Search Results (220)

Brain–Computer Interfaces (BCIs) have increasingly been explored as tools for monitoring and modulating cognitive processes relevant to learning. However, their application to learning disorders, and especially to mathematical learning difficulties such as dyscalculia and ageometria, remains conceptually promising but empirically underdeveloped. The present study offers a scoping review with structured narrative synthesis of recent empirical research on BCI-based interventions in learning disorder populations, with particular attention paid to their possible translational relevance for mathematical learning. Following PRISMA-ScR principles and a Population–Concept–Context framework, studies published between 2020 and 2025 were identified through database searches in Scopus, IEEE Xplore, and PubMed. A total of 30 studies met the inclusion criteria. All eligible studies focused on Attention-Deficit/Hyperactivity Disorder (ADHD), while no eligible BCI intervention studies were found for dyscalculia or ageometria. The reviewed literature was dominated by EEG-based neurofeedback interventions. To move beyond descriptive summary, the included studies were organized using a structured analytical framework based on intervention modality, primary cognitive target, methodological robustness, and translational proximity to mathematical learning disorders. Across the evidence base, the most consistent findings concerned attention regulation and executive function outcomes, whereas academic and mathematics-related outcomes were sparse and methodologically less developed. Although several studies suggested improvements in domain-general cognitive mechanisms relevant to mathematical learning, the absence of direct evidence in dyscalculia and ageometria prevents confirmatory conclusions. The review therefore identifies both the promise and the limits of current BCI applications in learning disorder contexts and argues that future research should prioritize theory-driven, disorder-specific trials targeting numeracy, visuospatial reasoning, and executive processes in mathematical learning disabilities. Although current findings suggest promising cognitive and educational potential, these technologies are not yet ready for routine implementation in standard classroom environments without further validation, teacher training, ethical safeguards, and cost-effective deployment models. Full article

Background: Electroencephalography (EEG) provides millisecond-resolution measurements of neural activity, offering a unique potential to identify biomarkers of cognition, emotion, and mental health. However, the proliferation of methodologically diverse studies necessitates systematic synthesis to establish the reliability and clinical utility of proposed EEG biomarkers. Methods: Following PRISMA 2020 guidelines, we systematically searched PubMed, PsycINFO, Web of Science, and Scopus for studies published 2015–2025 examining EEG correlates of cognitive control, learning, emotion regulation, and mental health. From 3847 initial records, k = 210 unique studies (estimated n ≈ 9935 participants across 38 countries; see Methods for sample size derivation) met the inclusion criteria. Random-effects meta-analyses estimated pooled effect sizes for primary EEG markers across five research domains. Results: Frontal-midline theta demonstrated robust effects for cognitive control (k = 12; d = 0.89, 95% CI [0.72, 1.07]; I² = 0.0%) and learning/memory (k = 10; d = 0.70, 95% CI [0.50, 0.89]). The late positive potential indexed emotional processing (k = 18; d = 0.87, 95% CI [0.75, 1.00]) and regulation success (k = 14; d = −0.65, 95% CI [−0.79, −0.51]). Neurofeedback showed very large effects for PTSD (k = 2; d = −1.98, 95% CI [−2.50, −1.47]) and moderate effects for anxiety (d = −0.62), ADHD (d = −0.60), and depression (d = −0.42). Alpha event-related desynchronization marked cognitive engagement (k = 18; d = −0.70, 95% CI [−0.85, −0.55]). Heterogeneity was negligible (I² = 0.0%) in most analyses, except for clinical interventions, which showed condition-explained heterogeneity (I² = 75.4%). Conclusions: EEG biomarkers demonstrate substantial effect sizes and a notable consistency across cognitive and clinical domains, supporting their potential as candidate neurophysiological indicators for diagnostic research, the investigation of treatment response, and intervention monitoring. Causal claims are not warranted from this evidence base alone. A four-phase implementation framework is proposed to facilitate clinical translation. Future research should prioritize methodological standardization, diverse samples, and real-world validation. Full article

Background: The optimal frequency of EEG biofeedback sessions for elite athletes remains unclear, despite growing adoption of neurofeedback in high-performance sport. Methods: This randomized, controlled study compared three EEG biofeedback protocols (daily, every-other-day, every-third-day) in 24 national-level male judo athletes stratified into three phenotypic groups. Each protocol comprised 15 standardized sessions. Pre- and post-intervention assessments included functional indices (strength, power) and neurophysiological measures (Frontal Alpha Index, EMG amplitude/RMS, corrected strength sum). Biosensor performance was validated via signal quality metrics. Results: Daily EEG biofeedback produced superior improvements in strength, FAI, and fatigue resistance. Although LRG showed the largest pre–post RMS increase (+17.44 μV vs. +16.54 μV in HRG), HRG maintained the highest post-intervention RMS values and best fatigue resistance (MF_drop = −2.15 Hz). Significant group × time interactions were observed for FAI (p = 0.027) and RMS (p = 0.019). Every-other-day protocols yielded moderate gains, while every-third-day protocols produced minimal or maladaptive EMG–load dynamics. A robust dose–response relationship was evident. Conclusions: Session frequency is critical for optimizing neurofeedback interventions in elite athletes. Daily EEG biofeedback confers superior adaptation compared to less frequent dosing. Full article

Background: Chronic pain is a prevalent and disabling condition that affects physical health but also cognitive domains. Executive functions, including inhibitory control, cognitive flexibility, and working memory, essentials for self-regulation, treatment adherence, and coping with symptoms, are particularly compromised. Physiotherapy interventions, traditionally aimed at physical outcomes, may also influence executive functions; however, their impact remains unclear. Objective: This review aimed to synthesize current evidence regarding the effects of physiotherapy-related interventions on executive function in adults with chronic pain. Methods: The review followed the Cochrane Handbook and Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD42024611800). A comprehensive search was performed. Randomized controlled trials (RCTs) included adults with chronic pain (≥3 months) whose executive function outcomes were evaluated after physiotherapy-based interventions. Results: Out of 12,391 records, 10 randomized controlled trials were included. Populations primarily had fibromyalgia, chronic low back pain, and chronic musculoskeletal pain. Interventions encompassed transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (rTMS), neurofeedback, structured exercise, and multimodal physical-cognitive-mindfulness training. Intervention durations ranged from one session to 16 weeks. Executive function was assessed with diverse neuropsychological tests. tDCS improved attention, inhibitory control, cognitive flexibility, and working memory. Exercise interventions showed benefits in working memory and inhibitory control. Conclusions: Preliminary evidence suggests that physiotherapy interventions, particularly anodal tDCS and structured exercise, may improve executive functions in individuals with chronic pain. Future trials should incorporate long-term follow-up. Integrating cognitive targets into physiotherapy may enhance the multidimensional management of chronic pain. Full article

Background: Post-traumatic stress disorder (PTSD) affects millions globally, with 40–50% of patients not responding adequately to first-line treatments. Prism neurofeedback, an FDA-cleared electroencephalography (EEG)-based system targeting amygdala-derived biomarkers, has demonstrated efficacy in randomized controlled trials (RCTs) and multicenter studies. Real-world implementation data from community clinical practice remain limited. Objective: To evaluate clinical outcomes and patient-developed self-regulation strategies of Prism neurofeedback in patients with PTSD in community clinical practice. Methods: Retrospective case series of 28 consecutive patients with PTSD treated with Prism neurofeedback in a community psychiatry practice. The primary outcome was change in PTSD Checklist for DSM-5 (PCL-5) from baseline to end of treatment. Results: Twenty-one of 28 patients (75.0%) completed treatment. Mean PCL-5 reduction was 37.0 ± 18.2 points (Cohen’s d = 2.03). Response rates were 100% for any improvement and 90.5% for clinically significant improvement (≥10-point reduction). Five patients (23.8%) achieved excellent response with ≥50-point reduction. Limited follow-up data (1–3 months post-treatment) were available for three patients; two of three (67%) exceeded their end-of-treatment gains. Four patients receiving booster sessions showed continued improvement. Limitations: The uncontrolled, retrospective design precludes causal attribution of improvements to the intervention versus placebo effects or regression to the mean. The 25% early discontinuation rate may introduce attrition bias. Durability data are available for only three patients. Conclusions: This case series provides real-world evidence supporting the feasibility and potential clinical utility of Prism neurofeedback in community practice, with outcomes comparable to controlled studies and preliminary evidence of durable treatment effects. These findings complement existing RCT evidence by demonstrating successful implementation outside research settings. Full article

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) has been less frequently and extensively investigated in university students than in children, despite substantial evidence demonstrating its significant impact on academic performance and negative affect, such as anxiety. We conducted two studies to address this gap. Methods: The objective of our first study (n = 233) was to assess the prevalence of subclinical ADHD among medical students and examine its associations with comorbid mental health conditions, such as Depression, Anxiety and Stress (DASS-21). In the second pilot intervention study (n = 16), we compared the ratio of negative and positive emotions (PANAS) and anxiety (STAI-S-5) before and after neurofeedback-based relaxation training in two groups of students: one with high scores and another with low scores on the Adult ADHD Self-Report Scale (ASRS). Results: According to our results, more than 50% of students showed risk for ADHD symptoms, and linear regression analyses revealed a strong association between ADHD symptoms and the prevalence of negative affect. Interestingly, no significant differences were found in ADHD and DASS scale scores between students who were falling behind and those progressing in line with the curriculum. Further results of the second study were inconclusive in several areas. In the examined group, a significant increase was observed in one of the core symptoms of ADHD—mind wandering—by the end of the intervention, compared to the baseline. Additionally, frustration levels were significantly higher at the second measurement point among participants with higher ASRS scores. Conclusions: Compared to the literature, it can be concluded that while longer interventions tend to be effective, two sessions are insufficient to reduce symptom. Full article

Slow-oscillation neurofeedback (NF), encompassing slow cortical potential (SCP), infra-low-frequency (ILF), and infra-slow-fluctuation (ISF) protocols, has gained increasing interest as a non-pharmacological intervention in pediatric mental health and neurodevelopmental care. This narrative review synthesizes peer-reviewed literature on the clinical efficacy of slow-oscillation NF in children and adolescents across various conditions, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), epilepsy, tic disorders, and eating-related concerns. SCP NF is the most extensively studied protocol and shows preliminary efficacy in reducing ADHD symptoms, particularly among individuals capable of learning self-regulation. For ASD and other conditions, early evidence from primarily small-scale or uncontrolled studies suggests possible benefits in emotional regulation, impulsivity, and behavioral symptoms, though findings remain mixed and often non-specific. Methodological heterogeneity, including variation in control conditions, training protocols, and outcome measures, limits the comparability of results. ILF and ISF protocols, while promising, are still emerging and require further validation. Overall, slow-oscillation NF appears to offer potential as a personalized therapeutic option for pediatric populations, but robust, well-controlled trials are needed to clarify its clinical utility and optimize its integration into multimodal care. Full article

This study investigated whether resting-state EEG coherence in the alpha, beta, and theta frequency bands predicts working memory performance in healthy middle-aged adults (N = 27, aged 49–64). Unlike prior research focusing on young adults or clinical populations, we examined the relationship between EEG coherence during eyes-open rest and performance on a range of working memory tasks, including updating (n-back task), switching, Stroop, and complex operation span (OSPAN task). Hierarchical regression analyses revealed that demographic variables (age, education) were generally not significant predictors, except for education in the updating task. Inclusion of EEG coherence significantly increased explained variance: alpha, beta, and theta coherence predicted performance in the updating task, while alpha and beta coherence predicted outcomes in the OSPAN task. Specifically, higher alpha coherence was associated with better performance, whereas lower theta and beta coherence predicted superior outcomes, suggesting enhanced neural flexibility and efficient cognitive resource allocation. EEG coherence did not significantly predict performance in the switching or Stroop tasks, likely because these tasks rely more on rapid reactive responses and local neural activity not captured by resting-state synchronization. These findings indicate that resting-state EEG coherence may serve as a frequency-specific neurophysiological marker of working memory in middle age. Future research should explore longitudinal changes and potential interventions, such as neurofeedback, to modulate coherence and enhance cognitive function. Full article

Introduction: Resting-state EEG (rsEEG) is a scalable window onto trait-like “executive readiness,” but findings have been fragmented by task impurity on the executive-function (EF) side and heterogeneous EEG pipelines. This review synthesizes rsEEG features that reliably track EF in healthy samples across development and aging and evaluates moderators such as cognitive reserve. Materials and methods: Following PRISMA 2020, we defined PECOS-based eligibility (human participants; eyes-closed/eyes-open rsEEG; spectral, aperiodic, connectivity, topology, microstate, and LRTC features; behavioral EF outcomes) and searched MEDLINE/PubMed, Embase, PsycINFO, Web of Science, Scopus, and IEEE Xplore from inception to 30 August 2025. Two reviewers were screened/double-extracted; the risk of bias in non-randomized studies was assessed using the ROBINS-I tool. Sixty-three studies met criteria (plus citation tracking), spanning from childhood to old age. Results: Across domains, tempo, noise, and wiring jointly explained EF differences. Faster individual/peak alpha frequency (IAF/PAF) related most consistently to manipulation-heavy working may and interference control/vigilance in aging; alpha power was less informative once periodic and aperiodic components were separated. Aperiodic 1/f parameters (slope/offset) indexed domain-general efficiency (processing speed, executive composites) with education-dependent sign flips in later life. Connectivity/topology outperformed local power: efficient, small-world-like alpha networks predicted faster, more consistent decisions and higher WM accuracy, whereas globally heightened alpha/gamma synchrony—and rigid high-beta organization—were behaviorally sluggish. Within-frontal beta/gamma coherence supported span maintenance/sequencing, but excessive fronto-posterior theta coherence selectively undermined WM manipulation/updating. A higher frontal theta/beta ratio forecasts riskier, less adaptive choices and poorer reversal learning for decision policy. Age and reserve consistently moderated effects (e.g., child frontal theta supportive for WM; older-adult slow power often detrimental; stronger EO ↔ EC connectivity modulation and faster alpha with higher reserve). Boundary conditions were common: low-load tasks and homogeneous young samples usually yielded nulls. Conclusions: RsEEG does not diagnose EF independently; single-band metrics or simple ratios lack specificity and can be confounded by age/reserve. Instead, a multi-feature signature—faster alpha pace, steeper 1/f slope with appropriate offset, efficient/flexible alpha-band topology with limited global over-synchrony (especially avoiding long-range theta lock), and supportive within-frontal fast-band coherence—best captures individual differences in executive speed, interference control, stability, and WM manipulation. For reproducible applications, recordings should include ≥5–6 min eyes-closed (plus eyes-open), ≥32 channels, vigilant artifact/drowsiness control, periodic–aperiodic decomposition, lag-insensitive connectivity, and graph metrics; analyses must separate speed from accuracy and distinguish WM maintenance vs. manipulation. Clinical translation should prioritize stratification and monitoring (not diagnosis), interpreted through the lenses of development, aging, and cognitive reserve. Full article

Background/Objectives: Transcranial direct current stimulation (tDCS) is increasingly used by athletes, yet sport-performance-enhancement findings are mixed and often small, with outcomes depending on stimulation target, timing, and task demands. Aim: This scoping review mapped and synthesized the soccer-specific trial evidence to identify (i) which tDCS targets and application schedules have been tested in soccer players, (ii) which soccer-relevant outcomes show the most consistent immediate (minutes–hours) or training-mediated benefits, and (iii) where evidence gaps persist. Methods: We conducted a scoping review of clinical trials in footballers, following review best-practice guidance (PRISMA-informed) and a preregistered protocol. Searches (August 2025) spanned PubMed/MEDLINE, ResearchGate, Google Scholar, and Cochrane, using combinations of “football/soccer” and “tDCS/transcranial direct current stimulation,” with inclusion restricted to trials from 2008–2025. Dual independent screening was applied. Of 47 records identified, 21 studies met the criteria. Across these, the total N was 593 (predominantly male adolescents/young adults; wide range of levels). Results: Prefrontal protocols—most commonly left-dominant dorsolateral prefrontal cortex (DLPFC) (+F3/−F4, ~2 mA, ~20 min)—most consistently improved post-match recovery status/well-being (e.g., fatigue, sleep quality, muscle soreness, stress, mood), and when repeated and/or paired with practice, shortened decision times and promoted more efficient visual search. Effects on classic executive tests were inconsistent, and bilateral anodal DLPFC under fatigue increased risk-tolerant choices. Motor-cortex targeting (C3/C4/Cz) rarely changed rapid force–power performance after a single session—e.g., multiple well-controlled trials found no immediate CMJ gains—but when paired with multi-week training (core/lumbar stability, plyometrics, HIIT, sling), it augmented strength, jump height, sprint/agility, aerobic capacity, and task-relevant EMG. Autonomic markers (exercise HR, early HR recovery) showed time-dependent normalization without specific tDCS effects in single-session, randomized designs. In contrast, a season-long applied program that added prefrontal stimulation to standard recovery reported significantly reduced creatine kinase. Across studies, protocols and masking were athlete-friendly and rigorous (~2 mA for ~20 min; robust sham/blinding), with only mild, transient sensations reported and no serious adverse events. Conclusions: In soccer players, tDCS shows a qualified pattern of benefits that follows a specificity model: prefrontal stimulation can support post-match recovery status/well-being and decision efficiency, while M1-centered stimulation is most effective when coupled with structured training to bias neuromuscular adaptation. Effects are generally modest and heterogeneous; practitioners should treat tDCS as an adjunct, not a stand-alone enhancer, and align montage × task × timing while monitoring individual responses. Full article

Background: The efficacy of real-time fMRI neurofeedback (NFB) depends critically on how feedback is presented and perceived by the participant. Although various visual feedback designs are used in practice, there is limited evidence on the impact of modality on learning and performance. We conducted a feasibility study to compare the effectiveness of different feedback modalities, and to evaluate the technical performance of NFB across two scanner field strengths. Methods: In a single-session study, nine healthy adults (6 men, 3 women) voluntarily adapted the activation level of the primary sensorimotor cortex (SMC) to reach three predefined activation levels. We contrasted a continuous, signal-proportional feedback (cFB; a thermometer-style bar) with an affect-based, categorical feedback (aFB; a smiling face). A no-feedback transfer condition (noFB) was included to probe regulation based on internal representations alone. To assess technical feasibility, three participants were scanned at 7T and six at 3T. Results: Participants achieved successful regulation in 44.4% of trials overall (cFB 46.9%, aFB 43.8%, noFB 42.6%). Overall success rates did not differ significantly between modalities and field strengths when averaged across the session; given the small feasibility sample, this null result is inconclusive and does not establish equivalence. Learning effects were modality-specific. Only cFB showed a significant within-session improvement (+14.8 percentage points from RUN1 to RUN2; p = 0.031; d_z = 0.94), whereas aFB and noFB showed no evidence of learning. Exploratory whole-brain contrasts (uncorrected) suggested increased recruitment of ipsilateral motor regions during noFB. The real-time pipeline demonstrated robust technical performance: transfer/reconstruction latency averaged 497.8 ms and workstation processing averaged 296.8 ms (≈795 ms end-to-end), with rare stochastic outliers occurring predominantly during 7T sessions. Conclusions: In this single-session motor rt-fMRI NFB paradigm, continuous signal-proportional feedback supported rapid within-session learning, whereas affect-based categorical cues did not yield comparable learning benefits. Stable low-latency operation was achievable at both 3T and 7T. Larger, balanced studies are warranted to confirm modality-by-learning effects and to better characterize transfer to feedback-free self-regulation. Full article

Hand rehabilitation in neurologic conditions such as stroke and cerebral palsy traditionally emphasizes repetitive task practice with visually observable feedback, despite motor impairment arising largely from abnormal neuromuscular activation. We present a platform that leverages noninvasive measurements of brain and muscle activity for neurofeedback-guided movement training. Trainees first learn to control EEG during movement preparation, followed by reciprocal control of finger muscle EMG during exoskeleton-assisted movement. We describe the platform design and two feasibility studies. Five neurotypical individuals learned to use EEG and EMG to drive an exoskeleton to grasp and release a virtual ball in a single session. They achieved a mean success rate of 65%, demonstrating improved movement latency (9%) and task completion time (6%) across the session. One individual post-stroke trained with the platform across eight sessions and exhibited improvements on the Box and Blocks Test, the Action Research Arm Test, and the Wolf Motor Function Test. These results demonstrate the feasibility of multi-level, neurofeedback training that targets neural activation throughout movement, rather than movement outcome alone. By explicitly engaging both cortical and muscular control signals, this paradigm offers a promising new direction for hand rehabilitation following neurologic injury. Full article

Background/Objectives: Neurodegenerative cerebellar ataxia (CA) is a movement disorder caused by progressive cell death in the cerebellum. Motor imagery represents a potential therapeutic tool to improve motor function by “exercising” brain regions associated with movement, without the need for overt activity. This study assessed the feasibility of combining motor imagery with real-time functional magnetic resonance imaging neurofeedback (rt-fMRI-NF) to improve motor function in CA. Methods: During finger tapping conditions, 16 participants with CA pushed a button at the same frequency in time with cross flashing at 1 Hz or 4 Hz, and this information was used to train the model. During motor imagery, participants imagined finger tapping while undergoing rt-fMRI-NF with visual feedback, steering them toward activating their motor circuit. Afterwards, they completed finger tapping again. FMRI analysis compared successful motor imagery trials versus all other imagery events. Brain activity on successful trials was covaried with pre–post rt-fMRI-NF tapping improvement scores. Results: Tapping was more accurate at 1 Hz than 4 Hz, and larger tapping error rates correlated with greater movement impairments. While not significant at the group level, 9 of the 16 participants improved tapping accuracy following rt-fMRI-NF. The size of motor improvements correlated with successful motor imagery activity at 1 Hz in the frontal lobe, insula, parietal lobe, basal ganglia, and cerebellum. Motor improvements were not associated with neurological impairment severity, mood, cognition, or imagery vividness. Conclusions: Feasibility was demonstrated for motor imagery therapy with neurofeedback to potentially improve fine motor precision in people with CA. Brain regions relevant to this process may be considered for targets of non-invasive therapeutic interventions. Full article

Introduction: Massage therapy delivers structured mechanosensory input that can influence brain function, yet the central mechanisms and potential for neuroplastic change have not been synthesized across neuroimaging modalities. This mechanistic review integrates evidence from electroencephalography (EEG), functional MRI (fMRI), and functional near-infrared spectroscopy (fNIRS) to map how massage alters human brain activity acutely and over time and to identify signals of longitudinal adaptation. Materials and Methods: We conducted a scoping, mechanistic review informed by PRISMA/PRISMA-ScR principles. PubMed/MEDLINE, Cochrane Library, Google Scholar, and ResearchGate were queried for English-language human trials (January 1990–July 2025) that (1) delivered a practitioner-applied manual massage (e.g., Swedish, Thai, shiatsu, tuina, reflexology, myofascial techniques) and (2) measured brain activity with EEG, fMRI, or fNIRS pre/post or between groups. Non-manual stimulation, structural-only imaging, protocols, and non-English reports were excluded. Two reviewers independently screened and extracted study, intervention, and neuroimaging details; heterogeneity precluded meta-analysis, so results were narratively synthesized by modality and linked to putative mechanisms and longitudinal effects. Results: Forty-seven studies met the criteria: 30 EEG, 12 fMRI, and 5 fNIRS. Results: Regarding EEG, massage commonly increased alpha across single sessions with reductions in beta/gamma, alongside pressure-dependent autonomic shifts; moderate pressure favored a parasympathetic/relaxation profile. Connectivity effects were state- and modality-specific (e.g., reduced inter-occipital alpha coherence after facial massage, preserved or reorganized coupling with hands-on vs. mechanical delivery). Frontal alpha asymmetry frequently shifted leftward (approach/positive affect). Pain cohorts showed decreased cortical entropy and a shift toward slower rhythms, which tracked analgesia. Somatotopy emerged during unilateral treatments (contralateral central beta suppression). Adjuncts (e.g., binaural beats) enhanced anti-fatigue indices. Longitudinally, repeated programs showed attenuation of acute EEG/cortisol responses yet improvements in stress and performance; in one program, BDNF increased across weeks. In preterm infants, twice-daily massage accelerated EEG maturation (higher alpha/beta, lower delta) in a dose-responsive fashion; the EEG background was more continuous. In fMRI studies, in-scanner touch and reflexology engaged the insula, anterior cingulate, striatum, and periaqueductal gray; somatotopic specificity was observed for mapped foot areas. Resting-state studies in chronic pain reported normalization of regional homogeneity and/or connectivity within default-mode and salience/interoceptive networks after multi-session tuina or osteopathic interventions, paralleling symptom improvement; some task-based effects persisted at delayed follow-up. fNIRS studies generally showed increased prefrontal oxygenation during/after massage; in motor-impaired cohorts, acupressure/massage enhanced lateralized sensorimotor activation, consistent with use-dependent plasticity. Some reports paired hemodynamic changes with oxytocin and autonomic markers. Conclusions: Across modalities, massage reliably modulates central activity acutely and shows convergent signals of neuroplastic adaptation with repeated dosing and in developmental windows. Evidence supports (i) rapid induction of relaxed/analgesic states (alpha increases, network rebalancing) and (ii) longer-horizon changes—network normalization in chronic pain, EEG maturation in preterm infants, and neurotrophic up-shifts—consistent with trait-level recalibration of stress, interoception, and pain circuits. These findings justify integrating massage into rehabilitation, pain management, mental health, and neonatal care and motivate larger, standardized, multimodal longitudinal trials to define dose–response relationships, durability, and mechanistic mediators (e.g., connectivity targets, neuropeptides). Full article

Background/Objectives: Post-traumatic epileptogenesis is a frequent and clinically relevant consequence of traumatic brain injury (TBI), often contributing to worsened neurological and functional outcomes. In patients experiencing early post-injury seizures, rehabilitative strategies that support recovery while considering increased epileptogenic risk are needed. This case study explores the potential benefits of combining neurofeedback (NFB) with motor therapy on cognitive and motor recovery. Methods: A patient hospitalized for severe TBI who experienced an acute symptomatic seizure in the early post-injury phase underwent baseline quantitative EEG (qEEG), neuromotor, functional, and neuropsychological assessments. The patient then completed a three-week rehabilitation program (five days/week) including 30 sensorimotor rhythm (SMR) NFB sessions (35 min each) combined with daily one-hour motor therapy. qEEG and clinical assessments were repeated post-intervention and at 6-month follow-up. Results: Post-intervention qEEG showed significant reductions in Delta and Theta power, reflecting decreased cortical slowing and enhanced neural activation. Relative power analysis indicated reduced Theta activity and Alpha normalization, suggesting improved cortical stability. Increases were observed in Beta and High-beta activity, alongside significant reductions in the Theta/Beta ratio, consistent with improved attentional regulation. Neuropsychological outcomes revealed reliable improvements in global cognition, memory, and visuospatial abilities, mostly maintained or enhanced at follow-up. Depressive and anxiety symptoms decreased markedly. Motor and functional assessments demonstrated meaningful improvements in motor performance, coordination, and functional independence. Conclusions: Findings suggest that integrating NFB with motor therapy may support recovery processes and be associated with sustained neuroplastic changes in the early post-injury phase after TBI, a condition associated with elevated risk for post-traumatic epilepsy. Full article