Frontiers in psychiatry
Clinical and resting-state EEG changes following neurofeedback in adult refugees with persistent trauma-related symptoms: a transdiagnostic pre-post observational study
By Askovic M, Mascelloni M, Murdoch S and 3 others.
Abstract
Background
Neurofeedback has shown promise as an adjunctive intervention for persistent trauma-related psychopathology, but its electrophysiological effects in refugees following war, torture, and forced displacement remain poorly understood. This study investigated changes in resting-state alpha electrophysiology during trauma treatment incorporating individualised neurofeedback and whether these changes related to clinical improvement.
Methods
This retrospective pre-post observational study included 53 adult refugees with persistent trauma-related symptoms who completed resting-state electroencephalography (EEG) before and after multidisciplinary treatment incorporating neurofeedback, trauma-focused counselling and pharmacotherapy. Participants received a mean of 38.7 neurofeedback sessions after remaining symptomatic despite previous treatment. Clinical improvement was assessed retrospectively using the Clinical Global Impression-Improvement (CGI-I) scale. Resting-state EEG analyses examined changes in global alpha amplitude, alpha reactivity, peak alpha frequency (PAF), and alpha coherence. Neurofeedback protocol implementation was characterised across 2,361 protocol applications, and secondary analyses examined electrophysiological differences between responders and non-responders and associations between electrophysiological and clinical change.



