42. Additive effects of EEG neurofeedback on medications for ADHD: a meta-analysis
Abstract
Abstract Background ADHD is commonly treated with medications, but residual symptoms and side effects remain a clinical challenge. EEG neurofeedback (NFB) has emerged as a potential non-pharmacological intervention. Previous studies suggest NFB may improve attention and behavioral regulation, but its additive effects when combined with medication remain unclear. Aims & Objectives To evaluate whether EEG Neurofeedback in combination with medication treatment provides greater improvement in ADHD symptoms compared to medication alone. Method Randomized controlled trials (RCTs) were retrieved from electronic databases including PubMed, EMBASE, ClinicalKey, Cochrane CENTRAL, ScienceDirect, and ClinicalTrials.gov from inception to March 2022. The primary outcomes were changes in ADHD symptoms (i.e., global, inattention, hyperactivity/impulsivity) assessed with validated rating scales, while secondary outcome was all-cause discontinuation rate. Results Meta-analysis of five RCTs involving 305 participants [Median age = 9.285 years (range 8.6–11.05)] with a median follow-up of 12 weeks showed additive effects of EEG-NF on medications from parents’ observations against ADHD global symptoms (Hedges’ g = 0.2898, 95%CI [0.0238; 0.5557]) and inattention symptoms (Hedges’ g = 0.3274, 95%CI [0.0493; 0.6055]). However, additive effects failed to sustain six months after EEG-NF intervention. Besides, there was no difference in improvement of hyperactivity/impulsivity from parents’ observation, attentional performance, and all-cause discontinuation rate between the two groups. Discussion & Conclusions Our results supported additional benefits of combining EEG-NF with medications compared to medication alone in treating global symptoms and symptoms of inattention in ADHD patients. Nevertheless, given a lack of evidence showing a correlation between underlying physiological changes and small effect sizes in our preliminary results, further studies are warranted to support our findings.