A randomized single-blind investigation of cognitive characteristics due to neurofeedback application in children with attention deficit by using the WİSC-R

The aim of this study was to examine the effects of the neurofeedback (NFB) system in terms of cognitive skills by the Wechsler Intelligence Scale for Children-Revised (WISC-R) in 100 children with attention deficit, between the ages of 8-12, with a randomized single-blind sham control group. For this purpose, the experimental group (n=50) to receive NFB training and the sham group (n=50) who received simulation were formed by random sampling from the participants who applied to the special education center with a diagnosis of attention deficit for one year (May 2021-May 2022). The average age of the participants was 9.72 years and 74% of them were men. In the first stage of the study, the WISC-R test was applied as a pre-test to determine the mental performance of the participants in both groups. Then, a total of 60 sessions of quantitative electroencephalography (QEEG) based infralow frequency (ILF) NFB training protocol was carried out in half-hour sessions, 3 days a week, for five months in the experimental group. At the end of the sixth month, WISC-R was applied again as a post-test and the data were analyzed with the SPSS v25.0 package program. When the within-group differences were examined, both the experimental group and the control group showed significant differences in all subtests of the WISC-R (p<0.05). In the comparison between the groups, no difference was found between the pretest and posttest scores of the experimental and control groups (p>0.05). Only the comprehension scores included in the verbal IQ differed significantly in the control and experimental groups (p=0.045). Therefore, when the differences between the test scores before and after the training were taken and these differences were compared between the groups, a difference was found in terms of verbal IQ, picture arrangement, performance IQ and total IQ (p=0.016; p=0.001; p<0.001; p=0.002, respectively). In addition, the sample of the study was categorized according to the IQs of the pre-test scores obtained from the WISC-R, and the difference between the groups was examined. In this context, although the normal intelligence group (n=77) gave close results to the sample that is not categorized according to IQs (picture arrangement p=0.012 and performance IQ p=0.020), differences were observed in the under-normal intelligence and gifted groups. While the children in the under-normal intelligence group (n=18) showed significant results in the coding subtest (p=0.05), the gifted group (n=5) could not be statistically analyzed due to the small sample size. In terms of WISC-R, it was clinically determined that the mental performance of the NFB group increased in terms of performance IQ and total IQ, and attention deficits decreased. Although this result, which is in agreement with the literature, was significant when the differences between pre- and post-test scores were taken and these differences were compared between the groups, it could not be statistically confirmed in the post-test comparisons between the sham-group and the experimental group. We think that it may be useful to use larger case series including control groups and to evaluate symptoms in long-term follow-ups to demonstrate the clinical significance of the results in future studies.