A double-blind randomized controlled trial of personalized upper-alpha neurofeedback in children with ADHD.

In 30 seconds

This double-blind randomized controlled trial evaluated session-adaptive personalized upper-alpha neurofeedback in 48 children aged 6–12 years with ADHD, compared with sham feedback. After eight sessions over four weeks, parent-rated ADHD symptoms improved in both groups, but the between-group difference was not significant (d = -0.062, p = .881). At six months, symptom improvements persisted without evidence of neurofeedback superiority. The neurofeedback group showed greater EEG learning and selective gains in motor performance and reaction time, but these findings did not translate into greater symptom reduction.

Key findings

• EEG learner status was achieved by 21/26 children (80.7%) receiving neurofeedback, compared with 36.4% receiving sham.
• Post-treatment SWAN Total scores improved in both groups, with no between-group difference (d = -0.062, p = .881).
• At six months, symptom improvement persisted in the neurofeedback group (d = -0.713, p = .006), without superiority over sham (d = 0.221, p = .633).
• Neurofeedback-specific gains were reported for Purdue Pegboard non-preferred hand performance (d = 1.093, FDR q = .042) and CPT-3 reaction time (d = -1.210, FDR q = .025).

Why it matters

The trial separates EEG target engagement from clinical benefit: children receiving personalized neurofeedback more often showed the intended EEG learning, yet their ADHD symptom improvement was not greater than with sham. This distinction is important when interpreting neurofeedback outcomes, because physiological or task-specific changes do not necessarily indicate an added effect on core symptoms.

What to keep in mind

The trial included 48 children and used eight sessions over four weeks; the abstract does not report longer-term follow-up beyond six months.