Placebo hampers ability to self-regulate brain activity: A double-blind sham-controlled neurofeedback study

ABSTRACT It is still poorly understood how unspecific effects peripheral to the supposed action mechanism of neurofeedback (NF) influence the ability to self‐regulate one's own brain signals. Recently, skeptical researchers have even attributed the lion's part of therapeutic outcomes of NF to placebo and other psychosocial factors. Here, we investigated whether and by which mechanisms unspecific factors influence neural self‐regulation during NF. To manipulate the impact of unspecific influences on NF performance, we used a sham transcranial direct current stimulation (tDCS) as active placebo intervention suggesting positive effects on NF performance. Our results show that the expectation of receiving brain stimulation, which should boost neural self‐regulation, interferes with the ability to self‐regulate the sensorimotor rhythm in the EEG. Hence, these results provide evidence that placebo reduces NF performance, and thereby challenge current theories on unspecific effects related to NF. HIGHLIGHTSPlacebo disturbs ability to up‐regulate the EEG sensorimotor rhythm.Placebo is associated with increased brain connectivity.Explicit instructions necessary to successfully modulate the sensorimotor rhythm.