Table 2.
Neurofeedback Treatment Studies in Patients With Schizophrenia, 1964–2019
| Authors | Year | N | NF Modality | Protocol | Treatment Dose (h) | Control | Outcomes |
|---|---|---|---|---|---|---|---|
| Zweerings J et al | 2019 | n = 56 | rt-fMRI | 8 NF sessions, ↑↓ left anterior IFG and left posterior STG activity | 0.56 ha | HC | Successful ↑↓ regulation, improved functional connectivity, decreased perceived illness severity, and decreased symptom severity |
| Balconi M et al | 2018 | n = 18 | EEG | 10 NF sessions, ↑ power in .5–5.5 Hz (delta/low theta) to treat hemispheric imbalance | 3.75 h | SCZ, TAU | Experimental group experienced ↑ hemispheric balance in delta power after NF |
| Storchak H et al | 2018 | n = 1 | fNIRS | 47 NF sessions, ↓ activity in STG during AVH, and ↑ activity in STG before AVH | — | — | Able to regulate activity in STG before AVH occurred, but not during AVH. Significant decrease in AVHs |
| Pazooki K et al | 2018 | n = 2 | EEG | 20 NF sessions, ↑ SMR and ↓ 4–8 Hz theta at C4/C3 (contralateral side to handedness). Followed by 2 wk NF to ↑ 13–18 Hz at F3 | 10 h | — | Both participants were able to regulate their alpha, beta, theta, and SMR activity, accompanied by significant improvements of negative symptoms |
| Rieger K et al | 2018 | n = 10 | EEG | 16 NF sessions, ↑ amplitude of N100 ERP component | 5.9 h | Sham NF | No significant improvement in AVH in regards to NF or sham NF |
| Orlov ND et al | 2018 | n = 12 | rt-fMRI | 4 NF sessions, ↓ regulate voice-sensitive regions in left STG | 1.93 ha | — | Patients learned to ↓ STG activation and increased functional connectivity |
| Gomes JS et al | 2018 | n = 20 | HEG | 10 NF sessions, ↑ activity at F7, Fp1, Fp2, and F8 | 1 h | HC | Both groups were able to regulate brain activity, improved cognitive function in multiple domains in both SCZ and HC |
| Nan W et al | 2017 | n = 1 | EEG | 12.5 h of NF, to ↑ alpha and ↓ beta2 at P4 | 12.5 h | — | Alpha/beta2 ratio increased over sessions. Significant improvement in + and − symptoms after 22 mo |
| Dyck MS et al | 2016 | n = 3 | rt-fMRI | 9 NF sessions, ↑ ACC activation | 1.28 ha | — | Significant ↑ activation of ACC and improvements in AVH |
| Cordes JS et al | 2015 | n = 22 | rt-fMRI | 3 NF sessions, ↑ ACC activation | 1.28 ha | HC | Experimental group ↑ activity in dorsal ACC, healthy subjects ↑ activity in rostral ACC |
| No description of effects on cognition | |||||||
| Ruiz S et al | 2013 | n = 9 | rt-fMRI | 12 NF sessions, ↑ activation of bilateral insular cortex | 1.30 ha | — | Improved control of anterior insula cortex: better control of negative symptoms |
| Surmeli T et al | 2012 | n = 51 | EEG | Average of 58.5 h of NF, targeting deviations in individual qEEG | Ave. 58.5 h | — | Significant improvements in qEEG deviations and symptoms |
| Schneider F et al | 1992 | n = 24 | EEG | 20 NF sessions, regulate activity of SCP (recorded from Cz) | 4.89 h | HC | Experimental group required more NF training to achieve similar control of SCP compared to healthy controls |
| Schneider SJ et al | 1982 | n = 9 | EEG | 5 NF sessions, ↑ 8–13 Hz and ↓ power densities over 15 Hz at O2 | 2.75 h | — | Successful within-session regulation of brain activity, no change between sessions |
Note: ACC, anterior cingulate cortex; AVH, auditory verbal hallucinations; EEG, electroencephalogram; ERP, event-related potential; fNIRS, functional near-infrared spectroscopy; HEG, hemoencephalography; IFG, inferior frontal gyrus; NF, neurofeedback; rt-fMRI, real-time functional magnetic resonance imaging; qEEG, quantitative EEG; SCP, slow cortical potentials; SCZ, schizophrenia; SMR, sensorimotor rhythm; STG, superior temporal gyrus; TAU, treatment as usual; ↑, increase; ↓, decrease.
art-fMRI alternates rest blocks with NF. Estimated NF dose includes both training and rest time.