Infralow neurofeedback in the treatment of substance use disorders: A randomized controlled trial

Neurofeedback (NF) is an electrophysiological training method which has been applied in the treatment of substance use disorders (SUD) for decades to help patients gain self-control of their EEG patterns, thereby preventing relapse by improving functioning in various areas. More recently, infralow frequency training (ILF-NF), a sub-type of NF, has been developed to target brain rhythmic activity below 0.5 Hz. The current study investigated the quality of life (QoL) of patients undergoing ILF-NF compared to controls, as well as how ILF-NF as an adjunct treatment affects drug use, sleep, mental health and restlessness.

A sample of 93 patients at an out-patient unit in Kristiansand, Norway, were randomized into either 20 sessions of ILF-NF training in combination with traditional psychotherapeutic treatment (treatment as usual (TAU) or TAU alone. Group differences post-treatment (average 5 months after inclusion) were analyzed using independent samples t-tests.

Post-test measures showed no statistical significant differences between the groups for QoL nor the secondary outcome measures of drug use, sleep, anxiety and depression. Compared with the TAU condition, the ILF-NF group reported significantly lower restlessness scores post-treatment (95% CI = -3.1 / -0.5; P=0.006).

Although clinical experience has been positive, the current study showed limited additional benefit of ILF-NF when combined with traditional treatment methods, except in the area of restlessness. Further studies using other measures should be directed at specific sub-populations with a view to differentiate between responders and non-responders and further investigate the relationship between ILF-NF, restlessness and substance use mechanisms such as relapse.