Neurostimulation & neurofeedback
EEG Neurofeedback
Graded on: ADHD symptoms in children and adolescents (self-report, blinding-sensitive).
Grade D, tested: a human randomized trial looked for a benefit on the endpoint The outcome a trial measures to decide whether the treatment worked, such as heart attacks, blood pressure or a symptom score. graded and did not find one. How to read a grade →
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How this letter has changedLatest: October 2026 · Corrected.
The October adjudication had already moved this record to D Route 2 Human randomized trials have been run and did not show benefit on the stated outcome. One of the two routes to the lowest letter on EBL's scale. on the blinded and sham-controlled evidence. Remaining from the review: van Dongen-Boomsma 2013 (PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 24021501), the independent double-blind Neither the participants nor the people assessing them know who received the real treatment until the trial ends. placebo-neurofeedback trial in 41 children, was named in the search record but not cited; it is now on the page with its null result and its chance-level guess rates. Mei 2026 (PMID 42358407) is now described as a network meta-analysis of 37 randomized trials of digital interventions whose neurofeedback ranking rests on unblinded ratings, not as a systematic review A review that searches for every study on a question using a method set in advance, then assesses them together.. The evidence note names the graded population, children and adolescents, and says that nothing on the page implies benefit for adults or consumer headsets. The sham-controlled trial (PMID 32853703; follow-up PMID 36521694) and the two meta-analyses, Cortese 2016 (PMID 27238063) and Westwood 2025 (PMID 39661381), stand. Letter unchanged.PMID 24021501 PMID 42358407 PMID 32853703 PMID 36521694 PMID 27238063 PMID 39661381
EEG neurofeedback held a C on a network meta-analysis of digital interventions whose neurofeedback signal rests on unblinded ratings (Mei et al., Front Psychiatry 2026; PMID 42358407). The largest double-blind sham-controlled trial was null at every time point (Neurofeedback Collaborative Group, J Am Acad Child Adolesc Psychiatry 2021; PMID 32853703), and meta-analyses limited to probably blinded ratings found no effect (Cortese et al., J Am Acad Child Adolesc Psychiatry 2016; PMID 27238063; Westwood et al., JAMA Psychiatry 2025; PMID 39661381). Tested, no benefit: D on Route 2. Editor adjudication, October 2026.PMID 42358407 PMID 32853703 PMID 27238063 PMID 39661381
Every change to a letter on this site is dated and published. The full evidence log →
EEG neurofeedback trains people to change their brain waves by watching them on a screen. It has been tested for ADHD in children. Parents who knew their child was being treated reported fewer symptoms. When the people rating symptoms did not know, or the control group got fake feedback, the benefit disappeared.
A letter describes the human evidence, not the product, the manufacturer, or the intervention's worth.
See the full evidence record →This was not skipped. A human randomized trial has tested it and did not find a benefit on the endpoint below. That is a different statement from an untested intervention, which may still turn out to work. A Route 1 No human randomized trial has been run, so the record rests on animal or mechanistic evidence only. One of the two routes to the lowest letter on EBL's scale. Grade D means nobody has looked. A Route 2 Grade D means somebody looked and the answer was no.
Population 144 children with ADHD, double-blind sham-controlled
Certainty Moderate to high. Largest sham-controlled trial; null at every time point.
PMID 32853703 →
Population Meta-analysis of 38 randomized trials
Certainty Moderate. SMD 0.04 on blinded ratings.
PMID 39661381 →
Population 41 children aged 8 to 15 with ADHD, double-blind, placebo An inactive substitute made to look like the real treatment, so participants cannot tell which one they received. neurofeedback control, 30 sessions
Certainty Moderate. Independent trial; null, with blinding confirmed by guess rates at chance.
PMID 24021501 →
Graded on ADHD symptoms in children and adolescents (self-report, blinding-sensitive).
Why this gradeGrade D, tested, no benefit. The reasoning, and what the grade does not cover.
Grade D, Route 2: tested against sham A fake version of a procedure or device used as the comparison, so participants cannot tell which one they received. with blinded ratings, and no benefit. The record's endpoint is ADHD symptoms as rated by parents, and that rating shrinks to nothing when the rater is blinded or the control is sham feedback. Moved from C in October 2026 by editor adjudication.
WHAT THIS GRADE DOES NOT COVERneurofeedback for conditions other than ADHD, adults with ADHD, and consumer neurofeedback devices, none of which these trials tested; and unblinded parent-rated benefit, which is real as a rating but disappears when the rater cannot tell which treatment the child received.
A grade describes the human evidence for a named use. It is not advice, and it is not a judgment on any individual prescription. How the letters are decided →
The evidence, in fullSix papers, each linked to its PubMed record.
Neurofeedback Collaborative Group (J Am Acad Child Adolesc Psychiatry, 2021; PMID 32853703): double-blind sham-controlled trial, 144 children aged 7 to 10 with ADHD; no specific effect at the end of treatment or at 13 months. Neurofeedback Collaborative Group (J Am Acad Child Adolesc Psychiatry, 2023; PMID 36521694): the 25-month follow-up of the same trial, again without a specific effect. Westwood et al. (JAMA Psychiatry, 2025; PMID 39661381): meta-analysis of 38 randomized trials, 2,472 participants; with probably blinded ratings the effect on total ADHD symptoms was absent (SMD 0.04, 95% CI -0.10 to 0.18); restricted to standard protocols it was small (SMD 0.21), and the authors conclude neurofeedback does not meaningfully benefit people with ADHD at the group level. van Dongen-Boomsma et al. (J Clin Psychiatry, 2013; PMID 24021501): independent double-blind trial, 41 children aged 8 to 15, 30 sessions of EEG neurofeedback against placebo neurofeedback; no treatment effect on ADHD symptoms or clinical improvement, and children and parents could not guess their assignment better than chance. Cortese et al. (J Am Acad Child Adolesc Psychiatry, 2016; PMID 27238063): meta-analysis; effects disappeared with probably blinded ratings or sham controls. Mei et al. (Front Psychiatry, 2026; PMID 42358407): network meta-analysis of 37 randomized trials, 2,922 participants, of many digital interventions in children and adolescents with ADHD; its neurofeedback ranking rests on unblinded subjective behavioral ratings and cannot carry a grade on its own. The null under blinding is replicated The same finding reproduced by a separate research group. A result seen once can be chance or bias; a replicated one is harder to explain away. across two sham-controlled trials and two meta-analyses.
The primary target frequency band using the same EEG system at baseline and after 20 sessions. Validated cognitive or symptom measures relevant to the indication (ADHD Rating Scale, QEEG, PSQI) at baseline and after 20 and 40 sessions. Most published benefits required 20-40 sessions: session count is the primary process measure.
Evidence notes: randomized trial, meta-analysis
Endpoint graded: ADHD symptoms in children and adolescents (self-report, blinding-sensitive) (self_report)
Last reviewed: July 2026
Educational use only · Not medical advice · EBL grades published human evidence and does not recommend treatment. Stopping a prescription is a decision for your physician.
Primary evidenceSix papers, each linked to its PubMed record.
Neurofeedback Collaborative Group (J Am Acad Child Adolesc Psychiatry, 2021; PMID 32853703): double-blind sham-controlled trial, 144 children aged 7 to 10 with ADHD; no specific effect at the end of treatment or at 13 months. Neurofeedback Collaborative Group (J Am Acad Child Adolesc Psychiatry, 2023; PMID 36521694): the 25-month follow-up of the same trial, again without a specific effect. Westwood et al. (JAMA Psychiatry, 2025; PMID 39661381): meta-analysis of 38 randomized trials, 2,472 participants; with probably blinded ratings the effect on total ADHD symptoms was absent (SMD 0.04, 95% CI -0.10 to 0.18); restricted to standard protocols it was small (SMD 0.21), and the authors conclude neurofeedback does not meaningfully benefit people with ADHD at the group level. van Dongen-Boomsma et al. (J Clin Psychiatry, 2013; PMID 24021501): independent double-blind trial, 41 children aged 8 to 15, 30 sessions of EEG neurofeedback against placebo neurofeedback; no treatment effect on ADHD symptoms or clinical improvement, and children and parents could not guess their assignment better than chance. Cortese et al. (J Am Acad Child Adolesc Psychiatry, 2016; PMID 27238063): meta-analysis; effects disappeared with probably blinded ratings or sham controls. Mei et al. (Front Psychiatry, 2026; PMID 42358407): network meta-analysis of 37 randomized trials, 2,922 participants, of many digital interventions in children and adolescents with ADHD; its neurofeedback ranking rests on unblinded subjective behavioral ratings and cannot carry a grade on its own. The null under blinding is replicated across two sham-controlled trials and two meta-analyses.
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Headband that measures EEG, plus fNIRS, heart rate and motion, with real-time feedback during meditation and sleep tracking.
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How EBL searched for the trials (1 search)
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neurofeedback[tiab] AND (ADHD[tiab] OR "attention-deficit"[tiab]) AND (sham[tiab] OR blind*[tiab]) AND (randomized controlled trial[pt] OR meta-analysis[pt])Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →