Research on biofeedback

What is biofeedback and why is it being researched?

Biofeedback is used to measure the body's physiological signals, such as heart rate variation, temperature and muscle tension. By viewing these signals in real time, you can learn how your body responds to breathing, stress and relaxation. The method has been studied since the late 1960s, particularly in psychology, neuroscience and physiology. The European and American scientific community defines biofeedback as a learning process in which technological measurements make it easier to understand and influence one's own bodily reactions (AAPB 2025).

International research on self-regulation and HRV training

Much of today's research investigates how biofeedback affects the autonomic nervous system and processes such as stress reactions and physiological regulation. Several meta-analyses show that HRV biofeedback (HRV: heart rate variability), which combines calm breathing with real-time measurements of heart rate, can strengthen the body's ability to regulate stress (Goessl et al. 2017; Lehrer et al. 2020). Studies have also been published that point to links between biofeedback and factors such as emotion regulation, sleep quality, and sense of control (Pizzoli et al. 2021). These studies examine physiological processes and perceived effects.

Norwegian research: Ten years of development at NTNU and St. Olavs hospital

In Norway, the research on biofeedback has been thorough and long-lasting. The work started with a meta-analysis in 2016 that investigated the use of biofeedback to reduce migraines in children (Stubberud et al. 2016). This was followed by the development of early app prototypes that assessed both the technology's functionality, usability studies and how sensors worked in practice (Stubberud et al. 2018; Stubberud et al. 2020; Ingvaldsen et al. 2021). In parallel, sensor technology was tested against standardized clinical equipment to ensure the accuracy of the measurements.

From pilot studies to a large randomized trial

The research gradually progressed from development and testing to pilot studies investigating how home-based biofeedback could be implemented over time as a treatment for episodic migraine in adults (Poole et al. 2025). The pilot work laid the groundwork for a larger randomized trial, which was conducted in 2024 with 286 participants. The study is described in detail in a published protocol (Poole et al. 2025), and the results were presented at the European Headache Congress in 2024. The findings show that app-based biofeedback can be carried out at home over several weeks and that the participants found the method relevant and useful in everyday life.

Statements about our clinical study on biofeedback

"The results are very promising. This is a thorough clinical study that shows that this non-drug treatment reduces the number of migraine days. The fact that this treatment can be carried out at home without guidance from healthcare professionals represents a minor revolution in migraine treatment."
- Tore Wergeland Meisingset, Senior Physician, St. Olavs Hospital
"This is an important breakthrough in non-pharmacological treatment of migraine. We now have solid evidence that patients can benefit greatly from clinically tested biofeedback therapy—at home, on their own terms. The study shows that a new home-based biofeedback system can significantly reduce the number of migraine days—with an effect comparable to many preventive migraine medications in use today."
- Erling Tronvik, Senior Physician and Professor of Neurology, NTNU and St. Olavs Hospital
"The study is the first clinical study to show that app-based biofeedback can be effective against migraines. This is a large and thorough study, and in fact one of the largest ever to demonstrate the effectiveness of biofeedback treatment in general."
- Anker Stubberud, researcher at the Department of Neuromedicine at NTNU and doctor specializing at St. Olav's Hospital
"I fell in love with the team and the product back in 2020. They have solid professional roots in the neurological community, and I am impressed by their staying power. Patients need alternatives to pills, and this is a digital treatment option that patients can easily use. Now everything is in place for Nordic Brain Tech to become the next big health export from Norway."
- Einar Klinge, Specialist in Neurology
"Through the study, I had the opportunity to help myself without being dependent on seizure medication. Frequent migraine attacks can make you feel powerless and desperate, so it's encouraging to be involved in testing new methods to relieve the pain. The combination of being able to prevent attacks before they occur, while also minimizing my use of medication, felt really good."
- Eline Drury Løvlien, Participant in the study
"Biofeedback as a concept is well known, but in practice it has been largely unavailable to migraine patients. Through the technological solution we have developed, combined with the results of the clinical study, we can make it available on a whole new scale. This gives us the opportunity to bring treatment right into patients' living rooms, thereby relieving pressure on an already strained healthcare system. The potential is huge."
- Einar Klinge, Specialist in Neurology

Participants' experiences support the knowledge base

In qualitative feedback, many participants described how biofeedback made it easier to understand their own stress reactions. Several found it meaningful to see the signals on the screen while exercising. Participants also said that short sessions were feasible in a busy schedule. Such experiences are in line with international literature on how real-time feedback can strengthen learning in the nervous system and promote self-regulation (AAPB 2025; Nestoriuc et al. 2008).

An established method in international literature

Biofeedback is currently mentioned in review articles, textbooks and guidelines in applied psychophysiology. Several leading institutions, such as the Mayo Clinic in the USA, describe the method as a tool for learning more about your own physiology. Overall, the research shows that biofeedback is a well-researched method for understanding and training the body's own regulatory processes. Cenli is building on this knowledge base by making the technology available as a home-based training tool.

  • A calm and
    stable
    nervous system with Cenli

    Modern lifestyles put our nervous systems under a lot of strain. We feel stressed and overwhelmed. This can trigger problems such as migraines, insomnia, and irritability.

    Cenli allows you to calm your nervous system right there and then, while also helping to build a stable nervous system and alleviate stress-related problems over time.

    Read more about Cenli here

References

AAPB. 2025. What is biofeedback. Association for Applied Psychophysiology and Biofeedback. https://aapb.org/

Goessl VC, Curtiss JE, Hofmann SG. The effect of heart rate variability biofeedback training on stress and anxiety: a meta-analysis. Psychol Med. 2017;47:2578-86.

Ingvaldsen SH, Tronvik E, Brenner E, et al. A Biofeedback App for Migraine: Development and Usability Study. JMIR Form Res. 2021;5:e23229.

Lehrer P, Kaur K, Sharma A, et al. Heart Rate Variability Biofeedback Improves Emotional and Physical Health and Performance: A Systematic Review and Meta Analysis. Appl Psychophysiol Biofeedback. 2020;45:109-29.

Nestoriuc Y, Martin A, Rief W, et al. Biofeedback treatment for headache disorders: a comprehensive efficacy review. Appl Psychophysiol Biofeedback. 2008;33:125-40.

Pizzoli SFM, Marzorati C, Gatti D, et al. A meta-analysis on heart rate variability biofeedback and depressive symptoms. Sci Rep. 2021;11:6650.

Poole AC, Stubberud A, Simpson M, et al. Biofeedback therapy using Cerebri for the
prevention of migraine attacks in adults with episodic migraine (BioCer): a randomized, wait-list controlled trial - the study protocol. F1000Res. 2025;13:775.

Poole AC, Winnberg IG, Simpson MR, et al. Feasibility of a 12-Week, Therapist-Independent, Smartphone-Based Biofeedback Treatment for Episodic Migraine in Adults: Single-Center, Open-Label, 1-Armed Trial. JMIR Hum Factors. 2025 Jun;12:e59622.

Stubberud A, Varkey E, McCrory DC, et al. Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis. Pediatrics. 2016;138:e20160675.

Stubberud A, Omland PM, Tronvik E, et al. Wireless surface electromyography and skin temperature sensors for biofeedback treatment of headache: validation study with stationary control equipment. JMIR Biomed Engineering. 2018;3:e1.

Stubberud A, Tronvik E, Olsen A, et al. Biofeedback Treatment App for Pediatric Migraine: Development and Usability Study. Headache. 2020;60:889-901.

Stress is your body's way of telling you something.
Time to listen.