AUTHOR=Cowley Benjamin , Holmström Édua , Juurmaa Kristiina , Kovarskis Levas , Krause Christina M. 

TITLE=Computer Enabled Neuroplasticity Treatment: A Clinical Trial of a Novel Design for Neurofeedback Therapy in Adult ADHD

JOURNAL=Frontiers in Human Neuroscience

VOLUME=10

YEAR=2016

URL=https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2016.00205

DOI=10.3389/fnhum.2016.00205

ISSN=1662-5161

ABSTRACT=<p><bold>Background:</bold> We report a randomized controlled clinical trial of neurofeedback therapy intervention for ADHD/ADD in adults. We focus on internal mechanics of neurofeedback learning, to elucidate the primary role of cortical self-regulation in neurofeedback. We report initial results; more extensive analysis will follow.</p><p><bold>Methods:</bold> Trial has two phases: intervention and follow-up. The intervention consisted of neurofeedback treatment, including intake and outtake measurements, using a waiting-list control group. Treatment involved ~40 h-long sessions 2–5 times per week. Training involved either theta/beta or sensorimotor-rhythm regimes, adapted by adding a novel “inverse-training” condition to promote self-regulation. Follow-up (ongoing) will consist of self-report and executive function tests.</p><p><bold>Setting:</bold> Intake and outtake measurements were conducted at University of Helsinki. Treatment was administered at partner clinic Mental Capital Care, Helsinki.</p><p><bold>Randomization:</bold> We randomly allocated half the sample then adaptively allocated the remainder to minimize baseline differences in prognostic variables.</p><p><bold>Blinding:</bold> Waiting-list control design meant trial was not blinded.</p><p><bold>Participants:</bold> Fifty-four adult Finnish participants (mean age 36 years; 29 females) were recruited after screening by psychiatric review. Forty-four had ADHD diagnoses, 10 had ADD.</p><p><bold>Measurements:</bold> Symptoms were assessed by computerized attention test (T.O.V.A.) and self-report scales, at intake and outtake. Performance during neurofeedback trials was recorded.</p><p><bold>Results:</bold> Participants were recruited and completed intake measurements during summer 2012, before assignment to treatment and control, September 2012. Outtake measurements ran April-August 2013. After dropouts, 23 treatment and 21 waiting-list participants remained for analysis.</p><p>Initial analysis showed that, compared to waiting-list control, neurofeedback promoted improvement of self-reported ADHD symptoms, but did not show transfer of learning to T.O.V.A. Comprehensive analysis will be reported elsewhere.</p><p><bold>Trial Registration:</bold> “Computer Enabled Neuroplasticity Treatment (CENT),” ISRCTN13915109.</p>