Predictors of neurofeedback training outcome: A systematic review

Neurofeedback (NF), a training tool aimed at enhancing neural self-regulation, has been suggested as a complementary treatment option for neuropsychiatric disorders. Despite its potential as a neurobiological intervention directly targeting neural alterations underlying clinical symptoms, the efficacy of NF for the treatment of mental disorders has been questioned recently by negative findings obtained in randomized controlled trials (e.g., Cortese et al., 2016). A possible reason for insufficient group effects of NF trainings vs. placebo could be related to the high rate of participants who fail to self-regulate brain activity by NF ("non-learners"). Another reason could be the application of standardized NF protocols not adjusted to individual differences in pathophysiology. Against this background, we have summarized information on factors determining training and treatment success to provide a basis for the development of individualized training protocols and/or clinical indications. The present systematic review included 25 reports investigating predictors for the outcome of NF trainings in healthy individuals as well as patients affected by mental disorders or epilepsy. We selected these studies based on searches in EBSCOhost using combinations of the keywords "neurofeedback" and "predictor/predictors". As "NF training" we defined all NF applications with at least two sessions. The best available evidence exists for neurophysiological baseline parameters. Among them, the target parameters of the respective training seem to be of particular importance. However, particularities of the different experimental designs and outcome criteria restrict the interpretability of some of the information we extracted. Therefore, further research is needed to gain more profound knowledge about predictors of NF outcome.