# PWR-205 — Neurofeedback: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 33 min reading and worksheet pass Difficulty: Advanced Equipment: Specialist equipment — Study A: “Better than sham? A double-blind placebo-controlled neurofeedback study in primary insomnia” — https://pubmed.ncbi.nlm.nih.gov/28335000/; Study B: “Neurofeedback-induced desynchronization of sensorimotor rhythm elicits pre-movement downregulation of intracortical inhibition that shortens simple reaction time in humans: A double-blind, sham-controlled randomized study” — https://pubmed.ncbi.nlm.nih.gov/40800510/; Protocol table with these columns: study; participants; intended EEG feature; sensor location; sampling or filtering; eye, muscle and movement handling; calibration; feedback shown; threshold changes; sessions; trial length; coaching.; Comparison table with these columns: sham feedback; matched contact time; participant blinding; assessor blinding; blinding check; outcome named in advance; signal result; neurofeedback-minus-sham result; uncertainty; adverse events; result without feedback; delayed result.; A conclusion sheet with four headings: “Signal learned?”, “Better than sham?”, “Meaningful function?”, and “Retained without feedback?” Space: Room-scale practice space Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G5; Focused research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context This is a paper-reading tutorial, not neurofeedback training. You will trace what the sensors measured, how non-brain noise was handled, what participants saw, what the comparison group received and which results were named before the data were known. You will then separate three questions: did people change the intended signal, did neurofeedback outperform believable placebo feedback, and did any benefit remain when feedback was absent? Target outcome: The learner completes every field in a two-study audit, using “not reported” where necessary, and writes separate conclusions for signal learning, the neurofeedback-versus-sham difference, functional benefit and no-feedback transfer. ### Authority and setup conditions - Keep this as a paper-only exercise. Do not connect a sensor, choose a protocol or change treatment. - Write these definitions at the top: “artefact” means eye, muscle, movement or equipment activity that can look like EEG; “sham” means believable comparison feedback; “between-group result” means the difference between neurofeedback and sham. - Open each paper's methods, supplement and registration when available. If a required detail cannot be verified, write “not reported” instead of guessing. - Keep the two studies in separate columns; they use different populations, targets and outcomes. ### Required or supplied materials - Study A: “Better than sham? A double-blind placebo-controlled neurofeedback study in primary insomnia” — https://pubmed.ncbi.nlm.nih.gov/28335000/ - Study B: “Neurofeedback-induced desynchronization of sensorimotor rhythm elicits pre-movement downregulation of intracortical inhibition that shortens simple reaction time in humans: A double-blind, sham-controlled randomized study” — https://pubmed.ncbi.nlm.nih.gov/40800510/ - Protocol table with these columns: study; participants; intended EEG feature; sensor location; sampling or filtering; eye, muscle and movement handling; calibration; feedback shown; threshold changes; sessions; trial length; coaching. - Comparison table with these columns: sham feedback; matched contact time; participant blinding; assessor blinding; blinding check; outcome named in advance; signal result; neurofeedback-minus-sham result; uncertainty; adverse events; result without feedback; delayed result. - A conclusion sheet with four headings: “Signal learned?”, “Better than sham?”, “Meaningful function?”, and “Retained without feedback?” ## 1. Write the three questions For each study, ask separately: Did participants change the intended EEG feature? Did neurofeedback outperform sham? Did it improve the named clinical or functional outcome? Why: A changed EEG feature, a specific treatment effect and a useful outcome are different claims. Success check: The worksheet has three separate questions rather than one general “did it work?” question. Accessible alternative: Complete the same research action — “For each study, ask separately: Did participants change the intended EEG feature? Did neurofeedback outperform sham? Did it improve the named clinical or functional outcome?” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The worksheet has three separate questions rather than one general “did it work?” question.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Trace the signal from sensor to score Copy the sensor type and location, sampling or filtering, intended EEG feature, calibration rule and the rule for turning EEG into a score. Write “not reported” for every missing item. Why: The reader needs to know what was actually measured before interpreting the feedback. Success check: Another reader can follow the paper from the sensor recording to the reported target-signal value. Accessible alternative: Complete the same research action — “Copy the sensor type and location, sampling or filtering, intended EEG feature, calibration rule and the rule for turning EEG into a score. Write “not reported” for every missing item.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “Another reader can follow the paper from the sensor recording to the reported target-signal value.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Check eye, muscle and movement artefacts Record how the study detected, rejected or corrected eye movements, facial or scalp muscle activity, body movement and poor sensor contact. Note any sensitivity check. Why: These signals can change the display without showing control of the intended brain activity. Success check: Every artefact category has a reported method or the words “not reported.” Accessible alternative: Complete the same research action — “Record how the study detected, rejected or corrected eye movements, facial or scalp muscle activity, body movement and poor sensor contact. Note any sensitivity check.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “Every artefact category has a reported method or the words “not reported.”” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Reconstruct what feedback participants received Record the picture, sound or score shown; what signal changed it; how thresholds changed; session count; trial length; rest; and coaching. Do not turn these fields into operating instructions. Why: The intervention cannot be judged if the feedback rule and exposure are unknown. Success check: The paper audit describes the intervention while remaining explicitly non-operational. Accessible alternative: Complete the same research action — “Record the picture, sound or score shown; what signal changed it; how thresholds changed; session count; trial length; rest; and coaching. Do not turn these fields into operating instructions.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The paper audit describes the intervention while remaining explicitly non-operational.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Audit sham and blinding Write exactly what sham participants saw, whether session time and staff contact matched, who was blinded, and whether participants were asked which group they thought they were in. Why: Expectation, attention and repeated contact can improve outcomes in both groups. Success check: The table shows whether the sham was believable and whether blinding was tested rather than merely claimed. Accessible alternative: Complete the same research action — “Write exactly what sham participants saw, whether session time and staff contact matched, who was blinded, and whether participants were asked which group they thought they were in.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The table shows whether the sham was believable and whether blinding was tested rather than merely claimed.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Extract outcomes named before the results Find the registration or protocol. Copy the primary signal and functional outcomes, their time points and responder rules. Label later-added or exploratory outcomes separately. Why: Choosing an attractive outcome after seeing the data can exaggerate the apparent result. Success check: Every reported conclusion is labelled primary, secondary, exploratory or not verifiable. Accessible alternative: Complete the same research action — “Find the registration or protocol. Copy the primary signal and functional outcomes, their time points and responder rules. Label later-added or exploratory outcomes separately.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “Every reported conclusion is labelled primary, secondary, exploratory or not verifiable.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Copy the neurofeedback-minus-sham result For each primary outcome, record the difference between groups with its confidence interval, uncertainty or exact reported statistic. Keep within-group improvement in a separate column. Why: Improvement in the neurofeedback group alone does not show that neurofeedback caused the improvement. Success check: The conclusion is based on the group comparison, not on one group's before-and-after change. Accessible alternative: Complete the same research action — “For each primary outcome, record the difference between groups with its confidence interval, uncertainty or exact reported statistic. Keep within-group improvement in a separate column.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The conclusion is based on the group comparison, not on one group's before-and-after change.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Check performance without feedback Look for a trial in which feedback was removed and for a delayed follow-up. Record the result and time point, or write “not tested.” Why: Controlling a display while it is present is not the same as retaining the skill or using it in daily life. Success check: Device-on performance, no-feedback performance and delayed function occupy separate cells. Accessible alternative: Complete the same research action — “Look for a trial in which feedback was removed and for a delayed follow-up. Record the result and time point, or write “not tested.”” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “Device-on performance, no-feedback performance and delayed function occupy separate cells.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 9. Write one verdict per study Answer the four conclusion headings using one or two sentences each, then list the largest missing detail and any adverse event information. Why: A structured verdict prevents one positive result from standing in for every unanswered question. Success check: The verdict states what changed, what did not, what remains uncertain and what was not tested. Accessible alternative: Complete the same research action — “Answer the four conclusion headings using one or two sentences each, then list the largest missing detail and any adverse event information.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The verdict states what changed, what did not, what remains uncertain and what was not tested.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## 10. Compare without mixing the studies Place the two verdicts side by side. Compare methods only where the fields mean the same thing, and do not import the reaction-time result into an insomnia claim. Why: Different EEG targets and outcomes do not become interchangeable because both studies use the word neurofeedback. Success check: The final paragraph preserves the population, target and outcome of each study. Accessible alternative: Complete the same research action — “Place the two verdicts side by side. Compare methods only where the fields mean the same thing, and do not import the reaction-time result into an insomnia claim.” — using speech-to-text, text-to-speech, enlarged text, keyboard-only navigation, shorter work blocks or a support person. Preserve this declared check: “The final paragraph preserves the population, target and outcome of each study.” Do not convert the research task into capability practice. Alternative relationship: Target preserving when declared check is preserved Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.