Neurofeedback Evidence & Studies

Krepel, N., Egtberts, T., Sack, A. T., Heinrich, H., Ryan, M., & Arns, M. (2020). A multicenter effectiveness trial of QEEG-informed neurofeedback in ADHD: Replication and treatment prediction. NeuroImage: Clinical, 28, 102399. 

Pimenta, M. G., Brown, T., Arns, M., & Enriquez-Geppert, S. (2021). Treatment efficacy and clinical effectiveness of EEG neurofeedback as a personalized and multimodal treatment in ADHD: A critical review. Neuropsychiatric disease and treatment, 17, 637. 

Van Doren, J., Arns, M., Heinrich, H., Vollebregt, M. A., Strehl, U., & K Loo, S. (2019). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European child & adolescent psychiatry, 28(3), 293-305. 

Studies on Neurofeedback in Children

Neurofeedback has been under investigation since the 1970s. Numerous clinical studies conducted by leading international clinics have now demonstrated that Neurofeedback therapy for children and adolescents with ADHD leads to sustained improvements in ADHD symptoms. A study on Neurofeedback training for adults with ADHD has also shown initial positive effects on ADHD symptoms.

This page presents some of the most significant studies to date. The original publications (mostly in English) can be accessed through the provided links.

ENHANCED ATTENTION AND IMPULSE CONTROL

Over the past 15 years, several studies have shown that Neurofeedback training can lead to noticeable improvements in behavior and attention. Parents and teachers evaluated the children before and after the training.

Key studies include:

2006: Self-regulation of Slow Cortical Potentials: A New Treatment for Children With Attention-Deficit/Hyperactivity Disorder, Strehl et al., Pediatrics
The study investigated the impact of Neurofeedback training on 23 children with ADHD. It was found that children were capable of learning self-regulation of brain activity, as measured by EEG. As a result, children improved their behavior, attention, and even their performance on an intelligence test.

2009: Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial, Gevensleben  et al., Child Psychol Psychiatry
Nearly 100 children with ADHD participated in this study. Parents and teachers reported significantly improved behavior and attention in the children after the training, compared to both before the training and to children receiving a control treatment.

2009: Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis, Arns et al., Clin EEG Neurosci.
These researchers compared worldwide Neurofeedback and ADHD studies, concluding that Neurofeedback is "effective and specific" for ADHD and corresponds to the highest level of treatment efficacy (Level 5). The therapy particularly improved inattention and impulsivity, and also positively impacted hyperactivity.

2017: Neurofeedback of Slow Cortical Potentials in Children with Attention-Deficit/Hyperactivity Disorder: A Multicenter Randomized Trial Controlling for Unspecific Effects. Strehl et al., U. Frontiers in Human Neuroscience
A large multicenter study on Neurofeedback in ADHD The largest multicenter randomized study on SCP-Neurofeedback (conducted with THERA PRAX®) in 150 children with ADHD. The study confirms the specific efficacy of SCP-Neurofeedback on core ADHD symptoms when compared to a semi-active control group. This demonstrates the feasibility and effectiveness of SCP-Neurofeedback in children with ADHD in a large sample, considering specific and nonspecific effects.

2019: Neurofeedback as a Treatment Intervention in ADHD: Current Evidence and Practice, Enriquez-Geppert et al., Curr Psychiatry Rep
Based on meta-analyses and studies, three common Neurofeedback protocols (Theta/Beta, Sensorimotor Rhythm, and Slow Cortical Potentials (SCP)) are effective for ADHD. Neurofeedback using standard protocols should be considered a valid alternative for ADHD. Uniform standards for professionals and clinical application are urgently needed.

2020: Neurofeedback and Attention-Deficit/Hyperactivity Disorder (ADHD) in Children: Rating the Evidence and Proposed Guidelines, Arns et al., Appl Psychophysiol
Biofeedback A quantitative analysis of multicenter randomized controlled studies. Standardized Neurofeedback protocols are established treatment methods for ADHD. The publication confirms moderate to large effects of standard protocols and sustains these effects for 6 to 12 months after treatment.

2020: Effects of Neurofeedback on the Dysregulation Profile in Children with ADHD: SCP NF meets SDQ-DP - A Retrospective Analysis, Heinrich et al., Psychol Med
SCP-Neurofeedback is a general tool for improving self-regulation in children.

EFFECTIVE BEYOND THE TREATMENT PERIOD

Two studies examined the long-term effects of Neurofeedback training beyond the end of therapy. Children were retested six months [Holger Gevensleben, Göttingen, [publication  link] or two years [Cihan Gani, Tübingen, publication link] after their last training session. Therapy sessions were conducted, and parents' and teachers' evaluations were considered. The studies suggest that the positive effects of Neurofeedback, such as successful self-control in EEG, behavior change, and increased attention, remained stable over these periods or even improved further after training.

AS EFFECTIVE AS MEDICATION

A publication by Leslie Sherlin and colleagues from 2010 compared multiple studies that compared Neurofeedback with the administration of Methylphenidate, a substance found in various ADHD medications. The authors concluded from the data that Neurofeedback improves behavior and cognitive performance of affected individuals similarly to medication therapy. However, medication was significantly more effective in reducing hyperactivity. Publication link

NEUROFEEDBACK IN ADULTS WITH ADHD

2016: Neurofeedback of Slow Cortical Potentials as a Treatment for Adults with Attention Deficit-/Hyperactivity Disorder, Mayer et al, Clinical Neurophysiology
Neurofeedback can also yield positive results in adult ADHD patients.

Arns, M., Feddema, I., & Kenemans, J. L. (2014). Differential effects of theta/beta and SMR neurofeedback in ADHD on sleep onset latency. Frontiers in human neuroscience, 8, 1019. 

Bijlenga, D., Vollebregt, M. A., Kooij, J. J., & Arns, M. (2019). The role of the circadian system in the etiology and pathophysiology of ADHD: time to redefine ADHD?. ADHD Attention Deficit and Hyperactivity Disorders, 11(1), 5-19. 

Arns, M., & Kenemans, J. L. (2014). Neurofeedback in ADHD and insomnia: vigilance stabilization through sleep spindles and circadian networks. Neuroscience & Biobehavioral Reviews, 44, 183-194. 

Arns, M., Swatzyna, R. J., Gunkelman, J., & Olbrich, S. (2015). Sleep maintenance, spindling excessive beta and impulse control: an RDoC arousal and regulatory systems approach?. Neuropsychiatric Electrophysiology, 1(1), 1-11. 

Martijn Arns MSc, Michiel Kleinnijenhuis MSc, Kamran Fallahpour PhD & Rien Breteler PhD (2008) Golf Performance Enhancement and Real-Life Neurofeedback Training Using Personalized Event-Locked EEG Profiles, Journal of Neurotherapy, 11:4, 11-18, DOI: 10.1080/10874200802149656 

Bijlenga, D., Vollebregt, M. A., Kooij, J. J., & Arns, M. (2019). The role of the circadian system in the etiology and pathophysiology of ADHD: time to redefine ADHD?. ADHD Attention Deficit and Hyperactivity Disorders, 11(1), 5-19. 

Bondopadhyay, U., Diaz-Orueta, U., & Coogan, A. N. (2022). A systematic review of sleep and circadian rhythms in children with attention deficit hyperactivity disorder. Journal of Attention Disorders, 26(2), 149-224. 

Arns, M., Kooij, J. S., & Coogan, A. N. (2021). Identification and management of circadian rhythm sleep disorders as a transdiagnostic feature in child and adolescent psychiatry. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1085-1095. 

Krepel, N., van Dijk, H., Sack, A. T., Swatzyna, R. J., & Arns, M. (2021). To spindle or not to spindle: A replication study into spindling excessive beta as a transdiagnostic EEG feature associated with impulse control. Biological Psychology, 165, 108188.

Donse, L., Sack, A. T., Fitzgerald, P. B., & Arns, M. (2017). Sleep disturbances in obsessive-compulsive disorder: Association with non-response to repetitive transcranial magnetic stimulation (rTMS). Journal of Anxiety Disorders, 49, 31-39.