The Effectiveness of Neurofeedback Training on Cognitive Function Improvement and Quantitative Electroencephalography Features in Poststroke Cognitive Impairment

Background. Poststroke cognitive impairment (PSCI) involves cognitive deficits emerging within 3 months after stroke. Quantitative EEG (qEEG) in PSCI typically shows changes in relative power, delta-alpha ratio, and peak alpha frequency. Neurofeedback training (NFT) is a promising intervention to improve cognitive function and qEEG patterns, though findings remain inconsistent. Nonetheless, even brief NFT interventions may yield meaningful benefits. Methods. This study assessed the effectiveness of five individualized qEEG-guided NFT sessions (30 min each) in 24 PSCI patients, focusing on changes in MoCA-INA scores and qEEG parameters. Results. NFT significantly improved MoCA-INA scores (Z = −4.106, p < .001, effect size = 0.839), particularly in visuospatial/executive and delayed recall domains, with sustained effects 1 month later. QEEG analysis revealed increased temporal alpha (t = −1.875, p = .037, effect size = 0.23) and parietal beta relative power (t = −1.827, p = .040, effect size = 0.11). Greater cognitive gains were observed in patients aged ≤60 years. Conclusion. These findings support the clinical utility of short-term, qEEG-guided NFT in improving cognitive outcomes and modulating neural activity in PSCI patients. The sustained benefits observed suggest potential for long-term therapeutic impact.