Efficacy of Neurofeedback in Adults With Posttraumatic Stress Disorder
DOI:
https://doi.org/10.15540/nr.13.3.256Keywords:
neurofeedback, EEG-neurofeedback, trauma, PTSD, EEG, fMRI, randomized controlled trialAbstract
Objective. To evaluate, under PRISMA, the clinical efficacy, safety/acceptability, and mechanistic evidence of neurofeedback (NF) for adult posttraumatic stress disorder (PTSD), stratified by modality and comparator, and to meta-analyze posttreatment severity. Method. I conducted an a priori systematic review following PRISMA 2020 and PRISMA-S. Sources were MEDLINE/PubMed, Cochrane CENTRAL, PsycINFO, ClinicalTrials.gov, WHO-ICTRP, and medRxiv, plus citation chasing. Eligible studies were parallel randomized controlled trials in adults with PTSD, comparing NF versus wait-list/treatment-as-usual (TAU), active, or sham. The primary outcome was posttreatment PTSD severity. Risk of bias (RoB 2) and certainty (GRADE) were assessed. Random-effects meta-analysis used REML with Knapp–Hartung adjustment. Results. Five trials met inclusion; three provided comparable data for pooling. The combined effect favored NF with minimal heterogeneity. Larger clinical signals appeared versus wait-list/TAU; double-blind sham/active contrasts were smaller or inconclusive yet showed mechanistic change (DMN/SN normalization; amygdala down-regulation). No NF-related serious adverse events were reported; dropout was low–moderate. GRADE certainty for posttreatment severity was low–moderate. Conclusions. NF is a promising, well-tolerated adjunct for adult PTSD; larger double-blind trials with active/sham comparators, longer follow-up, and standardized protocols are needed to establish specificity and durability of effects.
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