Rewiring Recovery: Cognitive and Motor Gains Through Personalized Neurofeedback After Tumor Resection—A Case Series from Neurorehabilitation Practice

Postoperative cognitive impairment is common among patients undergoing brain tumor resection. Neurofeedback (NF) represents a promising adjunctive intervention for cognitive rehabilitation, though its clinical application in neuro-oncology remains largely unexplored. This prospective case series enrolled seven inpatients (5 women, 2 men; aged 46-76 years) with cognitive deficits following brain tumor surgery. Each underwent 15 sessions of EEG-based NF (35 min/session, five times per week for three weeks) in parallel with daily motor rehabilitation. Baseline and post-intervention assessments included quantitative EEG (qEEG), a comprehensive neuropsychological battery, and functional measures. All patients completed the NF protocol without adverse events. qEEG analyses revealed heterogeneous but measurable modulations in absolute power and spectral ratios, with several patients showing normalization of pathological delta/beta activity. Reliable Change Index analyses indicated cognitive improvements in all patients, particularly in domains of memory, executive function, and language. Secondary benefits were also observed in mood, motor performance, and activities of daily living, though these varied across individuals. Intensive NF training combined with motor rehabilitation was feasible and well tolerated in this heterogeneous cohort. Preliminary results suggest that NF may promote postoperative cognitive recovery, with additional gains in functional and affective domains. Larger controlled studies are required to validate these exploratory findings.