Train Your Brain and Exercise Your Heart? Advancing the Treatment for Attention Deficit Hyperactivity Disorder (ADHD)

Study Overview
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Brief Summary
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Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder that has a severe impact on a child's life and society. The core symptoms are attention problems, hyperactivity and impulsivity. These symptoms are related to disruptions in neurocognitive functions (such as inhibition: the ability to stop behavior) and disruptions in cortical regulation (such as 'cortical underarousal' as measured with the electroencephalogram). To date, the only evidence-based treatment is pharmacological. Medication is not effective in 20-30% of the children with ADHD and it can have side effects. The lack of alternatives for medication is a severe problem for these children and society. Neurofeedback is becoming increasingly popular for treating ADHD. Neurofeedback is a training in which a person learns to alter its cortical regulation. Neurofeedback has been classified as 'probably effective' but its treatment effects need further empirical evidence. Non specific training effects, such as individual attention, may also contribute to treatment success. In this research project the investigators compare the efficacy of neurofeedback with exercise, a second non-pharmacological treatment, that may be comparable with neurofeedback in terms of non-specific effects. Exercise is also a promising treatment because of its positive effects on behavior, neurocognition in several patient groups. For these reasons, exercise deserves systematic research in ADHD. Furthermore, the investigators compare the efficacy of these two treatments with an optimal pharmacological treatment with methylphenidate (MPH). The main question is if neurofeedback and exercise are comparable in efficacy with MPH for treating ADHD. The primary outcome measure is behaviour (symptoms of ADHD). Secondary outcome measures include neurocognition and cortical regulation. This research project will give answer to the question if neurofeedback and exercise are as effective as MPH. Furthermore, it will give insight in how these interventions will give rise to improvements in behavior.

Official Title
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Train Your Brain? Exercise and Neurofeedback Intervention for ADHD

Conditions
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Attention Deficit Hyperactivity Disorder (ADHD)

Intervention / Treatment
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* Other: Neurofeedback
* Behavioral: Exercise
* Drug: methylphenidate


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ADHD diagnosis IQ above 80 Exclusion Criteria: neurological disorder severe physical or cognitive disability

Ages Eligible for Study
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Minimum Age: 7 Years
Maximum Age: 13 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: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Neurofeedback<br> | Other: Neurofeedback<br>* 30 sessions of theta/beta neurofeedback within 10 weeks.<br>* Other names: biofeedback;|
| Experimental: Exercise<br> | Behavioral: Exercise<br>* 30 sessions of individual sports training during 10 weeks.<br>* Other names: sports;|
| Active Comparator: methylphenidate<br>optimum dose of methylphenidate (assessed by a double blind placebo-controlled procedure) | Drug: methylphenidate<br>* The medication treatment is based on the MTA study and includes methylphenidate dosages of 5, 10, 15 (only for children with a weight below 25 kg) and 20 mg (only for children with a weight above 25 kg. The optimum dose will be determined by a double-blind placebo-controlled trial.<br>* Other names: Not applicable, a generic form will be used.;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement in Behaviour | Behaviour is assessed with rating scales (SWAN, SDQ, SDSC,DCD) and actigraphy | Within 2 weeks after the end of treatment (T1) and 6 months after the end of treatment (T2) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement in neurocognition | Neuorcognition is assessed with several neuropsychological tests measuring inhibition, working memory, time estimation and probabilistic learning | Within 2 weeks after the end of treatment (T1) and 6 months after the end of treatment (T2) | 
| Improvement in neurophysiology | Neurophysiology is measured with ERPs and quantitative EEG | Within 2 weeks after the end of treatment (T1) and 6 months after the end of treatment (T2) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ADHD, neurofeedback, exercise, neurophysiology