title: ADHD and EEG-neurofeedback: a double-blind randomized placebo-controlled feasibility study Neurofeedback in ADHD: a single-blind randomized controlled trial EEG Neurofeedback for ADHD Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial Functional Magnetic Resonance Imaging Investigation of the Effects of Neurofeedback Training on the Neural Bases of Selective Attention and Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. Neurofeedback Treatment for Attention-Deficit/Hyperactivity Disorder in Children: A Comparison with Methylphenidate Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: A functional magnetic resonance imaging study Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. THE EFFECTS OF NEUROFEEDBACK TRAINING IN THE COGNITIVE DIVISION OF THE ANTERIOR CINGULATE GYRUS Training of slow cortical potentials in attention-deficit/hyperactivity disorder: evidence for positive behavioral and neurophysiological effects The Effects of Stimulant Therapy, EEG Biofeedback, and Parenting Style on the Primary Symptoms of Attention-Deficit/Hyperactivity Disorder The Effectiveness of Neurofeedback and Stimulant Drugs in Treating AD/HD: Part II. Replication An Exploratory Study on the Effects of Tele-neurofeedback and Tele-biofeedback on Objective and Subjective Sleep in Patients with Primary Insomnia Neurofeedback Intervention in Fibromyalgia Syndrome; a Randomized, Controlled, Rater Blind Clinical Trial Neurofeedback in children with ADHD: Specific event-related potential findings of a randomized controlled trial Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder. DOTA derivatives for site-specific biomolecule-modification via click chemistry: synthesis and comparison of reaction characteristics. Distinct EEG effects related to neurofeedback training in children with ADHD: a randomized controlled trial. Computer-Based Attention Training in the Schools for Children With Attention Deficit/Hyperactivity Disorder: A Preliminary Trial Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status.
abstract: Electroencephalography (EEG)-neurofeedback has been shown to offer therapeutic benefits to patients with attention-deficit/hyperactivity disorder ( ADHD ) in several , mostly uncontrolled studies . This pilot study is design ed to test the feasibility and safety of using a double-blind placebo feedback-controlled design and to explore the initial efficacy of individualized EEG-neurofeedback training in children with ADHD . Fourteen children ( 8–15 years ) with ADHD defined according to the DSM-IV-TR criteria were r and omly allocated to 30 sessions of EEG-neurofeedback ( n = 8) or placebo feedback ( n = 6 ) . Safety measures ( adverse events and sleep problems ) , ADHD symptoms and global improvement were monitored . With respect to feasibility , all children completed the study and attended all study visits and training sessions . No significant adverse effects or sleep problems were reported . Regarding the expectancy , 75 % of children and their parent(s ) in the active neurofeedback group and 50 % of children and their parent(s ) in the placebo feedback group thought they received placebo feedback training . Analyses revealed significant improvements of ADHD symptoms over time , but changes were similar for both groups . This pilot study shows that it is feasible to conduct a rigorous placebo-controlled trial to investigate the efficacy of neurofeedback training  in children with ADHD . However , a double-blind design may not be feasible since using automatic adjusted reward thresholds may not work as effective as manually adjusted reward thresholds . Additionally , implementation of active learning strategies may be an important factor for the efficacy of EEG-neurofeedback training . Based on the results of this pilot study , changes are made in the design of the ongoing study Neurofeedback treatment has been demonstrated to reduce inattention , impulsivity and hyperactivity in children with attention deficit/hyperactivity disorder ( ADHD ) . However , previous studies did not adequately control confounding variables or did not employ a r and omized reinforcer-controlled design . This study addresses those method ological shortcomings by comparing the effects of the following two matched biofeedback training variants on the primary symptoms of ADHD : EEG neurofeedback ( NF ) aim ing at theta/beta ratio reduction and EMG biofeedback ( BF ) aim ing at forehead muscle relaxation . Thirty-five children with ADHD ( 26 boys , 9 girls ; 6–14 years old ) were r and omly assigned to either the therapy group ( NF ; n = 18 ) or the control group ( BF ; n = 17 ) . Treatment for both groups consisted of 30 sessions . Pre- and post-treatment assessment consisted of psychophysiological measures , behavioural rating scales completed by parents and teachers , as well as psychometric measures . Training effectively reduced theta/beta ratios and EMG levels in the NF and BF groups , respectively . Parents reported significant reductions in primary ADHD symptoms , and inattention improvements in the NF group were higher compared to the control intervention ( BF , dcorr = −.94 ) . NF training also improved attention and reaction times on the psychometric measures . The results indicate that NF effectively reduced inattention symptoms on parent rating scales and reaction time in neuropsychological tests . However , regarding hyperactivity and impulsivity symptoms , the results imply that non-specific factors , such as behavioural contingencies , self-efficacy , structured learning environment and feed-forward processes , may also contribute to the positive behavioural effects induced by neurofeedback training Objective : Preparing for a definitive r and omized clinical trial ( RCT ) of neurofeedback ( NF ) for ADHD , this pilot trial explored feasibility of a double-blind , sham-controlled design and adherence/palatability/relative effect of two versus three treatments/week . Method : Unmedicated 6- to 12-year-olds with Diagnostic and Statistical Manual of Mental Disorders ( 4th ed . ; DSM-IV ) ADHD were r and omized to active NF versus sham-NF and to 2X versus 3X/week treatment frequency . Frequency switch was allowed after Treatment 24 . Results : In two school years , 39 participants were recruited and 34 ( 87 % ) completed all 40 treatments . Child/parent guesses about assigned treatment were no better than chance . At Treatment 24 , 38 % chose 2X/week and 62 % chose 3X/week . Both active NF and sham yielded large pre – post improvement on parent ratings  but NF no more than sham . Conclusion : Blinding appears to work , and sham does not prevent recruitment/retention . Treatment frequency of 3X/week seems preferred over 2X/week and was as effective . A large double-blind RCT is feasible and necessary to test specific NF effectiveness Neurofeedback ( NF ) could help to improve attentional and self-management capabilities in children with attention-deficit/hyperactivity disorder ( ADHD ) . In a r and omised controlled trial , NF training was found to be superior to a computerised attention skills training ( AST ) ( Gevensleben et al. in J Child Psychol Psychiatry 50(7):780–789 , 2009 ) . In the present paper , treatment effects at 6-month follow-up were studied . 94 children with ADHD , aged 8–12 years , completed either 36 sessions of NF training ( n = 59 ) or a computerised AST ( n = 35 ) . Pre-training , post-training and follow-up assessment encompassed several behaviour rating scales ( e.g. , the German ADHD rating scale , FBB-HKS ) completed by parents . Follow-up information was analysed in 61 children ( ca . 65 % ) on a per- protocol basis . 17 children ( of 33 dropouts ) had started a medication after the end of the training or early in the follow-up period . Improvements in the NF group ( n = 38 ) at follow-up were superior to those of the control group ( n = 23 ) and comparable to the effects at the end of the training . For the FBB-HKS total score ( primary outcome measure ) , a medium effect size of 0.71 was obtained at follow-up . A reduction of at least 25 % in the primary outcome measure ( responder criterion ) was observed in 50 % of the children in the NF group . In conclusion , behavioural improvements induced by NF training in children with ADHD were maintained at a 6-month follow-up . Though treatment effects appear to be limited , the results confirm the notion that NF is a clinical ly efficacious module in the treatment of children with ADHD Two functional magnetic resonance imaging ( fMRI ) experiments were undertaken to measure the effect of neurofeedback training ( NFT ) , in AD/HD children , on the neural substrates of selective attention and response inhibition . Twenty unmedicated AD/HD children participated to these experiments . Fifteen children were r and omly assigned to the Experimental ( EXP ) group whereas the other five children were r and omly assigned to the Control ( CON ) group . Only subjects in the EXP group underwent NFT . EXP subjects were trained to enhance the amplitude of the SMR ( 12–15 Hz ) and beta 1 activity ( 15–18 Hz ) , and decrease the amplitude of theta activity ( 4–7 Hz ) . Subjects from both groups were scanned one week before the beginning of NFT ( Time 1 ) and 1 week after the end of NFT ( Time 2 ) , while they performed a “ Counting Stroop ” task ( Experiment 1 ) and a Go/No-Go task ( Experiment 2 ) . At Time 1 , in both groups , the  Counting Stroop task was associated with significant activation in the left superior parietal lobule . For the Go/No-Go task , no significant activity was detected in the EXP and CON groups . At Time 2 , in both groups , the  Counting Stroop task was associated with significant activation of the left superior parietal lobule . This time , however , there were significant loci of activation , in the EXP group , in the right ACC , left cau date nucleus , and left substantia nigra . No such activation loci were seen in CON subjects . For the Go/No-Go task , significant loci of activation were noted , in the EXP group , in the right ventrolateral prefrontal cortex , right ACcd , left thalamus , left cau date nucleus , and left substantia nigra . No significant activation of these brain regions was measured in CON subjects . These results suggest that NFT has the capacity to functionally normalize the brain systems mediating selective attention and response inhibition in AD/HD children OBJECTIVES To determine any long-term effects , 6 and 8 years after childhood enrollment , of the r and omly assigned 14-month treatments in the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder ( MTA ; N = 436 ) ; to test whether attention-deficit/hyperactivity disorder ( ADHD ) symptom trajectory through 3 years predicts outcome in subsequent years ; and to examine functioning level of the MTA adolescents relative to their non-ADHD peers ( local normative comparison group ; N = 261 ) . METHOD Mixed-effects regression models with planned contrasts at 6 and 8 years tested a wide range of symptom and impairment variables assessed by  parent , teacher , and youth report . RESULTS In nearly every analysis , the originally r and omized treatment groups did not differ significantly on repeated measures or newly analyzed variables ( e.g. , grade s earned in school , arrests , psychiatric hospitalizations , other clinical ly relevant outcomes ) . Medication use decreased by 62 % after the 14-month controlled trial , but adjusting for this did not change the results . ADHD symptom trajectory in the first 3 years predicted 55 % of the outcomes . The MTA participants fared worse than the local normative comparison group on 91 % of the variables tested . CONCLUSIONS Type or intensity of 14 months of treatment for ADHD in childhood ( at age 7.0 - 9.9 years ) does not predict functioning 6 to 8 years later . Rather , early ADHD symptom trajectory regardless of treatment type is prognostic . This finding implies that children with behavioral and sociodemographic advantage , with the best response to any treatment , will have the best long-term prognosis . As a group , however , despite initial symptom improvement during treatment that is largely maintained after treatment , children with combined-type ADHD exhibit significant impairment in adolescence . Innovative treatment approaches targeting specific areas of adolescent impairment are needed Clinical trials have suggested that neurofeedback may be efficient in treating attention-deficit/hyperactivity disorder ( ADHD ) . We compared the effects of a 3-month electroencephalographic feedback program providing reinforcement contingent on the production of cortical sensorimotor rhythm ( 12–15 Hz ) and beta1 activity ( 15–18 Hz ) with stimulant medication . Participants were N = 34 children aged 8–12 years , 22 of which were assigned to the neurofeedback group and 12 to the methylpheni date group according to their parents ' preference . Both neurofeedback and methylpheni date were associated with improvements on all subscales of the Test of Variables of Attention , and on the speed and accuracy measures of the d2 Attention Endurance Test . Furthermore , behaviors related to the disorder were rated as significantly reduced in both groups by both teachers and parents on the IOWA-Conners Behavior Rating Scale . These findings suggest that neurofeedback was efficient in improving some of the behavioral concomitants of ADHD in children whose parents favored a nonpharmacological treatment Attention Deficit Hyperactivity Disorder ( AD/HD ) is a neurodevelopmental disorder mainly characterized by impairments in cognitive functions . Functional neuroimaging studies carried out in individuals with AD/HD have shown abnormal functioning of the anterior cingulate cortex ( ACC ) during tasks involving selective attention . In other respects , there is mounting evidence that neurofeedback training ( NFT ) can significantly improve cognitive functioning in AD/HD children . In this context , the present functional magnetic resonance imaging ( fMRI ) study was conducted to measure the effect of NFT  on the neural substrates of selective attention in children with AD/HD . Twenty AD/HD children -- not taking any psychostimulant and without co-morbidity-participated to the study . Fifteen children were r and omly assigned to the Experimental ( EXP ) group ( NFT ) , whereas the other five children were assigned to the Control ( CON ) group ( no NFT ) . Subjects from both groups were scanned 1 week before the beginning of the NFT ( Time 1 ) and 1 week after the end of this training ( Time 2 ) , while they performed a Counting Stroop task . At Time 1 , for both groups , the Counting Stroop task was associated with significant loci of activation in the left superior parietal lobule . No activation was noted in the ACC . At Time 2 , for both groups , the Counting Stroop task was still associated with significant activation of the left superior parietal lobule . This time , however , for the EXP group only there was a significant activation of the right ACC . These results suggest that in AD/HD children , NFT has the capacity to normalize the functioning of the ACC , the key neural substrate of selective attention BACKGROUND For children with attention deficit/hyperactivity disorder ( ADHD ) , a reduction of inattention , impulsivity and hyperactivity by neurofeedback ( NF ) has been reported in several studies . But so far , unspecific training effects have not been adequately controlled for and /or studies do not provide sufficient statistical power . To overcome these method ological shortcomings we evaluated the clinical efficacy of neurofeedback in children with ADHD in a multisite r and omised controlled study using a computerised attention skills training as a control condition . METHODS 102 children with ADHD , aged 8 to 12 years , participated in the study . Children performed either 36 sessions of NF training or a computerised attention skills training within two blocks of about four weeks each ( r and omised group assignment ) . The combined NF treatment consisted of one block of theta/beta training and one block of slow cortical potential ( SCP ) training . Pre-training , intermediate and post-training assessment encompassed several behaviour rating scales ( e.g. , the German ADHD rating scale , FBB-HKS ) completed by parents and teachers . Evaluation ( ' placebo ' ) scales were applied to control for parental expectations and satisfaction with the treatment . RESULTS For parent and teacher ratings , improvements in the NF group were superior to those of the control group . For the parent-rated FBB-HKS total score ( primary outcome measure ) , the effect size was .60 . Comparable effects were obtained for the two NF protocol s ( theta/beta training , SCP training ) . Parental attitude towards the treatment did not differ between NF and control group . CONCLUSIONS Superiority of the combined NF training indicates clinical efficacy of NF in children with ADHD . Future studies should further address the specificity of effects and how to optimise the benefit of NF as treatment module for ADHD This study examines the efficacy of neurofeedback training in the cognitive division of the anterior cingulate gyrus and describes its relationship with cortical regions known to be involved in executive functions . This study was conducted with eight non- clinical students , four male and four female , with a mean age of twenty-two .  Learning occurred in the ACcd at significant levels over sessions and in the anterior regions that receive projections from the AC . There appears to be a multidimensional executive circuit that increases in the same frequency in apparent synchrony with the AC and it may be possible to train this sub-cortical region using LNFB BACKGROUND Learned self-control of slow cortical potentials ( SCPs ) may lead to behavioral improvement in attention-deficit/hyperactivity disorder ( ADHD ) . Hence , training effects should also be reflected at the neurophysiological level . METHODS Thirteen children with ADHD , aged 7 - 13 years , performed 25 SCP training sessions within 3 weeks . Before and after training , the German ADHD rating scale was completed by parents , and event-related potentials were recorded in a cued continuous performance test ( CPT ) . For a waiting-list group of nine children with ADHD , the same testing was applied . RESULTS ADHD symptomatology was reduced by approximately 25 % after SCP training . Moreover , a decrease of impulsivity errors and an increase of the contingent negative variation were observed in the CPT task . CONCLUSIONS This study provides first evidence for both positive behavioral and specific neurophysiological effects of SCP training in children with ADHD One hundred children , ages 6–19 , who were diagnosed with attention-deficit/hyperactivity disorder ( ADHD ) , either inattentive or combined types , participated in a study examining the effects of Ritalin , EEG biofeedback , and parenting style on the primary symptoms of ADHD . All of the patients participated in a 1-year , multimodal , outpatient program that included Ritalin , parent counseling , and academic support at school ( either a 504 Plan or an IEP ) . Fifty-one of the participants also received EEG biofeedback therapy . Posttreatment assessment s were conducted both with and without stimulant therapy . Significant improvement was noted on the Test of Variables of Attention ( TOVA ; L. M. Greenberg , 1996 ) and the Attention Deficit Disorders Evaluation Scale ( ADDES ; S. B. McCarney , 1995 ) when participants were tested while using Ritalin . However , only those who had received EEG biofeedback sustained these gains when tested without Ritalin . The results of a Quantitative Electroencephalographic Scanning Process ( QEEG-Scan ; V. J. Monastra et al. , 1999 ) revealed significant reduction in cortical slowing only in patients who had received EEG biofeedback . Behavioral measures indicated that parenting style exerted a significant moderating effect on the expression of behavioral symptoms at home but not at school This study replicated T. R. Rossiter and T. J. La Vaque ( 1995 ) with a larger sample , exp and ed age range , and improved statistical analysis . Thirty-one AD/HD patients who chose stimulant drug ( MED ) treatment were matched with 31 patients who chose a neurofeedback ( EEG ) treatment program . EEG patients received either office ( n = 14 ) or home ( n = 17 ) neurofeedback . Stimulants for MED patients were titrated using the Test of Variables of Attention ( TOVA ) .  EEG ( effect size [ ES ] = 1.01–1.71 ) and MED ( ES = 0.80–1.80 ) groups showed statistically and clinical ly significant improvement on TOVA measures of attention , impulse control , processing speed , and variability in attention . The EEG group demonstrated statistically and clinical ly significant improvement on behavioral measures ( Behavior Assessment System for Children , ES = 1.16–1.78 , and Brown Attention Deficit Disorder Scales , ES = 1.59 ) . TOVA gain scores for the EEG and MED groups were not significantly different . More importantly , confidence interval and nonequivalence null hypothesis testing confirmed that the neurofeedback program produced patient outcomes equivalent to those obtained with stimulant drugs . An effectiveness research design places some limitations on the conclusions that can be drawn Insomnia is a sleeping disorder , usually studied from a behavioural perspective , with a focus on somatic and cognitive arousal . Recent studies have suggested that an impairment of information processes due to the presence of cortical hyperarousal might interfere with normal sleep onset and /or consolidation . As such , a treatment modality focussing on CNS arousal , and thus influencing information processing , might be of interest . Seventien insomnia patients were r and omly assigned to either a tele-neurofeedback ( n = 9 ) or an electromyography tele-biofeedback ( n = 8) protocol . Twelve healthy controls were used to compare baseline sleep measures . A  polysomnography  was performed pre and post treatment . Total Sleep Time ( TST ) , was considered as our primary outcome variable . Sleep latency decreased pre to post treatment in both groups , but a significant improvement in TST was found only after the neurofeedback ( NFB ) protocol . Furthermore , sleep logs at home showed an overall improvement only in the neurofeedback group , whereas the sleep logs in the lab remained the same pre to post training . Only NFB training result ed in an increase in TST . The mixed results concerning perception of sleep might be related to method ological issues , such as the different locations of the training and sleep measurements We design ed a r and omized , rater blind study to assess the efficacy of EEG Biofeedback ( Neurofeedback-NFB ) in patients with fibromyalgia syndrome ( FMS ) . Eighteen patients received twenty sessions of NFB-sensory motor rhythm ( SMR ) treatment ( NFB group ) during 4 weeks , and eighteen patients were given 10 mg per day escitalopram treatment ( control group ) for 8 weeks . Visual Analog Scales for pain and fatigue , Hamilton and Beck Depression and Anxiety Inventory Scales , Fibromyalgia Impact Question naire and Short Form 36 were used as outcome measures which were applied at baseline and 2nd , 4th , 8th , 16th , 24th weeks . Mean amplitudes of EEG rhythms ( delta , theta , alpha , SMR , beta1 and beta2 ) and theta/SMR ratio were also measured in NFB group . All post-treatment measurements showed significant improvements in both of the groups ( for all parameters p < 0.05 ) . NFB group displayed greater benefits than controls ( for all parameters p < 0.05 ) . Therapeutic efficacy of NFB was found to begin at 2nd week and reached to a maximum effect at 4th week . On the other h and , the improvements in SSRI treatment were also detected to begin at 2nd week but reached to a maximum effect at 8th week . No statistically significant changes were noted regarding mean amplitudes of EEG rhythms ( p > 0.05 for all ) . However , theta/SMR ratio showed a significant decrease at 4th week compared to baseline in the NFB group ( p < 0.05 ) . These data support the efficacy of NFB as a treatment for pain , psychological symptoms and impaired quality of life associated with fibromyalgia OBJECTIVE In a r and omized controlled trial , we could demonstrate clinical efficacy of neurofeedback ( NF ) training for children with ADHD ( Gevensleben et al. , 2009a ) . The present investigation aim ed at learning more about the neuronal mechanisms of NF training . METHODS Children with ADHD either completed a NF training or a computerized attention skills training ( ratio 3:2 ) . NF training consisted of one block of theta/beta training and one block of slow cortical potential ( SCP ) training , each comprising 18 training units . At three times ( pre-training , between the two training blocks and at post-training ) , event-related potentials ( ERP ) were recorded during the Attention Network Test . ERP analysis focused on the P3 , reflecting inter alia attentional re sources for stimulus evaluation , and the contingent negative variation ( CNV ) , primarily related to cognitive preparation . RESULTS After NF training , an increase of the CNV in cue trials could be observed , which was specific for the SCP training . A larger pre-training CNV was associated with a larger reduction of ADHD symptomatology for SCP training . CONCLUSIONS CNV effects reflect neuronal circuits underlying re source allocation during cognitive preparation . These distinct ERP effects are closely related to a successful NF training in children with ADHD . In future studies , neurophysiological recordings could help to optimize and individualize NF training . SIGNIFICANCE The findings contribute to a better underst and ing of the mechanisms underlying NF training in children with ADHD PURPOSE To evaluate the motor vehicle driving knowledge , skills , and negative driving outcomes of older teens and young adults with attention deficit hyperactivity disorder ( ADHD ) . LOCATION A university medical center clinic for adult ADHD . SUBJECTS A total of 25 young adults with ADHD and 23 young adults without ADHD 17 to 30 years old drawn from the community and equated for age , gender , and educational level . MEASURES  Structured interview , behavior ratings by self- and others , video test of driving knowledge , computer simulated driving test , and official motor vehicle records .  RESULTS ADHD young adults were cited more often for speeding , were more likely to have had their licenses suspended , were involved in more crashes , were more likely to have had crashes causing bodily injury , and were rated by themselves and others as using poorer driving habits . Official driving records corroborated these negative outcomes . Although no group differences in driving knowledge were evident , young adults with ADHD had more crashes , scrapes , and erratic steering during the computer-stimulated driving test than did the control subjects . CONCLUSIONS Findings supported previous research suggesting that greater driving risks are associated with ADHD and suggested that ADHD does not interfere with driving knowledge so much as with actual performance ( motor control ) during vehicle operation Due to the high stability of its complexes with many M(2 + ) and M(3+)-ions , DOTA ( 1,4,7,10-tetraazacyclododecane-N , N',N″,N‴-tetraacetic acid ) is the most commonly used chelator for the derivatization and radiolabeling of bioactive molecules . Most of the currently used DOTA derivatives comprise amine-reactive functionalities , limiting their application to the derivatization of fully protected molecules or otherwise result ing in r and omly distributed conjugation sites of undefined number . Click chemistry reactions are a valuable alternative to this unspecific conjugation as they proceed efficiently and chemoselectively under mild conditions allowing a site-specific derivatization of unprotected biomolecules . In this work , we describe straightforward syntheses of DOTA derivatives containing thiol , maleimide , aminooxy , aldehyde , alkyne , and azide functionalities , amenable to the currently most often used click chemistry reactions . Furthermore , the efficiency of the respective click reactions introducing DOTA into bioactive molecules was investigated . For each of the synthesized DOTA synthons , the site-specific and efficient conjugation to Tyr(3)-octreotate could be shown . Among these , the addition and oxime formation reactions proceeded fast and without side reactions , giving the products in high yields of 64 - 83 % after purification . The copper-catalyzed triazole formation reactions produced some side-products , giving the desired products in lower , but still reasonable overall yields of 19 - 25 % . All synthesized peptide-DOTA-conjugates were labeled with (68)Ga in high radiochemical yields of 96 - 99 % and high specific activities providing compounds of high purity , demonstrating the applicability of all synthons for biomolecule modification and subsequent radiolabeling In a r and omized controlled trial , neurofeedback ( NF ) training was found to be superior to a computerised attention skills training concerning the reduction of ADHD symptomatology ( Gevensleben et al. , 2009 ) . The aims of this investigation were to assess the impact of different NF protocol s ( theta/beta training and training of slow cortical potentials , SCPs ) on the resting EEG and the association between distinct EEG measures and behavioral improvements . In 72 ( of initially 102 ) children with ADHD , aged 8 - 12 , EEG changes after either a NF training ( n=46 ) or the control training ( n=26 ) could be studied . The combined NF training consisted of one block of theta/beta training and one block of SCP training , each block comprising 18 units of 50 minutes ( balanced order ) .  Spontaneous EEG  was recorded in a two-minute resting condition before the start of the training , between the two training blocks and after the end of the training . Activity in the different EEG frequency b and s was analyzed . In contrast to the control condition , the combined NF training was accompanied by a reduction of theta activity . Protocol -specific EEG changes ( theta/beta training : decrease of posterior-midline theta activity ; SCP training : increase of central -midline alpha activity ) were associated with improvements in the German ADHD rating scale . Related EEG-based predictors were obtained . Thus , differential EEG patterns for theta/beta and SCP training provide further evidence that distinct neuronal mechanisms may contribute to similar behavioral improvements in children with ADHD Objective . This study examined the efficacy of 2 computer-based training systems to teach children with attention deficit/hyperactivity disorder ( ADHD ) to attend more effectively . Design / methods . A total of 41 children with ADHD from 2 middle schools were r and omly assigned to receive 2 sessions a week at school of either neurofeedback ( NF ) or attention training through a st and ard computer format ( SCF ) , either immediately or after a 6-month wait ( waitlist control group ) . Parents , children , and teachers completed question naires pre- and postintervention . Results . Primary parents in the NF condition reported significant ( P < .05 ) change on Conners ’s Rating Scales — Revised ( CRS-R ) and Behavior Assessment Scales for Children ( BASC ) subscales ; and in the SCF condition , they reported significant ( P < .05 ) change on the CRS-R Inattention scale and ADHD index , the BASC Attention Problems Scale , and on the Behavioral Rating Inventory of Executive Functioning ( BRIEF ) . Conclusion . This r and omized control trial provides preliminary evidence of the effectiveness of computer-based interventions for ADHD and supports the feasibility of offering them in a school setting OBJECTIVE The paucity of data concerning the long-term natural history of attention-deficit hyperactivity disorder ( ADHD ) , a common childhood psychiatric disorder , prompted a longitudinal study to investigate the adult sequelae of the childhood disorder . DESIGN Prospect i ve study , follow-up intervals ranging from 13 to 19 years ( mean , 16 years ) , with blind systematic clinical assessment s. SUBJECTS Ninety-one white males ( mean age , 26 years ) , representing 88 % of a cohort systematic ally diagnosed as hyperactive in childhood , and 95 ( 95 % ) of comparison cases of similar race , gender , age , whose teachers had voiced no complaints about their school behavior in childhood . RESULTS Prob and s had significantly higher rates than comparisons of ADHD symptoms ( 11 % vs 1 % ) , antisocial personality disorders ( 18 % vs 2 % ) , and drug abuse disorders ( 16 % vs 4 % ) . Significant comorbidity occurred between antisocial and drug disorders . Educational and occupational achievements were significantly compromised in the prob and s. These disadvantages were independent of psychiatric status . We did not find increased rates of affective or anxiety disorders in the prob and s. CONCLUSIONS Childhood ADHD predicts specific adult psychiatric disorders , namely antisocial and drug abuse disorders . In the adolescent outcome of this cohort , we found that these disturbances were dependent on the continuation of ADHD symptoms . In contrast , in adulthood , antisocial and drug disorders appeared , in part , independent of sustained ADHD . In addition , regardless of psychiatric status , ADHD placed children at relative risk for educational and vocational disadvantage . The results do not support a relationship between childhood ADHD and adult mood or anxiety disorders
target: Further data on specificity comes from electrophysiological studies reporting that  NF effectively changes brain activity patterns .
  No safety issues have emerged from clinical trials and NF seems to be well tolerated and accepted .
  Follow-up studies support long-term effects of NF .
  In conclusion , NF is a valid option for the treatment for ADHD , but further evidence is required to guide its use
background: Summary Neurofeedback ( NF ) is a training to enhance self-regulatory capacity over brain activity patterns and consequently over brain mental states .
  Recent findings suggest that NF is a promising alternative for the treatment of  attention-deficit/hyperactivity disorder ( ADHD ) .