Effects of Electroencephalographic Biofeedback Therapy on Depression Level, Sleep Quality and Cognitive Function in Patients With Non-Demented Vascular Cognitive Impairment

Objective: This study aimed to investigate the effects of electroencephalographic biofeedback (EEG-BF) treatment on cognitive function, sleep quality, anxiety and depression levels and quality of life in patients with vascular cognitive impairment-no dementia (VCI-ND). Methods: This study was a retrospective study that included a total of 128 patients diagnosed with VCI-ND at the Affiliated Hospital of North Sichuan Medical College from July 2022 to July 2024. The patients were divided into an EEG-BF group and a control group in accordance with whether they received EEG-BF treatment or not. Both groups received standard vascular risk factor management. The EEG-BF group separately received EEG-BF intervention two times a week for 12 weeks. Propensity score matching (PSM) was used to perform 1:1 nearest-neighbour matching between the two groups with respect to baseline characteristics. The matching variables included age; education; place of residence; family income; type of health insurance; number of underlying diseases; and pre-intervention scores on the Montreal Cognitive Assessment (MoCA), Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). The main outcome measures were the PSQI, MoCA, SAS, 36-item Short-Form Questionnaire (SF-36) and SDS before and after treatment. Results: After PSM, the baseline covariates between the two groups were well balanced, with no significant differences. The Love plot showed a significant decrease in standardised differences in covariates after matching. After 12 weeks of intervention, the EEG-BF group was significantly better than the control group in terms of MoCA scores (p = 0.013), SAS scores (p = 0.002), SDS scores (p = 0.004) and some of the SF-36 dimensions, and the within-group before and after comparisons was statistically different (p 0.05). Conclusion: EEG-BF may help improve cognitive function, sleep quality, emotional state and life quality in patients with VCI-ND, offering a promising individualised non-pharmacological intervention for this population. Future multicentre, prospective studies are needed to further validate its prolonged therapeutic effect and neuromodulatory mechanisms.