Clinical and resting-state EEG changes following neurofeedback in adult refugees with persistent trauma-related symptoms: a transdiagnostic pre–post observational study

About six in ten participants were rated as meaningfully improved during multidisciplinary care that included individualized neurofeedback. Because counseling, medication and other supports were delivered alongside neurofeedback, the study cannot show which part of care caused the change.

Askovic M, Mascelloni M, Murdoch S, Aroche J, Hamlin ED, Harris AWF.
Frontiers in Psychiatry · Publication date: 2026-10-07
Added to site: 2026-10-10
DOI: 10.3389/fpsyt.2026.1954165

Published October 7, 2026. Added to Neurofeedback.com October 10, 2026 after full-text review.

Modalities

Neurofeedback, EEG

Clinical focus

Persistent trauma-related symptoms, Refugee mental health

Population

Adult refugees with persistent trauma-related symptoms who had remained symptomatic despite previous treatment

Sample

53 adults with complete pre- and post-treatment EEG and clinical outcome data

Intervention / method

Individualized neurofeedback within multidisciplinary care that also included trauma-focused counseling, psychiatric management and psychosocial support; mean 38.7 neurofeedback sessions and 2,361 protocol applications

Comparator

Within-person pre- to post-treatment comparison; no control group

Clinician summary

Thirty-three of 53 participants, or 62.3%, met the retrospective CGI-I improvement threshold. Global alpha amplitude increased and occipital alpha reactivity decreased after false-discovery adjustment, while peak alpha frequency and coherence did not. EEG change was not significantly associated with clinical improvement, and responder versus nonresponder alpha patterns did not differ significantly.

How to interpret the findings

The study was retrospective, uncontrolled and based on routine care with concurrent interventions, so it cannot establish neurofeedback efficacy or causality. CGI-I ratings were retrospective, treatment protocols varied, pre- and post-recording times were not systematically matched, caffeine and nicotine were not restricted, and the modest cohort limited subgroup analyses. The cohort substantially overlapped with an earlier clinical report.

Equipment and disclosures

Resting EEG used a Mitsar-201 amplifier with 19 electrodes. Neurofeedback equipment and individualized protocol details varied; no product endorsement or sponsor-equipment attribution is made.

The authors reported no direct financial support for the work. Anthony W. F. Harris disclosed consultancy fees from Boehringer Ingelheim, Medical Research Future Fund support, an investigator role in an Arialys-sponsored trial and nonprofit governance roles; the other authors declared no relevant commercial or financial relationships. The authors reported using ChatGPT for language, formatting and organizational assistance while retaining responsibility for scientific content and decisions.

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