Neurofeedback System Research Articles

A home-based self-directed EEG neurofeedback intervention for people with chronic neuropathic pain following spinal cord injury (the StoPain Trial): description of the intervention

Study designRandomised controlled trial.ObjectivesThe objective is to describe an electroencephalography (EEG) neurofeedback intervention that will be provided in a randomised controlled trial for people with neuropathic pain following spinal cord injury (SCI): the StoPain Trial. In this trial, participants in the treatment group will implement an EEG neurofeedback system as an analgesic intervention at home, while participants in the control group will continue with the treatments available to them in the community.SettingUniversity-based study in Sydney, Australia.Methods/resultsThis manuscript describes the rationale and components of the EEG neurofeedback intervention designed for individuals with SCI neuropathic pain and intended for home-based implementation. Our report is based on the criteria of the Template for Intervention Description and Replication (TIDieR) checklist, and includes why the efficacy of EEG neurofeedback will be investigated, what will be provided, who will administer it, and how, where, when, and how much the EEG neurofeedback intervention will be administered.ConclusionsThis manuscript provides a detailed description of a complex intervention used in a randomised controlled trial. This description will facilitate the subsequent interpretation of the trial results and allow for the replication of the intervention in clinical practice and future trials.SponsorshipAustralian Government Medical Research Future Fund (2020 Rare Cancers Rare Diseases and Unmet Needs Scheme: 2006020).

Adaptive closed-loop modulation of cortical theta oscillations: Insights into the neural dynamics of navigational decision-making

Navigational decision-making tasks, such as spatial working memory (SWM), rely highly on information integration from several cortical and sub-cortical regions. Performance in SWM tasks is associated with theta rhythm, including low-frequency oscillations related to movement and memory. The interaction of the ventral hippocampus (vHPC) and medial prefrontal cortex (mPFC), reflected in theta synchrony, is essential in various steps of information processing during SWM. We used a closed-loop neurofeedback (CLNF) system to upregulate theta power in the mPFC and investigate its effects on circuit dynamics and behavior in animal models. Specifically, we hypothesized that enhancing the power of the theta rhythm in the mPFC might improve SWM performance. Animals were divided into three groups: closed-loop (CL), random-loop (RL), and OFF (without stimulation). We recorded local field potential (LFP) in the mPFC while electrical reward stimulation contingent on cortical theta activity was delivered to the lateral hypothalamus (LH), which is considered one of the central reward-associated regions. We also recorded LFP in the vHPC to evaluate the related subcortical neural changes. Results revealed a sustained increase in the theta power in both mPFC and vHPC for the CL group. Our analysis also revealed an increase in mPFC-vHPC synchronization in the theta range over the stimulation sessions in the CL group, as measured by coherence and cross-correlation in the theta frequency band. The reinforcement of this circuit improved spatial decision-making performance in the subsequent behavioral results. Our findings provide direct evidence of the relationship between specific theta upregulation and SWM performance and suggest that theta oscillations are integral to cognitive processes. Overall, this study highlights the potential of adaptive CLNF systems in investigating neural dynamics in various brain circuits.

The Impact of Neurofeedback Training on Cognitive Abilities Assessed by the Wechsler Intelligence Scale for Children-Revised in Children with Attention Deficit: A Randomized Single-Blind Sham-Controlled Study.

This study aims to investigate the effects of a neurofeedback system on cognitive skills, as measured by the Wechsler Intelligence Scale for Children-Revised (WISC-R), in a cohort of 100 children aged 8 to 12 who were diagnosed with attention deficit. A randomized single-blind sham control group design was employed, with 50 participants assigned to the experimental group receiving neurofeedback training and 50 participants assigned to the sham group receiving simulated training. Participants were selected through random sampling from individuals seeking assistance at a specialized education center over the course of one year (May 2021-2022). Pre- and post-test WISC-R assessments were administered to both groups to evaluate participants' mental performance. The experimental group underwent a total of 60 sessions of quantitative electroencephalography-based infralow frequency neurofeedback training, with half-hour sessions conducted three days a week over a five-month period. The post-test WISC-R was administered at the end of the sixth month. The results revealed significant differences between the pre- and post-training test scores, specifically in terms of verbal IQ, picture arrangement, performance IQ, and total IQ (p = 0.016, p = 0.001, p < 0.001, and p = 0.002, respectively), when comparing the differences between the two groups. These findings indicate a notable improvement in performance IQ, total IQ, and a reduction in attention deficits among the neurofeedback group based on the WISC-R assessments. Future studies should consider employing larger sample sizes, including appropriate control groups, and conducting long-term follow-ups to further elucidate the clinical significance of these results.

Analysis of an Integrated QEEG-Neurofeedback System Utilizing Active Stimuli for Non-Pharmacological Intervention in Enhancing Neurobehavioral Function

Quantitative Electroencephalogram (QEEG) and Neurofeedback (NF) are employed in the diagnosis and treatment of neurobehavioral deficits associated with various clinical conditions. These approaches enable the exploration of EEG usage within the context of neurobehavioral electrophysiology. This study aims to elucidate the fundamental evidence supporting NF and to outline strategies for its further development and application in ameliorating neurobehavioral deficits. Numerous research studies have demonstrated the efficacy of NF in enhancing neurobehavioral functions, including attention, language, memory, visuospatial abilities, and executive function. This study intends to develop an NF system that includes the establishment of a robust approach to QEEG transformation and database. The closed-loop QEEG-NF system under development incorporates active visual and auditory stimuli that leverage stochastic phenomena. The efficacy of the QEEG NF treatment was confirmed with a statistically significant increase in alpha brain wave percentages post-treatment (p = 0.018), indicating that the system effectively enhances alpha brain wave production.

Construction and evaluation of a neurofeedback system using finger tapping and near-infrared spectroscopy.

Neurofeedback using near-infrared spectroscopy (NIRS) has been used in patients with stroke and other patients, but few studies have included older people or patients with cognitive impairment. We constructed a NIRS-based neurofeedback system and used finger tapping to investigate whether neurofeedback can be implemented in older adults while finger tapping and whether brain activity improves in older adults and healthy participants. Our simple neurofeedback system was constructed using a portable wearable optical topography (WOT-HS) device. Brain activity was evaluated in 10 older and 31 healthy young individuals by measuring oxygenated hemoglobin concentration during finger tapping and neurofeedback implementation. During neurofeedback, the concentration of oxygenated hemoglobin increased in the prefrontal regions in both the young and older participants. The results of this study demonstrate the usefulness of neurofeedback using simple NIRS devices for older adults and its potential to mitigate cognitive decline.

Gait Training Based-Motor Imagery and EEG Neurofeedback in Lokomat: A Clinical Intervention with Complete Spinal Cord Injury Individuals.

Robotic systems, such as Lokomat® have shown promising results in people with severe motor impairments, who suffered a stroke or other neurological damage. Robotic devices have also been used by people with more challenging damages, such as Spinal Cord Injury (SCI), using feedback strategies that provide information about the brain activity in real-time. This study proposes a novel Motor Imagery (MI)-based Electroencephalogram (EEG) Visual Neurofeedback (VNFB) system for Lokomat® to teach individuals how to modulate their own μ (8-12 Hz) and β (15-20 Hz) rhythms during passive walking. Two individuals with complete SCI tested our VNFB system completing a total of 12 sessions, each on different days. For evaluation, clinical outcomes before and after the intervention and brain connectivity were analyzed. As findings, the sensitivity related to light touch and painful discrimination increased for both individuals. Furthermore, an improvement in neurogenic bladder and bowel functions was observed according to the American Spinal Injury Association Impairment Scale, Neurogenic Bladder Symptom Score, and Gastrointestinal Symptom Rating Scale. Moreover, brain connectivity between different EEG locations significantly (p <0.05) increased, mainly in the motor cortex. As other highlight, both SCI individuals enhanced their μ rhythm, suggesting motor learning. These results indicate that our gait training approach may have substantial clinical benefits in complete SCI individuals.

Application of Neurofeedback on Gilles de la Tourette Syndrome

Tourette’s syndrome is a neurological disorder which comprises of vocal and motor tics and adversely affect a patient’s quality of life. It has no known cure. Neurofeedback is a process in which patients are able to see data from their brain and respectively manipulate their actions to achieve the desired output. As success has been shown in using neurofeedback to manage symptoms of other neurological disorders, we chose to conduct research, outlined in this review, on its application in Tourette’s. Using MATLAB, we created a neurofeedback system that chose data from certain electrodes in the patient’s brain, filtered it and displayed it back to the patient in a comprehensible and visually appealing manner. We hope that this will provide a basis for clinicians to adopt this treatment in a widespread manner to help increase the quality of life in patients with Tourette’s.

Feasibility of a novel neurofeedback system: a parallel randomized single-blinded pilot study

Neurocognitive assessment tools have been proposed to optimize, maintain, and improve perceptual-cognitive performance. Here, we investigated the feasibility and efficacy of a novel neurofeedback system, neuroMoon (nM), on cognitive abilities compared with one of the most popular perceptual-cognitive training (PCT) tools both in sports and rehabilitation called NeuroTracker (NT). Thirty-one young athletes performed a comprehensive battery of cognitive tests from the Vienna Test System before and after a 12-session computer-based cognitive training program using nM (n = 11, age 22.6 ± 3.8 years), nM sham (CON, n = 10, age 20.3 ± 1.2 years) or NT (n = 10, age 20.5 ± 1.7 years) device. A series of repeated-measures ANOVA was performed to detect changes in cognitive abilities in response to the training. Participants had faster median reaction time in both the color-naming and word-reading conditions of the Stroop test (all p < 0.005), regardless of group. Regarding the task switching test, statistical analysis indicated faster working time and mean reaction time of the incongruent stimuli, repetition task, and shifting task (all p < 0.005), nevertheless, these changes were also regardless of group. In addition, we found fewer omitted (pre: 17.5 ± 8.3, post: 6.4 ± 1.5, d = 1.311) and more correct (pre: 261.6 ± 36.1, post: 278.6 ± 38.7, d = − 1.020) post-intervention answers in the determination test, regardless of group. Finally, participants in each group performed the digit span backward test with larger post (6.42 ± 1.54) vs. pre (5.55 ± 1.43) scores following the PCT (d = − 0.801). Overall, PCT with nM as compared with NT induced similar results in cognitive abilities suggesting its potential to be used to achieve and maintain better mental performance. However, considering that the sham stimulation also induced similar improvements in cognitive abilities, future studies should clearly determine the cognitive measures that could benefit from NF training.

Paving the Way for Memory Enhancement: Development and Examination of a Neurofeedback System Targeting the Medial Temporal Lobe.

Neurofeedback (NF) shows promise in enhancing memory, but its application to the medial temporal lobe (MTL) still needs to be studied. Therefore, we aimed to develop an NF system for the memory function of the MTL and examine neural activity changes and memory task score changes through NF training. We created a memory NF system using intracranial electrodes to acquire and visualise the neural activity of the MTL during memory encoding. Twenty trials of a tug-of-war game per session were employed for NF and designed to control neural activity bidirectionally (Up/Down condition). NF training was conducted with three patients with drug-resistant epilepsy, and we observed an increasing difference in NF signal between conditions (Up-Down) as NF training progressed. Similarities and negative correlation tendencies between the transition of neural activity and the transition of memory function were also observed. Our findings demonstrate NF's potential to modulate MTL activity and memory encoding. Future research needs further improvements to the NF system to validate its effects on memory functions. Nonetheless, this study represents a crucial step in understanding NF's application to memory and provides valuable insights into developing more efficient memory enhancement strategies.

Intracranial Neurofeedback Modulating Neural Activity in the Mesial Temporal Lobe During Memory Encoding: A Pilot Study

Removal of the mesial temporal lobe (MTL) is an established surgical procedure that leads to seizure freedom in patients with intractable MTL epilepsy; however, it carries the potential risk of memory damage. Neurofeedback (NF), which regulates brain function by converting brain activity into perceptible information and providing feedback, has attracted considerable attention in recent years for its potential as a novel complementary treatment for many neurological disorders. However, no research has attempted to artificially reorganize memory functions by applying NF before resective surgery to preserve memory functions. Thus, this study aimed (1) to construct a memory NF system that used intracranial electrodes to feedback neural activity on the language-dominant side of the MTL during memory encoding and (2) to verify whether neural activity and memory function in the MTL change with NF training. Two intractable epilepsy patients with implanted intracranial electrodes underwent at least five sessions of memory NF training to increase the theta power in the MTL. There was an increase in theta power and a decrease in fast beta and gamma powers in one of the patients in the late stage of memory NF sessions. NF signals were not correlated with memory function. Despite its limitations as a pilot study, to our best knowledge, this study is the first to report that intracranial NF may modulate neural activity in the MTL, which is involved in memory encoding. The findings provide important insights into the future development of NF systems for the artificial reorganization of memory functions.

Assessment of the capacity to modulate brain signals in a home-based SMR neurofeedback training setting.

Electroencephalogram (EEG)-based neurofeedback (NF) is mainly used in clinical settings as a therapeutic intervention or to optimize performance in healthy individuals. Home-based NF systems are available and might facilitate general access to NF training, especially when repeated training sessions are necessary. However, it remains an open question whether NF training at home is possible without remote monitoring. In the present study, we assessed the capacity of healthy individuals to modulate their own EEG activity when using a home-based NF training system in a comparable manner as if participants had purchased a commercially available NF system. Participants' face-to-face contact with experimenters was reduced to a minimum, and instructions were provided only in the form of written information or videos. Initially, 38 participants performed 9 sessions of sensorimotor rhythm (SMR) (12-15 Hz) based NF training (three generalization sessions, six training sessions). An active control group (n = 19) received feedback on random EEG frequencies. Because of technical problems, bad EEG data quality, or non-compliance, 21 participants had to be excluded from the final data analysis, providing first evidence for the difficulties of non-supervised home-based NF training. In this study, participants were not able to modulate their own brain activity in a desired direction during NF training. Our results indicate that personal interaction with a NF expert might be of relevance and that remote supervision of the training data and more direct communication with the NF users are necessary to enable successful NF training performance. We provide suggestions for the development and implementation of home-based NF systems.

A real-time fMRI neurofeedback system for the clinical alleviation of depression with a subject-independent classification of brain states: A proof of principle study.

Most clinical neurofeedback studies based on functional magnetic resonance imaging use the patient's own neural activity as feedback. The objective of this study was to create a subject-independent brain state classifier as part of a real-time fMRI neurofeedback (rt-fMRI NF) system that can guide patients with depression in achieving a healthy brain state, and then to examine subsequent clinical changes. In a first step, a brain classifier based on a support vector machine (SVM) was trained from the neural information of happy autobiographical imagery and motor imagery blocks received from a healthy female participant during an MRI session. In the second step, 7 right-handed female patients with mild or moderate depressive symptoms were trained to match their own neural activity with the neural activity corresponding to the “happiness emotional brain state” of the healthy participant. The training (4 training sessions over 2 weeks) was carried out using the rt-fMRI NF system guided by the brain-state classifier we had created. Thus, the informative voxels previously obtained in the first step, using SVM classification and Effect Mapping, were used to classify the Blood-Oxygen-Level Dependent (BOLD) activity of the patients and converted into real-time visual feedback during the neurofeedback training runs. Improvements in the classifier accuracy toward the end of the training were observed in all the patients [Session 4–1 Median = 6.563%; Range = 4.10–27.34; Wilcoxon Test (0), 2-tailed p = 0.031]. Clinical improvement also was observed in a blind standardized clinical evaluation [HDRS CE2-1 Median = 7; Range 2 to 15; Wilcoxon Test (0), 2-tailed p = 0.016], and in self-report assessments [BDI-II CE2-1 Median = 8; Range 1–15; Wilcoxon Test (0), 2-tailed p = 0.031]. In addition, the clinical improvement was still present 10 days after the intervention [BDI-II CE3-2_Median = 0; Range −1 to 2; Wilcoxon Test (0), 2-tailed p = 0.50/ HDRS CE3-2 Median = 0; Range −1 to 2; Wilcoxon Test (0), 2-tailed p = 0.625]. Although the number of participants needs to be increased and a control group included to confirm these findings, the results suggest a novel option for neural modulation and clinical alleviation in depression using noninvasive stimulation technologies.

A Study on Analysis Method for a Real-Time Neurofeedback System Using Non-Invasive Magnetoencephalography

For diseases that affect brain function, such as strokes, post-onset rehabilitation plays a critical role in the wellbeing of patients. MEG is a technique with high temporal and spatial resolution that measures brain functions non-invasively, and it is widely used for clinical applications. Without the ability to concurrently monitor patient brain activity in real-time, the most effective rehabilitation cannot occur. To address this problem, it is necessary to develop a neurofeedback system that can aid rehabilitation in real time; however, doing so requires an analysis method that is quick (less processing time means the patient can better connect the feedback to their mental state), encourages brain-injured patients towards task-necessary neural oscillations, and allows for the spatial location of those oscillation patterns to change over the course of the rehabilitation. As preliminary work to establish such an analysis method, we compared three decomposition methods for their speed and accuracy in detecting event-related synchronization (ERS) and desynchronization (ERD) in a healthy brain during a finger movement task. We investigated FastICA with 10 components, FastICA with 20 components, and spatio-spectral decomposition (SSD). The results showed that FastICA with 10 components was the most suitable for real-time monitoring due to its combination of accuracy and analysis time.

Novel EEG-Based Neurofeedback System Targeting Frontal Gamma Activity of Schizophrenia Patients to Improve Working Memory.

Patients with schizophrenia (SCZ) exhibit working memory (WM) deficits that are associated with deficient dorsal-lateral prefrontal cortical activity, including decreased frontal gamma power. We thus hypothesized that training SCZ patients to increase frontal gamma activity would improve their WM performance. We administered electroencephalographic (EEG) neurofeedback (NFB) to 31 participants with SCZ for 12 weeks (24 sessions), which provides real-time visual and auditory feedback related to frontal gamma activity. The EEG-NFB training significantly improved EEG markers of optimal working memory, e.g., frontal P3 amplitude and gamma power. Based on these promising results, we developed a novel, EEGLAB/MATLAB-based brain-computer interface (BCI) that delivers F3-F4 gamma coherence NFB with a dynamic threshold to SCZ patients randomized in a double-blind, placebo-controlled clinical trial. The BCI significantly increased F3-F4 gamma coherence after 12 weeks (24 sessions) of training, according to data from the first 12 subjects ( n=6 /group) who completed gamma- or placebo-NFB training.

Preliminary Real-World Evidence Supporting the Efficacy of a Remote Neurofeedback System in Improving Mental Health: Retrospective Single-Group Pretest-Posttest Study.

BackgroundNeurofeedback training (NFT) has been shown to be effective in treating several disorders (eg, attention-deficit/hyperactivity disorder [ADHD], anxiety, and depression); however, little is currently known regarding the effectiveness of remote NFT systems.ObjectiveThis retrospective study provides real-world data (N=593) to assess the efficacy of app-based remote NFT in improving brain health and cognitive performance.MethodsImprovement was measured from pre- to postintervention of in-app assessments that included validated symptom questionnaires (the 12-item General Health Questionnaire, the ADHD Rating Scale IV, the Adult ADHD Self-Report Scale, the 7-item Generalized Anxiety Disorder scale, and the 9-item Patient Health Questionnaire), a cognitive test of attention and executive functioning (ie, continuous performance task), and resting electroencephalography (EEG) markers. Clinically significant improvement was evaluated using standard approaches.ResultsThe greatest improvement was reported for the anxiety questionnaire, for which 69% (68/99) of participants moved from abnormal to healthy score ranges. Overall, adult and child participants who engaged in neurofeedback to improve attention and executive functions demonstrated improved ADHD scores and enhanced performance on a cognitive (ie, response inhibition) task. Adults with ADHD additionally demonstrated elevated delta/alpha and theta/alpha ratios at baseline and a reduction in the delta/alpha ratio indicator following neurofeedback.ConclusionsPreliminary findings suggest the efficacy of app-based remote neurofeedback in improving mental health, given the reduced symptom severity from pre- to postassessment for general psychological health, ADHD, anxiety, and depression, as well as adjusted resting EEG neural markers for individuals with symptoms of ADHD. Collectively, this supports the utility of the in-app assessment in monitoring behavioral and neural indices of mental health.

Assessing the mental state of attention using a neurofeedback system and serious game tool

Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric disorder, which is predominantly treated with the administration of psychostimulants. A complementary alternative for ADHD treatment is the neurofeedback (NFB), a method in which patients are trained to perceive and control their physiology, regulate their own brainwaves. As the NFB has a repetitive aspect and can be long lasting, “serious games” may be used to maintain interest throughout the process. This paper presents the development of a NFB system to assess the mental state of attention and analyze the improvement of concentrated attention using the Neurofeedback Space, a Serious Game tool. We present a preliminary validation to choose the brain region and the signal processing algorithm to be used. Training accuracy of 98.12% and test accuracy of 93.88% were achieved. To test the complete NFB system, an experiment with 5 volunteers, and 5 sessions was carried out. Three evaluation metrics were used to analyze the performance of the proposed system: the game metrics, the ratios alpha/beta and theta/beta throughout the sessions, defined here as brain data, and the Concentrated Attention Test. Almost all volunteers improved their performance in the Concentrated Attention Test. Regarding the game metrics, it was possible to observe improvements in the Attention and Score between the most sessions. The brain data results were inconclusive, as there was no common behavior pattern for the volunteers, but it was possible to notice a similarity between the behavior of the game metrics and the brain data in some volunteers in T3 and C3 electrodes. The attention test and game metrics improvement show that the volunteers were able to perceive their own attention and control it to advance in the game.

The Effectiveness of Neurofeedback on Working Memory and Cognitive Flexibility in Patients With Mild Depression

Background and Purpose: Depression is a common illness worldwide, with Approximately 280 million people in the world have depression.The aim of this study was to evaluate the effectiveness of neurofeedback on working memory, cognitive flexibility in patients with mild depression. Materials and Methods: This quasi-experimental study was performed on 30 patients with mild depression in Rasht in 2021 who were purposefully selected. Neurofeedback intervention program and Goldberg Depression Inventory, Dennis and Vanderwall Cognitive Flexibility and Danman &amp; Carpenter Working Memory Questionnaire were used. Data were analyzed by analysis of covariance Results: The results showed that neurofeedback training was effective in increasing working memory (P &lt;0.038),and cognitive flexibility (P &lt;0.001) in patients with mild depression. Conclusion: Neurofeedback system can change brain activity using a simple reward system. Therefore, neurofeedback training is suggested as a potential complementary therapy for patients with depression.

Real-Time Detection and Feedback of Canonical Electroencephalogram Microstates: Validating a Neurofeedback System as a Function of Delay.

Recent neurotechnology has developed various methods for neurofeedback (NF), in which participants observe their own neural activity to be regulated in an ideal direction. EEG-microstates (EEGms) are spatially featured states that can be regulated through NF training, given that they have recently been indicated as biomarkers for some disorders. The current study was conducted to develop an EEG-NF system for detecting “canonical 4 EEGms” in real time. There are four representative EEG states, regardless of the number of channels, preprocessing procedures, or participants. Accordingly, our 10 Hz NF system was implemented to detect them (msA, B, C, and D) and audio-visually inform participants of its detection. To validate the real-time effect of this system on participants’ performance, the NF was intentionally delayed for participants to prevent their cognitive control in learning. Our results suggest that the feedback effect was observed only under the no-delay condition. The number of Hits increased significantly from the baseline period and increased from the 1- or 20-s delay conditions. In addition, when the Hits were compared among the msABCD, each cognitive or perceptual function could be characterized, though the correspondence between each microstate and psychological ability might not be that simple. For example, msD should be generally task-positive and less affected by the inserted delay, whereas msC is more delay-sensitive. In this study, we developed and validated a new EEGms-NF system as a function of delay. Although the participants were naive to the inserted delay, the real-time NF successfully increased their Hit performance, even within a single-day experiment, although target specificity remains unclear. Future research should examine long-term training effects using this NF system.

NIRSを用いたニューロフィードバック訓練効果の検討─NIRSを用いたニューロフィードバックシステムの開発（続報）─

NIRSを用いたニューロフィードバック訓練効果の検討─NIRSを用いたニューロフィードバックシステムの開発（続報）─

Musical Auditory Alpha Wave Neurofeedback: Validation and Cognitive Perspectives

Neurofeedback through visual, auditory, or tactile sensations improves cognitive functions and alters the activities of daily living. However, some people, such as children and the elderly, have difficulty concentrating on neurofeedback for a long time. Constant stressless neurofeedback for a long time may be achieved with auditory neurofeedback using music. The primary purpose of this study was to clarify whether music-based auditory neurofeedback increases the power of the alpha wave in healthy subjects. During neurofeedback, white noise was superimposed on classical music, with the noise level inversely correlating with normalized alpha wave power. This was a single-blind, randomized control crossover trial in which 10 healthy subjects underwent, in an assigned order, normal and random feedback (NF and RF), either of which was at least 4 weeks long. Cognitive functions were evaluated before, between, and after each neurofeedback period. The secondary purpose was to assess neurofeedback-induced changes in cognitive functions. A crossover analysis showed that normalized alpha-power was significantly higher in NF than in RF; therefore, music-based auditory neurofeedback facilitated alpha wave induction. A composite category-based analysis of cognitive functions revealed greater improvements in short-term memory in subjects whose alpha-power increased in response to NF. The present study employed a long period of auditory alpha neurofeedback and achieved successful alpha wave induction and subsequent improvements in cognitive functions. Although this was a pilot study that validated a music-based alpha neurofeedback system for healthy subjects, the results obtained are encouraging for those with difficulty in concentrating on conventional alpha neurofeedback.Trial registration: 2018077NI, date of registration: 2018/11/27