Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 13, 2021
Date Accepted: Jun 9, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Preliminary Real-world Evidence Supporting the Efficacy of Remote Neurofeedback System in Improving Mental Health: A Retrospective Single-Group Pretest-Posttest Study
ABSTRACT
Background:
Neurofeedback training has been shown effective in treating several disorders (eg, ADHD, anxiety, depression); however, currently little is known regarding the effectiveness of remote NFT systems.
Objective:
This retrospective study provides real-world data (N=593) to assess the efficacy of remote neurofeedback training in improving brain health and cognitive performance.
Methods:
Improvement was found from pre- to post-intervention on in-app assessments that included validated symptom questionnaires (GHQ-12, ADHD-RS-IV; ASRS, GAD-7; PHQ-9), a cognitive test of attention and executive functioning (continuous performance task; CPT), and resting EEG markers. Clinically significant improvement was evaluated using standard approaches.
Results:
Greatest improvement was reported for the anxiety questionnaire, for which 69% of participants moved from abnormal to healthy score ranges. Overall, participants who engaged in neurofeedback to improve attention and executive functions demonstrated improved ADHD (adult and child) scores and enhanced performance on a cognitive (response inhibition) task. Adults with ADHD additionally demonstrated elevated delta/alpha and theta/alpha ratios at baseline and a reduction in the delta/alpha ratio indicator following neurofeedback.
Conclusions:
Preliminary findings suggest the efficacy of app-based remote neurofeedback in improving mental health and support the utility of its in-app assessment in monitoring behavioral and neural indices of mental health, particularly for individuals with symptoms of ADHD and anxiety. Moreover, its effectiveness in a real-world sample positions the app as an affordable, accessible, and clinically valuable alternative to clinic-based EEG systems.
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