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Meta-Analysis
. 2025 Aug 1;15(1):28148.
doi: 10.1038/s41598-025-94242-4.

Neurofeedback training for executive function in ADHD children: a systematic review and meta-analysis

Xiaoke Zhong  1   2 , Xiaoxia Yuan  3 , Yuanfu Dai  2 , Xinbi Zhang  2 , Changhao Jiang  4   5
Affiliations
Meta-Analysis

Neurofeedback training for executive function in ADHD children: a systematic review and meta-analysis

Xiaoke Zhong et al. Sci Rep. .

Abstract

Executive function deficits are commonly observed in children diagnosed with attention deficit hyperactivity disorder (ADHD). This research investigates the effectiveness of neurofeedback training (NFT) in improving executive functions among this group. Studies were meticulously selected following stringent inclusion and exclusion criteria. The quality of these studies was assessed using the PEDro scale. Seventeen RCT studies were identified, totaling 939 participants. We observed significant improvements in global executive function (p < 0.055), inhibitory control (p < 0.0001) and working memory (p < 0.05) following NFT. Notably, NFT exceeding 1,260 min was more effective in enhancing inhibitory control (p < 0.01) and working memory (p < 0.01). Additionally, the effects of NFT on inhibitory control (p = 0.05) and working memory (p < 0.01) were found to be enduring. NFT is an effective intervention for improving inhibitory control and working memory in children with ADHD. Working memory exhibits a more significant enhancement when the duration exceeds 1260 min, while inhibitory control follows closely behind. Moreover, it has a more sustained effect on working memory, alongside a notable albeit secondary effect on inhibitory control.

Keywords: ADHD; Children; Executive function; Meta-analysis; Neurofeedback training.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Literature review.
Fig. 2
Fig. 2
PRISMA flowchart diagram of the selection process of studies.
Fig. 3
Fig. 3
Risk of bias graph of all included study.
Fig. 4
Fig. 4
Risk of bias summary of all included study.
Fig. 5
Fig. 5
Pairwise meta-analysis. NFT effects on global executive function (A), inhibitory control (B), and working memory (C) by comparison group type (experimental group vs. control group). SD = Standard Deviation; Std Mean Difference = Standardized Mean Difference; Random = Random Effects Model; Fix = Fix Effects Model; IV = Inverse Variance (a method of weight allocation); CI = Confidence Interval; I2 = Higgins’ I2; ◆ = Overall effect estimates from all studies pooled together in this meta-analysis. If ◆ cross the line signifies no difference between groups (the same below).
Fig. 6
Fig. 6
Pairwise meta-analysis. Short-term NFT effects on inhibitory control (A) and working memory (B) by comparison group type (experimental group vs. control group).
Fig. 7
Fig. 7
Pairwise meta-analysis. Long-term NFT effects on inhibitory control (A) and working memory (B) by comparison group type (experimental group vs. control group).
Fig. 8
Fig. 8
Pairwise meta-analysis. sustained effects of NFT on inhibitory control (A) and working memory (B) by comparison group type (experimental group vs. control group).
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