Neurofeedback for Youth Trauma

Overseen By Tom O'Connor, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: University of Rochester

Disqualifiers: Epilepsy, High suicide risk, Psychosis

Stay on Your Current Meds You can continue your current medications while participating

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

Duration: 12 weeks

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore whether adding neurofeedback (a technique to train brain activity) to regular therapy can help reduce trauma symptoms in children. It involves two groups: one receiving standard therapy and another receiving therapy plus neurofeedback sessions. Children aged 6-12 who have experienced multiple traumatic events and are either receiving or eligible for trauma-focused therapy might be suitable candidates for this trial. As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance therapeutic options for children with trauma.

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this neurofeedback intervention is safe for youth?

Research has shown that neurofeedback is a promising method to help children with trauma. Neurofeedback enables individuals to learn to control their brain activity by providing real-time feedback on brain waves.

In one study involving children who experienced severe abuse and neglect, neurofeedback significantly improved PTSD (post-traumatic stress disorder) symptoms. Another study found that after 24 sessions of neurofeedback training, children exhibited fewer behavioral and emotional problems.

These studies suggest that neurofeedback is generally well-tolerated. No major side effects were reported, making it a safer option for children dealing with trauma. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using neurofeedback for youth trauma because it offers a different approach compared to standard psychotherapy. Unlike traditional therapy, which relies on talk and cognitive behavioral techniques, neurofeedback directly trains the brain by providing real-time feedback on brain activity. This method allows individuals to learn how to regulate their brain functions, potentially leading to improvements in emotional regulation and resilience. Additionally, neurofeedback can be integrated with existing therapies, enhancing their effectiveness without additional medication.

What evidence suggests that this trial's treatments could be effective for trauma in youth?

Research has shown that neurofeedback, which participants in this trial may receive alongside standard care, can help reduce trauma symptoms in young people. Studies have found that neurofeedback significantly lessens PTSD symptoms in children who have experienced severe abuse and neglect. One study demonstrated that 24 sessions of neurofeedback led to noticeable improvements in emotional and behavioral issues related to trauma. Additionally, reviews of multiple studies highlight that neurofeedback consistently outperforms other methods in reducing PTSD symptoms. This suggests that neurofeedback may be a promising tool for helping young people exposed to trauma manage their symptoms effectively. ^{2 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for children aged 6-12 who have experienced trauma and are receiving or eligible for trauma-focused therapy. They must have a caregiver, speak English, and own a device compatible with the MUSE Calm app. Children at high risk of suicide, experiencing psychosis, or with epilepsy cannot participate.

Inclusion Criteria

speaks and read English

I am a child.

The caregiver has reported that the child has experienced multiple adverse childhood experiences (ACEs) on a questionnaire.

Exclusion Criteria

I have a documented history of epilepsy.

Child-caregiver dyads will be excluded if

I am currently experiencing psychosis.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive routine clinical psychotherapy plus 3 to 4 neurofeedback interventions per week

12 weeks

3-4 visits per week (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Neurofeedback Intervention
• Standard of Care

Trial Overview The study is examining if neurofeedback can help reduce symptoms in traumatized youth when added to standard care. Participants will use the MUSE wearable device alongside their usual therapy to see if it improves outcomes.

How Is the Trial Designed?

Group I: Neurofeedback Intervention plus standard of care Experimental Treatment 2 Interventions

routine clinical psychotherapy plus 3 to 4 neurofeedback interventions per week.

Group II: Standard of Care Placebo Group 1 Intervention

routine clinical psychotherapy

Who Is Running the Clinical Trial?

University of Rochester

Lead Sponsor

Trials

883

Recruited

555,000+

Published Research Related to This Trial

Neurofeedback (NF) has been explored as a treatment for various child psychiatric disorders, including ADHD, autism, learning disorders, and epilepsy, by providing real-time feedback on brain activity.

However, many studies on NF have methodological limitations, such as not using proper blinding or sham controls, and while clinical experience suggests NF is reasonably safe, its safety has not been rigorously studied in youth or adults.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quantitative EEG neurofeedback for the treatment of pediatric attention-deficit/hyperactivity disorder, autism spectrum disorders, learning disorders, and epilepsy. Hurt, E., Arnold, LE., Lofthouse, N.[2019]

In a study involving 41 children with ADHD, EEG neurofeedback did not show a significant improvement in ADHD symptoms compared to placebo neurofeedback, indicating it may not be an effective treatment option.

Both treatment groups experienced a general improvement in ADHD symptoms over time, but there were no significant differences between the groups, and no clinically relevant side effects were reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder. van Dongen-Boomsma, M., Vollebregt, MA., Slaats-Willemse, D., et al.[2015]

In a study involving 36 children with ADHD, neurofeedback (NF) combined with medication showed a reduction in theta brainwaves, indicating potential changes in brain activity associated with ADHD symptoms.

However, the study did not find that NF provided superior cognitive benefits compared to medication alone, suggesting that while NF may have some positive effects, it does not enhance intelligence functioning beyond medication treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Additive effects of neurofeedback on the treatment of ADHD: A randomized controlled study. Lee, EJ., Jung, CH.[2022]

Electroencephalogram biofeedback (EBF) is recognized as a clinically effective treatment for ADHD, seizure disorders, anxiety, depression, and traumatic brain injury, meeting the 'Clinical Guidelines' standard set by the American Academy of Child and Adolescent Psychiatry.

Repetitive transcranial magnetic stimulation (rTMS) is also endorsed under 'Clinical Guidelines' for treating bipolar disorder, unipolar disorder, and schizophrenia, indicating its efficacy in managing these mental health conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Emerging brain-based interventions for children and adolescents: overview and clinical perspective. Hirshberg, LM., Chiu, S., Frazier, JA.[2009]

A survey of 66 hospitals in Sweden revealed that 76% have established guidelines for managing pediatric traumatic brain injury (TBI), indicating an improvement in clinical decision-making since the 2006 baseline.

Despite improvements, management still varies significantly across hospitals, with 84% of TBI cases being handled by inexperienced doctors from non-pediatric specialties, highlighting a need for further training and standardization in care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Management of paediatric traumatic brain injury in Sweden: a national cross-sectional survey. Wickbom, F., Persson, L., Olivecrona, Z., et al.[2022]

Neurofeedback is gaining popularity as an alternative treatment for various neurological disorders, including epilepsy, despite limited insurance coverage.

The individual progress of three children with epilepsy spectrum disorder who underwent neurofeedback training suggests potential therapeutic benefits, highlighting the need for further exploration of this modality in clinical practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical neurofeedback: case studies, proposed mechanism, and implications for pediatric neurology practice. Legarda, SB., McMahon, D., Othmer, S., et al.[2011]

In a study involving 91 children and adolescents with ADHD, neurofeedback (NF) treatment was found to be as effective as the standard medication methylphenidate in reducing symptoms of inattention and hyperactivity, based on parental reports.

The study included 30 sessions of NF and compared three groups: one receiving NF, one receiving methylphenidate, and one receiving both, but no significant differences were found between the treatment groups, suggesting NF could be a viable alternative to medication.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurofeedback for the treatment of children and adolescents with ADHD: a randomized and controlled clinical trial using parental reports. Duric, NS., Assmus, J., Gundersen, D., et al.[2022]

In a study of 104 children aged 7 to 11 with ADHD, those who received neurofeedback showed sustained improvements in attention and executive functioning six months after a 40-session intervention, with effect sizes indicating significant benefits over cognitive training and control groups.

Neurofeedback participants maintained their stimulant medication dosage, while those in cognitive training and control groups required significant increases in medication, suggesting that neurofeedback may be a more effective treatment option for managing ADHD symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In-school neurofeedback training for ADHD: sustained improvements from a randomized control trial. Steiner, NJ., Frenette, EC., Rene, KM., et al.[2022]

The mortality rate for children after traumatic brain injury varies from 2.5% to 21%, indicating a significant risk associated with these injuries.

Children tend to have better clinical outcomes than adults with similar head injuries, and improved medical management and rehabilitation can help decrease the chances of long-term disabilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Pediatric craniocerebral trauma. Special characteristics, therapy and prognosis]. Maier-Hauff, K., Gatzounis, G., Börschel, M.[2006]

A survey of 107 healthcare providers across 15 centers in the U.S. and Canada revealed that headache is the most common symptom reported after pediatric mild traumatic brain injury (mTBI), with non-steroidal anti-inflammatory medications and acetaminophen being the most frequently recommended treatments.

There is significant variation in the management of pediatric mTBI, with 83% of respondents recommending rest as a common non-pharmacological intervention, highlighting the need for more evidence-based guidelines in treating this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Practice Patterns in Pharmacological and Non-Pharmacological Therapies for Children with Mild Traumatic Brain Injury: A Survey of 15 Canadian and United States Centers. Mannix, R., Zemek, R., Yeates, KO., et al.[2020]

There is limited empirical data on the use of neuropharmacologic treatments for children and adolescents with traumatic brain injury (TBI), highlighting a need for more research in this area.

The review discusses various medication classes, such as dopamine agonists and antidepressants, that may aid in neuroprotection and recovery after TBI, suggesting potential avenues for future studies in pediatric populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neuropharmacology in pediatric brain injury: a review. Pangilinan, PH., Giacoletti-Argento, A., Shellhaas, R., et al.[2013]

Rapid stabilization of airway and blood flow is crucial in managing pediatric severe traumatic brain injury, with key treatments including sedation, hyperventilation, and hyperosmolar therapy to prevent intracranial hypertension and cerebral hypoperfusion.

Current management strategies for refractory intracranial hypertension involve high-dose barbiturate therapy and decompressive craniectomy, but much of the evidence is based on specific center practices rather than large-scale studies, highlighting the need for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Management of pediatric traumatic brain injury. Mtaweh, H., Bell, MJ.[2020]

Neurofeedback is gaining recognition in scientific and medical communities, indicating its potential relevance in treatment and research.

Researchers have developed a consensus checklist to enhance the quality of reporting and experimental design in neurofeedback studies, which could lead to more reliable and effective applications of this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Consensus on the reporting and experimental design of clinical and cognitive-behavioural neurofeedback studies (CRED-nf checklist). Ros, T., Enriquez-Geppert, S., Zotev, V., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10993781/

Systematic review and meta-analysis of neurofeedback and its ... In children 6–13 years of age with histories of severe abuse and neglect (PTSD) (N = 37), NF significantly decreased/improved upon PTSD symptoms ...

2. neuroregulation.org neuroregulation.org/article/view/23377

Therapists' Experiences With Integrating Neurofeedback ... Some studies have found neurofeedback to be effective for treating symptoms of complex/ developmental trauma. There is minimal guidance on ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10515677/

Neurofeedback for post-traumatic stress disorder: systematic ... Results: All included studies showed an advantage of NFB over control conditions in reducing symptoms of PTSD, with indications of improvement in symptoms of ...

4. researchgate.net researchgate.net/publication/342908715_The_impact_of_neurofeedback_training_on_children_with_developmental_trauma_A_randomized_controlled_study

The Impact of Neurofeedback Training on Children With ... This pilot study demonstrated that 24 sessions of NFT significantly decreased PTSD symptoms, internalizing, externalizing, other behavioral and emotional ...

5. journals.sagepub.com journals.sagepub.com/doi/abs/10.1177/15248380221134295

Review of the Evidence for Neurofeedback Training ... This review examined the evidence for the effectiveness of this intervention for children with trauma through a systematic search of the literature.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4892319/

Neurofeedback: A Comprehensive Review on System Design ... Neurofeedback is a kind of biofeedback, which teaches self-control of brain functions to subjects by measuring brain waves and providing a feedback signal.

7. frontiersin.org frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1323485/full

Systematic review and meta-analysis of neurofeedback ... In children 6–13 years of age with histories of severe abuse and neglect (PTSD) (N = 37), NF significantly decreased/improved upon PTSD symptoms ...

8. psycnet.apa.org psycnet.apa.org/record/2020-49861-001

The impact of neurofeedback training on children with ... The impact of neurofeedback training on children with developmental trauma: A randomized controlled study. Publication Date. Nov 2020. Publication History.