Development of Enhanced Stimulus Content to Improve the Treatment Efficacy of EEG–Based Frontal Alpha Asymmetry Neurofeedback for Stress Mitigation

The neurofeedback stimulus content has direct implications for the efficacy of the psychophysiological applications for neurofeedback modality. In particular, enhancements of neurofeedback stimulus content can facilitate improvements in the efficacy of neurofeedback applications in clinical practice. To further elaborate on this aspect, this study introduced systematic enhancements in neurofeedback stimulus content by developing enhanced neurofeedback stimulus content for stress mitigation. The enhancements included the automatic selection of colour of neurofeedback stimulus content environment and instruction messages, as well as, the adaptive selection of threshold of quantitative electroencephalogram (QEEG) features, such as frontal alpha power and frontal alpha asymmetry. The enhancements were based on the outcomes from previous research on the selection of neurofeedback stimulus content for stress mitigation. The improvement in the efficacy of neurofeedback stimulus content was measured statistically by comparing the QEEG and topographic maps. In this study, electroencephalogram data from 20 participants were acquired during multiple sessions of neurofeedback. Analysis of variance and a post hoc test were used to verify the improvement on the efficacy of the neurofeedback application for stress mitigation after the enhancements of the neurofeedback stimulus content; a t–test was used to verify the statistical significance of the stress mitigation by the neurofeedback. The results indicate that the enhancement of the developed neurofeedback stimulus content facilitated stress mitigation during the early sessions of neurofeedback. In conclusion, the efficacy of neurofeedback can be improved using the developed stimulus content with enhancements.