Neurofeedback with low-cost, wearable electroencephalography (EEG) reduces symptoms in chronic Post-Traumatic Stress Disorder

Background : The study examines the effectiveness of both neurofeedback and motor-imagery brain-computer interface (BCI) training, which promotes self-regulation of brain activity, using low-cost electroencephalography (EEG)-based wearable neurotechnology outside a clinical setting, as a potential treatment for post-traumatic stress disorder (PTSD) in Rwanda. Methods : Participants received training/treatment sessions along with a pre- and post- intervention clinical assessment, (N = 29; control n = 9, neurofeedback (NF, 7 sessions) n = 10, and motor-imagery (MI, 6 sessions) n = 10). Feedback was presented visually via a game. Participants were asked to regulate (NF) or intentionally modulate (MI) brain activity to affect/control the game. Results : The NF group demonstrated an increase in resting-state alpha (8-12Hz) bandpower following individual training sessions, termed alpha ‘rebound’ (Pz channel, p = 0.025, all channels, p = 0.024), consistent with previous research findings. This alpha ‘rebound’, unobserved in the BCI group, produced a clinically relevant reduction in symptom severity in NF group, as revealed in four of seven clinical outcome measures: PCL-5 (p = 0.005), PTSD screen (p = 0.005), HTQ (p = 0.005), and CD-RISC (p = 0.041). Limitations : Data collection took place in environments that posed difficulties in controlling environmental factors. Nevertheless, this limitation improves ecological validity, as neurotechnology treatments must be deployable outside controlled environments, to be a feasible technological treatment. Conclusions : The study produced the first evidence to support low-cost, neurotechnological solution for neurofeedback as an effective treatment of PTSD for victims of acute trauma in conflict zones in a developing country.