Can Electroencephalography-Based Neurofeedback Treat Post-traumatic Stress Disorder? A Meta-analysis Study.

Abstract

Post-traumatic stress disorder (PTSD) remains a significant clinical challenge with limited treatment options. Although electroencephalogram (EEG) neurofeedback has garnered attention as a prospective treatment modality for PTSD, no comprehensive meta-analysis has been conducted to assess its efficacy and compare different treatment protocols. This study aims to provide a multi-variable meta-regression analysis of EEG neurofeedback's impact on PTSD symptoms, while also assessing variables that may influence treatment outcomes. A systematic review was performed to identify controlled studies exploring for the efficacy of EEG neurofeedback on PTSD. The overall effectiveness was evaluated through meta-analysis, and a multi-variable meta-regression was employed to discern factors affecting the EEG neurofeedback efficacy. EEG neurofeedback demonstrated a statistically significant reduction in PTSD symptoms immediately post-intervention, with sustained effects observed at one-month and three-month follow-ups. A sub-analysis of sham-controlled studies confirmed that outcomes were not attributable to placebo effects. Sensitivity analysis revealed that excluding two outlying studies resolved heterogeneity entirely, and all subsequent analyses were conducted on the refined dataset. While initial analyses identified target frequency, target region, and feedback modality as significant moderators, meta-regressions controlling for publication year revealed that these effects were confounded by temporal trends in study design and methodological rigor. In contrast, variables related to treatment duration, such as session number, session length, or weeks of intervention, were not significant moderators. These findings suggest that EEG neurofeedback is robust across protocol variations and highlight the importance of methodological advancements in interpreting treatment efficacy. EEG neurofeedback emerges as a promising and robust treatment modality for PTSD, demonstrating sustained therapeutic effects across follow-up periods. Our findings confirm its efficacy beyond placebo effects and highlight the stability of outcomes across diverse neurofeedback protocols. This study underscores the importance of methodological rigor and standardization in EEG neurofeedback research and advocates for larger, well-controlled trials to refine and optimize treatment protocols. These findings reaffirm EEG neurofeedback's potential as a cost-effective and scalable intervention, while encouraging future research into alternative methodologies to enhance efficacy and expand accessibility.