Applications of Neurofeedback in Diagnosing and Treating Cognitive Impairments in Iranian Children and Adolescents with Neurodevelopmental Conditions: A Systematic Review

Objective: Attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and specific learning disorder (SLD) are some of the most common neurodevelopmental disorders (NDDs) impacting a child’s education and social behavior. There has been a growing interest in neurofeedback as a noninvasive method of using self-regulation to increase cognitive performance in children with NDD. The current systematic review evaluates the effectiveness of using neurofeedback either as a stand-alone or in combination with other methods to improve cognitive, academic, behavioral, and neurophysiological outcome measures in Iranian children and adolescents with neurodevelopmental conditions including ADHD, ASD, and SLD. Materials & Methods: A systematic search was conducted using the PRISMA-۲۰۲۰ guidelines in Iranian databases for studies published between ۲۰۱۵ and ۲۰۲۵. The inclusion criteria included quantitative research studies conducted on Iranian children and adolescents with neurodevelopmental conditions under ۱۸ years of age with ADHD, ASD, and SLDs utilizing Neurofeedback technology. Of the total of ۶۳ studies included in the analysis, ۳۸ were focused on ADHD, ۲۰ on SLDs, and ۵ on ASDs. The studies evaluated a total of ۲۱۴۸ subjects with ADHD, ASDs, and/ or SLDs. Two independent reviews conducted the extraction of data and the assessment of quality for each study selected for inclusion in the analysis. Results: Researchers found that after receiving neurofeedback training, participants exhibited improvement in cognitive and executive function (sustained attention, working memory, cognitive flexibility, inhibition) and academic achievement (reading, writing, and mathematics), behavioral improvements (reduced symptoms of hyperactivity, impulsivity, aggression), as well as significant neurophysiological changes (brain wave activity). Intervention combinations of neurofeedback with cognitive rehabilitation, transcranial direct current stimulation (tDCS), or play therapy have demonstrated superior and more lasting results than neurofeedback alone. Nevertheless, there were methodological limitations to the studies conducted, including small sample sizes, no use of sham controls, short-term follow-up periods, and limited generalization (primarily conducted on boys aged ۷-۱۲). Conclusion: Neurofeedback therapy has great potential as an alternative intervention for the treatment of cognitive impairment and other symptoms associated with ADHD, SLD, and ASD in children in Iran, particularly when individualized and integrated with other forms of treatment. Although the research is limited by methodological limitations, the results suggest that there is a potential for using neurofeedback therapy to promote brain plasticity and, therefore, improve cognition. The design of large-scale, randomized controlled clinical trials with sham groups, multiple ethnicities, longer duration of treatment, and established protocols should be the next step in establishing clinical use of neurofeedback therapy for children with ADHD, SLD, and ASD in Iran.

کلیدواژه ها:

Neurofeedback ، neurodevelopmental disorders ، ADHD ، SLD ، ASD