Double-Blind, Sham-Controlled Randomized Trial Testing the Efficacy of fMRI Neurofeedback on Clinical and Cognitive Measures in Children With ADHD
Commentary by Dr. Doron Almagor: This is a well-conducted randomized sham-controlled trial that used functional MRI neurofeedback (fMRI-NF) to assess its potential effectiveness in children with ADHD. The study aimed to control brain activity in the right inferior frontal cortex (rIFC) using fMRI-assessed blood-oxygen-level-dependent responses. However, the study failed to demonstrate significant differences between active and sham neurofeedback, suggesting that the benefits of neurofeedback may be due to nonspecific factors rather than a specific treatment effect. Despite many hopes, and years of research, well-controlled studies have failed to show any benefit for neurofeedback, even when using advanced technologies such as functional MRI. The dearth of evidence supporting the efficacy of neurofeedback raises significant concerns regarding its appropriateness for clinicians to administer or endorse. Given the substantial long-term implications associated with ADHD and the ample data supporting conventional treatment modalities, opting for an unverified therapy rather than effective interventions appears contrary to the best interests of patients. While ongoing advancements in more efficacious approaches to managing ADHD are imperative, it appears that neurofeedback as a treatment for ADHD is no longer tenable.
Published Online:9 Nov 2022
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