Neurofeedback, pharmacological treatment and behavioral therapy in hyperactivity: Multilevel analysis of treatment effects on electroencephalography

Abstract

The purpose of this study was to investigate the efficacy of neurofeedback, pharmacological treatment and behavioral therapy in Attention Deficit Hyperactivity Disorder (ADHD) through a controlled, randomized, multigroup design, with pre-, post- and follow-up treatment phases. The objectives of this study are: a) to analyze individual trajectories over time of each child in treatment, from specific measures of EEG (theta/beta ratio/TBR) considering age and sex and b) to determine the therapeutic effect on attentional and behavioral variables evaluated through the Integrated Visual and Auditory Continuous Performance Test. A total of 57 children (7-14 years) diagnosed with ADHD, were randomly assigned to one of the following experimental conditions: 1) 30 Theta/Beta training sessions, 2) Methylphenidate treatment and, 3) Behavior therapy administered according to a cognitive-behavioral protocol based on manuals. Data were analyzed using a Multilevel Longitudinal Regression Model. Results show that administered treatments are effective and cause similar effects on TBR variable, with no differences between them. However, significant differences were observed in the global attention (p=.002), auditory attention (p=.017) and visual attention (p=.028).

Se investiga la eficacia del neurofeedback, tratamiento farmacológico y terapia deconducta en el Trastorno por Déficit de Atención con Hiperactividad (TDAH) mediante un dise˜nomultigrupo, aleatorizado y controlado con fases pre, post-tratamiento y seguimiento. Se pre-tenden los siguientes objetivos: a) analizar las trayectorias individuales a través del tiempo,de cada ni˜no en tratamiento, en la medida del EEG (theta/beta ratio/TBR), considerando edady sexo, y b) determinar el efecto terapéutico en variables atencionales y conductuales evalu-adas mediante el Integrated Visual and Auditory Continuous Performance Test. Participaron 57ni˜nos (7-14 a˜nos) diagnosticados con TDAH, asignados aleatoriamente a alguna de las siguientescondiciones experimentales: 1) 30 sesiones de entrenamiento theta/beta, 2) tratamiento conmetilfenidato y 3) terapia de conducta, según protocolo basado en manuales. Se ha empleadoel Modelo Longitudinal de Regresión Multinivel para análisis de datos. Los resultados muestranque los tratamientos administrados son eficaces y originan efectos similares en la variable TBR,no apreciándose diferencias entre los mismos. Si bien, se observan diferencias significativas enla atención global (p=.002), atención auditiva (p=.017) y atención visual (p=.028).