Background: Neurofeedback (NFB) is a technique based on the principle of operant conditioning. It consists of modeling brain activity patterns to those considered to be deleterious to the organism to improve cognitive performance. Objective: This systematic review aims to present the neurofeedback field overview and results of empirical studies that tested the effects of neurofeedback training on cognitive performance in healthy subjects. Method: A systematic review of neurofeedback studies to increase cognitive performance in healthy subjects available on the Web of Science, BVSalud, PsycINFO, Redalyc, and Scielo databases, published between 2014 and 2020, was carried out. Initially, 192 articles were localized, of which 47 articles were included in order to present the general field overview, 34 empirical studies were included to discuss protocols and outcomes, and 18 trials were included to describe between-subjects effect size. Results: A contemporary trend toward the use of neurofeedback as a tool to improve cognition besides rehabilitation in healthy young adults, older adults, athletes, and the elderly was observed. Neurofeedback training had a large effect on working memory (WM), mood, and sleep quality; a medium to large effect on executive functions; a general medium effect size alongside a wider variation from low to large effect on attention. Conclusions: Although neurofeedback training studies showed promising results, not all studies found significant changes in electroencephalogram (EEG) signals that seemed to be linked to behavioral tests. This raises the question of causality relation between changes in brain activity and behavioral outcomes.
Public Significance StatementThe present study provides a systematic review of researches that tested the effects of neurofeedback training on cognitive performance in healthy subjects. There is a fertile contemporary trend toward the use of neurofeedback as a tool to improve cognition besides rehabilitation. Neurofeedback training has shown to be a useful technique to modulate brain activity as well as improve attention, working memory, mood, executive functions and sleep quality.