Is Gamification of Neurofeedback Training effective for ADHD treatment? A Systematic Review

This systematic literature review examines the efficacy of gamification in neurofeedback (NF) therapy approaches for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD). In recent research, gamification of brain-computer interfaces (BCI) has been shown to enhance user engagement and motivation when performing otherwise dull and tiring NF tasks. However, given the attentional deficits and hyperactivity symptoms in people with ADHD, it is possible that introducing game elements yields adverse effects such as distraction for this population. Therefore, following the PRISMA protocol, the present review synthesized findings from 13 empirical studies to determine 1) whether gamification of NF training is effective in ADHD treatments and 2) in what way gamification of the BCI system was applied in past NF research for ADHD. Results suggest that while many NF games have been introduced as potentially useful applications for ADHD, there is a systematic lack of controlled studies with sufficient sample size to evaluate their effectiveness. Additionally, an overall heterogeneity of the games and evaluation measures was observed which did not allow for robust conclusions on specific design recommendations for gamification. Based on this review, we present open questions and potential research directions for future researchers.