Combined Neurofeedback and Heart Rate Variability Training for Individuals with Symptoms of Anxiety and Depression: A Retrospective Study

Elyse Kemmerer White, Kayleah Michelle Groeneveld, Rachel Kelly Tittle, Nicholas Abram Bolhuis, Rachel E Martin, Timothy G Royer, Majid Fotuhi


Introduction.  Neurofeedback (NFB) and heart rate variability (HRV) training present promising, nonpharmaceutical intervention strategies for anxiety and depression.  This report is the first to address whether concurrent NFB and HRV (NFB+HRV) provides a viable intervention for symptoms of anxiety and depression, measured by the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire.  Methods.  183 children and adults with symptoms of anxiety and/or depression underwent NFB+HRV training.  Psychological symptom rating, EEG, blood pressure, breathing pattern, and HRV were measured before and after treatment.  Results.  After NFB+HRV training, symptoms of anxiety (p < .001, dz = 1.42) and depression (p < .001, dz = 1.34) were reduced in children and adults.  The majority of individuals with pretreatment symptoms of anxiety (82.8%) or depression (81.1%) experienced ASEBA improvements of clinical importance.  There were also significant changes in EEG, breathing rate, and HRV.  For the 16 individuals copresenting with hypertension, systolic and diastolic blood pressure were significantly reduced.  Conclusion.  We present evidence that NFB+HRV training may provide an effective, nonpharmaceutical intervention to reduce symptoms of anxiety and depression in children and adults.  Additionally, NFB+HRV training may improve EEG, blood pressure, resting breathing rate, and HRV.


Anxiety; Depression; Neurofeedback; Neurocore; Heart Rate Variability; EEG

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