A 6-month follow-up of an RCT on behavioral and neurocognitive effects of neurofeedback in children with ADHD

Katleen Geladé, Tieme W. P. Janssen, Marleen Bink, Jos W. R. Twisk, Rosa van Mourik, Athanasios Maras, Jaap Oosterlaan

Research output: Contribution to journalArticleAcademicpeer-review

27 Citations (Scopus)


To assess the long-term effects of neurofeedback (NFB) in children with attention deficit hyperactivity disorder (ADHD), we compared behavioral and neurocognitive outcomes at a 6-month naturalistic follow-up of a randomized controlled trial on NFB, methylphenidate (MPH), and physical activity (PA). Ninety-two children with a DSM-IV-TR ADHD diagnosis, aged 7–13, receiving NFB (n = 33), MPH (n = 28), or PA (n = 31), were re-assessed 6-months after the interventions. NFB comprised theta/beta training on the vertex (cortical zero). PA comprised moderate to vigorous intensity exercises. Outcome measures included parent and teacher behavioral reports, and neurocognitive measures (auditory oddball, stop-signal, and visual spatial working memory tasks). At follow-up, longitudinal hierarchical multilevel model analyses revealed no significant group differences for parent reports and neurocognitive measures (p = .058–.997), except for improved inhibition in MPH compared to NFB (p = .040) and faster response speed in NFB compared to PA (p = .012) during the stop-signal task. These effects, however, disappeared after controlling for medication use at follow-up. Interestingly, teacher reports showed less inattention and hyperactivity/impulsivity at follow-up for NFB than PA (p = .004–.010), even after controlling for medication use (p = .013–.036). Our findings indicate that the superior results previously found for parent reports and neurocognitive outcome measures obtained with MPH compared to NFB and PA post intervention became smaller or non-significant at follow-up. Teacher reports suggested superior effects of NFB over PA; however, some children had different teachers at follow-up. Therefore, this finding should be interpreted with caution. Clinical trial registration Train your brain and exercise your heart? Advancing the treatment for Attention Deficit Hyperactivity Disorder (ADHD), Ref. no. NCT01363544, https://clinicaltrials.gov/show/NCT01363544.
Original languageEnglish
Pages (from-to)581-593
Number of pages13
JournalEuropean child & adolescent psychiatry
Issue number5
Early online date2 Nov 2017
Publication statusPublished - 1 May 2018


  • ADHD
  • Behavior
  • Cognition
  • Naturalistic follow-up
  • Neurofeedback

Cite this