04/11/2025

Is Neurofeedback evidence-based?: Clinical applications

Interest in neurofeedback has grown in recent decades as a tool for treating neurodevelopmental disorders and emotional difficulties. Although there are an increasing number of studies, its effectiveness is still being evaluated in some clinical areas. Below, we review what neurofeedback is, the scientific evidence, and the main benefits and limitations of this technique.

What is neurofeedback and what is it for?

Neurofeedback is a brain self-regulation technique that uses real-time recording of the brain’s electrical activity, usually through an electroencephalogram (EEG), to modify dysfunctional patterns through positive reinforcement. In clinical practice, neurofeedback is used as a complementary tool in people with attention, emotional management, or self-regulation difficulties. The neurofeedback strategy consists of showing the person visual or auditory information about their brain activity, with the aim of teaching them to voluntarily modulate it. When asking ourselves what neurofeedback is and what it is used for, it is key to consider its application in contexts such as ADHD, anxiety, depression, or ASD, where its clinical impact has been researched.

Is there any scientific evidence of neurofeedback?

Scientific evidence for neurofeedback has grown in recent years, although some studies have methodological limitations. Systematic reviews and meta-analyses show promising results, especially in the treatment of ADHD, where a greater number of controlled studies have been collected in neuropsychological tests. Let’s look at the evidence for neurofeedback in specific examples.

Evidence of neurofeedback in ADHD

Neurofeedback has been shown to be effective in reducing symptoms of inattention and impulsivity, especially when protocols such as theta/beta are used, which work on the balance between brain waves that are associated with concentration and distraction. In some studies, the effects have been monitored long-term and have been comparable to those observed with stimulant drugs. In addition, using certain patterns detected in the EEG (biomarkers) allows training to be tailored to the individual characteristics of the patient, which can improve its effectiveness.

Evidence of neurofeedback in anxiety and depression

In people with anxiety or depression, neurofeedback can help regulate brain activity linked to emotional hyperarousal or rumination. Pilot studies have shown a decrease in anxiety symptoms and improvements in mood following specific training programs, although the results are less consistent than in ADHD.

Evidence of neurofeedback in ASD

In autism spectrum disorder (ASD), the use of neurofeedback has been explored to improve executive functions, emotional self-regulation, and social skills. While preliminary results are positive, sample sizes are often small, and further research with controlled trials is needed.

Evidence of neurofeedback in other disorders

The effects of neurofeedback on insomnia, chronic pain, epilepsy, addictions, and learning disorders have also been studied. In general, clinical improvement in specific symptoms has been found, although the level of evidence is still moderate or preliminary.

What are the pros and cons of neurofeedback?

Let’s take a look at the pros and cons of neurofeedback: Among some of the main benefits are:
  • Non-pharmacological and non-invasive intervention.
  • Potential for lasting effects after completing training.
  • Personalized adaptation according to cognitive and neurophysiological profiles.
  • Applicable to children, teenagers, and adults.
Among some of its current limitations are:
  • The need for multiple sessions to achieve stable effects.
  • High cost and limited availability in some clinical settings.
  • Variability in the protocols used between centers.
  • It requires supervision by specialized professionals.
In conclusion, although research is still ongoing to determine whether neurofeedback works with every clinical profile, the evidence available supports its use, especially in ADHD. This opens up promising lines of intervention in other disorders. The implementation of standardized criteria and advances in EEG technology will allow for more accurate neurofeedback evaluations on how it works, and its efficiency.

References:

  • Arns, M., Drinkenburg, W., & Kenemans, J. L. (2012). The effects of QEEG-informed neurofeedback in ADHD: An open-label pilot study. Applied Psychophysiology and Biofeedback, 37(3), 171–180. https://doi.org/10.1007/s10484-012-9191-4
  • Pineda, J. A., Brang, D., Hecht, E., Edwards, L., Carey, S., Bacon, M., & Seidenfeld, M. (2008). Positive behavioral and electrophysiological changes following neurofeedback training in children with autism. Research in Autism Spectrum Disorders, 2(3), 557–581. https://doi.org/10.1016/j.rasd.2007.12.003
  • Coben, R., & Myers, T. E. (2010). The relative efficacy of connectivity guided and symptom based EEG biofeedback for autistic disorders. Applied Psychophysiology and Biofeedback, 35(1), 13–23. https://doi.org/10.1007/s10484-009-9102-5
  • Hammond, D. C. (2005). Neurofeedback treatment of depression and anxiety. Journal of Adult Development, 12(2–3), 131–137. https://doi.org/10.1007/s10804-005-7029-5
  • Arns, M., de Ridder, S., Strehl, U., Breteler, M., & Coenen, A. (2009). Efficacy of neurofeedback treatment in ADHD: The effects on inattention, impulsivity and hyperactivity: A meta-analysis. Clinical EEG and Neuroscience, 40(3), 180–189. https://doi.org/10.1177/155005940904000310
   

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