Neurofeedback for Healthy Emotion Regulation in Youth

Overseen By Kara L Kerr, PhD

Age: Any Age

Sex: Female

Trial Phase: Academic

Sponsor: Oklahoma State University Center for Health Sciences

Must not be taking: fMRI-influencing medications

Disqualifiers: Psychiatric disorder, Neurodevelopmental delay, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 1

Duration: One hour per session

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how neurofeedback, a type of biofeedback therapy, might enhance communication between mothers and their teenage daughters, particularly during emotional conversations. Neurofeedback shows mothers a real-time visual of their daughter's brain activity and encourages them to calm it with supportive words. The study aims to determine if this method can improve emotional regulation. It may suit biological mothers and daughters who live together most of the week, with daughters aged 14-17 who can undergo an fMRI scan. As an unphased trial, this study provides a unique opportunity to explore innovative communication techniques that could strengthen mother-daughter relationships.

Will I have to stop taking my current medications?

The trial requires that adolescent participants do not take medications that influence fMRI. If you are on such medications, you may need to stop taking them to participate.

What prior data suggests that this neurofeedback protocol is safe for youth?

Research shows that neurofeedback is generally safe and well-tolerated. This treatment offers real-time feedback on brain activity, helping individuals control their brain functions. Studies have found neurofeedback safe for teenagers with emotional issues. It has also been used for conditions like ADHD and anxiety without major safety concerns.

The technology is non-invasive, requiring no surgery or implants, which typically results in fewer side effects. Overall, based on available studies, neurofeedback is considered safe, though individual experiences may vary. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about neurofeedback for healthy emotion regulation in youth because it offers a novel approach compared to traditional therapies. Unlike standard treatments that often involve medication or talk therapy, neurofeedback uses real-time fMRI to help mothers guide their daughters' emotional responses by visually representing brain activity. This method targets the anterior insula, a brain region associated with emotion regulation, and allows for direct, dynamic interaction between the mother and daughter. By focusing on modifying brain activity itself, neurofeedback has the potential to enhance emotional regulation in a more interactive and personalized way.

What evidence suggests that this neurofeedback protocol is effective for emotion regulation?

Research shows that neurofeedback, which participants in this trial may receive, can help individuals learn to control brain activity related to emotions. Studies have found that neurofeedback aids in managing brain activity, leading to improved emotional control. Specifically, neurofeedback has been linked to increased feelings of happiness and reduced sadness. It also boosts activity in certain brain areas, such as the anterior cingulate cortex, which assists in managing emotions. Overall, these findings suggest neurofeedback may effectively help young people manage their emotions better. ^{1 2 6 7 8}

Who Is on the Research Team?

Kara L Kerr, PhD

Principal Investigator

Oklahoma State University

Are You a Good Fit for This Trial?

This trial is for biological female mother-daughter pairs, where the daughter is aged 14-17 and has experienced at least two adverse childhood events. They must live together most of the week, speak English well enough to do tasks, and both be eligible for fMRI scans. Those with psychiatric disorders, neurodevelopmental delays or on medications that affect fMRI cannot participate.

Inclusion Criteria

Sufficient English fluency to complete tasks

I am a biological female.

Primary caregiver for more than 50% of child's lifespan (adult participants)

Exclusion Criteria

I am a teenager with a developmental delay.

Current or past psychiatric disorder (adolescent participants)

I am a teenager with no conditions that affect brain scans.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo real-time fMRI dyadic neurofeedback sessions with their mothers, focusing on emotion regulation tasks

One hour per session

1 visit (in-person)

Follow-up

Participants are monitored for changes in depressive symptoms, parenting behaviors, and emotion regulation over time

One year

Ecological Momentary Assessment

Adolescents complete EMA measures multiple times per day over two weeks to assess affect variability and parent-adolescent interaction quality

Two weeks

What Are the Treatments Tested in This Trial?

Interventions

• Neurofeedback

Trial Overview The study tests a new way to help young girls manage their emotions using real-time brain activity feedback (neurofeedback). Mothers will see their daughters' brain signals while talking to them and try to influence these signals positively.

How Is the Trial Designed?

Group I: Neurofeedback Group Experimental Treatment 1 Intervention

Mothers of adolescent participants will view real-time fMRI neurofeedback representing activity in their daughter's anterior insula during an emotion discussion task. Activity will be presented as a colored bar of moving height, and mothers will be instructed to attempt to downregulate the activity through what they say to their daughter.

Group II: Control Group Active Control 1 Intervention

The paradigm for the control condition will be identical to that of the experimental condition except that no neurofeedback will be presented. Participants in the control group will be told that we would like to see if the mother can regulate her daughter's brain activity through supportive statements.

Neurofeedback is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Neurofeedback for:

• Chronic low back pain
• Fibromyalgia
• Neuropathic pain

Approved in European Union as Neurofeedback for:

• Chronic pain
• Fibromyalgia
• Neuropathic pain

Approved in Canada as Neurofeedback for:

• Chronic pain
• Fibromyalgia

Who Is Running the Clinical Trial?

Oklahoma State University Center for Health Sciences

Lead Sponsor

Trials

37

Recruited

4,900+

Published Research Related to This Trial

A new two-channel EEG headband was developed that is safe, easy to attach and remove, and does not require electrode paste, making it suitable for frequent use in monitoring neurodevelopment.

Preliminary tests with a visual neurofeedback game showed age-dependent changes in brain wave activity among 30 children aged 5 to 20, suggesting potential for using this device in educational and neurocognitive development applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simplified Attachable EEG Revealed Child Development Dependent Neurofeedback Brain Acute Activities in Comparison with Visual Numerical Discrimination Task and Resting. Oda, K., Colman, R., Koshiba, M.[2022]

In a study involving 144 children aged 7 to 10 with moderate to severe ADHD, theta/beta-ratio neurofeedback (NF) did not show a significant advantage over a control treatment in reducing inattention, with both groups improving similarly over time.

While both groups reported improvements, the NF group required significantly less medication at the 13-month follow-up, suggesting a potential benefit in medication management, even though the specific efficacy of NF was not established.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Double-Blind Placebo-Controlled Randomized Clinical Trial of Neurofeedback for Attention-Deficit/Hyperactivity Disorder With 13-Month Follow-up. [2022]

Functional magnetic resonance imaging (fMRI)-based neurofeedback shows promise in helping adolescents gain control over their emotion regulation brain networks, which are still developing during this critical period.

Studies indicate that this neurofeedback approach can enhance effective emotion regulation abilities in children and adolescents, potentially aiding in the treatment of social anxiety disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Training the anxious brain: using fMRI-based neurofeedback to change brain activity in adolescence. Lipp, A., Cohen Kadosh, K.[2021]

Neurofeedback, including techniques like surface neurofeedback and advanced methods such as real-time z-score neurofeedback, shows promise in treating conditions like anxiety, mood disorders, and traumatic brain injury, particularly in children and adolescents.

The article emphasizes the need for more randomized controlled studies to establish effective clinical guidelines and to identify which patients may benefit most from neurofeedback interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quantitative EEG and neurofeedback in children and adolescents: anxiety disorders, depressive disorders, comorbid addiction and attention-deficit/hyperactivity disorder, and brain injury. Simkin, DR., Thatcher, RW., Lubar, J.[2015]

A structured neurofeedback training program using electroencephalography showed some positive effects on attentional performance in 24 children and adolescents with ADHD, particularly in reducing reaction times in attention tasks after 20 sessions.

While the results indicated improvements in attention, the effects were generally small and preliminary, highlighting the need for larger studies with control groups to better assess the efficacy of this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of a structured 20-session slow-cortical-potential-based neurofeedback program on attentional performance in children and adolescents with attention-deficit hyperactivity disorder: retrospective analysis of an open-label pilot-approach and 6-month follow-up. Albrecht, JS., Bubenzer-Busch, S., Gallien, A., et al.[2020]

The study successfully implemented the first simultaneous neurofeedback system using both real-time functional MRI (rtfMRI) and EEG, allowing participants to regulate brain activity related to emotional self-regulation.

Participants were able to control their brain activation in the left amygdala and adjust EEG power, indicating the potential of this combined approach for developing new therapies for mental disorders like depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Self-regulation of human brain activity using simultaneous real-time fMRI and EEG neurofeedback. Zotev, V., Phillips, R., Yuan, H., et al.[2013]

Real-time fMRI can help patients learn to self-regulate brain circuits related to emotion and depression, showing promise as a new approach to treating affective disorders.

Initial results from fMRI-based neurofeedback (fMRI-NF) in depression are encouraging, but further clinical trials are needed to establish its efficacy and to develop practical applications for everyday use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurofeedback and networks of depression. Linden, DE.[2021]

A novel neurofeedback protocol was tested on 34 depressed and 19 healthy adolescents, showing that neurofeedback can enhance brain activity in regions related to self-processing and emotion regulation, particularly the amygdala and hippocampus.

The study found that while depressed adolescents had different brain activity patterns compared to healthy controls during neurofeedback, the training successfully engaged brain circuits that could potentially improve emotional regulation and self-recognition in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurofeedback and neuroplasticity of visual self-processing in depressed and healthy adolescents: A preliminary study. Quevedo, K., Liu, G., Teoh, JY., et al.[2020]

In a study involving 41 children with ADHD, EEG neurofeedback did not show a significant improvement in ADHD symptoms compared to placebo neurofeedback, indicating it may not be an effective treatment option.

Both treatment groups experienced a general improvement in ADHD symptoms over time, but there were no significant differences between the groups, and no clinically relevant side effects were reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized placebo-controlled trial of electroencephalographic (EEG) neurofeedback in children with attention-deficit/hyperactivity disorder. van Dongen-Boomsma, M., Vollebregt, MA., Slaats-Willemse, D., et al.[2015]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4892319/

Neurofeedback: A Comprehensive Review on System Design ... Neurofeedback is a kind of biofeedback, which teaches self-control of brain functions to subjects by measuring brain waves and providing a feedback signal.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT03964545

Neurofeedback in Adolescents With Emotion Dysregulation With neurofeedback, patients can learn to regulate brain activation from emotion brain circuit. The technique allows neurofeedback training of sub-cortical ...

3. sciencedirect.com sciencedirect.com/science/article/pii/S1053811923004718

Neural modulation enhancement using connectivity-based ... Specifically, connectivity-based neurofeedback results in a greater increase in happiness and decrease in sadness when compared to traditional ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9837918/

Individual brain regulation as learned via neurofeedback is ... We found increases of resting activity in the anterior cingulate cortex and right inferior temporal gyrus as well as improvements in affective characteristics ...

5. frontiersin.org frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2024.1339444/pdf

Mapping the evolution of neurofeedback research Unlike traditional techniques that primarily aim to adjust thoughts, emotions, or behaviors through subjective means (Zabihiyeganeh et al., 2019 ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0165178125001222

A systematic review on the role of EEG and fMRI ... EEG/fMRI-neurofeedback can improve addictive symptoms especially craving. EEG/fMRI-neurofeedback can be promising add-on therapies for substance use disorders.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9670077/

Infraslow closed-loop brain training for anxiety and depression ... Closed-loop brain training of electrophysiological (EEG) signals, also known as EEG-neurofeedback (EEG-NFB), is a non-invasive therapy aimed at ...

8. nature.com nature.com/articles/s41598-025-94242-4

Neurofeedback training for executive function in ADHD ... This research investigates the effectiveness of neurofeedback training (NFT) in improving executive functions among this group. Studies were ...