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• W2768658006 abstract "We thank Edmund Pigott and colleagues for their comments on our study.1Schönenberg M Wiedemann E Schneidt A et al.Neurofeedback, sham neurofeedback, and cognitive-behavioural group therapy in adults with attention-deficit hyperactivity disorder: a triple-blind, randomised, controlled trial.Lancet Psychiatry. 2017; 4: 673-684Summary Full Text Full Text PDF PubMed Scopus (84) Google Scholar The first point raised was that we failed to assess whether or not participants thought they received sham or verum neurofeedback. This argument is surprising since we used an authorised deception protocol in which participants were deliberately kept uninformed about the existence of the sham neurofeedback condition (in contrast to previous studies) and were only informed about the meta-cognitive and neurofeedback condition. Assessing deception perceptions and thereby revealing the existence of a sham condition would undermine the very idea of authorised deception. Given no knowledge of another group, no differences in the expectation to receive sham or verum can be expected. Consequently, we did not observe any differences in participants' expectation of treatment success across the different conditions and assessment points. Pigott and colleagues also claimed that our training methodology violated the principles of operant conditioning. We used this previously established protocol2van Dongen-Boomsma M Vollebregt MA Slaats-Willemse D Buitelaar JK A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder.J Clin Psychiatr. 2013; 74: 821-827Crossref PubMed Scopus (71) Google Scholar mainly to allow blinding of the neurofeedback trainers. As far as we know, whether 70% or 60% reward would result in better efficacy, or whether manual-thresholding is superior to auto-thresholding, has never been explored in previous EEG studies.2van Dongen-Boomsma M Vollebregt MA Slaats-Willemse D Buitelaar JK A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder.J Clin Psychiatr. 2013; 74: 821-827Crossref PubMed Scopus (71) Google Scholar Notably, the effect size in our trial even exceeds those reported in neurofeedback studies “whose methodology mirror the best practice of operant conditioning”. In this context, we also want to point out that until now, there was no reliable and conclusive evidence suggesting that patients and controls actually differ in the neural oscillations targeted by most protocols,3Loo SK Cho A Hale TS McGough J McCracken J Smalley SL Characterization of the theta to beta ratio in ADHD: identifying potential sources of heterogeneity.J Atten Disord. 2013; 17: 384-392Crossref PubMed Scopus (102) Google Scholar that brain oscillations will stably improve under neurofeedback,4Zuberer A Brandeis D Drechsler R Are treatment effects of neurofeedback training in children with ADHD related to the successful regulation of brain activity? A review on the learning of regulation of brain activity and a contribution to the discussion on specificity.Front Hum Neurosci. 2015; 9: 135Crossref PubMed Scopus (87) Google Scholar and even less that there is a direct association between altered EEG signals and improved symptomatology.4Zuberer A Brandeis D Drechsler R Are treatment effects of neurofeedback training in children with ADHD related to the successful regulation of brain activity? A review on the learning of regulation of brain activity and a contribution to the discussion on specificity.Front Hum Neurosci. 2015; 9: 135Crossref PubMed Scopus (87) Google Scholar Thus instead of continuing to search for the specific effects of neurofeedback, we hope that future investigations will start to focus more on non-specific effects that drive the benefits of this form of placebo intervention.5Thibault RT Raz A The psychology of neurofeedback: clinical intervention even if applied placebo.Am Psychol. 2017; 72: 679-688Crossref PubMed Scopus (53) Google Scholar We declare no competing interests. Neurofeedback, sham neurofeedback, and cognitive-behavioural group therapy in adults with attention-deficit hyperactivity disorder: a triple-blind, randomised, controlled trialOur findings suggest that neurofeedback training is not superior to a sham condition or group psychotherapy. All three treatments were equivalently effective in reducing ADHD symptoms. This first randomised, sham-controlled trial did not show any specific effects of neurofeedback on ADHD symptoms in adults. Full-Text PDF Confusion regarding operant conditioning of the EEGMichael Schönenberg and colleagues1 report a trial of neurofeedback for the treatment of adults with attention-deficit hyperactivity disorder (ADHD). Neurofeedback and sham-feedback were triple blinded, and participants were unaware, via a deception protocol, that sham feedback was one intervention. Surprisingly, the authors did not assess participants' perceptions of the deception, even though in a previous study with sham feedback as the control group done by one of the authors, Logemann, the majority of participants in both groups thought that they were in the sham group. Full-Text PDF" @default.
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• W2768658006 date "2017-12-01" @default.
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• W2768658006 title "Confusion regarding operant conditioning of the EEG – Authors' reply" @default.
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• W2768658006 doi "https://doi.org/10.1016/s2215-0366(17)30437-6" @default.
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