The efficacy of virtual reality-based EEG neurofeedback in health-related symptoms relief: a systematic review

EEG Neurofeedback is a noninvasive therapeutic modality that can potentially modify targeted aspects of brain function, considered promising for the treatment of neuropsychiatric disorders. Nevertheless, some limitations have considerable potential to compromise its efficacy, including the requirement for a high number of sessions, the repetition of therapeutic tasks, and the challenge in sustaining the objectives of these tasks. These limitations can induce a decline in system dynamism and user motivation. However, barriers can be overcome by integrating immersive virtual reality into a neurofeedback system to increase motivation, interest, and adherence through immersion and a sense of presence. This systematic review aimed to determine whether this combined treatment is effective in relieving symptoms related to general health. To conduct this search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, six electronic databases were accessed on January 26, 2024. Inclusion and exclusion criteria were defined to select the articles, and risk of bias and methodological quality assessment was conducted using the Mixed Methods Appraisal Tool and the CRED-nf checklist. A total of 24 trials were included, and according to Template for Developing Guidelines for the Evaluation of the Clinical Efficacy of Psychophysiological Interventions, the results showed that it was considered a probably efficacious treatment for attention and a possibly efficacious treatment for emotions, mood, pain, relaxation, impulsiveness, memory, self-esteem, creativity, empathy, meditation, and tiredness. Several methodological factors of the trials restrict the generalization of these findings and require caution in their interpretation, despite the promising results in future directions.