Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 143 No. 3334 (2013)

A randomised controlled trial of combined EEG feedback and methylphenidate therapy for the treatment of ADHD

  • Li Li
  • Li Yang
  • Chuan-jun Zhuo
  • Yufeng Wang
Cite this as:
Swiss Med Wkly. 2013;143:w13838


PURPOSE: To evaluate the efficacy of combined methylphenidate and EEG feedback treatment for children with ADHD.

METHODS: Forty patients with ADHD were randomly assigned to the combination group (methylphenidate therapy and EEG feedback training) or control group (methylphenidate therapy and non-feedback attention training) in a 1:1 ratio using the double-blind method. These patients, who met the DSM-IV diagnostic criteria and were aged between 7 and 16 years, had obtained optimal therapeutic effects by titrating the methylphenidate dose prior to the trial. The patients were assessed using multiple parameters at baseline, after 20 treatment sessions, after 40 treatment sessions, and in 6-month follow-up studies.

RESULTS: Compared to the control group, patients in the combination group had reduced ADHD symptoms and improved in related behavioural and brain functions.

CONCLUSION: The combination of EEG feedback and methylphenidate treatment is more effective than methylphenidate alone. The combined therapy is especially suitable for children and adolescents with ADHD who insufficiently respond to single drug treatment or experience drug side effects.


  1. Monastra VJ. Electroencephalographic biofeedback (neurotherapy)as a treatment for attention deficit hyperactivity disorder: rationale and empirical foundation. Child Adolesc Psychiatr Clin N Am. 2005;14(1):55–82.
  2. Lubar JF, Shouse MN. EEG and behavioral changes in a hyperkinetic child concurrent with training of the sensorimotor rhythm (SMR): a preliminary report. Biofeedback Self Regul. 1976;1(3):293–306.
  3. Lubar JF. Discourse on the development of EEG diagnostics and biofeedback for attention-deficit/hyperactivity disorders. Biofeedback Self Regul. 1991;16(3):201–25.
  4. Thompson L, Thompson M. Neurofeedback combined with training in metacognitive strategies: effectiveness in students with AD. Appl Psychophysiol Biofeedback. 1998;23(4):243–63.
  5. Monastra VJ, Lynn S, Linden M, Lubar JF, Gruzelier J, LaVaque TJ. Electroencephalographic biofeedback in the treatment of attention-deficit/hyperactivity disorder. Appl Psychophysiol Biofeedback. 2005;30(2):95–114.
  6. Lubar JF, Swartwood MO,Swartwood J,etal.Evaluation of the effectivenes of EEG neurofeedback training for ADHD in a clinical setting as measured by changes in T.O.V.A.scores, behavioral ratings, and WISC-R performance. Biofeedback Self Regul,1995,20(1):83–99.
  7. Linden M, Habib T ,Radojevic V. A controlled study of the effects of EEG biofeedback on cognition and behavior of children with attention deficit disorder and learning disabilities. Biofeedback Self Regul. 1996,21(1):35–49.
  8. Drechsler R, Straub M, Doehnert M, Heinrich H, Steinhausen HC, Brandeis D. Controlled evaluation of a neurofeedback training of slow cortical potentials in children with Attention Deficit/Hyperactivity Disorder (ADHD). Behav Brain Funct. 2007;3(1):35.
  9. Gevensleben H, Holl B, Albrecht B, Vogel C, Schlamp D, Kratz O,et al. Is neurofeedback an efficacious treatment for ADHD? A randomised controlled clinical trial. J Child Psychol Psychiatry. 2009;50(7):780–9.
  10. Gevensleben H, Holl B, Albrecht B, Schlamp D, Kratz O, Studer P, et al. Neurofeedback training in children with ADHD: 6-month follow-up of a randomised controlled trial. Eur Child Adolesc Psychiatry. 2010;19(9):715–24.
  11. Heinrich H, Gevensleben H, Freisleder FJ, Moll GH, Rothenberger A. Training of slow cortical potentials in attention-deficit/hyperactivity disorder: evidence for positive behavioral and neurophysiological effects. Biol Psychiatry. 2004;55(7):772–5.
  12. Li X, Wang Y. A case-control study of EEG feedback treatment of children with ADHD. Chinese Journal of Psychiatry. 2001;34(3):168–71.
  13. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. (DSM-IV). Washington: American Psychiatric Association; 1994. p.100–5.
  14. Barkley RA, Murphy KR. Attention-deficit hyperactivity disorder: a clinical workbook. (2nd ed.). New York, Guilford; 1988. p. 39–55.
  15. DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale-IV: Checklists, norms, and clinical interpretations. New York, Gulford; 1998. p. 28–42.
  16. Xu T. Conner children’s behavior questionnaire. Shanghai Archives of Psychiatry. 1990;2(supp.):46–7.
  17. Su L, Xie G, Luo X. Conners Teacher Questionnaire used in urban China. Chinese Journal of Practical Pediatrics. 2001;16(12):717–9.
  18. Wang Y. Rutter Children’s Behavior Questionnaire. See Wang X, Wang X and Ma H. Rating scales for mental health. Chinese Mental Health Journal. 1999;(supp.):56–9.
  19. Xu T. Achenbach Child Behavior Checklist. Shanghai Archives of Psychiatry. 1990;(supp.)2:47–50.
  20. Wilens T, Pelham W, Stein M, Conners CK, Abikoff H, Atkins M, et al. ADHD treatment with once-daily OROS methylphenidate: interim 12-month results from a long-term open-label study. J Am Acad Child Adolesc Psychiatry. 2003;42(4):424–33.
  21. Mei L. ET – a new technology for brain function research. Beijing: National Defence Industry Press, 1995.
  22. Sun L. Brain function research on children with attention deficit hyperactivity disorder and their subtypes (doctoral dissertation). Beijing: Peking University; 2003. p. 34–5.
  23. Barkley RA, McMurray MB, Edelbrock CS, Robbins K. Side effects of methylphenidate in children with attention hyperactivity disorder: a systemic, placebo-controlled evaluation. Pediatrics. 1990;86(2):184–92.
  24. Charach A, Ickowicz A, Schachar R. Stimulant treatment over five years: adherence, effectiveness, and adverse effects. J Am Acad Child Adolesc Psychiatry. 2004;43(5):559–67.
  25. Jensen PS, Arnold LE, Swanson JM, Vitiello B, Abikoff HB, Greenhill LL, et al. 3-year follow-up of the NIMH MTA study. J Am Acad Child Adolesc Psychiatry. 2007;46(8):989–1002.
  26. Arns M, de Ridder S, Strehl U, Breteler M, Coenen A. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clin EEG Neurosci. 2009;40(3):180–9.
  27. Li L, Wang Y. Neurofeedback therapy of neuropsychiatric diseases. Chinese Journal of Rehabilitation Medicine. 2012;27(6):583–6.
  28. Rossier TR, Lavaque TJ. A comparison of EEG biofeedback and psychostimulants in treating attention- deficit/hyperactivity disorders. J Neurother. 1995;1:48–59.
  29. Lévesque J, Beauregard M, Mensour B. Effect of neurofeedback training on the neural substrates of selective attention in children with attention-deficit/hyperactivity disorder: afunctional magnetic resonance imaging study. Neurosci Lett. 2006;394(3):216–21.
  30. Fuchs T, Birbaumer N, Lutzenberger W, Gruzelier JH, Kaiser J. Neurofeedback treatment for attention-deficit/hyperactivity disorder in children: a comparison with methylphenidate. Appl Psychophysiol Biofeedback. 2003;28(1):1–12.
  31. Monastra VJ, Monastra DM, George S. The effects of stimulant therapy, EEG biofeedback, and parenting style on the primary symptoms of attention-deficit/hyperactivity disorder. Appl Psychophysiol Biofeedback. 2002;27(4):231–49.
  32. Rossiter T. The effectiveness of neurofeedback and stimulant drugs in treating AD/HD: part II. Replication. Appl Psychophysiol Biofeedback. 2004;29(4):233–43.
  33. Jiang R. EEG biofeedback treatment on cognitive function in children with ADHD (doctoral dissertation). Beijing: Peking University; 2002. p. 51–63.

Most read articles by the same author(s)