NeuroModulation Rehabilitation. A neurofeedback and transcranial alternating-current stimulation approach for the neurorehabilitation of patients with attentional deficits after acquired brain injury

Project Information

NeMoRe

Grant agreement ID: 101108141

DOI

10.3030/101108141

Project closed

EC signature date 4 May 2023

Start date 11 September 2023

End date 10 October 2025

Funded under

• Marie Skłodowska-Curie Actions (MSCA)

Total cost

No data

EU contribution

€ 165 312,96

Coordinated by

IRENEA NEURO-RHB SOCIEDAD LIMITADA
Spain

Periodic Reporting for period 1 - NeMoRe (NeuroModulation Rehabilitation. A neurofeedback and transcranial alternating-current stimulation approach for the neurorehabilitation of patients with attentional deficits after acquired brain injury)

Reporting period: 2023-09-11 to 2025-10-10

Summary of the context and overall objectives of the project

Acquired brain injury (ABI) is a leading cause of long-term cognitive disability in Europe, with attentional deficits representing one of the most frequent and functionally disabling consequences. Despite their impact on autonomy, return to work, and quality of life, available cognitive rehabilitation interventions often show limited effectiveness and poor patient engagement. At the same time, non-invasive, technology-based interventions such as EEG neurofeedback have gained increasing attention, but robust clinical evidence supporting their efficacy, feasibility, and added value over standard rehabilitation remains scarce.

Within this context, the NeMoRe project aimed to investigate EEG-based neurofeedback as a novel, patient-centered cognitive rehabilitation approach for ABI. The overarching objective was to validate neurofeedback as a safe, feasible, and effective intervention for attentional rehabilitation, and to explore its future integration with neuromodulation techniques. The project was embedded in a broader political and strategic framework promoting digital health solutions, innovation in neurorehabilitation, and evidence-based, personalized medicine within the European Union.

By generating clinical, behavioral, and neurophysiological evidence, NeMoRe sought to address the need for more engaging and scalable rehabilitation tools, while strengthening European expertise in advanced neurotechnologies for health. The expected impact spans clinical practice, research innovation, and health system sustainability.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

During the fellowship, the project focused on the full implementation of the first scientific objective: the validation of EEG-based neurofeedback as a cognitive rehabilitation intervention in ABI patients. Following extensive methodological refinement and specialized training, a controlled clinical study was conducted comparing a neurofeedback intervention to standard cognitive rehabilitation.

Key activities included protocol optimization, ethics approval procedures, patient recruitment, administration of a 12-session neurofeedback training program, and comprehensive pre- and post-intervention assessments. Behavioral outcomes targeted attention and working memory, complemented by patient-reported measures addressing feasibility, safety, and motivation. Neurophysiological data (EEG and P300) were also collected to support mechanistic interpretation.

The main achievements of the project include the successful implementation of a complex neurofeedback protocol in a clinical population, demonstration of excellent safety and tolerability, and high patient engagement and motivation. Behavioral analyses revealed selective improvements and trends favoring neurofeedback on attention and working memory measures, while confirming the strong influence of baseline cognitive status on rehabilitation outcomes. These results establish a solid empirical foundation for further investigation and clinical translation.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

NeMoRe advances the state of the art by providing controlled, clinically grounded evidence on the feasibility and patient acceptability of EEG-based neurofeedback in ABI, a population underrepresented in neurofeedback research. Unlike many previous studies, the project adopted a conservative and methodologically rigorous approach, prioritizing safety, interpretability, and real-world applicability over overly complex experimental designs and non-controlled/open label studies.

The results highlight neurofeedback as a promising complementary tool to conventional rehabilitation to improve attentional cognitive processes, particularly due to its high motivational value and patient-perceived benefits. Importantly, the project also clarifies methodological challenges, such as the limitations of placebo neurofeedback and the need to account for clinical heterogeneity, thus contributing valuable guidance for future trials.

Beyond immediate scientific outcomes, the project identifies key needs for further uptake, including integration of neurophysiological markers as predictors of response, and evaluation of combined interventions. Continued research is already secured through additional regional funding, ensuring progression toward clinical scalability and long-term impact.

patient during the neurofeedback training of NeMoRe (patient gave consent for picture publication)