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Neuroimaging-Guided TMS&#8211;EEG for Real-Time Cortical Network Mapping
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EEG Neurofeedback for Major Depressive Disorder: A Scoping Review.

Dan Cătălin Oprea1,2, Jonathan Rabinowitz1,3, Bogdan Gireadă1,2

  • 1Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania.

Alpha Psychiatry
|July 8, 2026
PubMed
Summary
This summary is machine-generated.

Electroencephalography-based neurofeedback (EEG-NF) shows promise for treating Major Depressive Disorder (MDD) by enabling self-regulation of brain activity. However, varied protocols and methodological limitations necessitate further standardized research.

Keywords:
biofeedbackdepressive disorderelectroencephalographyendogenous depressionsmajor depressive disorderneurofeedback

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Area of Science:

  • Neuroscience
  • Clinical Psychology
  • Biomedical Engineering

Background:

  • Major Depressive Disorder (MDD) is a prevalent mental health condition with complex neurobiological underpinnings.
  • Neurofeedback (NF) offers a non-invasive approach to train self-regulation of brain activity, potentially addressing cognitive and emotional dysfunctions in MDD.
  • Current research on EEG-based NF for MDD is growing but lacks standardized protocols and shows variable results.

Purpose of the Study:

  • To systematically map and synthesize existing peer-reviewed evidence on electroencephalography (EEG)-based neurofeedback interventions for MDD.
  • To focus on training protocols, neurophysiological targets, clinical outcomes, and methodological limitations of these interventions.
  • To identify gaps and guide future research directions in this emerging treatment area.

Main Methods:

  • A systematic scoping review was conducted following PRISMA-ScR guidelines.
  • Searches were performed across Embase, PubMed, Web of Science, and ClinicalTrials.gov.
  • Eleven studies involving 175 adult patients with MDD receiving active EEG-NF were included.

Main Results:

  • A reduction in depressive symptoms was observed across studies, with frontal alpha asymmetry protocols being most common.
  • Four studies reported potential cognitive performance improvements, particularly with upper-alpha or beta/theta modulation.
  • Connectivity-based LORETA neurofeedback showed possible effects on deep brain networks, but replication is limited.

Conclusions:

  • EEG-based neurofeedback demonstrates potential as an intervention for MDD, with preliminary evidence supporting symptom reduction and cognitive benefits.
  • Significant methodological limitations and heterogeneity in protocols, targets, and outcomes were identified.
  • More rigorous, standardized, and longitudinal research is crucial to establish the efficacy and clinical utility of EEG-NF for MDD treatment.