The effect of neurofeedback compared to methylphenidate in the treatment of attention deficit/hyperactivity disorder
doi:10.4236/nm.2011.22012 Published Online June 2011
Effectiveness of EEG Biofeedback as Compared with Methylphenidate in the Treatment of Attention-Deficit/Hyperactivity Disorder: A Clinical Outcome Study
Mohammad Ali Nazari1,2, Laurent Querne1, Alain De Broca1, Patrick Berquin1
1. Department of Paediatric Neurology, Lab. Neurosciences Fonction- nelles & Pathologies, Amiens, France.
2. Department of Psychology, University of Tabriz, Tabriz, Iran
Operant conditioning of brain waves (neurofeedback) has been discussed as an effective method in the treatment of children with attention deficit/hyperactivity disorder (ADHD). This study was conducted to compare the effectiveness of neurofeedback with the drug methylphenidate. 39 children aged 7-12 years participated in this study. 13 of these children with attention deficit/hyperactivity disorder were treated using neurofeedback (increasing the amplitude of beta waves (15-18 Hz) and decreasing the amplitude of theta waves (4-8 Hz)] and 13 were treated only using methylphenidate. 13 healthy children also did not receive any therapeutic intervention. Various behavioral, photophysiological and computer tests were used before and after the therapeutic interventions. Although the results obtained from “behavioral indices” indicated improvement with both methods, Methyl Phenidide was significantly more effective than neurofeedback in this regard. Response inhibition was improved only in the neurofeedback method. Both neurofeedback therapeutic intervention and methylphenidate drug improved the indicators obtained from computerized tests. Intelligence also increased in both methods. Although it seems that the average effect of methylphenidate is higher than neurofeedback, the differences are not significant. If we consider other studies, these findings show that neurofeedback can effectively improve many behavioral and cognitive functions. It forgives and can be used as an alternative treatment method in people who are resistant to drug treatment, people for whom only drug therapy is not effective, or people whose parents are interested in using non-drug treatment methods.
Operant conditioning of the electroencephalographic rhythm (EEG biofeedback) is argued to be an effective method for treating children with ADHD. This study was designed to evaluate whether this method, compared to methylphenidate, achieves an equally effective outcome. Participants were 39 children aged between 7-12 years. Thirteen children with attention-deficit/hyperactivity disorder (ADHD) were trained to enhance the amplitude of the beta1 activity (15-18 Hz) and decrease the amplitude of the theta activity (4-8 Hz), and 13 of which were treated with methylphenidate alone. Thirteen healthy children did not receive intervention. Several behavioral, neuropsychological and experimental tests were administered before and after intervention. While behavioral measures were improved by both types of method, methylphenidate was significantly more effective than EEG biofeedback. Response inhibition was improved only by EEG biofeedback. Both EEG biofeedback and methylphenidate were associated with improvements on the variability and accuracy measures of computerized tests. Intellectual ability increased also by both methods. Although averaged effect size for methylphenidate seems to be greater than for EEG biofeedback, the difference was not significant. In conjunction with other studies, these findings demonstrate that EEG biofeedback can significantly improve several behavioral and cognitive functions in children with ADHD, and it might be an alternative treatment for non-responders or incomplete responders to medication as well as for those their parents favor a non-pharmacological treatment.