Exploring the Effects of Z-Score Neurofeedback Training in PTSD: A Preliminary Investigation

Neurofeedback, a form of biofeedback using electroencephalography, enables individuals to self-regulate brain activity through operant conditioning. This technique shows promise as a non-invasive intervention for neuropsychiatric disorders like post-traumatic stress disorder (PTSD) and may improve cognitive functions such as attention and working memory. However, limited research, particularly using Z-Score neurofeedback, exists on its effects on PTSD-related symptoms, cognitive function, and identifying treatment-specific EEG markers. In this study, twenty-one individuals diagnosed with PTSD (17 females; mean age = 26.02 [SD = 9.51]) received a diagnostic interview using the MINI Neuropsychiatric Interview and completed self-report measures on PTSD, depression, and insomnia symptoms. Participants completed 5-min eyes-open and eyes-closed EEG recordings and received 10 20-min Z-scoring neurofeedback sessions. Results indicated significant reductions in PTSD and insomnia symptoms, with the most pronounced effects observed in intrusion, negative alterations in cognition and mood, and arousal/reactivity symptoms. Additionally, executive attention improved post-treatment. Alterations in cognition and mood were negatively correlated with alpha power globally and positively correlated with beta power in the parietal region. Beta power at T3 significantly decreased following neurofeedback training. These findings provide further support for neurofeedback as a viable intervention for PTSD, with implications for both symptom reduction and cognitive enhancement. Future studies are needed to investigate individual differences in treatment response and assess long-term outcomes to improve the clinical applicability of this approach.