Neurofeedback & ADHD: Does it work?
HTML-код
- Опубликовано: 29 окт 2023
- This video discusses the evidence concerning the effectiveness of neurofeedback (NF) for the management of ADHD symptoms. Several recent meta-analyses (reviews) of the evidence are discussed that reached a variety of conclusions. In general, it appears that NF does result in improvements in lab measures and ADHD symptoms when compared to wait-list control groups or those receiving no active therapy. However, when compared to active therapies, such as stimulant medications, or sham NF, the benefits are far less apparent, if at all. Lab measures seem to be more likely to improve from NF than ratings of ADHD symptoms in daily life, but as we know lab measures are not correlated much if at all with real world functioning. To me, the plethora of evidence suggests that NF is not an established treatment for ADHD and should only be considered when other treatments that are evidence based have been tried and found not to produce the desired effects and assuming the patient or family has the expendable income to pay for this expensive type of treatment.
Image of NF in the video is from: unsplash.com/photos/electrica...
You can find more information on this topic in my books, Taking Charge of ADHD: The Complete Authoritative Guide for Parents, and in Taking Charge of Adult ADHD.
References cited in the video:
Van Doren, J. et al. (2019) Sustained effects of neurofeedback in ADHD: A systemative review and meta-analysis. European Child and Adolescent Psychiatry. link.springer.com/article/10....
Chiu, H-J. et al. (2022). Surface electroencephalographic neurofeedback improves sustained attention in ADHD: a meta-analysis of randomized controlled trials. Child and Adolescent Psychiatry and Mental Health. capmh.biomedcentral.com/artic...
Rahmani, E. et al.(2022). Is neurofeedback effective in children with ADHD? A systematic review and meta-analysis. Neurocase. www.tandfonline.com/doi/abs/1...
Louthrenoo. O. et al. (2021). The Effects of Neurofeedback on Executive Functioning in Children With ADHD: A Meta-Analysis. Journal of Attention Disorders. journals.sagepub.com/doi/abs/...
Yan, L. et al. (2019). Effects of neurofeedback versus methylphenidate for the treatment of ADHD: systematic review and meta-analysis of head-to-head trials. BMJ Mental Health. mentalhealth.bmj.com/content/...
I did a two week intensive of Neurofeedback in 2011. It was for the Wuttke Insitute model of Neurofeedback. I was desperately looking back then for something that could help me with my learning problems. I had bad concentration and focus, spatial awareness difficulties, problems with maths, physical coordination problems. Everything was and is much more difficult for me and takes me much longer to learn than other people. School was not a pleasant experience. Anyway, I decided to give Neurofeedback a go. It was a generally enjoyable and pleasant experience. The QEEG brain map was interesting. They showed me according to their brain map what my brain looked like. They said I had a quiet brain but too many theta waves and not enough alpha and mid range beta. Also some areas of my brain were doing the job of other areas. So we looked into rebalancing them. The outcome was OK but nothing life changing. They recommended I do some mediation to help with learning to be 'in the moment' and this would also continue to balance my brain. I did meditation for 3 years after this everyday and once again the results were nothing to shout about and hardly helped at all. I had considered in the past of going to a psychiatrist to get an assessment of ADHD but was told by well meaning people that as I was not hyper I would not be ADHD. Last year in my 41st year on this planet after losing my job being told I am making too many careless mistakes and lack attention to detail I paid to see a Psychiatrist and he diagnosed me as ADHD combined type. He started me on Methylphenidate and though I didn't get on with the first meds prescribed, the second medication he prescribed the Concerta XL worked and has improved my concentration a lot. I think Neurofeedback is not as advanced and does not help as much as it claims to help. Hopefully better options can be created in the future. May I ask what do you think about the potential of TDCS- tranacranial direct current stimulation?
Wow 5 minutes ago, recently was brought into the ADHD world and thanks for everything you do Dr Barkley.
3 hours later, shall we assume you are still diving down the rabbit hole devouring all the info you can find? 😂
@@Lucky9_9 Been doing it for a while haha
Yes, there have been five or six studies with some finding a small additive benefit that disappeared at follow up and was more likely to be seen on lab measures than ratings of behavior in natural settings, as I recall.
Is TMS better than Neurofeedback
I have seen a difference in using neurofeedback along with medication, therapy and physical activity. When neurofeedback was added, there was an increase in my nephew's understanding of cause/effect and consequences- which to me , was a win .
Thank you for writing your conclusion in the description and not hiding it in the video.
I had 30 sessions of Neurofeedback. No improvement in symptoms, but my accuracy in shooting basketball 🏀 went from
2 out of 10 shots to 10 out of 10,
until my muscles got tired out. Was temporarily lasted a few weeks but my accuracy is still good ( way better than before Neurofeedback)!!!
Grandad Barkley has put in more effort than me on Halloween this year.. I feel ashamed. 😂 Great lecture thank you! ❤
Thank you for all you do. I am so grateful for your knowledge and skills and the time you take to share this. You are very kind to do this for us and our children.
I was diagnosed in my 30s as the textbook case for ADHD. Then after moving to another state and seeking new care I have been told I am everything but. Now the severity of my ADHD symptoms have gotten so bad I cannot care or leave my house as they are being exacerbated by my IUD. My severity is so bad shame cycles and low self esteem create a paralyzed state from the overwhelm of my emotions. I cannot leave the house and create extreme depression and anxiety. I've been looking into biofeedback since all these new professionals want to label it as my trauma or brain injury or just giving me the diagnosis and declining medication. Hoping biofeedback would have been just as effective as medication. So thank you so much for doing this video to save me from another disappointment . In addition, thanks for your humor. You are truly amazing!
You are truly are gift to humankind
I am so glad you made this video because I was wondering if or how effective neurofeedback treatment actually is.
I have come across a few of these places in google search listings when I was looking for some type of councellor or therapist with specialization with adult ASD and depression. I have learned since I started counseling that I also have ADHD, and that my idea of what ADHD entailed or looked like was somewhat wrong all my life, partly because of the misleading name, (which you discussed have discussed before).
It's good that I could find a trusted source that can fairly discuss the actual research and studies on this treatment and not just hopelessly swim through the types of articles that draw overly broad conclusions based on anecdotal examples.
Thank you for covering this
I'd be curious to know whether there have been any studies of neurofeedback combined with medication or other treatments, as opposed to comparing it to them.
Thank you for sharing the very helpful info and your guidance.
Thank you very much for doing what you do!
ADHD medicine sounds great but I cant get away the thought of it being a symptomatic treatment that can lead to downregulation in the body. What if it makes it better short term but worsens everything long term, while there are some hypothetical brain excersizes improving and developing the prefrontal cortex?
The long term outcomes of ADHD medication are largely positive. Compared to someone with ADHD, but not medicated, medicated ADHDers have less mental illness, criminal behaviour, relationship breakdown, even less dementia.
There are tons of reasons to be scared of medication. I was certainly super hesitant to try. For me, it came down to being in denial about how bad ADHD was for me, how badly it was impacting my life.
Here are some points to consider:
- ADHD medication helps with driving and reducing accidents. Unmedicated ADHD people are almost on the level of drunk drivers. We can be a danger to ourselves and others.
- ADHD medication helps us stay on top of our general health, and habit forming behaviours. Not procrastinating that dental appointment, brushing your teeth regularly, cooking food vs health food.
- ADHD medication reduces our likelihood to turn to drug, internet, and alcohol abuse.
- We are more likely to struggle at school and work. Medication helps with that as well.
I may be misremembering the exact number, but I think Dr Barkley said in one of his videos that our average lifespan unmedicated is something like 10-13 less on average. That's huge! I just didn't know, or else I'd have tried medication earlier.
Based on my amateur reading, the biggest risk seems to be a slight risk to cardiovascular health particularly with blood pressure, but I think a lot of evidence points to that being offset by eating healthier and exercising regularly, which medication helps us do. Given how helpful the medication can be, I am open to starting stimulant medication. There's also blood pressure medication if your doctor feels you need it.
I started 10mg of Adderall XR just last week. This dose is fairly small, it's close to a child's dose. I don't see many benefits yet aside from mild appetite suppression - the small dose was just to make sure I don't react to it badly. I'll be starting 20mg next week some time next week now that I know my blood pressure stays at reasonable levels. I'm looking forward to it.
I was scared it would change my personality. It didn't. I was scared I would be dependent on it. But it's a disorder, a real health condition - what does it mean to be dependent on something? Is a person with glasses dependent on their glasses to see? Maybe technically, but so what? It helps them interact better with the world, and that's what stimulants can do for people with ADHD. I guess I was too proud to take medication. But what's the real failure - accepting help, or denying help when you know you need it? Framed that way, it became a no-brainer to try them. You can always stop if it doesn't work.
I want to be healthier and medication is the clearest path. It's the first line treatment. It's ADHD medication is more effective at treating ADHD than anti-depressants are for treating depression. It's probably best combined with therapy and intentional lifestyle changes, which I'm trying to access. But self education is good too, which is why I super appreciate Dr. Barkley's videos.
Thank you for this. That is an extremely valuable video taking up what desperate patents or people could use their last dime on. This we really do need more of 🙂 What is what in "all the alternatives". So people have a fair idea about how to best use their money.
Funny enough. When you had the mask on in the beginning, I was like, there's no way I can pay attention to him the whole time with that mask on 😅 Happy Halloween Dr. Barkley. Thanks so much for your content! ❤🎃👻
Neurofeedback in it's form is very seductive because it's so easy to tell a story about how it could do something. I also imagine that there are so many parameters to it that it would be very hard to test most of the variations of it.
What you're saying about the research here though is that it looks like the literature for phenomena where there is little or no effect of importance.
That's one of the hard parts to communicate about science. That in cases where there is no effect, you typically still have some research that show some slight effect and when you make the studies more rigorous you see a decrease in effect.
And if you're not very well read on the literature, you only need someone who makes a strong but slightly inaccurate positive claim about the research for it to sound plausible.
My interactions about it has only been with someone who had invested in equipment and were taking customers to do it. I didn't know too much about it and for all I knew it might do something. It's just the kind of situation that would require a lot of careful work to teach the scientific version skepticism.
Never looked into it further, so it was interesting to hear your summary of the literature. If I ever need to learn more I have a place to start.
I'm curious to know what neurofeedback is effective for. Maybe not ADHD but what about concurrent conditions like anxiety, depression, emotional regulation. Thanks for all your time and dedication to this topic
To me it honestly seems like commodified mindfulness. How do we make mindfulness into a thing we can licence.
I agree - there are so many claims for neurofeedback, they sell it like a miracle cure for just about all mental issues. I'm sure it's good for something, but it would be nice to know where it actually shines, vs where it might kinda help a little bit.
How does neuroptimal rank?
I would be curious to see your opinions of the research of tDCS and tACS on ADHD symptoms. There is some research published in this area that seems potentially promising.
Agreed! I really want to hear his thoughts on this!
If I understood correctly, they are basically teaching you the skill of concentration. The feedback is just a visual representation, a meter if you will, of the activity that goes on in your brain regardless if you’re wearing electrodes or not.
So you might as well be playing a game that rewards you for concentrating.
In a lab. With nothing else to do anyway.
Someone should have told them ADHD isn’t a problem with lacking skills. Sure, we’ll play the game and get good at the game but it all goes out the window when we step outside to the real world.
Hey, maybe going to the lab to play the game is very important and I have to do it right now because I really don’t feel like taking care of the dishes.
"Someone should have told them ADHD isn’t a problem with lacking skills." Excellent point! As Dr. B. always says, ADHD isn't a problem of not knowing what to do but rather of not doing what you know.
Happy Halloween from Germany!
Happy Halloween! 🎃
Happy Halloween RB gang. I would also love to know the mainstream research and the Dr's thoughts combining methylphenidate (Ritalin) and amphetamine-dextroamphetamine (Adderall/Dexedrine). The MPH apparently can cancel out the APH neuro-toxicity. For my personal. I theorize Dex is good for daytime to get stuff done. Ritalin is good at night to relax and sleep. Even more what if you added a non-stim as well. So low dose MPH (Ritalin), APH (Dexedrine), Non-Stim (Starttera) combo. So, is it safe and even beneficial to combine methylphenidate and amphetamine? Help!
🎃 Happy Halloween! 🎃 ...you must be on the East Coast too. Cheers!
what about NF in conjunction with medication? It seemed like all the studies assume NF is a replacement for medication.
what is SHAM treatment?
I was planning on purchasing neurofeedback but now im not so sure
And what would be an affective substitute if medication doesn't work?
There are several meds to choose from. It’s very likely that one of them will work.
Meds and psychotherapy is a strong combination. Psychotherapy in itself can be life-changing even if you have no luck with medication.
Saffron & microdosing psilocybin helps
It's sad, that so few people watch your works nowadays, but choose trash from ADHD "experts"
Thank you Doctor Barkley!
So does it work?
Probably not.
Spooky!
In the lab, in the lab, blahblahblah yeah.
You scared me shitless with your mask on.
It’s not like lufe really is a video game… unless we are all in the matrix?