Level 1
Single Case Study
Show indications (1)
- Anxiety, nonspecific (BF)
Scientific evidence
Clinical evidence and efficacy
AAPB, ISNR and BBNS classify the clinical evidence for biofeedback and neurofeedback across five evidence levels.
Updated February 2026
The five evidence levels
The ratings follow the AAPB/ISNR classification, 4th edition of 2023, and BBNS METID v3.0 of January 2026. On this page, Level 1 is named Single Case Study.
From a single case study to the highest evidence level
Open a level to see every assigned indication. NF means neurofeedback and BF means biofeedback.
Level 2
Possibly Efficacious
Show indications (8)
- Anxiety, phobia
- Asthma (Capno)
- Chemobrain
- Diabetes, claudication
- Functional abdominal pain
- Hyperhidrosis
- Tinnitus (NF)
- Vasovagal syncope
Level 3
Probably Efficacious
Show indications (17)
- Alcohol or drug addiction
- Arthritis
- Autism
- Chemotherapy-induced peripheral neuropathy (CIPN)
- Concussion / TBI
- COPD
- Coronary artery disease
- Diabetes ulcers
- Fibromyalgia
- Immune function
- Insomnia
- Motion sickness
- Optimal performance (NF)
- Other paediatric pain
- Repetitive strain injury (RSI)
- Schizophrenia
- Tinnitus (BF)
Level 4
Efficacious
Show indications (15)
- Adult headache
- Generalised anxiety disorder
- Asthma (Pranayama)
- Cerebral palsy
- Chronic pain
- Epilepsy
- Hypertension
- Irritable bowel syndrome
- Optimal performance (BF)
- Paediatric headache and pain
- PTSD
- Raynaud’s disease
- Stroke
- Temporomandibular disorder
- Urinary incontinence in children
Level 5
Efficacious and Specific
Show indications (8)
- ADHD¹ (NF)
- Panic disorder (BF/NF)
- Asthma (HRV/Buteyko)
- Depression (NF/BF)
- Diabetes, glycaemic control
- Erectile dysfunction
- Preeclampsia
- Urinary incontinence in adults
Frequently requested applications
A direct overview of selected ratings. Different methods for the same indication can sit at different levels.
Anxiety and panic
Level 4Level 5
Generalised anxiety disorder is classified at Level 4; panic disorder with biofeedback or neurofeedback is classified at Level 5. The level depends on the specific condition and protocol.
Headache and migraine
Level 4
Adult headache is classified at Level 4. This category includes established biofeedback protocols for headache and migraine treatment.
Hypertension
Level 4
Biofeedback for hypertension is classified at Level 4.
Epilepsy
Level 4
Neurofeedback for epilepsy is classified at Level 4 and is integrated into a specialist-led treatment plan.
Depression
Level 5
Neurofeedback and biofeedback for depression are classified at Level 5.
Tinnitus
Level 2Level 3
Neurofeedback for tinnitus is classified at Level 2; biofeedback for tinnitus is classified at Level 3.
Insomnia
Level 3
Neurofeedback and biofeedback for insomnia are classified at Level 3.
ADHD
Level 5
Neurofeedback for ADHD is classified at Level 5.¹
¹ ADHD remains at Level 5 in the AAPB/ISNR and BBNS classification. Methodological controversy relates mainly to blinded outcome measurement.
Quality and safety
Clinical technology rather than consumer wearables
Accurate measurement, qualified guidance and the right protocol are central to safe and efficient training.
Limits of consumer EEG
Consumer EEG devices do not provide the signal quality required for clinical neurofeedback and are particularly susceptible to artefacts. Imprecise signals can lead to inefficient training and poorly targeted protocols.
Medically certified systems
I-NFBF uses only modern, medically certified technology meeting CE, FDA and Swissmedic standards, together with qEEG-guided protocols. This supports precise training plans and structured progress review.
Classification sources
The complete classifications and methodological framework are available from the professional bodies.
Questions about the evidence?
We can explain how the levels apply to a particular concern and selected protocol.