ORIGINAL RESEARCH article
Front. Virtual Real.
Sec. Virtual Reality in Medicine
Volume 6 - 2025 | doi: 10.3389/frvir.2025.1499413
This article is part of the Research TopicEnabling the Medical Extended Reality ecosystem - Advancements in Technology, Applications and Regulatory ScienceView all 11 articles
Intuitive Virtual Reality Based Frontal-Midline Theta Neurofeedback: A Feasibility Study in Young Ages
Provisionally accepted
- 1University of Bern, Bern, Bern, Switzerland
- 2Florida State University, Tallahassee, Florida, United States
- 3University of North Carolina at Chapel Hill, Chapel Hill, United States
- 4Michigan State University, East Lansing, Michigan, United States
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Background: Neurofeedback is a method to modulate neural activity, such as frontal-midline theta oscillations. Given the emerging role of pathologically disrupted neuronal oscillations in psychiatric disorders, neurofeedback has potential as a novel therapeutic intervention. Participant immersion in the neurofeedback paradigm is critical to its efficacy. Here, we tested whether virtual reality enabled immersion and rapid acquisition of the ability to intentionally modulate frontalmidline theta oscillations. Methods: We developed a neurofeedback task in which participants were instructed to clean up trash in a virtual underwater environment with their own thoughts. Unbeknownst to the participant, the amount of trash was updated as a function of frontal-midline theta power estimated from realtime electroencephalography recording. The neurofeedback blocks were interleaved with a working memory task, which is known to increase frontal-midline theta oscillations.The study involved 29 participants (Mean age = 24.62 years, SD = 9.31). By the end of the first block, 70% of participants successfully increased and sustained their frontal-midline theta oscillations. The amplitude of frontal-midline theta during neurofeedback was greater than rest but not as strong as during the working memory task.We suggest that virtual-reality-based neurofeedback is highly immersive, causes minimal discomfort and increases theta oscillations with a brief learning period. Neurofeedback is a feasible method of increasing neural activity similar to working memory tasks and a promising method for training individuals to increase endogenous theta oscillations. Future research should investigate potential transfer effects into cognitive domains to increase cognitive control and topdown control.
Keywords: Neurofeedback, working memory, virtual reality, theta oscillations, Frontal-Midline
Received: 20 Sep 2024; Accepted: 31 Jul 2025.
Copyright: © 2025 Gerber, Riddle, LaGarde, Zhang and Frohlich. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Flavio Frohlich, University of North Carolina at Chapel Hill, Chapel Hill, United States
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