Neurofeedback

Neurofeedback
This is a letter I received recently:

I visited your web site and noticed a section called How to
Read a Scientific Article. I was quite impressed with this
article.

This special report on your web site is vitally important
for treatment providers and treatment seekers. It is
important for all of us who value the use of the scientific
method in making decisions about what kinds of services to
seek and what kinds of services to provide.

What you mention in that article can serve as reminder to
what many of us learned as undergraduates and graduate
students in science based programs. It can serve as a
simplified and easy to remember scientifically based
evaluation tool to help sort out the different types of
interventions.

Within the context of that special report on your web site
about learning to evaluate and to interpret what is true
and expose what is hype, how would you rate the evidence
presented for Neurofeedback compared to other types of
interventions?"

Here is my reply:

I am glad you enjoyed How to Read a Scientific Article.
Feel free to download it and distribute it to your patients
and colleagues.

As for your question about Neurofeedback:

There are many leading ADHD researchers who come out very
strongly against Neurofeedback as a treatment for ADHD.
Their main complaint against Neurofeedback is that the
research is not well done.

There are numerous studies available, but they all have
weaknesses. Most studies lack the proper controls to prove
that Neurofeedback works. In many studies, Neurofeedback
was used in conjunction with other modalities, so it isn't
clear why the children in these studies got better.

So scientifically, I would have to conclude that
Neurofeedback has not been proven to be an effective
treatment for ADHD.

Thank God, I am a clinician and not a scientist!

In my opinion, based upon the evidence that we have
available, Neurofeedback works very well for ADHD as well
as a number of other conditions.

It's true that the research does not rule out other
possible explanations for the effectiveness of
neurofeedback in ADHD. No one has proven that it is not a
placebo effect. No one has proven that it is not the extra
therapeutic interaction.

However, in my opinion, these other explanations are not
very likely. We do not see any other placebo getting the
results that Neurofeedback gets. Nor do we see intense
therapeutic attention in other settings delivering such
results.

To the best of my knowledge, there has never been a study
that shows or even suggests that it Neurofeedback does not
work. The worst complaint the antagonists can level is
that it has not yet been proven to work.

It is true that the studies on Neurofeedback have not
proven that it works. I want to stress, however, that not
proven does not mean disproved.

Although in the pure scientific sense there is something
lacking from the Neurofeedback literature, we are dealing
with patients' lives.

It is not fair to our patients not to use what is most
probably a very effective treatment modality just because
we would like more elegant research. With that in mind we
have to evaluate neurofeedback based upon the evidence that
is in front of us.

I agree that neurofeedback needs more scientific work to be
proven an effective modality. However, as a clinician I
feel that I have all the evidence that I need in order to
advise patients to use it.

I still have a lot of questions about it. It is not really
clear to me how effective it is. What percentage of
patients fail? What percentage achieves only partial
success? I have heard claims of success ranging in the
95+%. I don't know how accurate these claims really are.

I personally don't have enough information to discern
between the effectiveness of different neurofeedback
techniques. I would like to see more research in these
areas.

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Anthony Kane, MD has been helping parents of ADHD and
Oppositional Defiant Disorder children online since 2003.
Join over three thousand parents and get help for your
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