Lixia Yan 1,2 , Siyuan Wang 3 , Yang Yuan 4 , Junhua Zhang 5,6 Show Affiliations »
Abstract
BACKGROUND: The comparative efficacy and tolerability of methylphenidate (MPH) and neurofeedback (NF) in individuals with attention-deficit/hyperactivity disorder (ADHD) remains uncertain. This study aimed to fill this gap by means of a systematic review/meta-analysis. METHODS: PubMed, OVID, ERIC, Web of Science, ClinialTrials.gov and a set of Chinese databases were searched until 22 August 2018. Standardised mean differences (SMD) were pooled using comprehensive meta-analysis software. RESULTS: 18 randomised controlled trials (RCTs) were included (778 individuals with ADHD in the NF arm and 757 in the MPH group, respectively; 13 studies in Chinese, five in English). At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)). Dropouts were significantly lower in NF versus MPH (OR=0.412, 0.186 to 0.913). Results were robust to sensitivity analyses, with two important exceptions: removing Chinese studies and non-funded studies, no differences emerged between MPH and NF, although the number of studies was small. At the study follow-up, MPH was superior to NF in some outcomes, but results were inconsistent across raters. CONCLUSIONS: Due to the risk of bias of included studies, the results of the sensitivity analysis excluding Chinese and non-funded studies, and the mixed findings on at the follow-up endpoint, further high quality studies are needed to assess the comparative efficacy and acceptability of NF and MPH in individuals with ADHD. TRIAL REGISTRATION NUMBER: CRD42018090256. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
BACKGROUND: The comparative efficacy and tolerability of methylphenidate (MPH ) and neurofeedback (NF ) in individuals with attention-deficit/hyperactivity disorder (ADHD ) remains uncertain. This study aimed to fill this gap by means of a systematic review/meta-analysis. METHODS: PubMed, OVID, ERIC, Web of Science, ClinialTrials.gov and a set of Chinese databases were searched until 22 August 2018. Standardised mean differences (SMD ) were pooled using comprehensive meta-analysis software. RESULTS: 18 randomised controlled trials (RCTs) were included (778 individuals with ADHD in the NF arm and 757 in the MPH group, respectively; 13 studies in Chinese, five in English). At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD =-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)). Dropouts were significantly lower in NF versus MPH (OR=0.412, 0.186 to 0.913). Results were robust to sensitivity analyses, with two important exceptions: removing Chinese studies and non-funded studies, no differences emerged between MPH and NF , although the number of studies was small. At the study follow-up, MPH was superior to NF in some outcomes, but results were inconsistent across raters. CONCLUSIONS: Due to the risk of bias of included studies, the results of the sensitivity analysis excluding Chinese and non-funded studies, and the mixed findings on at the follow-up endpoint, further high quality studies are needed to assess the comparative efficacy and acceptability of NF and MPH in individuals with ADHD . TRIAL REGISTRATION NUMBER: CRD42018090256. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Chemical
Disease
Gene
Keywords:
impulse control disorders
Mesh： See more »
Substances： See more »
Year: 2019
PMID： 31221690 DOI： 10.1136/ebmental-2019-300088
Source DB: PubMed Journal: Evid Based Ment Health ISSN： 1362-0347