Self-Guided Beta-Responsive Visual Neurofeedback in a Public Exhibition: Feasibility and Usability Randomized Controlled rial

Neurofeedback is studied for stress and anxiety regulation, but most systems require supervision or research-grade equipment. Consumer electroencephalography (EEG) could broaden access, yet autonomous first-contact feasibility, usability, and baseline neural-state effects remain unclear.

We assessed autonomous completion and usability, tested whether a fixed breathing pacer improved outcomes over visual neurofeedback alone, and explored whether pretask resting beta was associated with usability.

We conducted a single-session, 2-arm randomized feasibility and usability trial at a public science exhibition in Bern, Switzerland, between March and June 2025. Eligible adults were aged 18 years or older, could read German or French, and reported no epilepsy or implanted electronic device. A tablet app guided participants without experimenter assistance through consent, setup, a 30-second eyes-closed baseline, 1:1 randomization, a 120-second beta-responsive task, and questionnaires. The final analytic sample included participants assigned to visual neurofeedback only (VN; n=27) or visual neurofeedback plus a 6 breaths/minute breathing pacer (VN+BP; n=25). Outcomes were usability, relaxation, and state mindfulness. Data were collected prospectively; no secondary data were used. Analyses used Mann-Whitney U, chi-square, Spearman, and permutation tests (2-sided, α=.05); EEG outcome and item analyses were exploratory.

Of 110 visitors initiating a session, 79 completed the task with a valid EEG recording (71.8%, 95% CI 62.8-79.4) and 52 met analytic criteria (47.3%, 95% CI 38.2%-56.5%). Participants (35 women) had a mean age of 39.0 (SD 11.3) years. Usability was good (System Usability Scale [SUS] mean 72.3, SD 14.7; 95% CI 68.3-76.2), and 31/52 participants scored at least 68 (59.6%, 95% CI 46.1%-71.8%). Usability did not differ between VN and VN+BP (median 75.0, IQR 62.5-81.3 vs median 72.5, IQR 65.0-90.0; Mann-Whitney U=362.5, P=.65; rank-biserial r=-0.07, 95% CI -0.39 to 0.25). Relaxation (median 63.0, IQR 50.0-80.0 vs median 61.0, IQR 50.0-67.0; Mann-Whitney U=276.5, P=.27; r=0.18, 95% CI -0.14 to 0.49) and mindfulness (median 2.4, IQR 2.1-2.8 vs median 2.5, IQR 2.0-3.2; Mann-Whitney U=346.5, P=.68; r=-0.07, 95% CI -0.39 to 0.26) did not differ. Higher resting beta was associated with lower SUS before correction (Spearman ρ=-0.31, 95% CI -0.54 to -0.04; raw P=.03), but not after Benjamini-Hochberg correction (adjusted P=.30). SUS item analyses showed a global pattern (permutation P=.02), strongest for functional integration (ρ=-0.43, 95% CI -0.63 to -0.18; Holm-adjusted P=.01).

This trial evaluated an autonomous consumer-EEG neurofeedback system integrating self-fitting, signal-quality checking, baseline calibration, adaptive feedback, randomization, and self-report without operator support. Many first-time users completed the autonomous workflow with acceptable-to-good usability; a fixed, open-loop breathing pacer did not improve usability, relaxation, or state mindfulness; and higher resting beta showed a preliminary association with lower perceived usability. These findings support autonomous consumer-EEG neurofeedback and motivate work on adaptive onboarding, validated EEG pipelines, and objective self-regulation outcomes.