Neurofeedback with low-cost, wearable electroencephalography (EEG) reduces symptoms in chronic Post-Traumatic Stress Disorder

Naomi Du Bois, Alain Desire Bigirimana, Attila Korik, Lisette Gaju Kéthina, Eugène Rutembesa, Jean Mutabaruka, Leon Mutesa, Girijesh Prasad, Stefan Jansen, Damien Coyle

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)
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Background: The study examines the effectiveness of both neurofeedback and motor-imagery brain-computer interface (BCI) training, which promotes self-regulation of brain activity, using low-cost electroencephalography (EEG)-based wearable neurotechnology outside a clinical setting, as a potential treatment for post-traumatic stress disorder (PTSD) in Rwanda.
Methods: Participants received training/treatment sessions along with a pre- and post- intervention clinical assessment, (N = 29; control n = 9, neurofeedback (NF, 7 sessions) n = 10, and motor-imagery (MI, 6 sessions) n = 10). Feedback was presented visually via a videogame. Participants were asked to regulate (NF) or intentionally modulate (MI) brain activity to affect/control the game.
Results: The NF group demonstrated an increase in resting-state alpha 8–12 Hz bandpower following individual training sessions, termed alpha ‘rebound’ (Pz channel, p = 0.025, all channels, p = 0.024), consistent with previous research findings. This alpha ‘rebound’, unobserved in the MI group, produced a clinically relevant reduction in symptom severity in NF group, as revealed in three of seven clinical outcome measures: PCL-5 (p = 0.005), PTSD screen (p = 0.005), and HTQ (p = 0.005). Limitations: Data collection took place in environments that posed difficulties in controlling environmental factors. Nevertheless, this limitation improves ecological validity, as neurotechnology treatments must be deployable outside controlled environments, to be a feasible technological treatment.
Conclusions: The study produced the first evidence to support a low-cost, neurotechnological solution for neurofeedback as an effective treatment of PTSD for victims of acute trauma in conflict zones in a developing country.

Original languageEnglish
Pages (from-to)1319-1334
Number of pages16
JournalJournal of Affective Disorders
Early online date31 Aug 2021
Publication statusPublished (in print/issue) - 1 Dec 2021

Bibliographical note

Funding Information:
This research was supported by funding from the United Kingdom Research Innovation (UKRI) Global Challenges Research Fund (GCRF), under Grant 71574R. N. du Bois, A. Bigirimana, G. Prasad and D.H. Coyle were supported in part by the Northern Ireland Functional Brain Mapping Facility Project through Invest NI and the Ulster University under Grant 1303/101154803. We are grateful for access to the Tier 2 High Performance Computing resources provided by the Northern Ireland High Performance Computing (NI-HPC) facility funded by the UK Engineering and Physical Sciences Research Council (EPSRC), Grant No. EP/T022175. Damien Coyle is grateful for funding from UKRI Turing AI Fellowship 2021-2025 funded by the EPSRC (grant number EP/V025724/1). Damien Coyle is Founder, CEO and shareholder of NeuroCONCISE Ltd, the supplier of the FlexEEG wearable Neurotechnology used in this study.

Funding Information:
We would like to thank Mrs Caritas Umurerwa, Mr Vestine Mukantwali, and Mrs Immaculee Uwayezu, for their contribution to the project. Furthermore, we would like to thank all our participants, who took the time to take part in this study, at a very busy time of year (Christmas) ? some of whom had to travel quite a distance on training days.

Publisher Copyright:
© 2021


  • Electroencephalography (EEG)
  • Neurofeedback
  • Motor imagery
  • Post-traumatic stress disorder
  • Brain-computer interface (BCI)
  • Rwanda
  • Post-traumatic stress disorder (PTSD)


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