The efficacy of neurofeedback treatment on positive and negative symptoms in schizophrenia: a systematic review

Schizophrenia is a complex and severe psychotic disorder characterized by positive symptoms (delusions, hallucinations, and disorganization of thought and behavior), negative symptoms (diminished emotional expression, avolition, alogia, anhedonia, and asociality) and significant cognitive defects (memory, executive function, and attention). Despite optimal pharmacological treatments, up to one-half of the schizophrenia patients remain relatively or actively psychotic.  Although, new progresses in computational neurobiology have enhanced interest in neurofeedback (NF), a form of self-regulation or neuromodulation, in potentially decreasing cognitive symptoms in schizophrenia patients. In this systematic review, we investigated the effectiveness of NF on positive and negative symptoms in schizophrenia patients by reviewing the current body of researches. Following the PRISMA guidelines, databases were searched from inception through to ۳۰ April ۲۰۲۳. We identified ۱۳ studies (including a total of ۲۰۹ schizophrenia cases and ۷۰ controls) that met inclusion criteria, of which ۶ used the electroencephalography NF (EEG NF), ۵ used the real-time functional magnetic resonance imaging NF (rt-fMRI NF), one of the studies used hemoencephalography (HEG) and one study used functional near-infrared spectroscopy (fNIRS). Our results indicated that NF studies until now comprised of case studies and small sample, single-group studies, and a few randomized clinical trials. In summary, the different NF approaches are feasible and lead to measurable changes in brain function and symptoms improvement. The future studies need to be larger, randomized clinical trials and testing the efficacy of NF comparing well thought out placebos.

کلیدواژه ها:

neurofeedback ، schizophrenia ، treatment ، EEG ، rt-fMRI ، self-regulation.