Preliminary Real-World Evidence Supporting the Efficacy of a Remote Neurofeedback System in Improving Mental Health: Retrospective Single-Group Pretest-Posttest Study

Abstract

Background Neurofeedback training (NFT) has been shown to be effective in treating several disorders (eg, attention-deficit/hyperactivity disorder [ADHD], anxiety, and depression); however, little is currently known regarding the effectiveness of remote NFT systems. Objective This retrospective study provides real-world data (N=593) to assess the efficacy of app-based remote NFT in improving brain health and cognitive performance. Methods Improvement was measured from pre- to postintervention of in-app assessments that included validated symptom questionnaires (the 12-item General Health Questionnaire, the ADHD Rating Scale IV, the Adult ADHD Self-Report Scale, the 7-item Generalized Anxiety Disorder scale, and the 9-item Patient Health Questionnaire), a cognitive test of attention and executive functioning (ie, continuous performance task), and resting electroencephalography (EEG) markers. Clinically significant improvement was evaluated using standard approaches. Results The greatest improvement was reported for the anxiety questionnaire, for which 69% (68/99) of participants moved from abnormal to healthy score ranges. Overall, adult and child participants who engaged in neurofeedback to improve attention and executive functions demonstrated improved ADHD scores and enhanced performance on a cognitive (ie, response inhibition) task. Adults with ADHD additionally demonstrated elevated delta/alpha and theta/alpha ratios at baseline and a reduction in the delta/alpha ratio indicator following neurofeedback. Conclusions Preliminary findings suggest the efficacy of app-based remote neurofeedback in improving mental health, given the reduced symptom severity from pre- to postassessment for general psychological health, ADHD, anxiety, and depression, as well as adjusted resting EEG neural markers for individuals with symptoms of ADHD. Collectively, this supports the utility of the in-app assessment in monitoring behavioral and neural indices of mental health.

Effects of Digital Interventions on Neuroplasticity and Brain Function of Individuals With Developmental Disabilities: A Systematic Review (Preprint)

“…This review adopted the targeted neural functions of the digital interventions as the concept of "coping mechanisms." The included studies targeted cognitive competency (n=22), social competency (n=6), motor competency (n=2) [43,48], language competency (n=2) [36,50], and mental health (n=2) [43,49].…”

“…In the study, breathing training based on CBT was integrated into the final stage of VR-based cognitive training, to mitigate anxiety symptoms in individuals with ASD [43]. In Whitehead's [49] study, researchers provided neurofeedback therapy to individuals with ADHD using a mobile application. Through this application, participants received personalized neurofeedback protocols aimed at improving mental health [49].…”

“…In Whitehead's [49] study, researchers provided neurofeedback therapy to individuals with ADHD using a mobile application. Through this application, participants received personalized neurofeedback protocols aimed at improving mental health [49].…”

Consumer-Grade Electroencephalogram and Functional Near-Infrared Spectroscopy Neurofeedback Technologies for Mental Health and Wellbeing

“…Neurofeedback is a form of self-regulation based on physiological variables that are modified by the individual that were previously thought to be involuntary. Significant interest in these noninvasive applications led to studies of the efficacy of neurofeedback training for epilepsy, attention deficit disorder, hyperactive disorder, and later, anxiety and mental wellness [2].…”