Attention Deficits

Attention Deficit Hyperactivity Disorder (ADHD) - Neurofeedback Publications

PracticeWise - Level 1: Best Support

EEG and Clinical Neuroscience - Level 5: Efficacious and Specific

BCIA - Level 4: Efficacious  (description of efficacy levels here)


Efficacy of Neurofeedback Treatment in ADHD: the Effects on Inattention, Impulsivity and Hyperactivity: a Meta-Analysis
Arns M, de Ridder S, Strehl U, Breteler M and Coenen A
Journal of Clinical EEG & Neuroscience, July, 2009

reported that Neurofeedback should be regarded as an evidence-based treatment for Attention Deficit / Hyperactivity Disorder (ADHD) based on accepted scientific standards of clinical medicine.  Neurofeedback has steadily gained acceptance as a mainstream medical technique for the treatment of several disorders; however critics persist in questioning the efficacy of neurofeedback and the quantity and quality of the clinical studies that support its use. The study was a so-called meta-analysis which examined the caliber of the scientific and statistical techniques and robustness of all recently published research about neurofeedback treatment for ADHD. This meta-analysis included 15 studies and 1194 ADHD patients. Based on this study, the research team concluded that neurofeedback should be regarded as an “Evidence-Based treatment for ADHD”. The results show that neurofeedback treatment has large and clinically significant effects on Impulsivity and Inattention and a modest improvement of Hyperactivity.  full text

EEG Biofeedback in the Treatment of Attention Deficit Hyperactivity Disorder (abs.)
Friel PN
Alternative Medicine Review, Volume 12, #2, June, 2007, pp146-151
Electroencephalogram (EEG) biofeedback, also known as neurofeedback, is a promising alternative treatment for patients with attention deficit/hyperactivity disorder (AD/HD). EEG biofeedback therapy rewards scalp EEG frequencies that are associated with relaxed attention, and suppresses frequencies associated with under- or over-arousal.
full text

Electroencephalographic Biofeedback in the Treatment of Attention-Deficit/Hyperactivity Disorder
Monastra VJ, Lynn S, Linden M, Lubar JF, Gruzelier J, LaVaque TJ
Historically, pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) have been considered to be the only type of interventions effective for reducing the core symptoms of this condition. However, during the past three decades, a series of case and controlled group studies examining the effects of EEG biofeedback have reported improved attention and behavioral control, increased cortical activation on quantitative electroencephalographic examination, and gains on tests of intelligence and academic achievement in response to this type of treatment. full text

Deficit Hyperactivity Disorder: Rationale and Empirical Foundation (abs.)
Monastra VJ
During the past three decades, electroencephalographic (EEG) biofeedback has emerged as a nonpharmacologic treatment for attention-deficit/hyperactivity disorder (ADHD). This intervention was derived from operant conditioning studies that demonstrated capacity for neurophysiologic training in humans and other mammals and targets atypical patterns of cortical activation that have been identified consistently in neuroimaging and quantitative EEG studies of patients diagnosed with ADHD. full text

Treatment of Attention Deficit Hyperactivity Disorder with Neurotherapy (abs.)
Nash JK
Significant public health concerns exist regarding our current level of success in treating ADHD. Medication management is very helpful in 60-70% of patients. Side effects, lack of compliance and the fact that stimulant medications cannot be given late in the day limit the benefits largely to school hours. full text

Review of the Literature Regarding the Efficacy of Neurofeedback in the Treatment of Attention Deficit Hyperactivity Disorder
Lingenfelter JE
The following is a review of the most recent literature regarding the efficacy of EEG Neurofeedback in the treatment of attention deficit hyperactivity disorders. full text

Update on Attention-Deficit/Hyperactivity Disorder (abs.)
Campbell Daley K
In her recent paper, Update on Attention-Deficit/Hyperactivity Disorder, published in Current Opinion in Pediatrics, Katie Campbell Daley reviewed the research and practice standards on treatment of ADHD.

Dr. Campbell is on the staff of the Department of Medicine, Children's Hospital Boston and in the Department of Pediatrics of the Harvard Medical School. Her conclusion:

"Overall, these findings support the use of multi-modal treatment, including medication, parent/school counselling, and EEG biofeedback, in the long term management of ADHD, with EEG biofeedback in particular providing a sustained effect even without stimulant treatment... Parents interested in non-psychopharmacologic treatment can pursue the use of complementary and alternative therapy. The therapy most promising by recent clinical trials appears to be EEG biofeedback."
full text

In-School Neurofeedback Training for ADHD: Sustained Improvements From a Randomized Control Trial 

Naomi J. Steiner, MDa, Elizabeth C. Frenette, MPHa, Kirsten M. Rene, MAa, Robert T. Brennan, EdDb, and Ellen C. Perrin, MDa

(104 participants) Response rates were 90% at the 6-month follow-up. Six months postintervention, neurofeedback participants maintained significant gains on Conners 3-P (Inattention effect size [ES] = 0.34, Executive Functioning ES = 0.25, Hyperactivity/Impulsivity ES = 0.23) and BRIEF subscales including the Global Executive Composite (ES = 0.31), which remained significantly greater than gains found among children in CT and control conditions. full text

A Comparison of EEG Biofeedback and Psychostimulants in Treating Attention Deficit Hyperactivity Disorder
Tom Rossiter, PhD and Theodore LeVaque, PhD. Reprinted with permission: Journal of Neurotherapy, Summr, 10995, 48-59 full text

Quantitative QEEG and Auditory Event-Related Potentials in the Evaluation of Attention Deficit/Hyperactivity Disorder: Effects of Methylphenidate and Implications for Nerofeedback Training
J.F. Lubar, PhD, M.O. Swartwood, PhD, J.N. Swartwood, PhD and D.L. Timmerman, PhD. Reprinted with permission: Journal of Psychoeducational Assessment, ADHD Special, 1995 143-160 full text

Wechsler (WISC-R) Changes Following Treatment of Learning Disabilities via EEG Biofeedback Training in a Private Practice Setting

Micheal Tansey, PhD. Reprinted with permission: Australian Journal or Psychology, 1991, 43 147-153 full text

Gates, States, Rhythms and Resonance: The Scientific Basis of Neurofeedback Training
A. Arbanal, PhD, MD. Reprinted with permission: Journal of Neurotherapy, Vol 1 No 2 Fall 1995 15-38 full text

Alhambra, M.A, Fowler, T.P, & Alhambra A.A. (1995). EEG biofeedback: A new treatment option for ADD/ADHD. Journal of Neurotherapy,1(2), 39-43.

Arns, M., Kleinnijenhuis, M., Fallahpour, K., & Bretler, R. (2007).  Golf performance enhancement and real-life neurofeedback training using personalized event-locked EEG profiles.  Journal of Neurotherapy, 11(4), 11-18.

Barabasz, A, & Barabasz, M. (1996). Neurotherapy and alter hynosis in the treatment of attention deficit disorder. Chapter in Lynn, Kirsch, Rhue (EDs.), Casebook of Clinical Hypnosis. Washington D.C: American Psychological Association Press, pp. 271- 292.

Barabasz, A & Barabasz, M. (2000). Treating AD/HD with hypnosis and neurotherapy. Child Study Journal,30 (1),25-42.

Bazanova, O.M., Aftanas, L.I. (2010).Individual EEG alpha activity analysis for enhancement neurofeedback efficiency: Two case studiesJournal of Neurotherapy 14(3), 244 – 253.

Beauregard, M & Levesque, J (2006). Functional magnetic resonance imaging investigation of the effects of neurfeedback training on the neural bases of selective attention and response inhibition in children with attention-deficit/hyperactivity disorder. Applied Psychophysiology & Biofeedback, 31(1) 3-20.

Becerra, J., Fernndez, T., Harmony T., Caballero M.I, Garcia F., Fernandez-Bouzas A., Santiago-Rodriguez E, Prado-Alcala R.A. (2006) "Follow-up study of Learning Disabled children treated with Neurofeedback or placebo." Clinical EEG & Neuroscience, 37(3), 198-203.

Boyd, W.D & Campbell, S.E. (1998) EEG biofeedback in schools: The use of EEG biofeedback to treat ADHD in a school setting. Journal of Neurotherapy, 2(4), 65-71.

Breteler, M. H. M., Arns, M., Peters, S., Giepmans, I., & Verhoeven, L. (2010).  Improvements in spelling after
QEEG-based neurofeedback in dyslexia: A randomized controlled treatment study.  Applied Psychophysiology & Biofeedback, 35(1), 5-11.

Budzynski, T.H. (1996). Braining brightening: Can neurofeedback improve cognitive process? Biofeedback, 24(2), 14-17.

Carmody, D. P., Radvanski, D. C., Wadhwani, S., Sabo, J. J., & Vergara, L. (2001). EEG biofeedback training and attention-deficit/hyperactivity disorder in an elementary school setting. Journal of Neurotherapy, 4(3), 5-27.

Carter, J. L., & Russell, H. L. (1991). Changes in verbal performance IQ discrepancy scores after left hemisphere frequency control training: A pilot report. American Journal of Clinical Biofeedback, 4(1), 66-67.

Cunningham, M., & Murphy, P. (1981). The effects of bilateral EEG biofeedback on verbal, visuospatial and creative skills in LD male adolescents. Journal of Learning Disabilities, 14(4), 204-208.

Drechsler R, Straub M, Doehnert M, Heinrich H, Steinhausen H, Brandeis D. (2007). Controlled evaluation of a neurofeedback training of slow cortical potentials in children with ADHD. Behavioral & Brain Functions, 3, 35

Egner, T., & Gruzelier, J. H. (2001). Learned self-regulation of EEG frequency components affects attention and event-related brain potentials in humans. NeuroReport, 12, 4155-4159.

Egner, T., & Gruzelier, J. H. (2004).EEG biofeedback of low beta band components: Frequency-specific effects on variables of attention and event-related brain potentials.Clinical Neurophysiology, 115(1), 131-139. 

Fehmi, L. G. (2007).  Multichannel EEG phase synchrony training and verbally guided attention training for disorders of attention.  Chapter in J. R. Evans (Ed.), Handbook of Neurofeedback.  Binghampton, NY: Haworth Medical Press, pp. 301-319.

Fehmi, L. G., & Selzer, F. A. (1980). Biofeedback and attention training. Chapter in S. Boorstein (Ed.), Transpersonal Psychotherapy. Palo Alto: Science and Behavior Books.

Fehmi, L. G. (1978). EEG biofeedback, multichannel synchrony training, and attention. Chapter in A. A. Sugarman & R. E. Tarter (Eds.), Expanding Dimensions of Consciousness. New York: Springer.

Fernandez, T., Herrera, W., Harmony, T., Diaz-Comas, L., Santiago, E., Sanchez, L., Bosch, J., Fernandez-Bouzas, A., Otero, G., Ricardo-Garcell, J., Barraza, C., Aubert, E., Galan, L., & Valdes, P. (2003). EEG and behavioral changes following neurofeedback treatment in learning disabled children. Clinical Electroencephalography, 34(3), 145-150.

Fleischman, M. J., & Othmer, S. (2005). Case study: Improvements in IQ score and maintenance of gains following EEG biofeedback with mildly developmentally delayed twins. Journal of Neurotherapy, 9(4), 35-46.

Foks, M. (2005).Neurofeedback training as an educational intervention in a school setting: How the regulation of arousal states can lead to improved attention and behaviour in children with special needs. Educational & Child Psychology, 22(3), 67-77.

Fox, D. J., Tharp, D. F., & Fox, L. C. (2005). Neurofeedback: An alternative and efficacious treatment for attention deficit hyperactivity disorder. Applied Psychophysiology & Biofeedback, 30(4), 365-274.

Fritson, K. K., Wadkins, T. A., Gerdes, P., & Hof, D. (2007).  The impact of neurotherapy on college students’ cognitive abilities and emotions.  Journal of Neurotherapy, 11(4), 1-9.

Fuchs, T., Birbaumer, N., Lutzenberger, W., Gruzelier, J. H., & Kaiser, J. (2003). Neurofeedback treatment for attention deficit/hyperactivity disorder in children: A comparison with methylphenidate. Applied Psychophysiology and Biofeedback, 28, 1-12. 

Gani C, Birbaumer N & Strehl U. (2008). Long term effects after feedback of slow cortical potentials and of theta-beta amplitudes in children with attention-deficit/hyperactivity disorder(ADHD). International Journal of Bioelectromagnetism, 10(4), 209-232.

Hansen, L. M., Trudeau, D., & Grace, L. (1996). Neurotherapy and drug therapy in combination for adult ADHD, personality disorder, and seizure. Journal of Neurotherapy, 2(1), 6-14.

Hirshberg, L. M. (2007). Place of electroencephalographic biofeedback for attention-deficit/hyperactivity disorder. Expert Review of Neurotherapeutics, 7(4), 315-319.

Jackson, G. M., & Eberly, D. A. (1982). Facilitation of performance on an arithmetic task as a result of the application of a biofeedback procedure to suppress alpha wave activity. Biofeedback & Self-Regulation, 7(2), 211-221.

Jacobs, E. H. (2005). Neurofeedback treatment of two children with learning, attention mood, social, and developmental deficits. Journal of Neurotherapy, 9(4), 55-70.

Kaiser, D. A., & Othmer, S. (2000). Effect of Neurofeedback on variables of attention in a large multi-center trial. Journal of Neurotherapy, 4(1), 5-15.

Kirk, L. (2007).  Neurofeedback protocols for subtypes of attention deficit/hyperactivity disorder.  Chapter in J. R. Evans (Ed.), Handbook of Neurofeedback.  Binghampton, NY: Haworth Medical Press, pp. 267-299.

Kotwal, D. B., Burns, W. J., & Montgomery, D. D. (1996). Computer-assisted cognitive training for ADHD: A case study. Behavior Modification, 20(1), 85-96. 

Kropotov, J. D., Grin-Yatsenko, V. A., Ponomarev, V. A., Chutko, L. S., Yakovenko, E. A., & Nikishena, I. S. (2007).  Changes in EEG spectograms, event-related potentials and event-related desynchronization induced by relative beta training in ADHD children.  Journal of Neurotherapy, 11(2), 3-11.

Kropotov, J. D., Grin-Yatsenko, V. A., Ponomarev, V. A., Chutko, L. S., Yakovenko, E. A., Nildshena, I. S. (2005). ERPs correlates of EEG relative beta training in ADHD children. International Journal of Psychophysiology, 55(1), 23-34.

Kwon, H., Cho, J., Lee, E. (2009). EEG asymmetry analysis of the left and right brain activities during simple versus complex arithmetic learning. Journal of Neurotherapy 13(2), 109 – 116.

Leins, U., Goth, G., Hinterberger, T., Klinger, C., Rumpf, M., & Strehl, U. (2007). Neurofeedback for Children with ADHD: A Comparison of SCP and Theta/Beta Protocols. Applied Psychophysiology & Biofeedback, 32

Levesque, J., Beauregard, M., & Mensour, B. (2006). Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: a functional magnetic resonance imaging study. Neuroscience Letters, 394(3), 216-221.

Linden, M., Habib, T., & Radojevic, V. (1996). A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback & Self-Regulation, 21(1), 35-49.

Loo, S., & Barkley, R. (2005). Clinical utility of EEG in attention deficit hyperactivity disorder. Applied Neuropsychology, 12(2), 64-76.

Lubar, J. F. (1985). EEG biofeedback and learning disabilities. Theory into Practice, 26, 106-111

Lubar, J. F. (1995). Neurofeedback for the management of attention-deficit/hyperactivity disorders. Chapter in M. S. Schwartz (Ed.), Biofeedback: A Practitioner's Guide. New York, Guilford, 493-522.

Lubar, J. F. (2003). Neurofeedback for the management of attention deficit / hyperactivity disorders. Chapter in M. S. Schwartz & F. Andrasik (Eds.), Biofeedback: A Practitioner's Guide Third Edition. New York, Guilford, 409-437.

Lubar, J. O., & Lubar, J. F. (1984). Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting.