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. 2021 Feb;25(3):448-457.
doi: 10.1177/1087054718790802. Epub 2018 Aug 6.

The Fallacy of Sham-Controlled Neurofeedback Trials: A Reply to Thibault and Colleagues (2018)

H Edmund Pigott  1   2 , Rex Cannon  3 , Mark Trullinger  1
Affiliations

The Fallacy of Sham-Controlled Neurofeedback Trials: A Reply to Thibault and Colleagues (2018)

H Edmund Pigott et al. J Atten Disord. 2021 Feb.

Abstract

Background: Sham-controlled neurofeedback (NFB) trials consistently find no separation on ADHD outcome measures leading many to conclude that NFB's beneficial effects are due to placebo. Method: We deconstruct the NFB training methodology and findings of six sham-controlled trials that assessed for evidence of learning. Results: All six studies found no evidence NFB subjects learned to self-modulate the targeted electroencephalogram (EEG). Careful analyses revealed these studies' training methodologies were antithetical to the established science of operant conditioning thereby preventing subjects from learning to self-modulate. These findings are in marked contrast to NFB studies whose methodology mirror the best practices of operant conditioning. Conclusion: The premise that NFB's beneficial effects are due to placebo phenomenon is unproven as these studies compared two forms of false-feedback, not operant conditioning of the EEG. Because these studies are highly cited and considered the gold standard in scientific rigor, a reappraisal of the evidence is urgently needed.

Keywords: neurofeedback; operant conditioning; placebo; sham-controlled trials.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: H.E.P. is board certified in neurofeedback and has consulted for Amen Clinics, Brain Resources, CNS Response, and the International Society of Neurofeedback and Research. He is also on the scientific advisory board of Narbis, a neurofeedback technology company. R.C. is board certified in neurofeedback and Editor-in-Chief of the journal NeuroRegulation. M.T. is board certified in neurofeedback.

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