Neurofeedback and traumatic brain injury: A literature review

BACKGROUND: Neurofeedback is a form of biofeedback whereby a patient can learn to control measurements of brain activity such as those recorded by an electroencephalogram. It has been explored as a treatment for sequelae of traumatic brain injury, although the use of neurofeedback remains outside the realm of routine clinical practice. METHODS: Google Scholar™ was used to find 22 examples of primary research. Measures of symptom improvement, neuropsychological testing, and changes in subjects' quantitative electroencephalogram were included in the analysis. A single reviewer classified each study according to a rubric devised by 2 societies dedicated to neurofeedback research. RESULTS: All studies demonstrated positive findings, in that neurofeedback led to improvement in measures of impairment, whether subjective, objective, or both. However, placebo-controlled studies were lacking, some reports omitted important details, and study designs differed to the point where effect size could not be calculated quantitatively. CONCLUSIONS: Neurofeedback is a promising treatment that warrants double-blind, placebo-controlled studies to determine its potential role in the treatment of traumatic brain injury. Clinicians can advise that some patients report improvement in a wide range of neuropsychiatric symptoms after undergoing neurofeedback, although the treatment remains experimental, with no standard methodology.