Can electroencephalography-based neurofeedback treat post-traumatic stress disorder? A meta-analysis study

Objective: 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. Methods: 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 fact0rs affecting the EEG neurofeedback efficacy. Results: EEG neurofeedback yielded a statistically significant reduction in PTSD symptoms immediately post-intervention, with sustained effects at one and three months follow-up. A sub-analysis of sham-controlled studies confirmed that outcomes were not driven by placebo effects. Our findings also identified the target frequency and region, as well as feedback modality, as significant factors for treatment success. In contrast, variables related to treatment duration were not found to be significant moderators, suggesting cost-effectiveness. Conclusions: EEG neurofeedback emerges as a promising and cost-effective treatment modality for PTSD with the potential for long-term benefits. Our findings challenge commonly utilized protocols and advocate for further research into alternative methodologies to improve treatment efficacy.