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Attention Deficit Hyperactivity DisorderNCT04112082

Efficacy of Mobile Neurofeedback for Adult Attention-Deficit/Hyperactivity Disorder (ADHD)

A study testing Mobile Neurofeedback and Treatment as Usual in people with Attention Deficit Hyperactivity Disorder, run by Sheba Medical Center.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study is an assessor-blind, parallel-group, controlled trial to evaluate the benefit of home-based training with a low-cost, mobile neurofeedback system (Myndlift) in adults with ADHD. Read more about this study

Who is it for?
Ages 18 to 50 years
Conditions the study is for
Attention Deficit Hyperactivity Disorder
What is being tested?
Mobile Neurofeedback and Treatment as Usual
Could I receive a placebo?
No, everyone receives an active treatment
How many people
70 participants
Where
No sites listed yet
Study dates
22 Dec 2019to Jun 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 50 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • willingness to provide consent
  • diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) of any type as ascertained by clinical interview conducted by a board-certified psychiatrist
  • at the time of enrollment, not receiving treatment for symptoms of ADHD

Who cannot join

  • comorbid psychotic or bipolar disorder or an active affective disorder
  • medical disorder with potentially confounding psychiatric effects (either due to direct effects of the condition or medication effects)
  • diagnosis of substance abuse disorder (SUD), sleep apnea, restless legs syndrome (RLS), or borderline intellectual functioning
  • unable to attend in-clinic follow-up assessment
  • antipsychotic agent in the three months prior to baseline assessment
  • any selective serotonin reuptake inhibitor (SSRI) treatment in the four weeks prior to baseline
Show all 9Show fewer
  • other psychiatric medication in the two weeks prior to baseline that the principal investigator deems to be confounding
  • experimental group only: plans to start stimulant medication during the course of the study (use of nutritional supplements including "prescription medical foods" is not exclusionary)
  • neurofeedback treatment in the two years prior to baseline

Trial locations and contacts

No sites are listed yet.

About this study

This study is an assessor-blind, parallel-group, controlled trial to evaluate the benefit of home-based training with a low-cost, mobile neurofeedback system (Myndlift) in adults with ADHD. Randomized controlled trials have shown significant benefit for neurofeedback, including persistent effects without the side effects of psychostimulants (i.e., diminished appetite, insomnia, anxiety, irritability). However, standard application requires clinic visits and significant expense, limiting training frequency and compromising potential efficacy. Additionally, extant evidence for efficacy comes almost exclusively from children and adolescents, with very few studies in adults. The present trial will measure the ability of home-based neurofeedback using a low-cost, user-friendly system to ameliorate symptomatology (e.g., enhancing attention, reducing impulsive behavior) in adults with ADHD. Participants will receive either neurofeedback or treatment as usual (TAU). Primary outcomes will be objective scores on a continuous performance task (CPT) and subjective report on a standardized adult ADHD symptoms questionnaire. Eligible participants recruited from an adult ADHD clinic will complete a baseline assessment (1.25 hours) including subjective questionnaires, computerized cognitive assessment, and resting-state EEG administered by a blinded assessor. The experimental group will train at home with a neurofeedback headset and tablet 4 times/week for ten weeks (session duration: 21-30 minutes). Neurofeedback will be provided via a conventional theta beta protocol in which participants train using gamified tasks, videos, or audio clips in a tablet-based app, and receive positive visual/auditory feedback when their brainwaves are in the desired range. The control group will follow the regular treatment plan set by the clinic (i.e., treatment as usual; TAU). Care may include pharmacological intervention, cognitive behavioral therapy (CBT), a combination of both, or no intervention. Care will often include pharmacological intervention (e.g., methylphenidate), with the specifics (e.g., type of medication, dosage) determined by psychiatrist recommendation. After completing the ten-week intervention period, all participants will return to the clinic for a follow-up assessment identical to the baseline assessment. It is hypothesized that home-based neurofeedback training will demonstrate non-inferiority to TAU as measured by improvement in subjective and objective symptoms.

Being tested
Mobile Neurofeedback, Treatment as Usual
Keywords
neurofeedback, Attention Deficit Hyperactivity Disorder (ADHD), attention, executive function, electroencephalogram (EEG), adult ADHD, wearable sensors
Medical subject headings
Attention Deficit Disorder with Hyperactivity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mobile NeurofeedbackBehavioural

    Also called neurotherapy, electroencephalogram (EEG) biofeedback, brainwave biofeedback

    Home-based neurofeedback training (downtrain theta, uptrain beta; training site: Cz) 4 times weekly for a 40 of total sessions over the ten-week training period. Session duration of 21 minutes for the first 20 sessions to 30 minutes for the last 20 sessions. Positive visual and auditory feedback when brainwaves are within the desired range.

  • Treatment as UsualOther

    Treatment plan as part of regular care at the ADHD clinic, which may include pharmacological intervention, cognitive behavioral therapy (CBT), a combination of pharmacological intervention and CBT, or no intervention. Care will often include pharmacological intervention, with the specifics (e.g., type of medication, dosage) determined by psychiatrist recommendation considering such factors as response to previous interventions, participant characteristics, and practical constraints. Most pharmacological interventions will be stimulants (e.g., methylphenidate) with various release mechanisms. Each participant will receive an individualized dose titration and follow-up plan, including clinic visits as needed (generally 1-2 visits over the 10-week intervention period); interventions may be switched in accord with clinical judgment.

Study groups in NCT04112082
Study groupRoleWhat they receive
Home-Based Neurofeedback TrainingExperimentalNot described
Receives: Behavioral: Mobile Neurofeedback
Treatment as UsualActive comparatorNot described
Receives: Other: Treatment as Usual

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Continuous Performance Task (CPT) Response Time

    mean response time for correct responses on a computerized CPT

    Measured: baseline, immediately after 10-week intervention period

  2. Change in Continuous Performance Task (CPT) Response Time Variability

    standard deviation of response time for correct responses on a computerized CPT

    Measured: baseline, immediately after 10-week intervention period

  3. Change in Self-Reported ADHD Symptoms

    total score on the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1)

    Measured: baseline, immediately after 10-week intervention period

Secondary outcomes (13)
  1. EEG Theta Amplitude

    resting state fronto-central theta amplitude

    Measured: baseline, immediately after 10-week intervention period

  2. EEG Beta Amplitude

    resting state fronto-central beta amplitude

    Measured: baseline, immediately after 10-week intervention period

  3. EEG Theta/Beta Ratio

    resting state fronto-central theta/beta ratio

    Measured: baseline, immediately after 10-week intervention period

  4. Continuous Performance Task (CPT) Accuracy

    percent correct on a computerized CPT

    Measured: baseline, immediately after 10-week intervention period

  5. Continuous Performance Task (CPT) Commission Errors

    number of commission errors on a computerized CPT

    Measured: baseline, immediately after 10-week intervention period

  6. Continuous Performance Task (CPT) Omission Errors

    number of commission errors on a computerized CPT

    Measured: baseline, immediately after 10-week intervention period

  7. ADHD Screener Score

    sum of item scores for the first 6 items (Part A) of the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1); item ratings: 0=never, 1=rarely, 2=sometimes, 3=often, 4=very often; scoring: for items 1-3, ratings of sometimes, often, or very often are assigned one point; for items 4-6 ratings of often or very often are assigned one point; a higher score reflects a worse outcome

    Measured: baseline, immediately after 10-week intervention period

  8. ADHD Symptom Inattention Subtype Score

    sum of item scores for the 9 inattention items from the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1): items 1-4 \& 7-11; item ratings: 0=never, 1=rarely, 2=sometimes, 3=often, 4=very often; scoring: for items 1-3 \& 9, ratings of sometimes, often, or very often are assigned one point; for items 4, 7, 8, 10 \& 11, ratings of often or very often are assigned one point; a higher score reflects a worse outcome

    Measured: baseline, immediately after 10-week intervention period

  9. ADHD Symptom Hyperactivity/Impulsivity Subtype Score

    sum of item scores for the 9 hyperactivity/impulsivity items from the Adult ADHD Self-Report Scale Symptom Checklist (ASRS-v1.1): items 5-6 \& 12-18; item ratings: 0=never, 1=rarely, 2=sometimes, 3=often, 4=very often; scoring: for items 12 \& 18, ratings of sometimes, often, or very often are assigned one point; for items 5-6 \& 13-17, ratings of often or very often are assigned one point; a higher score reflects a worse outcome

    Measured: baseline, immediately after 10-week intervention period

  10. Global Cognitive Score from Cognitive Battery

    global cognitive score (average of standardized domain scores) from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation: 15

    Measured: baseline, immediately after 10-week intervention period

  11. Attention Domain Score from Cognitive Battery

    standardized attention domain score from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation 15

    Measured: baseline, immediately after 10-week intervention period

  12. Executive Function Domain Score from Cognitive Battery

    standardized executive function domain score from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation 15

    Measured: baseline, immediately after 10-week intervention period

  13. Information Processing Speed Domain Score from Cognitive Battery

    standardized information processing speed domain score from a computerized cognitive battery; scale: age- and education-adjusted mean: 100; standard deviation 15

    Measured: baseline, immediately after 10-week intervention period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Oct 2019
  2. Study start22 Dec 2019 (estimated)
  3. Primary completionJun 2021 (estimated)
  4. Study completionJun 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
70 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04112082
Sponsor's protocol ID
6362-19-SMC
Status last verified
Sep 2019
First submitted
25 Sep 2019
Last updated
2 Oct 2019
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Adler LA, Spencer T, Faraone SV, Kessler RC, Howes MJ, Biederman J, Secnik K. Validity of pilot Adult ADHD Self- Report Scale (ASRS) to Rate Adult ADHD symptoms. Ann Clin Psychiatry. 2006 Jul-Sep;18(3):145-8. doi: 10.1080/10401230600801077.

    PubMed 16923651
  • Brod M, Johnston J, Able S, Swindle R. Validation of the adult attention-deficit/hyperactivity disorder quality-of-life Scale (AAQoL): a disease-specific quality-of-life measure. Qual Life Res. 2006 Feb;15(1):117-29. doi: 10.1007/s11136-005-8325-z.

    PubMed 16411036
  • Schweiger A, Abramovitch A, Doniger GM, Simon ES. A clinical construct validity study of a novel computerized battery for the diagnosis of ADHD in young adults. J Clin Exp Neuropsychol. 2007 Jan;29(1):100-11. doi: 10.1080/13803390500519738.

    PubMed 17162726
  • Micoulaud-Franchi JA, Geoffroy PA, Fond G, Lopez R, Bioulac S, Philip P. EEG neurofeedback treatments in children with ADHD: an updated meta-analysis of randomized controlled trials. Front Hum Neurosci. 2014 Nov 13;8:906. doi: 10.3389/fnhum.2014.00906. eCollection 2014.

    PubMed 25431555
  • 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 Jul;40(3):180-9. doi: 10.1177/155005940904000311.

    PubMed 19715181
  • Riesco-Matias P, Yela-Bernabe JR, Crego A, Sanchez-Zaballos E. What Do Meta-Analyses Have to Say About the Efficacy of Neurofeedback Applied to Children With ADHD? Review of Previous Meta-Analyses and a New Meta-Analysis. J Atten Disord. 2021 Feb;25(4):473-485. doi: 10.1177/1087054718821731. Epub 2019 Jan 15.

    PubMed 30646779

Questions about this trial

What is this clinical trial studying?

A study testing Mobile Neurofeedback and Treatment as Usual in people with Attention Deficit Hyperactivity Disorder, run by Sheba Medical Center.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 2 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Tamir Epstein, MD (+972-50-640-8442, tamir.epstein@sheba.health.gov.il), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Continuous Performance Task (CPT) Response Time (time frame: baseline, immediately after 10-week intervention period). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04112082, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2019.

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