ADHD is a heterogeneous disorder and a challenge to treat. Neurofeedback may be considered as a promising treatment option or component of the recommended multimodal treatment. It utilizes operant learning techniques with brain activity parameters to compensate deficits or to enhance self-regulation in patients. Neurofeedback has demonstrated promising and partly specific effects particularly improving inattention problems in ADHD, but effects on probably blinded outcomes are often inconclusive. This situation may reflect current inconsistencies in Neurofeedback protocols and shortcomings of evaluation studies with blinded outcomes, but it may also indicate limitations of Neurofeedback as a treatment for some ADHD patients. This important issue should be clarified in further studies.
Neurofeedback is appealing to many patients and their families and well tolerated, but there is need for more systematic evaluation to understand the specific mode of action. Future studies will need to disentangle mechanisms underlying both specific and unspecific effects of Neurofeedback. An additional challenge will be to identify robust predictors in order to decide which group of patients particularly benefits from this intervention.

Prof. Martin Holtmann, MD, PhD
Chair of Child and Adolescent Psychiatry, Ruhr-University Bochum
Medical Director, LWL-University Hospital for Child and Adolescent Psychiatry
Heithofer Allee 64
59071 Hamm, Germany