EEG Neurofeedback for Attention and Executive Functions in Intellectual Disability: A Systematic Review of Treatment...

Background: EEG neurofeedback has been proposed as a non-pharmacological approach to enhance attention and cognitive performance in neurodevelopmental conditions. However, its efficacy in individuals with intellectual disability (ID) remains limited. Methods: We conducted a systematic review of treatment studies evaluating EEG-based neurofeedback targeting attention and executive function outcomes in participants with ID. Searches were performed in Embase, Web of Science, Scopus, PubMed, and the Cochrane Library from inception to 12 March 2026. Two reviewers independently completed screening, eligibility assessment, data extraction, and risk-of-bias appraisal, with disagreements resolved by a third reviewer. Due to heterogeneity in study designs, neurofeedback protocols, participant characteristics, and outcome measures, data were synthesized narratively. Results: Six studies met the inclusion criteria, comprising small randomized or controlled experimental studies, case series, and single-case reports. Several studies suggested improvements in attention-related neuropsychological performance and behavioral or task-based outcomes, and in some cases were accompanied by parallel EEG changes. Nevertheless, the overall body of evidence was constrained by small sample sizes, heterogeneous populations, limited blinding, infrequent sham or active controls, variable follow-up durations, and incomplete effect-size reporting. Conclusions: EEG neurofeedback appears to confer benefits for attention-related outcomes in individuals with ID, but current findings are preliminary and warrant larger, well-controlled trials with standardized protocols and reporting.