A PRISMA-guided systematic review found that while patients with idiopathic Parkinson's can learn to self-modulate neural signals via fMRI, EEG, or DBS neurofeedback, consistent improvements on validated clinical or behavioral outcomes are lacking due to small samples and methodological…

Indicates neurofeedback has mechanistic plausibility and translational potential but currently insufficient, underpowered clinical evidence—prioritizing larger, standardized trials and standardized effect-size reporting could determine its real therapeutic value for PD.

OBJECTIVE: Standard treatments for Parkinson's disease (PD) often lose effectiveness over time, motivating interest in complementary, non-pharmacological approaches. Neurofeedback, which trains patients to consciously modulate brain activity, has shown theoretical promise in PD; however, its clinical value remains uncertain. We conducted a PRISMA-guided systematic review to evaluate the current evidence. METHODS: We included studies of patients with idiopathic PD undergoing any form of neurofeedback training. Case studies were excluded to reduce intersubject variability. Sixteen studies met inclusion criteria; after methodological quality appraisal, twelve were retained for qualitative synthesis. RESULTS: Neurofeedback modalities included functional magnetic resonance imaging (n = 4), electroencephalography (n = 4), and deep brain stimulation (n = 4). Across modalities, patients generally learned to voluntarily modulate targeted neural signals. However, translation of neural self-regulation into improvement on validated clinical measures or task-specific behavioral outcomes was limited and inconsistent. Interpretation was constrained by small sample sizes and frequent absence of standardized effect size reporting, which weakens statistical robustness and complicates the distinction between true null effects and underpowered findings. CONCLUSIONS: While patients with PD can self-modulate brain activity, current evidence does not demonstrate consistent therapeutic benefit. SIGNIFICANCE: Despite a compelling mechanistic rationale, available data are insufficient to support neurofeedback as an effective treatment for PD.