Comparing Live Z-Score Training and Theta/Beta Protocol to Reduce Theta-to-Beta Ratio: A Pilot Study

  • Ruben Perez-Elvira NEPSA Rehabilitacion Neurologica
  • Javier Oltra-Cucarella Dpt. Health Psychology, University of Alicante
  • José Antonio Carrobles Dpt. Personalidad, Evaluación y Tratamientos psicológicos, Universidad Autónoma de Madrid
Keywords: neurofeedback, Z-score training, Theta-to-Beta ratio


Objective/Background: Theta-to-Beta ratio is one of the most studied electroencephalography findings in ADHD in the neurotherapy field, alongside the neurofeedback (NF) protocols whose objective is reducing it.  The NF field has developed to a great level in the last decade.  One of the approaches that became of particular interest to the clinicians has been Z-score training (ZT).  In general, there are still a few studies about the efficacy of ZT and even fewer that compare this technique with the classic protocols.  This study aimed to check the efficacy of ZT in reducing Theta-to-Beta ratio.  Participants: 15 patients diagnosed with combined type ADHD aged 7 to 18, recruited in retrospect.  Methods: The participants were divided in two groups.  One of the groups was provided with the ZT intervention and the other one, the Theta/Beta (T/B) protocol.  Both groups went through ten 30-min NF sessions using videos selected by themselves as a reinforcement.  The main outcomes of this study were the patients’ Theta-to-Beta ratio metrics.  Results: Both groups showed a decrease in Theta-to-Beta ratio; the ZT group showed a decrease of 1.02 points average and the T/B group showed a decrease of 0.15 points average, only being statistically significant for the ZT group.

Author Biography

Ruben Perez-Elvira, NEPSA Rehabilitacion Neurologica

Clinical Chief

NEPSA Rehabilitación Neurológica


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