An Evaluation of Neurofeedback Efficacy in Adults With ADHD

Study Overview
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Brief Summary
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The primary objective of this study is to evaluate the effectiveness of neurofeedback training (NFB) on objective measurements of attention in young adults with ADHD. The secondary objectives are to evaluate neurofeedback effects on self-report measures of attention, ADHD symptoms, and to identify electroencephalogram (EEG) markers of ADHD and neurofeedback efficacy. The study is a double-blind, placebo controlled clinical trial to test the efficacy and safety of EEG neurofeedback in individuals 18-40 years of age with attention deficit hyperactivity disorder (ADHD). Attention will be evaluated at baseline, after 12 and 24 training sessions (an average of 4 and 8 weeks, respectively), and 4 weeks after the last neurofeedback session. The primary outcome will be change from baseline on the Attention Performance Index (API) variable of the Test of Variables of Attention (TOVA) a standardized, well-normed, computerized test of attention, after 12 neurofeedback or sham training sessions (and average of 4 weeks). Secondary outcomes will be change from baseline on other TOVA variables after 12 and 24 sessions (an average of 4 and 8 weeks, respectively), at 4 weeks post-training follow-up, and changes from baseline at each time point on the Adult Self Report Scale (ASRS) and Mindful Awareness and Attention Scale (MAAS). EEG data collected during TOVA attention testing at baseline will be used to model EEG differences between ADHD and non-ADHD participants. Additional EEG data collected during the TOVA at midpoint (average of 4 weeks), after 24 NFB sessions (average of 8 weeks), and 4 weeks post-NFB will be used to develop statistical models to use as indicators of neurofeedback efficacy

Official Title
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A Placebo-Control Evaluation of Neurofeedback Efficacy in Adults With ADHD

Conditions
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ADHD

Intervention / Treatment
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* Other: Neurofeedback
* Other: Sham Neurofeedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Be between the ages of 18 and 40 years old. ADHD participants must have a previous diagnosis of ADHD (inattentive or mixed type) by a licensed psychologist or psychiatrist. ADHD participants must have scores on the Adult Self-Report Scale V1.1 (ASRS; (Kessler et al. 2005)) > 24. ADHD participants must have TOVA API z score < 0. Ability to understand study procedures and to comply with them for the entire length of the study. Men and women of reproductive capability will be enrolled. Contraception is not necessary or required. Exclusion Criteria: A history of psychiatric disorder. Scores in clinical ranges on the Beck Depression Inventory II (20 or above) or Beck Anxiety Inventory (16 or above). A history of seizures. Known neurological disorders. Current drug or alcohol use or dependence that, in the opinion of the site investigator, would interfere with adherence to study requirements. Inability or unwillingness of individual to give written informed consent.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Sham control<br>This group will receive 12 sham neurofeedback sessions in which the feedback is based on pre-recorded data. | Other: Sham Neurofeedback<br>* Feedback generated by data not associated with the current participant.<br>|
| Experimental: Neurofeedback<br>The intervention will be 24 sessions of beta/SMR neurofeedback. | Other: Neurofeedback<br>* The intervention will be 24 sessions of beta/sensorimotor rhythm (SMR) neurofeedback.<br>* Other names: EEG biofeedback;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attention Performance Index of the Test of Variables of Attention | The primary outcome will be change from baseline on the Attention Performance Index (API) variable of the Test of Variables of Attention (TOVA) a standardized, well-normed, computerized test of attention, after 12 neurofeedback or sham training sessions (an average of 4 weeks). | After 12 neurofeedback or sham sessions (an average of 4 weeks). | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Test of Variables of Attention | Secondary outcomes will be change from baseline on other TOVA variables after 12 and 24 sessions (4 and 8 weeks on average, respectively), at 4 weeks post-training follow-up | after 12 (average 4 weeks) and 24 sessions (average 8 weeks) and 1 month followup |