Search Results (9,811)

Background/Objectives: Palpitations are among the most common reasons for cardiology referrals. Despite widespread use of ambulatory cardiac monitoring, contemporary data from the Middle East are scarce. Extended Holter monitoring provides detailed evaluation of arrhythmia burden, autonomic regulation, and symptom–rhythm correlation in routine clinical practice. Methods: We conducted a prospective observational study of consecutive patients presenting with palpitations who underwent 24–96 h ambulatory Holter monitoring at a cardiology outpatient clinic in Saudi Arabia in 2025. Demographic and clinical characteristics, comorbidities, medication use, echocardiographic parameters, heart rate variability (HRV), ventricular and supraventricular ectopy, tachyarrhythmias, and symptom diary activations were systematically evaluated. Results: Among 251 patients (mean age 41.9 ± 16.4 years; 35.5% male), Holter monitoring showed excellent recording quality (mean analyzable time 98.7 ± 9.5%). Premature ventricular contractions (PVCs) were detected in 53.4% of patients, but burden was low (median 0.0%, IQR 0–0.1%), with only 4.4% exceeding 10%. Atrial premature contractions (APCs) were common (92.0%), though usually low-burden (median burden 0.0%, IQR 0–0.1%); atrial fibrillation and supraventricular tachycardia were rare (0.8% each). Symptom diary activation occurred in 116 patients (46.2%), with 996 events; most (87.9%) correlated with sinus tachycardia, while only 8.6% correlated with PVCs and 2.6% with APCs. In the remaining 53.8% of patients, no symptom–rhythm correlation was documented during monitoring. Heart rate variability showed expected age-related changes. Conclusions: In this predominantly young cohort, Holter monitoring revealed frequent low-burden atrial and ventricular ectopy, whereas clinically significant tachyarrhythmias were uncommon. Holter monitoring up to 96 h provided a diagnostic yield in approximately 50% of patients and should be considered a first-line screening tool. Patients without diagnostic findings may require prolonged monitoring using external or implantable devices. Full article

Background: Sleep bruxism involves repetitive jaw-muscle activity, including teeth clenching, grinding, or mandibular bracing. Despite the growing interest in botulinum toxin type A (BTX-A) as a therapeutic intervention for bruxism, evidence remains limited, particularly regarding studies using portable electromyography (EMG) monitoring devices. This study evaluated the effects of BTX-A injections into the masseter muscle on the reduction of bruxism activity, as measured using the portable electromyographic Holter Bruxoff system. Methods: Adult patients with diagnosed sleep bruxism were monitored for two nights using the Bruxoff device to record masseter EMG activity, respiratory rate, and heart rate. After receiving standardized bilateral masseter BTX-A injections, participants underwent the same monitoring protocol 40 days later. Statistical analyses compared pre- and post-treatment values, and effect sizes were calculated. Results: Ten participants (60% women; mean age 47.6 ± 4.4 years) completed the study. The Bruxism Index showed a marked reduction, dropping from 12.2 ± 1.32 at baseline to 7.4 ± 1.35 after 40 days, a statistically significant change (t (9) = 10.23, p < 0.001; Cohen’s d = 3.25). Average heart rate also decreased significantly, from 64.4 ± 2.99 to 62.6 ± 2.63 (t (9) = 2.86, p = 0.018; Cohen’s d = 0.91). However, the respiratory rate measurement remains stable. Conclusions: BTX-A injections into the masseter muscles produced a marked reduction in sleep-related bruxism activity as measured by portable EMG. These findings support BTX-A as a promising and effective treatment option for sleep bruxism. Full article

Work-related stress is a significant concern among employees in multinational corporations, where workloads and performance expectations are high. This study examines pre–post changes associated with a Virtual Reality (VR)-based mindfulness intervention designed to support stress management after a workday. A sample of 134 corporate employees from multinational companies reporting moderate to high stress participated in the study. Physiological indicators, including heart rate and skin conductance, were recorded before and after the VR session, alongside self-reported measures of perceived stress and relaxation. The intervention consisted of immersive VR environments integrating guided breathing, calming narration, and natural landscapes. Results indicated significant reductions in physiological stress markers following the intervention compared to baseline levels, accompanied by improvements in self-reported relaxation, reduced tension, and enhanced mental clarity. These findings suggest that VR-based mindfulness is associated with short-term reductions in both physiological and perceived stress. VR-based mindfulness may represent a complementary and non-invasive approach to stress management in individuals exposed to high occupational demands. Future research using controlled designs and longitudinal approaches is needed to evaluate the sustained effects of repeated VR sessions and their integration into corporate wellness programs. Full article

Background/Objective: Mental fatigue (MF) significantly impairs psychomotor performance in dynamic sports; however, its specific impact on closed-skill precision-demanding tasks remains underexplored. This study investigated the acute effects of experimentally induced MF exposure on psychophysiological responses, mood states, and archery shooting performance. Methods: Fifteen well-trained male compound-bow archers participated in a randomized crossover study. Participants completed an MF condition (30 min modified Stroop task) and a control condition (CON; passive viewing of a neutral documentary), separated by a 72 h washout period. Continuous heart rate (HR), archery shooting accuracy, ratings of perceived exertion (RPE), rating scale of mental effort (RSME), state anxiety (VAS-A), mood states, and exercise enjoyment scale (EES) were assessed. Results: The Stroop task successfully induced subjective MF. Consequently, shooting accuracy significantly deteriorated in the MF condition compared to that in the CON condition (p < 0.001; g = 0.731). While HR and VAS-A remained consistent across conditions, the MF condition elicited a significant increase in RPE (p = 0.007; g = 0.836) and RSME (p = 0.010; g = 0.794). Furthermore, MF significantly increased feelings of anger and fatigue while drastically reducing PACES (p < 0.001; g = 1.530). Conclusions: Acute MF significantly degrades fine motor accuracy in precision sports. The pronounced dissociation between elevated RPE and stable peripheral physiological strain suggests that performance decline is driven by top-down cognitive burden rather than physiological limitations. Therefore, systematic monitoring of cognitive load is crucial for optimizing performance in precision sports. Full article

Despite the widespread use of Aloe vera extracts, their developmental toxicity in aquatic organisms remains poorly understood. This study investigated the effects of a commercial Aloe vera extract on zebrafish embryogenesis, focusing on developmental, morphological, behavioural, and oxidative stress-related endpoints. The 96 h-LC₅₀ was determined to be 0.03%. Embryos at 2 h post-fertilization (hpf) were exposed for 96 h to 0.0004% (LC₁₀) and 0.03% (LC₅₀). Exposure to 0.0004% caused no significant effects compared to controls. In contrast, exposure to 0.03% significantly increased mortality, reduced heart rate, impaired locomotion, and induced multiple malformations. Biochemical analyses revealed alterations in redox-associated biomarkers, characterized by unchanged ROS levels and mitochondrial activity, increased antioxidant enzyme activities (SOD, GPx, GR), and a decreased GSH:GSSG ratio. Lipid peroxidation levels were reduced, while a significant increase in DNA double-strand breaks (DSBs) was observed. Additionally, Nrf2 protein expression was upregulated at 0.03%. Together, these findings suggest concentration-dependent developmental toxicity correlated with alterations in redox homeostasis and genomic stability during early zebrafish development. This study provides new insight into the developmental hazard potential of a commercial Aloe vera extract in an aquatic vertebrate model. Full article

Background: Surfactant Protein D (SP-D) is a critical immunomodulatory collectin maintaining alveolar homeostasis. Obstructive sleep apnea (OSA)-related intermittent hypoxia (IH) disrupts pulmonary surfactant integrity; however, severity-dependent SP-D dynamics remain incompletely characterized. This study explores SP-D as a potential indicator of IH-induced alveolar stress and evaluates whether Galectin-3 (Gal-3) inhibition modulates surfactant homeostasis. Methods: Forty adult male Sprague-Dawley rats (8 per group) were randomized to Control (normoxia), Moderate IH (MIH; 15–30 events/hour), Severe IH (SIH; 30–60 events/hour), MIH + Gal-3 inhibitor (Modified Citrus Pectin, 800 mg/kg/day), or SIH + Gal-3 inhibitor. IH exposure lasted 8 h/day for 10 days. Outcomes included circulating SP-D, Surfactant Protein B (SP-B), inflammatory markers, physiological parameters, and histopathological lung injury scores assessed via American Thoracic Society guidelines. Results: SP-D levels showed numerical reductions with increasing IH severity (Control: 1969.07 pg/mL [IQR: 262.15]; SIH: 1404.30 pg/mL [IQR: 351.88]), representing a 28.6% decrease. However, between-group variability resulted in non-significant omnibus testing (Kruskal–Wallis p = 0.187). Gal-3 inhibition elevated SP-D levels, particularly in severe IH (2133.95 pg/mL [IQR: 1240.70]), though high inter-individual variability was observed (CV = 58.1%). SP-B showed significant suppression under moderate IH (p = 0.019) with restoration by treatment. Exploratory correlation analysis revealed moderate positive associations between SP-D and heart rate (r = 0.587) and respiratory rate (r = 0.419) in severe IH, though these did not reach statistical significance (p = 0.126 and p = 0.301, respectively). Histologically, severe IH induced diffuse alveolar damage (total lung score: 19.67 ± 0.82). Gal-3 inhibition produced context-dependent effects: protective in severe IH but paradoxically exacerbating inflammation under moderate IH (29.20 ± 4.64 vs. 20.00 ± 4.34; p < 0.05). Gal-3 inhibition significantly attenuated cardiac injury (injury score: 0.00 ± 0.00 vs. 7.17 ± 0.75 in severe IH; p < 0.001, η² = 0.859). Conclusions: SP-D demonstrates severity-associated alterations consistent with alveolar epithelial stress during IH, though high variability limits definitive biomarker validation in this sample. Gal-3 inhibition modulates surfactant homeostasis and attenuates cardiopulmonary injury in a context-dependent manner. These findings support further investigation into SP-D as a component of multimodal severity stratification in OSA and highlight Gal-3 inhibition as a context-dependent anti-inflammatory strategy, pending validation in larger cohorts with tissue-level confirmation. Full article

Background: Heart failure with reduced ejection fraction (HFrEF) and chronic kidney disease (CKD) are common in the growing population of elderly patients, yet little evidence specifically targeting this population exists. The purpose of this study is to analyze the effect of SGLT2 inhibition in this cohort. Methods: A single-center, real-world observational study was performed. Patients aged >75 with HFrEF and CKD and theoretical indication for sodium–glucose cotransporter 2 (SGLT2) inhibitors were enrolled. Results: A total of 173 patients were included, with a mean age of 84.7 years, mean left ventricle ejection fraction of 29.5% and estimated glomerular filtration rate of 45.9 mL/min/1.73 m². During a median follow-up of 39 months, 73 (42.2%) deaths from any cause and 95 (53.3%) major clinical events (composite of mortality and heart failure admission) were recorded. Multivariate Cox proportional hazards regression analyses were performed to identify associated variables, and SGLT2 inhibition showed to be a protective factor for the mortality endpoint (hazard ratio 0.324 [0.117–0.894]). Male sex was shown to be a risk factor for both endpoints, diabetes mellitus for the mortality endpoint and diuretic use for the major clinical event endpoints. Conclusions: In a real-world study, treatment with SGLT2 inhibitors in elderly patients with HFrEF and CKD was associated with a lower rate of all-cause mortality. Full article

Peripheral nerves provide a direct connection between the brain and the tumor microenvironment. This connection allows the nervous system to influence processes associated with the development, progression, and metastasis of different tumor types. Therefore, tumor innervation by peripheral nerve fibers is currently emerging as a characteristic that contributes to multiple hallmarks of cancer. Several experimental studies have shown that cancer progression involves actively inducing the ingrowth of autonomic and sensory nerve fibers into tumor tissue. In this process, known as neoaxonogenesis, cancer and other cells in the tumor microenvironment play an important role by synthesizing and releasing neurotrophic factors (e.g., nerve growth factor, brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor), axonal guidance molecules (netrins, semaphorins, ephrins, slits), exosomes (containing microRNA and axonal guidance molecules), and other molecules present in the tumor microenvironment (e.g., granulocyte colony-stimulating factor, leukemia inhibitory factor), which modulate the ingrowth of nerve fibers into the tumor. This results in an increased nerve supply to tumor tissue, which is primarily linked to its growth. However, there are also studies demonstrating the protective effects of increased nerve fiber density against processes associated with cancer progression in certain types of cancer. The findings from these studies contribute to the complexity of neuro-cancer interactions, which is probably based on the type of cancer and the physiological specializations of the nerve fibers in a given organ. Despite contrasting findings, the stimulatory effects of nerve fibers on cancer growth are supported by several studies that described reducing the negative impact of nerve fibers on tumors and thus inhibiting cancer progression. The most significant approaches to reducing neural effects appear to be denervation, the administration of neurotransmitter receptor antagonists, the administration of local anesthetics, and the administration of antibodies against neurotrophic factors. Other significant approaches include methods that improve quality of life, such as psychotherapy and heart rate variability biofeedback. Despite their therapeutic potential, there are several limitations to using approaches that manipulate cancer innervation in clinical practice. These limitations include impaired normal tissue function and nervous system function, as well as the problematic direct application of the therapeutic agent to the tumor site, dosage-dependent, cancer type-dependent, cancer stage-dependent, duration-dependent, and timing-dependent effects. Procedures that modify neoaxonogenesis and nerve fiber signaling appear to be a promising new therapeutic approach in oncology. However, more research is needed to better understand their effects on cancer progression. In the future, the assessment of the presence and density of nerve fibers in tumors, as well as the evaluation of approaches aimed at reducing their negative impact, could be part of personalized anticancer therapy. As part of this therapy, a fresh tumor sample would be collected from the patient to generate patient-derived organoid models to test and consider the possibility of using supportive therapy and to predict its efficacy. Based on these results, it would be possible to evaluate the applicability of nerve-fiber-targeted therapy for a given patient. This review article summarizes and describes the current knowledge concerning the significance of nerve fibers in cancer progression, with a particular emphasis on neoaxonogenesis in tumors and the various factors that influence this process. Full article

Postpartum depression (PPD) affects a substantial proportion of women globally and is often underdiagnosed due to barriers in screening, stigma, and limited access to care. This study presents the design and pilot evaluation of an mHealth application (“HeartHabit”) intended to support user awareness, self-monitoring, and potential identification of symptoms of PPD among Greek-speaking mothers. An alpha version of the application was evaluated through an online survey with 30 women within the first postpartum year, using a walkthrough video. The evaluation focused on perceived usability and acceptability rather than clinical outcomes or real-world use. Usability and app quality were assessed via the System Usability Scale (SUS) and a qualitative version of the user Mobile Application Rating Scale (uMARS), respectively, adopting a mixed-methods approach. Demographics, and mood and stress screening data were also captured. Quantitative data were analysed via descriptive statistics and qualitative responses via Framework Analysis. The results indicated high perceived usability (mean SUS = 83.7/100). Qualitative findings highlighted the importance of practical usability, self-regulation tools, personalisation, and connectivity with healthcare professionals. Privacy, data transparency, and user control over personal data were perceived as critical for trust. The application was perceived as a potentially useful adjunct to formal care or as at-home support when access to services is limited. Larger, controlled trials, clinical implementation protocols and clinician training are needed to promote the app’s safe integration into formal care. This mixed-methods evaluation, incorporating usability assessment and patient involvement, may offer a useful paradigm for early-stage digital mental health intervention development. Full article

Background and Objectives: Idiopathic ventricular arrhythmias commonly occur in patients without structural heart disease and most often present as premature ventricular contractions (PVCs). Although generally considered benign, a high PVC burden may cause symptoms, reduce quality of life, and lead to reversible PVC-induced cardiomyopathy. This study aimed to evaluate long-term outcomes after radiofrequency catheter ablation of idiopathic outflow tract PVCs. Materials and Methods: This single-center retrospective study included 101 patients with idiopathic PVCs who underwent radiofrequency catheter ablation. PVC burden and clinical outcomes were assessed at baseline and during follow-up at 3 months, 12 months, and 5 years. Procedural success, predictors of success, and changes in antiarrhythmic drug therapy were analyzed. Results: During follow-up, a marked reduction in PVC burden was observed compared with baseline values. The median PVC burden decreased from 21.89% at baseline to 0.79% at 3 months, 0.23% at 12 months, and 0.09% at the 5-year follow-up after ablation. Acute procedural success was achieved in 88.1% of patients. Long-term success at 5 years was observed in 80.2% of patients. The use of antiarrhythmic drugs decreased during follow-up. Left ventricular ejection fraction remained stable, with no significant difference between baseline and 5-year values. Monomorphic PVC morphology and procedural success at 12 months were identified as independent predictors of long-term success. Conclusions: Radiofrequency catheter ablation provides effective and sustained reduction in PVC burden in patients with idiopathic outflow tract PVCs, with high acute success rates, durable long-term outcomes, and reduced reliance on antiarrhythmic drug therapy. Full article

Recruitment of firefighters is, in part, hindered due to attrition from fire academies. This study explored initial fitness differences between those who graduated (GRAD) or were released (REL) from the academy. During the first week of the academy, recruits (N = 407; GRAD = 354, REL = 53; 26.6 ± 7.2 yrs; 177.6 ± 8.6 cm; 87.9 ± 17.2 kg) completed an assessment battery including: body composition using skinfold calipers to estimate percent body fat (BF) and fat-free mass (FFM); shoulder mobility via Apley’s scratch test (APLEY); aerobic fitness (VO_2peak) and heart rate recovery (HRR_1min) estimated from the five-minute Forestry step test; muscular strength via the sum of right and left handgrip (SHG); and muscular endurance via a paced two-minute push-up test (PU). A t-test identified age differences between GRAD and REL, followed by separate ANCOVAs for each fitness measure, and logistic regression to identify the ability of fitness measures to predict academy outcome. GRAD had a lower age and BF and a higher FFM, VO_2peak, SHG, and PU, but did not differ in APLEY or HRR_1min. The full model predicting release was significant; age, BF, and FFM were significant predictors. These results provide pre-fire academy preparation guidance for optimizing the potential for successful academy completion. Full article

Background: Metabolic syndrome (MetS) is a cluster of pathologies (obesity, dyslipidemia, insulin resistance, hypertension) that affects over one quarter of old adults. MetS is a condition that markedly increases the susceptibility of various organs to dysfunctionality and is associated with the development of oxidative stress. The existing guidelines point out that exercise is highly advantageous for patients with MetS. However, there is a need for specific guidance and clinical evidence. Objective: This study aimed to investigate the effects of a moderate aerobic exercise program on older women without and with MetS. Methods: A total of 120 women aged 60–70 years old were recruited and divided into two groups: healthy old women (HOW, N = 60) and old women with MetS (OW-MetS, N = 60). Anthropometric values, biochemical parameters and markers of oxidative damage were evaluated before and after moderate aerobic exercise. Exercise was performed five days per week for three months (64 sessions). Each exercise session consisted of 40 min and included the following: (a) five minutes of warm-up exercise; (b) ten minutes of flexibility exercise with resistance using own weight and coordination; (c) twenty minutes of moderate-intensity aerobic exercise (heart rate max between 60% and 70%); and (d) five minutes to cool down/stretching with respiratory techniques. Results: A significant decrease in anthropometric variables was generated by the exercise program [waist circumference 4.35 cm (p < 0.05) in OW-MetS, body fat −1.55, −1.39% (p < 0.05) and muscle mass 0.8, 1.1% (p < 0.05) in HOW and OW-MetS, respectively]. The exercise program resulted in beneficial changes in all biochemical parameters in both groups. Importantly, HOMA values showed a significant decline of −0.85 and −6.17 in HOW and OW-MetS, respectively. Furthermore, oxidative stress was present in the OW-MetS group, which was reduced by the exercise program, resulting in a decrease in protein damage [formazan 45% and 42% in HOW and OW-MetS respectively] and an increase in antioxidant defenses (thiol groups 36%, 99% and GPx 55%, 20% in HOW and OW-MetS, respectively). Conclusions: The data of this study show that moderate aerobic exercise may be potentially useful in treating and preventing MetS in older patients. Full article

Background: Trace elements function as essential micronutrients involved in oxidative balance, mitochondrial activity, and cardiovascular metabolism. Cigarette smoking represents a significant source of toxic metals and may disrupt systemic trace element homeostasis. Alterations in micronutrient and metal balance may contribute to oxidative stress, endothelial dysfunction, and myocardial remodeling, which are central mechanisms in the pathogenesis of heart failure with preserved ejection fraction (HFpEF). This study aimed to investigate whether smokers with HFpEF exhibit distinct hair trace element profiles compared with smokers without HFpEF. Methods: In this prospective pilot study, scalp hair samples were collected from adults undergoing clinical evaluation for suspected cardiovascular disease. Trace element concentrations were determined using inductively coupled plasma mass spectrometry (ICP-MS). Participants were first stratified according to smoking status and subsequently, within the smoker subgroup, according to HFpEF diagnosis based on the Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide score (HFA-PEFF) algorithm. Differences in trace element concentrations were analyzed using appropriate statistical tests, with multiple-comparison correction using the Benjamini–Hochberg false discovery rate (FDR). Active smoking was defined as ≥10 cigarettes per day for at least 1 year, and cumulative exposure was quantified in pack-years. Results: Fifty-eight participants were included, including 27 active smokers. In unadjusted analyses, several trace elements differed between smokers with HFpEF and those without HFpEF, including vanadium, lithium, aluminum, and copper. However, after FDR correction, only copper remained significantly elevated in smokers with HFpEF (q = 0.004). Hair copper concentrations were markedly higher in the HFpEF group compared with smokers without HFpEF. These differences were observed alongside echocardiographic features consistent with diastolic dysfunction and structural cardiac remodeling. Conclusions: In this hypothesis-generating pilot study, smokers with HFpEF demonstrated elevated hair copper concentrations, suggesting disturbances in trace element and micronutrient homeostasis. Altered copper metabolism may reflect oxidative stress-related cardiometabolic remodeling associated with HFpEF. These findings raise the hypothesis that cardiometabolic phenotype, rather than smoking exposure alone, may modulate trace element homeostasis in HFpEF; however, causal relationships cannot be established. Full article

Background/Objectives: Heart failure (HF) is associated with substantial morbidity, impaired quality of life (QOL), and reduced functional capacity. In selected patients with symptomatic HF despite Optimal Medical Therapy (OMT), Cardiac Contractility Modulation (CCM) may be a therapeutic option. Identifying patients most likely to benefit from CCM remains an unmet need. The Predict-CCM study aims to evaluate long-term clinical and objective outcomes after CCM therapy and to assess the predictive value of pre-implant low-dose dobutamine stress echocardiography (LDDSE). Methods and Results: Predict-CCM is an independent, non-profit, multicenter, observational cohort study conducted in Italy, with both retrospective and prospective enrollment. The primary endpoint is the proportion of subjects with a clinical response to CCM at 12 months, defined as a ≥1-class reduction in NYHA class. Secondary clinical endpoints include reductions in HF-related hospitalizations, changes in QOL assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and changes in NT-proBNP levels from baseline to follow-up. Outcomes will be evaluated in the overall cohort and in two subcohorts stratified by pre-implant LDDSE response: (1) reduction in left ventricular end systolic volume (LVESV) ≥ 15% (DeltaLVESV ≥ 15%); and (2) reduction in LVESV < 15% (DeltaLVESV < 15%). Assuming a 70% clinical response rate at 12 months, the estimated sample size is 120 patients. The study was approved by the Ethics Committee in March 2025. Enrollment will continue for 2 years, with a 12-month follow-up period after implant for each subject. Conclusions: This study may provide new criteria for patient selection and outcome assessment in CCM therapy. Left ventricular contractile reserve assessed by stress echocardiography may be a promising predictor of response. Full article

This systematic review synthesized the existing evidence on neurofeedback interventions applied to football players, aiming to clarify their effects on cognitive, technical–tactical, physical and psychological performance. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, four databases (PubMed, Web of Science, SCOPUS and SportsDiscus) were searched up to November 2025. Seven studies met the inclusion criteria, involving 133 players across youth, amateur, national and elite levels. Neurofeedback protocols primarily targeted alpha or sensorimotor rhythm (SMR) activity, and some were combined with heart rate variability (HRV) biofeedback. Across studies, neurofeedback may be associated with improvements in several cognitive outcomes, including improvements in working memory, visuospatial memory, task switching, mental rotation and decision-making. Limited evidence suggests potential improvements in technical skills (particularly shooting accuracy) and tactical decision-making. Some studies reported changes in physiological markers and stress-recovery capacity, although their interpretation remains uncertain. However, the evidence base remains constrained by small samples, heterogeneous protocols and limited use of randomized controlled designs. Overall, neurofeedback appears to be a potentially promising but still experimental tool to support cognitive and psychophysiological readiness in football, warranting more rigorous and standardized research to establish efficacy and optimal training parameters. Full article