Attention deficit hyperactivity disorder (ADHD) is a prevalent neuropsychiatric condition that affects both children and adults, leading to significant impairment in various aspects of life. The disorder is characterized by behavioral symptoms such as inattention, impulsivity, and hyperactivity. Understanding the neural basis of ADHD is critical for developing effective treatments. Anatomical and functional brain anomalies are evident in individuals with ADHD, primarily within the prefrontal cortex and associated circuits. These anomalies are linked to cognitive deficits underpinning ADHD symptoms, with the theta/beta ratio (TBR) in electroencephalogram (EEG) studies serving as a prominent biomarker.

Current treatment options for ADHD include pharmacological and non- pharmacological approaches. While stimulant medications, such as methylphenidate and amphetamines, target catecholamine transmission and have shown efficacy in symptom management, they come with side effects. Non-pharmacological interventions, such as TBR EEG-neurofeedback, have gained attention and shown promise in reducing ADHD symptoms. The integration of virtual reality (VR) could offer a more engaging perspective in such long and tedious therapies.

The primary aim of this study is to validate an innovative protocol that combines EEG- neurofeedback with a VR environment to reduce protocol length and improve the efficiency of neurofeedback training in children with ADHD. This thesis seeks to evaluate the feasibility of this novel approach, while exploring the efficacy of a TBR based NFB method and elucidating its beneficial effects.

Preliminary findings suggest that the combination of EEG-neurofeedback and VR is feasible and attractive to children with ADHD. While some participants showed a (non- significant) reduction in the theta/beta ratio, indicating potential benefits, further research is needed to understand the variability in individual responses. This innovative approach has the potential to enhance the efficiency of ADHD treatment and improve engagement, making it a promising avenue for future research and practical use in the field.