Harnessing brain-computer interfaces for psychosomatic disorders: Mechanisms, outcomes, and ethics

Brain-computer interfaces (BCIs) are advancing from proof-of-concept to early clinical use for psychosomatic disorders, yet a concise synthesis that links mechanisms, therapeutic value, and governance remains limited. This review integrates present knowledge on how BCIs modulate emotion-cognition-autonomic networks, summarizes clinical signals in depression, anxiety/post-traumatic stress disorder, somatoform conditions, and chronic pain, as well as outlines the ethical-regulatory context shaping translation. Peer-reviewed studies and authoritative policy documents were retrieved from scholarly literature and organizational websites. The authors screened and narratively synthesized neural targets, outcomes, adverse events, and governance themes. As the aim was conceptual integration and policy mapping rather than quantitative pooling, no meta-analysis, formal risk-of-bias scoring, or registration of the International Prospective Register of Systematic Reviews was undertaken. Converging evidence indicates that electroencephalogram-based neurofeedback and real-time functional magnetic resonance imaging can reduce distress, enhance emotion regulation, and modulate interoceptive/autonomic markers with generally mild and transient adverse events. Nevertheless, gaps persist in long-term safety monitoring, standardized protocols, and explicit safeguards for brain-data privacy, autonomy, and equity. BCIs thus appear as a mechanistically plausible, moderately effective, and well-tolerated adjunct in psychosomatic care, provided that future multicenter trials embed harmonized methods, extended follow-up, and robust governance aligned with emerging international guidance.