Blog Post Neurofeedback versus stimulant medication: Who is the winner?

Neurofeedback versus stimulant medication: Who is the winner?
Mar

30

2016

Neurofeedback versus stimulant medication: Who is the winner?

ADHD is commonly combated with medication and this is because pharmaceutical methods have historically been considered the only efficacious treatment for this disorder. However neurofeedback has recently emerged as a complementary or even alternative treatment to medication. By training the patient to increase or decrease certain levels of cortical activation, symptoms of inattention, impulsivity, and hyperactivity can be effectively decreased on a long-term basis with prolonged training. This of course provides many advantages over medication as it has been shown to have minimal side effects unlike medication where the side effects can be very severe. Unlike medication once training is stabilised the effects are long-term and neurofeedback can be ceased, whereas with medication you need to take it for the rest of your life to obtain the benefits (and it often wears off at night meaning for teens and adults very impulsive behaviours can occur socially). The massive advantages of neurofeedback over medication are obvious, hence it provides a very valuable option for both children and adults.
González-Castro and fellow researchers in Spain wanted to analyse the efficacy of neurofeedback compared to pharmacological support in children with ADHD, and if combining both treatments would generate more positive results on AHD symptoms, executive control and cortical activation.
131 students between 8 to 11 years were recruited for the study and split into four groups: control (no treatment), neurofeedback group (received 15 min session, 3 days a week, for 3 months), pharmacological support group (received methylphenidate) and combined group (received neurofeedback and pharmacological support). Participants were assessed on their symptoms (Scale of Assessment Deficit with Hyperactivity), executive control (Test of Variables Attention) and cortical activation (QEEG and EEG Spectrum).
The results of the study indicated that all the groups that received some form of treatment showed increased cortical activation, improved executive control, and a reduction in observed symptomatology (hyperactivity and attention deficit). Overall, the combined group obtained more benefits on all three spheres recorded, therefore researchers concluded that multimodal treatments produce better results than isolated interventions. Researchers did not find any significant differences between participant’s cortical activation in the neurofeedback group and pharmacological support group that received a single treatment, showing that both treatments have similar effects on cortical activation. This supports other research showing that the benefits of neurofeedback to medication are often equivalent. Overall the results indicate that a combined treatment is more effective in reducing symptoms of ADHD, and that this improvement is consistent over time. It also suggests that neurofeedback can be a possible substitution for children and adults who want longer acting effects, do not like the side effects of medication, and desire a more permanent solution. This study is in line with past research that support neurofeedback as a legitimate alternative and recommended accompaniment to pharmaceutical methods in stimulating activation in students with ADHD.
Several limitations of the above study must be acknowledged. Firstly the study did not adopt random assignment in allocating participants to treatment groups, instead students were assigned to groups based on preferences expressed by their parents. Secondly, participant’s diagnosis was not confirmed with additional instruments. Lastly, the intervention program for the neurofeedback group was only applied for periods of 15 mins each session. The effects of the intervention might have been more pronounced if the sessions lasted 30 mins, and would have allowed for an established training protocol. Hence it is possible with the more standard 30 minute training neurofeedback participants may have actually done better than the group who took medication alone. Further research is required using strong NF protocols, however it is pleasing that with even rather short protocols such advantages are evident.
So who is the winner in the neurofeedback versus medication competition? We would have to say neurofeedback in this one given that the benefits are equal, but neurofeedback is long-term, has minimal side effects, and as training progresses lasts 24/7 rather than 8-10 hours. The research will continue and we will continue to evaluate the outcomes.
Original Article: González-Castro, Paloma et al. “Efficacy Of Neurofeedback Versus Pharmacological Support In Subjects With ADHD”. Applied Psychophysiology and Biofeedback 41.1 (2015): 17-25. Web.
  Written by Valencia Phua