Citation

Steingrimsson S, Bilonić G, Ekelund AC, Larson T, Stadig I, Svensson M, Vuković IS, Wartenberg C, Wrede O, Bernhardsson S. Eur. Psychiatry 2020; 63(1): e7.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1192/j.eurpsy.2019.7

PMID

32093790

PMCID

PMC8057448

Abstract

BACKGROUND: Post-traumatic stress disorder (PTSD) is debilitating for patients and society. There are a number of treatment methods albeit not all patients respond to these and an interesting method using electroencephalography-based neurofeedback (EEG-NF) has become more prominent in recent years. This systematic review aimed to assess whether EEG-NF, compared with sham NF, other treatment, or no treatment, is effective for PTSD. Primary outcomes were self-harm, PTSD symptoms, level of functioning and health-related quality of life.
METHODS: Systematic literature searches for randomized controlled trials (RCTs) were conducted in six databases. Random effects meta-analysis was performed. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation.
RESULTS: Four RCTs were included (123 participants). Suicidal thoughts were significantly reduced after EEG-NF compared with a waiting list in a small study. PTSD symptoms were assessed in all studies with different instruments.

RESULTS were consistently in favor of EEG-NF with large effect sizes (standardized mean difference -2.30 (95% confidence interval: -4.37 to -0.24). One study reported significantly improved level of executive functioning and one study a reduction in use of psychotropic medication. Complications were scarcely reported. Certainty of evidence was assessed as very low for the four assessed outcomes.
CONCLUSIONS: Based on four RCTs, with several study limitations and imprecision, it is uncertain whether EEG-NF reduces suicidal thoughts, PTSD symptoms, medication use, or improves function. Although all studies showed promising results, further studies are needed to increase the certainty of evidence.

Language: en

Keywords

Humans; systematic review; Self-Injurious Behavior; Quality of Life; EEG; post-traumatic stress disorder; Electroencephalography; Stress Disorders, Post-Traumatic; neurofeedback; Neurofeedback; Biofeedback; Waiting Lists