Neurofeedback for obsessive compulsive disorder: A randomized, double-blind trial

Mariela Rance, Zhiying Zhao, Brian Zaboski, Stephen A. Kichuk, Emma Romaker, William N. Koller, Christopher Walsh, Cheyenne Harris-Starling, Suzanne Wasylink, Thomas Adams, Patricia Gruner, Christopher Pittenger, Michelle Hampson

Research output: Contribution to journalArticlepeer-review


We aim to develop fMRI neurofeedback as a treatment for obsessive compulsive disorder (OCD). In prior work, we found that providing neurofeedback of activity in the anterior prefrontal cortex (aPFC) improved control over contamination anxiety in a subclinical population. Here, we present the results of a randomized, double-blind clinical trial (NCT02206945) testing this intervention in patients with OCD. We recruited patients with primary symptoms in the fear-of-harm/checking or contamination/washing domains. During neurofeedback, they viewed symptom provocative images and attempted to up- and down-regulate the aPFC during different blocks of time. The active group received two sessions of neurofeedback and the control group received yoked sham feedback. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Symptom scale. The secondary outcome was control over aPFC. Thirty-six participants completed feedback training (18 active, 18 control). The active group had a slightly but significantly greater reduction of obsessive-compulsive symptoms after neurofeedback compared to the control group (p<.05) but no significant differences in control over the aPFC. These data demonstrate that neurofeedback targeting the aPFC can reduce symptoms in OCD. Future investigations should seek to optimize the training protocol to yield larger effects and to clarify the mechanism of action.

Original languageEnglish
Article number115458
JournalPsychiatry Research
StatePublished - Oct 2023

Bibliographical note

Publisher Copyright:
© 2023 Elsevier B.V.


  • Biofeedback
  • Neurofeedback
  • OCD
  • Obsessive compulsive disorder
  • rt-fMRI

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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