Patients with mental health disorders usually require pharmacological and/or psychological interventions such as cognitive-behavioral therapy. However, patients may not have easy access to such treatments, especially for those living in rural areas, or may not respond well to them. For example, approximately two-thirds of patients with major depressive disorder do not have adequate responses to pharmacological and/or psychological interventions. Biofeedback therapies are non-pharmacological treatments that use non-invasive electrical devices with bio-monitoring system and sensors to measure, amplify and feed back information primarily from nervous system processes such as respiration, heart rate, muscle tension, skin temperature, blood flow and blood pressure, to the individual being monitored, thus promoting awareness of these processes in an individual to assist with gaining voluntary control over body and mind. Neurofeedback is a specific form of biofeedback that monitors central nervous system activity via the measurement and regulation of brainwave activity from electrodes placed on the scalp. Training with neurofeedback aims to enable the individual to modify patterns of cortical activity and normalize brain activity. In general, biofeedback and neurofeedback are designed to increase patients’ coping skills for their current situations, and usually multiple sessions of treatment are required.

This report was undertaken to update a previous summary of the evidence on the clinical effectiveness and safety of neurofeedback and biofeedback which was completed in 2012. In that report, findings from preliminary analyses raised the possibility that biofeedback and neurofeedback may have a potential for the treatment of post-traumatic stress disorder (PTSD), generalized anxiety disorder (GAD) or depression.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Strategy
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX 1 Selection of Included Studies
• APPENDIX 2 Characteristics of Included Studies
• APPENDIX 3 Summary of Critical Appraisal of Included Studies
• Appendix 4 Main Study Findings and Authors’ Conclusions

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.