Comparison of 2 Neurofeedback protocols as a non pharmacological treatment of ADHD in children and adolescents.

ADHD represents a public health issue given its short and long term consequences, and its prevalence. It affects at least 5% of school aged-children, but due to missed diagnosis some estimates of prevalence are considerably higher . Its symptomatic triad of inattention, impulsiveness and hyperactivity are usually associated with behavioral, learning and sleep disorders . Stimulant medicines, such as methylphenidate, is the standard treatment and generally regarded as efficacious. There are however, good reasons that the search for alternative treatments continues. Those reasons include questions regarding the long-term efficacy of stimulant medications, the inability of many patients to tolerate its side effects, the lack of efficacy of those medications for many ADHD patients, and parental reluctance to medicate their children.

The purpose of this controlled, randomized study is to compare the effects of two distinct neurofeedback protocols on the impact of ADHD symptoms, and with particular regard to hyperactivity. Both of these protocols have been less-studied than other more commonly-used neurofeedback protocols. Sixty (60) children and adolescents from ages 7 to 15, assigned to two groups, will participate in 30 neurofeedback sessions each, either in a SMR neurofeedback or an upper alpha neurofeedback protocol.

To date, no controlled, randomized study has been able to demonstrate the efficacy of an upper alpha neurofeedback protocol in the improvement of sleep, hyperactivity, and comorbidities among ADHD children and adolescents. Effects on psychological dimensions such as self regulation, have also not been yet demonstrated. We predict a decrease in ADHD symptoms and concomitant improvement in sleep  in the upper alpha neurofeedback group. We also predict maintenance of the effects of neurofeedback training several months after the conclusion treatment, and without any medicine being reintroduced in the interim.

This study would permit 60 children and adolescents to potentially benefit from an effective and alternative treatment. No placebo group is planned for the study. The benchmark goal of the study is clinical reduction of at least 30% of ADHD symptoms. Another possible benefit of the study will be increased development of a newer field of research and clinical practice, which remains under-investigated in France. Additionally, the demonstration of the clinical efficacy of alpha band neurofeedback training on frontocentral sites would be an advance in clinical practice and research. It is also important to note that neurofeedback treatment is very likely to be more acceptable than stimulant medication to the parents of children with ADHD, as there are no known side effects to neurofeedback treatment.