Abstract

Background: Long COVID affects a substantial number of individuals with persistent symptoms such as cognitive impairment, fatigue, and emotional distress impacting quality of life and functionality.1 Current management primarily relies on supportive care, underscoring an urgent need for novel therapeutic approaches to alleviate these enduring symptoms. Neurofeedback is a non-invasive complementary therapy that promotes self-regulation by training the brain to achieve optimal functioning via auditory feedback with demonstrated improvements in symptoms of cognitive impairment, fatigue, anxiety, depression and sleep problems in other patient populations including cancer survivors.2,3 We propose neurofeedback could be used to address persistent symptoms associated with Long COVID.

Purpose: This nurse-led study aimed to explore the feasibility of using nonlinear dynamical neurofeedback as a potential intervention for alleviating cognitive impairment, fatigue, and other symptoms in individuals experiencing Long COVID.

Methods: This feasibility study employed a quasi-experimental repeated measures design. Participants received 20 sessions of NeurOptimal nonlinear dynamical neurofeedback over a 10-week period. Symptoms were assessed at four time points using standardized measures of cognitive function, fatigue, sleep quality, and psychological symptoms.

Results: Twenty participants were recruited, four dropped out early in the study and 16 completed all neurofeedback sessions and assessments. Repeated measures ANOVA analysis indicated that cognitive dysfunction, fatigue, sleep problems, anxiety and depressive symptoms decreased significantly from pre-intervention to post-intervention (p=.001) and results were maintained at 10-week follow-up.

Conclusions: Results of this pilot feasibility study indicate it is feasible and acceptable to provide neurofeedback to individuals with Long COVID and suggests that nonlinear dynamical neurofeedback has a positive effect on persistent symptoms in this population. By gathering preliminary data on the feasibility, acceptability, and potential effectiveness of this intervention, the study will inform the design of a future randomized controlled trial. Findings will inform clinical nurses working with Long COVID patients and could support the integration of neurofeedback into mainstream rehabilitation programs, offering an innovative, non-invasive option for managing the persistent and debilitating symptoms of Long COVID.

Notes

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References:

1. Government of Canada. Frequency and impact of longer-term symptoms following COVID-19 in Canadian adults (2022-10-20). 2022. Available from: https://health-infobase.canada.ca/covid-19/post-covid-condition/ [Last Accessed; Feb 26].

2. Alvarez J, Meyer FL, Granoff DL, et al. The effect of EEG biofeedback on reducing postcancer cognitive impairment. Integr Cancer Ther 2013;12(6):475-87, https://doi.org/10.1177/1534735413477192

3. Luctkar-Flude M, Tyerman J, Burnett S, et al. Exploring the effect of neurofeedback on postcancer cognitive impairment and fatigue: A pilot feasibility study. Can Oncol Nurs J 2022;32(2):214-222, https://doi.org/10.5737/23688076322214222

Description

This nurse-led study explored the feasibility of using neurofeedback to manage Long COVID symptoms like cognitive impairment, fatigue, and psychological distress. Sixteen participants completed 20 neurofeedback sessions. Results showed significant improvements in cognitive function, fatigue, sleep, and psychological symptoms, maintained at follow-up. Findings support feasibility and potential effectiveness of neurofeedback, suggesting its future integration into rehabilitation for Long COVID.

Author Details

Marian Luctkar-Flude, PhD, RN, CCSNE, FCNEI; Jane Tyerman, PhD, RN, CCSNE

Sigma Membership

Lambda Pi at-Large

Lead Author Affiliation

Queen's University, Kingston, Ontario, Canada

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quasi-Experimental Study, Other

Research Approach

Quantitative Research

Keywords:

Academic-Clinical Partnership, Acute Care, Sub-Acute Care, Long COVID, Post-Acute COVID-19 Syndrome, Post-Acute COVID-19 Syndrome--Rehabilitation, Neurofeedback, Biofeedback

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-08-04

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Exploring Feasibility of Neurofeedback to Alleviate Cognitive Impairment and Fatigue in Long COVID

Toronto, Ontario, Canada

Background: Long COVID affects a substantial number of individuals with persistent symptoms such as cognitive impairment, fatigue, and emotional distress impacting quality of life and functionality.1 Current management primarily relies on supportive care, underscoring an urgent need for novel therapeutic approaches to alleviate these enduring symptoms. Neurofeedback is a non-invasive complementary therapy that promotes self-regulation by training the brain to achieve optimal functioning via auditory feedback with demonstrated improvements in symptoms of cognitive impairment, fatigue, anxiety, depression and sleep problems in other patient populations including cancer survivors.2,3 We propose neurofeedback could be used to address persistent symptoms associated with Long COVID.

Purpose: This nurse-led study aimed to explore the feasibility of using nonlinear dynamical neurofeedback as a potential intervention for alleviating cognitive impairment, fatigue, and other symptoms in individuals experiencing Long COVID.

Methods: This feasibility study employed a quasi-experimental repeated measures design. Participants received 20 sessions of NeurOptimal nonlinear dynamical neurofeedback over a 10-week period. Symptoms were assessed at four time points using standardized measures of cognitive function, fatigue, sleep quality, and psychological symptoms.

Results: Twenty participants were recruited, four dropped out early in the study and 16 completed all neurofeedback sessions and assessments. Repeated measures ANOVA analysis indicated that cognitive dysfunction, fatigue, sleep problems, anxiety and depressive symptoms decreased significantly from pre-intervention to post-intervention (p=.001) and results were maintained at 10-week follow-up.

Conclusions: Results of this pilot feasibility study indicate it is feasible and acceptable to provide neurofeedback to individuals with Long COVID and suggests that nonlinear dynamical neurofeedback has a positive effect on persistent symptoms in this population. By gathering preliminary data on the feasibility, acceptability, and potential effectiveness of this intervention, the study will inform the design of a future randomized controlled trial. Findings will inform clinical nurses working with Long COVID patients and could support the integration of neurofeedback into mainstream rehabilitation programs, offering an innovative, non-invasive option for managing the persistent and debilitating symptoms of Long COVID.