The Effects of Neurofeedback Training on Depressive Disorders: A Narrative Review

Abstract

Neurofeedback (NFB) represents an emerging non-invasive technique for treating psychiatric disorders enabling the individuals to monitor and modify brainwave patterns through brain-computer interfaces based on electroencephalography (EEG) principle. This mechanism leverages neuroplasticity that reveals the capacity of the brain to reorganize neural pathways and also facilitate lasting improvements in mental health conditions. Major Depressive Disorder (MDD), shows neurobiological aberrations such as frontal alpha asymmetry and limbic system dysregulation which provides specific targets for neurofeedback interventions. While traditional therapies including pharmacological interventions and electroconvulsive therapy (ECT) are commonly employed, neurofeedback offers a promising adjunct or alternative, especially for populations hesitant about medication use. This review synthesizes findings from 15 rigorous clinical trials between 2008 and 2024, spanning multiple countries, to evaluate the efficacy of neurofeedback training in depression. The evidence indicates that specific NFB protocols includes alpha wave asymmetry training, beta reinforcement, and targeting peak alpha frequency that can significantly decrease the symptoms of depressive disorders such as fatigue, rumination, and anxiety whereas it can improve executive functioning and quality of life. Neurofeedback demonstrates specific potential in treatment-resistant depression and comorbid conditions such as multiple sclerosis. Most studies report clinically meaningful improvements sustained at follow-up, although limited sample sizes and varying methodologies temper conclusions. The findings of the study highlight the importance of tailored neurofeedback protocols aligned with neurophysiological targets.