The Role of Neurofeedback and Non-Invasive Brain Stimulation (tDCS/rTMS) in Enhancing Athletic Performance and Psychological Resilience in Elite Athletes

نوع مقاله : مقاله پژوهشی

نویسندگان

1 Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500068 Braşov, Romania.

2 Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal; ResearchCenter in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal

3 Research Unit, Sportive Sciences, Health and Movement, High Institute of Sports and Physical Education of Kef, University of Jendouba, 7100 Kef, Tunisia

4 Department of Physical Education and Sports, University of Granada, Granada, Spain

5 Department of Teacher Education, NLA University College, 0166 Oslo, Norway.

چکیده

Objective: This study investigated the synergistic effects of neurofeedback (NF) and transcranial direct current stimulation (tDCS) on enhancing athletic performance and psychological resilience in elite athletes, addressing critical gaps in standardized protocols and long-term efficacy within sports neuroscience.
Methods: A randomized, double-blind, sham-controlled crossover design was employed with 60 national-level athletes (30 male, 30 female) stratified by sport type (endurance/skill-based). Participants underwent 10 sessions of either: (1) active NF (SMR upregulation via 64-channel EEG) + active tDCS (2mA over left DLPFC), (2) active NF + sham tDCS, (3) sham NF + active tDCS, or (4) sham NF + sham tDCS. Primary outcomes included sport-specific performance metrics (reaction time, time-to-exhaustion) and psychological resilience (CD-RISC-25), with secondary EEG measures (beta power, P300) assessed at baseline, post-intervention, and 8-week follow-up.
Results: The combined NF+tDCS group demonstrated superior improvements versus sham controls: 15.2% faster reaction time (p < 0.001, d = 1.21), 12.4% increased endurance (p = 0.002), and 22.3-point higher resilience scores (p < 0.001). EEG revealed sustained beta power elevation over the left DLPFC (+2.1 dB at follow-up, p = 0.01), mediating 41% of resilience gains through reduced amygdala reactivity (HRV analysis, β = 0.64, p = 0.003). Skill-based athletes showed greater cognitive benefits, while endurance athletes exhibited stronger psychological gains, with sex-specific effects noted (females: better tDCS response; males: superior NF anxiety reduction).
Conclusion: Combined NF and tDCS induces durable, sport-specific enhancements in both performance and resilience, likely through prefrontal-amygdala circuit plasticity. These findings advocate for personalized neuromodulation protocols in elite sports while highlighting the need for ethical frameworks governing neuroenhancement technologies.

تازه های تحقیق

Key Message:

 

This study demonstrates that combining neurofeedback (NF) and transcranial direct current stimulation (tDCS) produces synergistic, long-lasting improvements in both athletic performance (15.2% faster reaction time, 12.4% increased endurance) and psychological resilience (22.3-point gain) in elite athletes. The intervention induces durable neuroplastic changes in prefrontal-amygdala circuits, with effects persisting for 8 weeks, offering a scientifically validated, 

personalized approach to optimizing both physical and mental aspects of elite sports performance.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Role of Neurofeedback and Non-Invasive Brain Stimulation (tDCS/rTMS) in Enhancing Athletic Performance and Psychological Resilience in Elite Athletes

نویسندگان [English]

  • Georgian Badicu 1
  • Rui Miguel Silva 2
  • Seifeddine Brini 3
  • Francisco Tomas Gonzalez-Fernandes 4
  • Luca Paolo Ardigò 5
1 Department of Physical Education and Special Motricity, Transilvania University of Brasov, 500068 Braşov, Romania.
2 Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal; ResearchCenter in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
3 Research Unit, Sportive Sciences, Health and Movement, High Institute of Sports and Physical Education of Kef, University of Jendouba, 7100 Kef, Tunisia
4 Department of Physical Education and Sports, University of Granada, Granada, Spain
5 Department of Teacher Education, NLA University College, 0166 Oslo, Norway.
چکیده [English]

Objective: This study investigated the synergistic effects of neurofeedback (NF) and transcranial direct current stimulation (tDCS) on enhancing athletic performance and psychological resilience in elite athletes, addressing critical gaps in standardized protocols and long-term efficacy within sports neuroscience.
Methods: A randomized, double-blind, sham-controlled crossover design was employed with 60 national-level athletes (30 male, 30 female) stratified by sport type (endurance/skill-based). Participants underwent 10 sessions of either: (1) active NF (SMR upregulation via 64-channel EEG) + active tDCS (2mA over left DLPFC), (2) active NF + sham tDCS, (3) sham NF + active tDCS, or (4) sham NF + sham tDCS. Primary outcomes included sport-specific performance metrics (reaction time, time-to-exhaustion) and psychological resilience (CD-RISC-25), with secondary EEG measures (beta power, P300) assessed at baseline, post-intervention, and 8-week follow-up.
Results: The combined NF+tDCS group demonstrated superior improvements versus sham controls: 15.2% faster reaction time (p < 0.001, d = 1.21), 12.4% increased endurance (p = 0.002), and 22.3-point higher resilience scores (p < 0.001). EEG revealed sustained beta power elevation over the left DLPFC (+2.1 dB at follow-up, p = 0.01), mediating 41% of resilience gains through reduced amygdala reactivity (HRV analysis, β = 0.64, p = 0.003). Skill-based athletes showed greater cognitive benefits, while endurance athletes exhibited stronger psychological gains, with sex-specific effects noted (females: better tDCS response; males: superior NF anxiety reduction).
Conclusion: Combined NF and tDCS induces durable, sport-specific enhancements in both performance and resilience, likely through prefrontal-amygdala circuit plasticity. These findings advocate for personalized neuromodulation protocols in elite sports while highlighting the need for ethical frameworks governing neuroenhancement technologies.

کلیدواژه‌ها [English]

  • Neuroenhancement
  • Athletic Performance
  • Transcranial Direct Current Stimulation (Tdcs)
  • Psychological Resilience
  • Elite Athletes
  1. Angius, L., Hopker, J., & Mauger, A. R. (2017). The Ergogenic Effects of Transcranial Direct Current Stimulation on Exercise Performance. Frontiers in physiology8, 90. https://doi.org/10.3389/fphys.2017.00090
  2. Cailhol, L., Soltani, K., Neige, C., Mondino, M., Brunelin, J., & Blay, M. (2025). Transcranial Direct Current Stimulation (tDCS) for borderline personality disorder (BPD): Why and How? Brain Sciences15(6), 547. https://doi.org/10.3390/brainsci15060547
  3. Mohebbian, B., Najafi, M. & Sabahi, P. The effect of transcranial direct current stimulation on sleep quality, resilience, and optimism. Curr Psychol42, 5785–5792 (2023). https://doi.org/10.1007/s12144-021-01944-9
  4. Noroozi Homayoon, M., Nasiri, A., Sadri Damirchi, E., & Narimani, M. (2025). The Comparison of the Effectiveness of Emotional Cognitive Regulation Training and Transcranial Direct Current Stimulation on Resilience, Cognitive Flexibility, and Rumination in Older Women with Major Depressive Disorder. Aging Psychology11(1), 42-21. https://doi.org/10.22126/jap.2025.11478.1821
  5. Courrèges, M., Hoareau, M., Levenes, C., & Rahioui, H. (2025). Comparative efficacy of neurofeedback, tDCS, and TMS: The future of therapy for adults with ADHD. A systematic review and meta-analysis. Journal of affective disorders388, 119585. https://doi.org/10.1016/j.jad.2025.119585
  6. Courrèges, M., Hoareau, M., Levenes, C., & Rahioui, H. (2025). Comparative efficacy of neurofeedback, tDCS, and TMS: The future of therapy for adults with ADHD. A systematic review and meta-analysis. Journal of affective disorders388, 119585. https://doi.org/10.1016/j.jad.2025.119585
  7. Husain, H., Samsudin, S., Ayub, A. F. M., Ahmad, M. F., & Afwan, N. S. Z. S. (2024). A systematic literature review on the impact of participation in sport and physical activities on psychological resilience.  J. Public Health Sci. (IJPHS)13, 1727.‏ https://doi.org/10.11591/ijphs.v13i4.24345
  8. Krause, F., Linden, D. E., & Hermans, E. J. (2024). Getting stress-related disorders under control: the untapped potential of neurofeedback. Trends in neurosciences.‏ https://doi.org/10.1016/j.tins.2024.08.007
  9. Di Martino, G., Della Valle, C., di Cagno, A., Fiorilli, G., Calcagno, G., & Conte, D. (2025). The Role of Sports in Building Resilience: A Machine Learning Approach to the Psychological Effects of the COVID-19 Pandemic on Children and Adolescents. Sports (Basel, Switzerland)13(2), 37. https://doi.org/10.3390/sports13020037
  10. Klomjai, W., & Aneksan, B. (2022). A randomized sham-controlled trial on the effects of dual-tDCS "during" physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a "before" stimulation protocol. BMC sports science, medicine & rehabilitation14(1), 68. https://doi.org/10.1186/s13102-022-00463-9
  11. Xu, Z., Shen, B., Xiao, S., Zhang, C., Zhan, J., Li, J., Fu, W., & Jin, J. (2024). The Effect of Transcranial Direct Current Stimulation on Lower-Limb Endurance Performance: A Systematic Review. Bioengineering11(11), 1088. https://doi.org/10.3390/bioengineering11111088
  12. Corrado, S., Tosti, B., Mancone, S., Di Libero, T., Rodio, A., Andrade, A., & Diotaiuti, P. (2024). Improving Mental Skills in Precision Sports by Using Neurofeedback Training: A Narrative Review. Sports12(3), 70. https://doi.org/10.3390/sports12030070
  13. Tosti, B., Corrado, S., Mancone, S., Di Libero, T., Carissimo, C., Cerro, G., Rodio, A., da Silva, V. F., Coimbra, D. R., Andrade, A., & Diotaiuti, P. (2024). Neurofeedback Training Protocols in Sports: A Systematic Review of Recent Advances in Performance, Anxiety, and Emotional Regulation. Brain sciences14(10), 1036. https://doi.org/10.3390/brainsci14101036
  14. Li, L., & Smith, D. M. (2021). Neural Efficiency in Athletes: A Systematic Review. Frontiers in behavioral neuroscience15, 698555. https://doi.org/10.3389/fnbeh.2021.698555
  15. Judge, L. W., Moreau, C., & Burke, J. R. (2003). Neural adaptations with sport-specific resistance training in highly skilled athletes. Journal of sports sciences21(5), 419–427. https://doi.org/10.1080/0264041031000071173
  16. Montero, A., Baranoff, J., Adams, R., & Drummond, M. (2024). Athletic retirement: factors contributing to sleep and mental health problems. Frontiers in psychology15, 1350925. https://doi.org/10.3389/fpsyg.2024.1350925
  17. Chen, M., Zhao, G., & Peng, L. (2024). Transcranial Magnetic Stimulation Applications in the Study of Executive Functions: A Review. Brain and behavior14(11), e70099. https://doi.org/10.1002/brb3.70099
  18. Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R., Campriani, N., Castaldelli-Maia, J. M., Currie, A., Derevensky, J. L., Glick, I. D., Gorczynski, P., Gouttebarge, V., Grandner, M. A., Han, D. H., McDuff, D., Mountjoy, M., Polat, A., Purcell, R., … Engebretsen, L. (2020). Infographic: Mental health in elite athletes. An IOC consensus statement. British journal of sports medicine54(1), 49–50. https://doi.org/10.1136/bjsports-2019-101087
  19. Yu, C. L., Cheng, M. Y., An, X., Chueh, T. Y., Wu, J. H., Wang, K. P., & Hung, T. M. (2025). The Effect of EEG Neurofeedback Training on Sport Performance: A Systematic Review and Meta-Analysis. Scandinavian journal of medicine & science in sports35(5), e70055. https://doi.org/10.1111/sms.70055
  20. van Boxtel, G. J. M., Denissen, A. J. J. M., de Groot, J. A., Neleman, M. S., Vellema, J., & Hart de Ruijter, E. M. (2024). Alpha Neurofeedback Training in Elite Soccer Players Trained in Groups. Applied psychophysiology and biofeedback49(4), 589–602. https://doi.org/10.1007/s10484-024-09654-1
  21. Bojarczuk A. (2024). Ethical Aspects of Human Genome Research in Sports-A Narrative Review. Genes15(9), 1216. https://doi.org/10.3390/genes15091216
  22. Cheng, M. Y., Yu, C. L., An, X., Wang, L., Tsai, C. L., Qi, F., & Wang, K. P. (2024). Evaluating EEG neurofeedback in sport psychology: a systematic review of RCT studies for insights into mechanisms and performance improvement. Frontiers in psychology15, 1331997. https://doi.org/10.3389/fpsyg.2024.1331997
  23. Nooripour R, Viki MG, Ghanbari N, Farmani F, Emadi F. (2024(. Alpha/Theta Neurofeedback Rehabilitation for Improving Attention and Working Memory in Female Students with Learning Disabilities. OBM Neurobiology; 8(3): 229; https://doi.org/10.21926/obm.neurobiol.2403229
  24. Rydzik, Ł., Wąsacz, W., Ambroży, T., Javdaneh, N., Brydak, K., & Kopańska, M. (2023). The Use of Neurofeedback in Sports Training: Systematic Review. Brain sciences13(4), 660. https://doi.org/10.3390/brainsci13040660
  25. Chinzara, T. T., Buckingham, G., & Harris, D. J. (2022). Transcranial direct current stimulation and sporting performance: A systematic review and meta-analysis of transcranial direct current stimulation effects on physical endurance, muscular strength and visuomotor skills. The European journal of neuroscience55(2), 468–486. https://doi.org/10.1111/ejn.15540
  26. Kirby, E. D., Jones, K., Campbell, N., Fickling, S. D., & D'Arcy, R. C. N. (2025). Objective Neurophysiological Measures of Cognitive Performance in Elite Ice Hockey Players. Open access journal of sports medicine16, 15–24. https://doi.org/10.2147/OAJSM.S494589
  27. Cheron G, Petit G, Cheron J, Leroy A, Cebolla A, Cevallos C, Petieau M, Hoellinger T, Zarka D, Clarinval A-M and Dan B (2016) Brain Oscillations in Sport: Toward EEG Biomarkers of Performance.  Psychol. 7:246. https://doi.org/10.3389/fpsyg.2016.00246
  28. Cheng M-Y, Yu C-L, An X, Wang L, Tsai C-L, Qi F and Wang K-P (2024) Evaluating EEG neurofeedback in sport psychology: a systematic review of RCT studies for insights into mechanisms and performance improvement.  Psychol.15:1331997. https://doi.org/10.3389/fpsyg.2024.1331997
  29. Santander, T., Leslie, S., Li, L. J., Skinner, H. E., Simonson, J. M., Sweeney, P., Deen, K. P., Miller, M. B., & Brunye, T. T. (2024). Towards optimized methodological parameters for maximizing the behavioral effects of transcranial direct current stimulation. Frontiers in human neuroscience18, 1305446. https://doi.org/10.3389/fnhum.2024.1305446
  30. Martín-Rodríguez, A., Gostian-Ropotin, L. A., Beltrán-Velasco, A. I., Belando-Pedreño, N., Simón, J. A., López-Mora, C., Navarro-Jiménez, E., Tornero-Aguilera, J. F., & Clemente-Suárez, V. J. (2024). Sporting Mind: The Interplay of Physical Activity and Psychological Health. Sports (Basel, Switzerland)12(1), 37. https://doi.org/10.3390/sports12010037
  31. Staiano, W., Marcora, S., Romagnoli, M., Kirk, U., & Ring, C. (2023). Brain Endurance Training improves endurance and cognitive performance in road cyclists. Journal of science and medicine in sport26(7), 375–385. https://doi.org/10.1016/j.jsams.2023.05.008
  32. Naghizadeh, Z. , Movahedi, A. , Namazi zadeh, M. and Mirdamadi, M. (2024). Effect of transcranial direct current stimulation on performance of basketball free throws in skilled basketball players. Motor Behavior16(55), 17-34. https://doi.org/10.22089/mbj.2020.8028.1833
  33. Proietti G, Borozan M, Chaigneau A, Cannito L, Palumbo R, Thouvarecq R and Iodice P (2024) Self-regulation training improves stress resilience in elite pre-pubescent female gymnasts.  Psychol. 15:1341437. https://doi.org/10.3389/fpsyg.2024.1341437
  34. Furrer, R., Hawley, J. A., & Handschin, C. (2023). The molecular athlete: exercise physiology from mechanisms to medals. Physiological reviews103(3), 1693–1787. https://doi.org/10.1152/physrev.00017.2022
  35. Meidl, V., Dallmann, P., Steffen, K., Bretthauer, B., Busch, A., Kubosch, E. J., Leonhart, R., & Hirschmueller, A. (2024). Mental health surveillance in elite Para athletes: early identification and follow-up of athletes at risk of mental health problems. British journal of sports medicine58(16), 902–909. https://doi.org/10.1136/bjsports-2023-107995
  36. Van Cutsem, J., Marcora, S., De Pauw, K., Bailey, S., Meeusen, R., & Roelands, B. (2017). The Effects of Mental Fatigue on Physical Performance: A Systematic Review. Sports medicine (Auckland, N.Z.)47(8), 1569–1588. https://doi.org/10.1007/s40279-016-0672-0
  37. Mann, D. T., Williams, A. M., Ward, P., & Janelle, C. M. (2007). Perceptual-cognitive expertise in sport: a meta-analysis. Journal of sport & exercise psychology29(4), 457–478. https://doi.org/10.1123/jsep.29.4.457