KITE - Neurofeedback and working memory training

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KITE is a comparative, randomized and controlled study focusing on the question: Does Neurofeedback and Working Memory Training Improve Core Symptoms of ADHD in Children and Adolescents? 

Attention-deficit/hyperactivity disorder (ADHD/ADD) is a highly prevalent and heterogenic neuropsychiatric disorder affecting about 5% of school-aged children [1]. The core symptoms of inattention, impulsivity and hyperactivity in AD/HD causes significant problems in several areas in life, affecting adversely children’s development and function and causes increased risk of developing mental illness. International and local guidelines recommend multimodal treatment combining psychosocial and educational interventions with medication [2]. Most available and commonly used intervention is drug therapy, particularly in the form of stimulants (methylphenidate) which targets behavioral symptoms and has positive effects in the short term, but has limited effect on the long term [3] and after treatment the core symptoms remains.

Cognitive learning and training (CLT) methods like neurofeedback (NF) and working memory training (WMt) are non-invasive methods which during the recent years experienced a growing interest and empirical support for improving ADHD/ADD symptoms [4]. NF trains the brains electrical activity through an operant/classical learning paradigm and is supposed to enhance the brains self-regulating ability, i.e. flexibly adapt brain activity to better meet the changing demands of the environment [5]. WMt focuses on improving working memory functions through challenging exercises in computerized software. Besides encouraging results in enhancing the capacity of foremost visual working memory there has been more sparse evidence that WMt could have beneficial effects on behavioral measures for children with ADHD/ADD and questions remain of the nature of the effects and long term effects [6].

KITE is an ongoing study to evaluate two different neurofeedback methods and a working memory training program. The primary aim is to evaluate if neurocognitive training improves core symptoms in ADHD/ADD and the purpose is to find effective non-pharmacological interventions as an adjunct to or in place of pharmacological treatment. A total of 200 children and adolescents with ADHD/ADD between 9-17 years of age will participate in the study alongside with treatment as usual, and the first children were enrolled in August 2013.

Inclusion criteria: Clinical diagnosis of AD/HD according to DSM-IV-TR and the K-SADS interview, drug naive or under stable medication with stimulants or equivalent for at least 1 month. Exclusion criteria: IQ <80 (WISC-IV or WAIS-IV), clinically unstable psychiatric condition such as suffering from acute depression, bipolar disorder, severe obsessive compulsive disorder, clinically judged severe self-harming behavior,  severe somatic (neurological) disease, or has a very limited knowledge of the Swedish language.

The KITE study is registered in (NCT01841151).


[1] The worldwide prevalence of ADHD: a systematic review and metaregression analysis.
Polanczyk G, de Lima M, Horta B, Biederman J, Rohde L
Am J Psychiatry 2007 Jun;164(6):942-8

[2] Systematic review of national and international guidelines on attention-deficit hyperactivity disorder.
Seixas M, Weiss M, Müller U
J. Psychopharmacol. (Oxford) 2012 Jun;26(6):753-65 

[3] Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment Study of children with ADHD (MTA): Part II: supporting details.
Swanson J, Arnold L, Kraemer H, Hechtman L, Molina B, Hinshaw S, et al
J Atten Disord 2008 Jul;12(1):15-43

[4] Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments.
Sonuga-Barke E, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, et al
Am J Psychiatry 2013 Mar;170(3):275-89

[5] Neurofeedback for ADHD: a review of current evidence.
Holtmann M, Sonuga-Barke E, Cortese S, Brandeis D
Child Adolesc Psychiatr Clin N Am 2014 Oct;23(4):789-806

[6] Computer-based cognitive training for ADHD: a review of current evidence.
Sonuga-Barke E, Brandeis D, Holtmann M, Cortese S
Child Adolesc Psychiatr Clin N Am 2014 Oct;23(4):807-24

[7] Historical Overview of Attention Deficit-Hyperactivity Disorder and Neurofeedback: Implications for Academic Achievement, Assessment, and Intervention in Schools
La Marca, J.P.
Contemp School Psychol (2017)



John Hasslinger

Cell phone: +46-(0)70-4849632
Address: Division for Neuropsychiatry
Visiting address: CAP Research Center
Gävlegatan 22B, floor 8

NeuropsychiatryPsychiatric disordersPsychology