The psychology of neurofeedback: Clinical intervention even if applied placebo.

Abstract

Advocates of neurofeedback make bold claims concerning brain regulation, treatment of disorders, and mental health. Decades of research and thousands of peer-reviewed publications support neurofeedback using electroencephalography (EEG-nf); yet, few experiments isolate the act of receiving feedback from a specific brain signal as a necessary precursor to obtain the purported benefits. Moreover, while psychosocial parameters including participant motivation and expectation, rather than neurobiological substrates, seem to fuel clinical improvement across a wide range of disorders, for-profit clinics continue to sprout across North America and Europe. Here, we highlight the tenuous evidence supporting EEG-nf and sketch out the weaknesses of this approach. We challenge classic arguments often articulated by proponents of EEG-nf and underscore how psychologists and mental health professionals stand to benefit from studying the ubiquitous placebo influences that likely drive these treatment outcomes.

Perspectives on Placebo: The Psychology of Neurofeedback

“…1) It claims "ubiquitous placebo influences" of NT (Thibault & Raz, 2017). This statement is not consistent with research on placebo effects, which show only 7% overall effectiveness across different clinical conditions, only 32% of patients respond to placebos, a genetic predisposition, and a lower percentage of patient responsiveness than an effective drug (for pain).…”

Smartphone Apps in the Context of Tinnitus: Systematic Review

“…NFB is a non-invasive method, generally based on EEG recordings, which are analyzed in real-time, visualizing certain aspects of brain activity (for example, frequency band power) as a positive or negative feedback that enables users or participants to voluntarily control their brain activity patterns. While its mechanisms of action are still under scrutiny [107], NFB seems to be a viable candidate for interventions in tinnitus and other chronic diseases. Available NFB applications in the open market are primarily offered for concentration and meditation exercises and less for the medical field.…”

An artistic approach to neurofeedback for emotion regulation

“…We did not control the extent to which subjects used different strategies among themselves and over time, which can strongly influence neurofeedback performance. Moreover, from a methodological point of view, it will be necessary to establish a control condition, a critical point in any neurofeedback study, to verify whether the effect comes from the experience itself, or from other factors such as the attention given to the patient (Thibault et Raz 2017;Jean-Arthur Micoulaud-Franchi et Fovet 2018). In addition, it is well known that the placebo effect can have a significant influence on the outcome.…”

“…In addition, it is well known that the placebo effect can have a significant influence on the outcome. However, if the result is present, the use of such a method may be acceptable, even as a placebo (Thibault et Raz 2016). Finally, future evaluations will have to assess whether the artistic interface manages to keep the level of motivation of participants at a high level during repeated experiences.…”