedback and psychotherapy
    • Acknowledgments
    • References
  • Are treatment effects of neurofeedback training in children with ADHD related to the successful regulation of brain activity? A review on the learning of regulation of brain activity and a contribution to the discussion on specificity
    • ADHD Neurofeedback Protocols and Learning of EEG Self-Regulation
    • Measuring Learning of EEG Self-Regulation
      • Units of Measurement
      • Cross-Session Learning
      • Within-Session Learning
      • Baseline Increments
      • Classification of Good and Poor Learning
    • Failing to Learn
    • Learning Patterns of Self-Regulated Brain Activity
    • The Association between Self-Regulated Brain Activity and Clinical Outcome Gains
    • Electrophysiological Pre-Post Changes, Protocol Specific Effects and Prediction
    • Is it Possible to Promote EEG Self-Regulation Performance?
    • Conclusion
    • References
  • Tuning pathological brain oscillations with neurofeedback: a systems neuroscience framework
    • (De)synchronized brain states
    • Normal and pathological oscillations
    • The brain as a dynamical system
    • Neurofeedback: unlocking direct control of brain oscillations
      • Control I: an engineering perspective on neurofeedback control
      • Control II: neurobehavioral conditioning
      • Control III: must neurofeedback signals be conscious? A global workspace hypothesis
      • Plasticity I: Hebbian mechanisms of plasticity
      • Plasticity II: homeostatic plasticity
      • Plasticity III: structural plasticity
    • Closing remarks: why neurofeedback?
    • Acknowledgments
    • References
  • What future research should bring to help resolving the debate about the efficacy of EEG-neurofeedback in children with ADHD
    • EEG-NF; the current state of affairs
    • Study-design
      • Placebo-controlled RCT's
      • Alternatives to placebo-controlled RCT's
      • The optimal design
    • Implementation and embedding of the training
      • EEG deviation
      • Reward feedback
      • Learning paradigms
      • Transfer
    • Different forms of neurofeedback
    • Conclusion
    • Acknowledgments
    • References
  • EEG-based local brain activity feedback training—tomographic neurofeedback
    • Introduction
    • Proposed solutions
    • The EEG-based LBA-feedback training: the principle
    • First applications
    • Discussion
    • Conclusion
    • Acknowledgments
    • References
  • EEG spectral analysis of attention in ADHD: implications for neurofeedback training?
    • Introduction
      • Resting EEG studies in ADHD
      • EEG studies in ADHD during task performance
      • Information about the dataset/objectives of the study
    • Materials and methods
      • Participants
      • Procedure and task
      • EEG recording and preprocessing
      • Data analysis
      • Statistical analysis
    • Results
      • Performance measures
      • Spectral EEG parameters
      • Associations between spectral EEG parameters and performance measures
    • Discussion
      • Spectral EEG measures during an attentive state in ADHD (subtypes)
      • Associations between spectral EEG parameters and reaction time measures
      • Potential implications for neurofeedback training in ADHD
      • Limitations of our study
    • Conclusions
    • Acknowledgments
    • References
  • Neurofeedback of slow cortical potentials: neural mechanisms and feasibility of a placebo-controlled design in healthy adults
    • Introduction
    • Materials and methods
      • Subjects
      • Procedure
      • Treatment (training)
        • SCP training
        • Sham training
      • Estimation of treatment assignment
      • Neuro-regulation assessment and analysis
      • Continuous performance task (CPT)
      • EEG recording and processing
      • fMRI imaging and data analysis
      • EEG data analysis
    • Results
      • Estimation of treatment assignment
      • SCP-regulation performance
      • Interrelation of regulation capability and estimation of treatment assignment
      • Neurophysiological test session: tCNV and performance
      • Functional MRI
    • Discussion
      • Neuronal plasticity: tCNV, fMRI, and performance
      • Blinding, estimation of treatment assignment, and regulation capability
      • Limitations and conclusions
    • Acknowledgments
    • References
  • Slow cortical potential and theta/beta neurofeedback training in adults: effects on attentional processes and motor system excitability
    • Introduction
    • Materials and methods
      • Participants
      • Design
        • Neurofeedback
        • Control training
      • Learning of self-regulation skills
      • Assessments and neurophysiological recordings
        • Attention task and event-related potentials
        • Tms
      • Statistical analysis
    • Results
      • Learning of self-regulation skills
      • Attentional processes
        • Performance measures
        • CNV
        • Target-p3
      • Motor system excitability
    • Discussion
      • Learning of self-regulation skills
      • Attentional processes
      • Motor system excitability
      • Methodical issues
    • Conclusion
    • Acknowledgments
    • References
  • EEG neurofeedback treatments in children with ADHD:an updated meta-analysis of randomized controlled trials
    • Introduction
    • Methods
    • Results
      • Results of the literature search
      • Results of the meta-analysis
        • Studies and populations characteristics
        • Effects of EEG-NF on parent assessment (probably no-blinded assessment)
        • Effect of EEG-NF on teacher assessment (probably blinded assessment)
        • Sensitivity analysis to test for medication effects
    • Discussion
    • Acknowledgments
    • References
  • Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency
    • Introduction
      • Sleep and cognition in children
      • Sleep, sleep restriction and ADHD
      • Neurofeedback and sleep
    • Methods
      • Participants
      • Controls
      • Neurofeedback treatment
    • Analysis
    • Results
      • Healthy controls vs. adult ADHD
      • Neurofeedback treatment effects: SMR vs. TBR
        • Mediator analysis
      • Learning
      • Post-hoc tests
    • Discussion
    • Author contributions
    • Disclosures
    • Acknowledgments
    • References
  • Slow cortical potential neurofeedback and self-management training in outpatient care for children with ADHD: study protocol and first preliminary results of a randomized controlled trial
    • Background
    • Aims of the trial
    • Methods
      • Participants
        • Inclusion criteria
        • Exclusion criteria
      • Design and procedure
        • Recruitment and consent
        • Randomization and treatment allocation
        • Procedure
      • Treatment protocols
        • Neurofeedback
        • Self-management
        • Treatment of comorbid disorders
        • Parent Training
      • Therapists
      • Measurements
        • Selection and diagnostic measurements
        • Outcome measures
        • Primary and secondary outcome measures
      • Statistical analyses
        • Sample size
      • Ethical review and trial registration
      • Preliminary Results
    • Discussion
    • Limitations
    • Conclusion
    • Author's contributions
    • Author's information
    • References
  • Near-infrared spectroscopy (NIRS) neurofeedback as a treatment for children with attention deficit hyperactivity disorder (ADHD)—a pilot study
    • Introduction
    • Materials and methods
      • Participants
      • Procedure and measurement instruments
      • NIRS-neurofeedback
      • EEG-neurofeedback and EMG-feedback
      • Data analysis and statistics
    • Results
      • Within-group comparisons for the NIRS-group
        • FBB-ADHS
        • SDQ and KID-KINDL
        • TAP
      • Within and between group comparisons for EEG-, EMG- and NIRS-group
    • Discussion
      • NIRS -neurofeedback—effects and feasibility
      • Comparison with EEG-neurofeedback and EMG-feedback and future directions
    • Acknowledgments
    • References
  • Back Cover
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