Real-Time EEG Neurofeedback Using a Subject-Independent Classifier in Women With Depressive Symptoms

This completed feasibility study examined whether right-handed women aged 18-35 years with mild-to-moderate depressive symptoms could use real-time electroencephalography (EEG) neurofeedback based on a subject-independent classifier to regulate brain activity toward a classifier-defined reference pattern. Participants were randomly assigned to receive either classifier-contingent visual feedback with performance-contingent monetary rewards or noncontingent sham visual feedback with yoked monetary rewards. All participants completed five training sessions over approximately 3 weeks. The primary purpose was to determine whether overall classifier accuracy during training exceeded the theoretical 50% chance level. Changes in clinician-rated and self-reported depressive symptoms, associations between classifier performance and symptom change, EEG spatial patterns, and procedural tolerability were exploratory.