Current Studies 2025/2026

Study type: Systematisches Review + Meta-Analysis

Scope: 10 studies with 539 participants (inhibition) + 7 studies with 370 children (working memory)

Key findings:

• Significant improvement in inhibitory control (p < 0.0001) – small to medium effect
• Significant improvement in working memory (p < 0.05) with a clear dose-response effect
• Key finding: Only after >21 hours of total training (approx. 30 sessions) do significant cognitive improvements emerge
• Sustained: Effects persist even after training ends

Significance: This meta-analysis establishes for the first time a clear dose-response relationship for neurofeedback in ADHD: A minimum of 21 hours of training is required for measurable cognitive improvements. Published in the Nature Portfolio journal Scientific Reports.

Study type: Systematisches Review + Meta-Analysis (PRISMA, PROSPERO-registered)

Scope: Multiple RCTs on EEG neurofeedback and fMRI neurofeedback for PTSD

Key findings:

• EEG neurofeedback shows moderate to large effect sizes for PTSD symptom reduction (k = 5 RCTs)
• Effect sizes increase at follow-up – a clinically meaningful signal
• Alpha rhythm modulation identified as the most promising protocol
• Neural mechanisms: Changes in the Default Mode Network and Salience Network correlate with PTSD improvement

Significance: First integrated meta-analysis to systematically capture the neural mechanisms of neurofeedback for PTSD. The increasing effect size at follow-up suggests sustained neuroplastic changes.

Study type: Double-blind, sham-controlled RCT

Scope: 60 children with ADHD diagnosis (mean age 11 years)

Key findings:

• Effect sizes: Cohen's d = −0.29 to −0.45 (small to medium)
• Frontal theta power significantly increased (p = 0.0125)
• Effects persist 1 month after treatment ends

Significance: First double-blind study combining respiratory biofeedback with neurofeedback and nerve stimulation in ADHD. The sham-controlled design confirms a genuine treatment effect. Particularly relevant: The combination of multiple modalities outperforms single approaches.

Study type: Phase-2 RCT (8-week intervention)

Scope: 115 adults with severe substance use disorder

Key findings:

• 64 % fewer days of substance use compared to control group
• Negative affect: Systematically decreased in the HRV-BF group, increased in the control group
• Cravings: Systematically decreased in the HRV-BF group
• Positive affect: Improved in the HRV-BF group

Significance: Published in the world's most prestigious psychiatry journal. First RCT using wearable HRV biofeedback for substance use disorders. A 64 % reduction in substance use days is highly clinically relevant. Funded by NIDA and NIAAA (US National Institutes of Health).

Study type: Pilot RCT (Universitäts-Setting)

Scope: Patients with coronary heart disease (aged 30–79 years)

Key findings:

• HRV biofeedback led to significantly increased myocardial flow reserve under mental stress vs. usual care
• Mechanistic evidence: Mental stress reduces myocardial perfusion; HRV-BF can buffer this effect
• First RCT combining HRV-BF with objective cardiac imaging

Significance: Published in JAMA Network. Provides the first mechanistic evidence via cardiac imaging of how autonomic nervous system regulation (through HRV training) can protect the heart under stress. Highly relevant for cardiovascular rehabilitation.

Study type: Pilot RCT (Treatment vs. Waitlist)

Scope: 20 female fibromyalgia patients (10 treatment, 10 waitlist)

Measured parameters: Skin conductance (EDA), Heart rate variability (HRV), Respiration rate – embedded in an immersive VR environment

Key findings:

• Physiological improvements: Significant reduction in skin conductance and respiration rate, HRV improvements
• Effects sustained 2 weeks after treatment ended

Significance: 51 % pain reduction in fibromyalgia is comparable to approved medications – without side effects. The multimodal approach with EDA + HRV + respiration rate shows synergistic effects. Relevant for combining different biofeedback sensors.