Effectiveness, cost-utility, and safety of neurofeedback self-regulating training in patients with post-traumatic stress disorder: a randomized controlled trial
Open accessAbstract
Post-traumatic stress disorder (PTSD) is characterized by neurophysiological and psycho-emotional problems after exposure to trauma. Several pharmacological and psychotherapy limitations, such as adverse events and low adherence, increase the need for alternative therapeutic options. Neurofeedback is widely used for PTSD management. However, evidence of its clinical efficacy is lacking. We conducted a randomized, waitlist-controlled, assessor-blinded clinical trial to assess the effectiveness, cost-utility, and safety of 16 sessions of neurofeedback on people with PTSD for eight weeks. Eleven participants were allocated to each group. One and two subjects dropped out from the neurofeedback and control groups, respectively. The primary outcome was PTSD symptom change evaluated using the PTSD Checklist-5 (PCL-5-K). The PCL-5-K levels improved more in the neurofeedback group (44.3 ± 10.8 to 19.4 ± 7.75) than in the control group (35.1 ± 18.5 to 31.0 ± 14.92). The change value was significantly improved in the neurofeedback group (24.90 ± 13.13 vs. 4.11 ± 9.03). Secondary outcomes such as anxiety, depression, insomnia, and quality of life were also improved. In an economic analysis using EuroQol-5D, the incremental cost-per-quality-adjusted life-year was approximately $15,600, indicating acceptable cost-utility. There were no adverse events in either group. In conclusion, neurofeedback might be a useful, cost-effective, and safe intervention for PTSD management.
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Previous studies demonstrated significant success with a frequency of two sessions per week.
“This is based on previous studies that demonstrated significant success with a frequency of two sessions per week.24–26”
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Cites
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407 · see citing works
Validation of the Insomnia Severity Index as an outcome measure for insomnia research
Bastien, C. (2001) · Sleep Medicine · doi:10.1016/s1389-9457(00)00065-4 · Cited by 8,067 · see citing works
Boutron, I., Altman, D. G., Moher, D., Schulz, K. F., Ravaud, P., & for the CONSORT NPT Group* (2017) · Annals of Internal Medicine · doi:10.7326/m17-0046 · Cited by 1,538 · see citing works
Measuring and Valuing Health Benefits for Economic Evaluation
Brazier, J. E., Ratcliffe, J., Salomon, J. A., & Tsuchiya, A. (2016) · Oxford University Press eBooks · doi:10.1093/med/9780198725923.001.0001 · Cited by 1,051 · see citing works
SSRI Antidepressant Medications: Adverse Effects and Tolerability
Ferguson, J. M. (2001) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.v03n0105 · Cited by 669 · cited 1× · see citing works
“However, it is well known that long-term SSRI therapy is associated with several adverse events such as sexual dysfunction, sleep disturbance, and weight gain [9].”
BackgroundSmith, T. C., Ryan, M. A. K., Wingard, D. L., Slymen, D. J., Sallis, J. F., & Kritz‐Silverstein, D. C. (2008) · BMJ · doi:10.1136/bmj.39430.638241.ae · Cited by 631 · see citing works
Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions
Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2018.00258 · Cited by 563 · see citing works
Marzbani, H., Marateb, H., & Mansourian, M. (2016) · Basic and Clinical Neuroscience Journal · doi:10.15412/j.bcn.03070208 · Cited by 484 · see citing works
Epidemiology of posttraumatic stress disorder
Atwoli, L., Stein, D. J., Koenen, K. C., & McLaughlin, K. A. (2015) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000167 · Cited by 426 · see citing works
Scoring the SF-36 in Orthopaedics: A Brief Guide
Laucis, N. C., Hays, R. D., & Bhattacharyya, T. (2015) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.o.00030 · Cited by 420 · see citing works
Lewis, C., Roberts, N. P., Gibson, S., & Bisson, J. I. (2020) · European Journal of Psychotraumatology · doi:10.1080/20008198.2019.1709709 · Cited by 382 · see citing works
Sleep Disturbances in Patients with Post-Traumatic Stress Disorder
Maher, M. J., Rego, S. A., & Asnis, G. M. (2006) · CNS Drugs · doi:10.2165/00023210-200620070-00003 · Cited by 337 · see citing works
Posttraumatic Stress Disorder and Completed Suicide
Gradus, J. L., Qin, P., Lincoln, A. K., Miller, M., Lawler, E. V., Sørensen, H. T., & Lash, T. L. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwp456 · Cited by 315 · see citing works
Kim, M., Cho, Y.-S., Uhm, W.-S., Kim, S., & Bae, S. (2005) · Quality of Life Research · doi:10.1007/s11136-004-5681-z · Cited by 309 · see citing works
Abbreviated PTSD Checklist (PCL) as a guide to clinical response
Lang, A. J., Wilkins, K., Roy-Byrne, P. P., Golinelli, D., Chavira, D., Sherbourne, C., Rose, R. D., Bystritsky, A., Sullivan, G., Craske, M. G., et al. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.02.003 · Cited by 280 · see citing works
Ros, T., Théberge, J., Frewen, P., Kluetsch, R. C., Densmore, M., Calhoun, V. D., & Lanius, R. A. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2012.09.046 · Cited by 251 · see citing works
Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment
Lancaster, C. L., Teeters, J. B., Gros, D., & Back, S. E. (2016) · Journal of Clinical Medicine · doi:10.3390/jcm5110105 · Cited by 225 · see citing works
A Study on Reliability and Validity of the Korean Version of Impact of Event Scale-Revised
Eun, H. J., Kwon, T. W., Lee, S., Kim, T. H., Choi, M. R., & Cho, S. J. (2005) · Cited by 183 · see citing works
Self-citationA Randomized Controlled Study of Neurofeedback for Chronic PTSD
van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R. M., Suvak, M. K., Hamlin, E., & Spinazzola, J. (2016) · PLoS ONE · doi:10.1371/journal.pone.0166752 · Cited by 174 · see citing works
Scott, K. M., Koenen, K. C., Aguilar‐Gaxiola, S., Alonso, J., Angermeyer, M. C., Benjet, C. L., Bruffaerts, R., Caldas‐de‐Almeida, J. M., de Girolamo, G., Florescu, S., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0080573 · Cited by 165 · see citing works
Neurofeedback Training Induces Changes in White and Gray Matter
Ghaziri, J., Tucholka, A., Larue, V., Blanchette-Sylvestre, M., Reyburn, G., Gilbert, G., Lévesque, J., & Beauregard, M. (2013) · Clinical EEG and Neuroscience · doi:10.1177/1550059413476031 · Cited by 155 · see citing works
(1991) · Cited by 149 · see citing works
Ferguson, L., & Scheman, J. (2009) · Journal of Pain · doi:10.1016/j.jpain.2009.01.258 · Cited by 143 · see citing works
Economic Evaluation Enhances Public Health Decision Making
Rabarison, K. M., Bish, C. L., Massoudi, M. S., & Giles, W. H. (2015) · Frontiers in Public Health · doi:10.3389/fpubh.2015.00164 · Cited by 126 · see citing works
Yoga for posttraumatic stress disorder-a systematic review and meta-analysis
Cramer, H., Anheyer, D., Saha, F. J., & Dobos, G. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1650-x · Cited by 126 · see citing works
Chiba, T., Kanazawa, T., Koizumi, A., Ide, K., Taschereau‐Dumouchel, V., Boku, S., Hishimoto, A., Shirakawa, M. N., Sora, I., Lau, H. C., et al. (2019) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2019.00233 · Cited by 97 · see citing works
Reliability and validity of the Korean version of the Impact of Event Scale-Revised
Lim, H. K., Woo, J., Kim, T., Kim, T., Choi, K., Chung, S., Chee, I., Lee, K., Paik, K. C., Seo, H., et al. (2008) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2008.09.011 · Cited by 94 · see citing works
Neurofeedback Treatment and Posttraumatic Stress Disorder
Reiter, K., Andersen, S. B., & Carlsson, J. M. (2016) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000418 · Cited by 78 · see citing works
Stefanovics, E. A., Rosenheck, R. A., Jones, K. M., Huang, G., & Krystal, J. H. (2018) · Psychiatric Quarterly · doi:10.1007/s11126-017-9522-y · Cited by 74 · see citing works
Aliev, G. M., Beeraka, N. M., Nikolenko, V. N., Svistunov, A. А., Rozhnova, T., Kostyuk, S. V., Cherkesov, I. V., Владимировна, Г. Л., Chekhonatsky, A. A., Михалева, Л. М., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9092951 · Cited by 71 · see citing works
Symptoms to Use for Diagnostic Criteria of Hwa-Byung, an Anger Syndrome
Min, S. K., Suh, S.-Y., & Song, K. (2009) · Psychiatry Investigation · doi:10.4306/pi.2009.6.1.7 · Cited by 65 · see citing works
Bothe, T., Jacob, J., Kröger, C. B., & Walker, J. (2020) · The European Journal of Health Economics · doi:10.1007/s10198-020-01184-x · Cited by 64 · see citing works
Development and validation of the Hwa-Byung Scale
Kwon, J.-H., Lee, M.-S., Kim, J., 권호인, Park, D.-K., & Min, S. K. (2008) · Korean Journal of Clinical Psychology · doi:10.15842/kjcp.2008.27.1.014 · Cited by 59 · see citing works
Steingrímsson, S., Bilonic, G., Ekelund, A.-C., Larson, T., Stadig, I., Svensson, M., Vuković, I. S., Wartenberg, C., Wrede, O., & Bernhardsson, S. (2020) · European Psychiatry · doi:10.1192/j.eurpsy.2019.7 · Cited by 49 · see citing works
Predictors of Sexual Dysfunction in Veterans with Post-Traumatic Stress Disorder
Crepulja, M. L., Stevanović, A., Protuđer, M., Popović, B., Salopek-Žiha, D., & Vondraček, S. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8040432 · Cited by 42 · see citing works
Clinical causality assessment for adverse drug reactions
Parida, S. (2013) · Indian Journal of Anaesthesia · doi:10.4103/0019-5049.115608 · Cited by 31 · see citing works
김종원, 정혜경, 최진희, et al. (2017) · Anxiety and Mood · doi:10.24986/anxmod.2017.13.2.010 · Cited by 30 · see citing works
Noohi, S., Miraghaie, A. M., Arabi, A., & Nooripour, R. (2017) · Biomedical Research-tokyo · Cited by 21 · see citing works
Kim, W., Jung, Y., Roh, D. D., Kim, D., Kang, S.-H., Chae, J., & Park, J. E. (2019) · Journal of Korean Medical Science · doi:10.3346/jkms.2019.34.e219 · Cited by 21 · see citing works
Leem, J., Cheong, M. J., Yoon, S.-H., Kim, H., Jo, H.-G., Lee, H., Kim, J., Kim, H. Y., Kim, G.-W., & Kang, H.-W. (2020) · Integrative Medicine Research · doi:10.1016/j.imr.2020.100464 · Cited by 21 · see citing works
Self-citationMills, K. L., Barrett, E. L., Merz, S., Rosenfeld, J., Ewer, P. L., Sannibale, C., Baker, A., Hopwood, S., Back, S. E., Brady, K. T., et al. (2016) · Journal of Clinical Medicine · doi:10.3390/jcm5110101 · Cited by 19 · see citing works
Validation of the Core Seven-Emotions Inventory – short form
Cheong, M. J., Lee, G., Lee, Y., et al. (2019) · Integrative Medicine Research · doi:10.1016/j.imr.2019.04.003 · Cited by 14 · see citing works
Self-citationLee, G., Park, B., Moon, K., et al. (2015) · Journal of Oriental Neuropsychiatry · doi:10.7231/jon.2015.26.2.143 · Cited by 12 · see citing works
Kim, J., Sue, J.-H., Lee, G., Kim, N.-K., Choi, S.-Y., Lyu, Y.-S., & Kang, H.-W. (2015) · Journal of Oriental Neuropsychiatry · doi:10.7231/jon.2015.26.1.049 · Cited by 8 · see citing works
Self-citationDiagnosis and pathophysiology of Posttraumatic stress disorder(PTSD)
채정호 (2004) · Cited by 6 · see citing works
Cho, E., Yoo, S.-L., Kang, Y.-J., et al. (2020) · Regenerative Medicine · doi:10.2217/rme-2020-0035 · Cited by 6 · see citing works
Self-citation
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Research works printed but not linked: 2
- [16]First M.B. Structured Clinical Interview for the DSM (SCID) Available online: https://onlinelibrary.wiley.com/doi/book/10.1002/9781118625392 (accessed on 29 December 2014) · DOI
- [46]Kelson C.Y. The Impact of EEG Biofeedback on Veterans’ Symptoms of Posttraumatic Stress Disorder (PTSD)—ProQuest Ph.D. Thesis The Chicago School of Professional Psychology Chicago, IL, USA 2013
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Schmidt, K. L., Kowalski, A., Schweda, A., Dörrie, N., Skoda, E. M., Bäuerle, A., & Teufel, M. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-079098 · Cited by 3 · see citing works
- Authors
- Leem, J., Cheong, M. J., Lee, H., Cho, E., Lee, S. Y., Kim, G.-W., & Kang, H. W.
- Affiliations
- Wonkwang University (KR)
- Sookmyung Women's University (KR)
- Dongguk University Bundang Oriental Hospital (KR)
- Corresponding author
- Kim, Geun-Woo
- Kang, Hyung Won
- Venue
- Healthcare
- Publisher
- MDPI AG
- Published
- 2021-10-11
- Volume
- 9
- Issue
- 10
- Pages
- 1351
- ISSN
- 2227-9032 (ISSN-L)
- PMC
- PMC8544423
- OpenAlex
- W3205870723
- Cited by
- 23
- References
- 46
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 5 · 2023: 3 · 2022: 1
- FWCI
- 1.53
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Healthcare (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Korea Health Industry Development Institute (HB16C0021)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- neurofeedback, post-traumatic stress disorder, self-regulation training, cost-utility analysis, quality-adjusted life years, PTSD symptom severity, anxiety, depression, insomnia, quality of life, treatment safety, non-pharmacological treatment
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