Search Results (209)

Motor impairments significantly affect individuals’ ability to perform activities of daily living, reducing autonomy and quality of life. In response to this, robot-assisted rehabilitation has emerged as an effective and practical solution, enabling controlled limb movements and supporting functional recovery. This study presents the development of an upper-limb exoskeleton designed to assist rehabilitation by integrating neurophysiological signal processing and real-time control strategies. The system incorporates a proportional–derivative (PD) controller to execute cyclic flexion and extension movements based on a sinusoidal reference signal, providing repeatability and precision in motion. The exoskeleton integrates a brain–computer interface (BCI) that utilizes electroencephalographic signals for therapy selection and engagement enabling user-driven interaction. The EEG data extraction was possible by using the UltraCortex Mark IV headset, with electrodes positioned according to the international 10–20 system, targeting alpha-band activity in channels O1, O2, P3, P4, Fp1, and Fp2. These channels correspond to occipital (O1, O2), parietal (P3, P4), and frontal pole (Fp1, Fp2) regions, associated with visual processing, sensorimotor integration, and attention-related activity, respectively. This approach enables a more adaptive and personalized rehabilitation experience by allowing the user to influence therapy mode selection through real-time feedback. Experimental evaluation across five subjects showed an overall mean accuracy of 86.25% in alpha wave detection for EEG-based therapy selection. The PD control strategy achieved smooth trajectory tracking with a mean angular error of approximately 1.70°, confirming both the reliability of intention detection and the mechanical precision of the exoskeleton. Also, our core contributions in this research are compared with similar studies inspired by the rehabilitation needs of stroke patients. In this research, the proposed system demonstrates the potential of integrating robotic systems, control theory, and EEG data processing to improve rehabilitation outcomes for individuals with upper-limb motor deficits, particularly post-stroke patients. By focusing the exoskeleton on a single degree of freedom and employing low-cost manufacturing through 3D printing, the system remains affordable across a wide range of economic contexts. This design choice enables deployment in diverse clinical settings, both public and private. Full article

The neuropeptide oxytocin (OXT) is involved in social bonding, reproduction, and childbirth. Its activity is mediated by the oxytocin receptor (OXTR), also expressed in the skin. OXT alleviates dermal fibroblast senescence, and OXT levels correlate with visible skin aging. OXT inhibits nociceptive signaling and promotes neuronal plasticity. Here, we demonstrate OXT-like benefits of OXTR activation for skin touch sensoriality and nociception, as well as visible skin health and beauty indicators, using an aqueous extract of Hyacinthus orientalis bulbs. OXTR activation was evaluated in a Chinese hamster ovary (CHO) cell model. Nociception and innervation benefits were investigated in keratinocyte/sensory neuron coculture models. A placebo-controlled clinical study evaluated gentle touch receptivity, nociception, skin tone, elasticity, and wrinkling. The extract activated OXTR and enhanced dermal fibroblast proliferation in vitro. In the keratinocyte-neuron coculture, the HO extract lowered nociceptive CGRP release below that of the unstimulated and OXT controls and promoted neuronal survival and dendricity. An organ-on-a-chip coculture showed decreased electrical activity and increased neuronal peripherin. Clinically, we observed selective left-side frontal alpha-wave activation, indicating pleasant sensation, reduced nociception, enhanced skin glow, improved elasticity, and reduced wrinkling. This extract thus shows high value for holistic wellbeing solutions, enhancing the skin’s receptivity to pleasant sensations and promoting well-aging. Full article

Borderline Personality Disorder (BPD) is marked by emotional dysregulation, instability in self-image and relationships, and high impulsivity. While functional magnetic resonance imaging (fMRI) studies have provided valuable insights into the disorder’s neural correlates, electroencephalography (EEG) may capture real-time brain activity changes relevant to BPD’s rapid emotional shifts. This review summarizes findings from studies investigating resting state and task-based EEG in individuals with BPD, highlighting common neurophysiological markers and their clinical implications. A targeted literature search (1980–2025) was conducted across databases, including PubMed, Google Scholar, and Cochrane. The search terms combined “EEG” or “electroencephalography” with “borderline personality disorder” or “BPD”. Clinical trials and case reports published in English were included if they recorded and analyzed EEG activity in BPD. A total of 24 studies met the inclusion criteria. Findings indicate that individuals with BPD often show patterns consistent with chronic hyperarousal (e.g., reduced alpha power and increased slow-wave activity) and difficulties shifting between vigilance states. Studies examining frontal EEG asymmetry reported varying results—some linked left-frontal activity to heightened hostility, while others found correlations between right-frontal shifts and dissociation. Childhood trauma, mentalization deficits, and dissociative symptoms were frequently predicted or correlated with EEG anomalies, underscoring the impact of adverse experiences on neural regulation—however, substantial heterogeneity in methods, small sample sizes, and comorbid conditions limited study comparability. Overall, EEG research supports the notion of altered arousal and emotion regulation circuits in BPD. While no single EEG marker uniformly defines the disorder, patterns such as reduced alpha power, increased theta/delta activity, and shifting frontal asymmetries converge with core BPD features of emotional lability and interpersonal hypersensitivity. More extensive, standardized, and multimodal investigations are needed to establish more reliable EEG biomarkers and elucidate how early trauma and dissociation shape BPD’s neurophysiological profile. Full article

Introduction: Learning disabilities (LD) compromise academic achievement in approximately 5–10% of school-aged children, yet the neurophysiological signatures that could facilitate earlier detection or stratification remain poorly defined. Resting-state electroencephalography (rs-EEG) offers millisecond resolution and is cost-effective, but its findings have never been synthesized systematically across pediatric LD cohorts. Methods: Following a PROSPERO-registered protocol (CRD420251087821) and adhering to PRISMA 2020 guidelines, we searched PubMed, Embase, Web of Science, Scopus, and PsycINFO through 31 March 2025 for peer-reviewed studies that recorded eyes-open or eyes-closed rs-EEG using ≥ 4 scalp electrodes in children (≤18 years) formally diagnosed with LD, and compared the results with typically developing peers or normative databases. Four reviewers independently screened titles and abstracts, extracted data, and assessed the risk of bias using ROBINS-I. Results: Seventeen studies (704 children with LD; 620 controls) met the inclusion criteria. The overall risk of bias was moderate, primarily due to small clinic-based samples and inconsistent control for confounding variables. Three consistent electrophysiological patterns emerged: (i) a 20–60% increase in delta/theta power over mesial-frontal, fronto-central and left peri-Sylvian cortices, resulting in markedly elevated θ/α and θ/β ratios; (ii) blunting or anterior displacement of the posterior alpha rhythm, particularly in language-critical temporo-parietal regions; and (iii) developmentally immature connectivity, characterized by widespread slow-band hypercoherence alongside hypo-connected upper-alpha networks linking left-hemisphere language hubs to posterior sensory areas. These abnormalities were correlated with reading, writing, and IQ scores and, in two longitudinal cohorts, they partially normalized in parallel with academic improvement. Furthermore, a link between reduced posterior/overall alpha and neuroinflammation has been found. Conclusions: Rs-EEG reveals a robust yet heterogeneous electrophysiological profile of pediatric LD, supporting a hybrid model that combines maturational delay with persistent circuit-level atypicalities in some children. While current evidence suggests that rs-EEG features show promise as potential biomarkers for LD detection and subtyping, these findings remain preliminary. Definitive clinical translation will require multi-site, dense-array longitudinal studies employing harmonized pipelines, integration with MRI and genetics, and the inclusion of EEG metrics in intervention trials. Full article

Introduction: Burnout syndrome, long described as an “occupational phenomenon”, now affects 15–20% of the general workforce and more than 50% of clinicians, teachers, social-care staff and first responders. Its precise nosological standing remains disputed. We conducted a mechanistic review of electroencephalography (EEG) studies to determine whether burnout is accompanied by reproducible brain-function alterations that justify disease-level classification. Methods: Following PRISMA-adapted guidelines, two independent reviewers searched PubMed/MEDLINE, Scopus, Google Scholar, Cochrane Library and reference lists (January 1980–May 2025) using combinations of “burnout,” “EEG”, “electroencephalography” and “event-related potential.” Only English-language clinical investigations were eligible. Eighteen studies (n = 2194 participants) met the inclusion criteria. Data were synthesised across three domains: resting-state spectra/connectivity, event-related potentials (ERPs) and longitudinal change. Results: Resting EEG consistently showed (i) a 0.4–0.6 Hz slowing of individual-alpha frequency, (ii) 20–35% global alpha-power reduction and (iii) fragmentation of high-alpha (11–13 Hz) fronto-parietal coherence, with stage- and sex-dependent modulation. ERP paradigms revealed a distinctive “alarm-heavy/evaluation-poor” profile; enlarged N2 and ERN components signalled hyper-reactive conflict and error detection, whereas P3b, Pe, reward-P3 and late CNV amplitudes were attenuated by 25–50%, indicating depleted evaluative and preparatory resources. Feedback processing showed intact or heightened FRN but blunted FRP, and affective tasks demonstrated threat-biassed P3a latency shifts alongside dampened VPP/EPN to positive cues. These alterations persisted in longitudinal cohorts yet normalised after recovery, supporting trait-plus-state dynamics. The electrophysiological fingerprint differed from major depression (no frontal-alpha asymmetry, opposite connectivity pattern). Conclusions: Across paradigms, burnout exhibits a coherent neurophysiological signature comparable in magnitude to established psychiatric disorders, refuting its current classification as a non-disease. Objective EEG markers can complement symptom scales for earlier diagnosis, treatment monitoring and public-health surveillance. Recognising burnout as a clinical disorder—and funding prevention and care accordingly—is medically justified and economically imperative. Full article

Objective: This study aimed to explore the acute neurophysiological effects of a single oral dose of Astragaloside IV (AS-IV) on EEG-measured brain oscillations and cognitive-relevant spectral markers in healthy young adults. Methods: Twenty healthy adults (8 females, 12 males; mean age: $23.4\pm 2.1$) underwent eyes-closed resting-state EEG recordings before and approximately 90 min after oral intake of 150 mg AS-IV. EEG data were collected using a 21-channel 10–20 system and cleaned via Artifact Subspace Reconstruction and Independent Component Analysis. Data quality was confirmed using a signal-to-noise ratio and 1/f spectral slope. Absolute and relative power values, band ratios, and frontal alpha asymmetry were computed. Statistical comparisons were made using paired t-tests or Wilcoxon signed-rank tests. Results: Absolute power decreased in delta, theta, beta, and gamma bands (p < 0.05) but remained stable for alpha. Relative alpha power increased significantly (p = 0.002), with rises in relative beta, theta, and delta and a drop in relative gamma (p = 0.003). Alpha/beta and theta/beta ratios increased, while delta/alpha decreased. Frontal alpha asymmetry was unchanged. Sex differences were examined in all measures that showed significant changes; however, no sex-dependent effects were found. Conclusions: A single AS-IV dose may acutely modulate brain oscillations, supporting its potential neuroactive properties. Larger placebo-controlled trials, including concurrent psychometric assessments, are needed to verify and contextualize these findings. A single AS-IV dose may acutely modulate brain oscillations, supporting its potential neuroactive properties. Full article

Background: Asymmetrical brain oscillations may be characteristic of Parkinson’s disease (PD). We investigated differences in oscillation asymmetry between individuals with PD and healthy controls and explored associations between the asymmetry and clinical features. Methods: Clinical and resting-state EEG data from 37 patients and 24 controls were cross-sectionally analyzed. EEG asymmetry indices were calculated for the delta, theta, alpha, and beta frequencies in the frontal, central, and parietal regions. Independent t-tests and linear regression models were employed. Results: Patients exhibited lower alpha asymmetry than controls in the parietal region (t(59) = 2.12, p = 0.03). In the frontal alpha asymmetry models, there were associations with time since diagnosis (β = −0.042) and attention/orientation (β = 0.061), and with Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRSIII)-posture (β = 0.136) and MDS-UPDRSIII-rest-tremor persistence (β = −0.111). In the central alpha model, higher asymmetry was associated with the physical activity levels (International Physical Activity Questionnaire) IPAQ-active (β = 0.646) and IPAQ-very active (β = 0.689), (Timed Up and Go) TUG dual-task cost (β = 0.023), MDS-UPDRSII-freezing (β = 0.238), and being male (β = 0.535). In the parietal alpha asymmetry model, MDS-UPDRSII-gait/balance was inversely associated with alpha asymmetry (β = −0.156), while IPAQ-active (β = −0.247) and being male (β = −0.191) were associated with lower asymmetry. Conclusions: Our findings highlight the potential role of alpha asymmetry as a neurophysiological marker of PD’s motor symptoms, mainly rest tremor, gait/balance, freezing, and specific cognitive domains such as attention/orientation. The models stressed the relationship between disease progression and reduced alpha asymmetry. Brazilian Registry of Clinical Trials (RBR-7zjgnrx, 9 June 2022). Full article

Empathy has been linked to enhanced processing of social information, yet the neurophysiological correlates of such individual differences remain underexplored. Objectives: The aim of this study was to investigate how individual differences in trait empathy are reflected in oscillatory brain activity during the perception of non-verbal social cues. Methods: In this EEG study involving 30 participants, we examined spectral and time–frequency dynamics associated with trait empathy during a visual task requiring the interpretation of others’ body gestures. Results: FFT Power spectral analyses (applied to alpha/mu, beta, high beta, and gamma bands) revealed that individuals with high empathy quotients (High-EQ) exhibited a tendency for increased beta-band activity over frontal regions and markedly decreased alpha-band activity over occipito-parietal areas compared to their low-empathy counterparts (Low-EQ), suggesting heightened attentional engagement and reduced cortical inhibition during social information processing. Similarly, time–frequency analysis using Morlet wavelets showed higher alpha power in Low-EQ than High-EQ people over occipital sites, with no group differences in mu suppression or desynchronization (ERD) over central sites, challenging prior claims linking mu ERD to mirror neuron activity in empathic processing. These findings align with recent literature associating frontal beta oscillations with top-down attentional control and emotional regulation, and posterior alpha with vigilance and sensory disengagement. Conclusions: Our results indicate that empathic traits are differentially reflected in anterior and posterior oscillatory dynamics, supporting the notion that individuals high in empathy deploy greater cognitive and attentional resources when decoding non-verbal social cues. These neural patterns may underlie their superior ability to interpret body language and mental states from visual input. Full article

Background: Target enhancement and non-target suppression are two critical mechanisms underlying representational prioritization in visual working memory (VWM). However, it remains unclear how VWM load modulates these prioritization mechanisms. Methods: Using EEG combined with a retro-cue paradigm, this study investigated how representational prioritization emerges under low (Experiment 1) and high (Experiment 2) memory load conditions. Methods: Behavioral results showed that under low load, both target and non-target items benefited from retro-cue. ERP analyses revealed significantly larger P2 and P3b amplitudes in response to valid compared to neutral retro-cues, whereas no significant contralateral delay activity (CDA) component was observed. Under high load, cueing benefits were restricted to target items, whereas non-target items suffered impaired performance. ERP analyses again showed enhanced P2 and P3b amplitudes for valid compared to neutral retro-cues, but a significant CDA component was also observed. Time–frequency analyses further revealed frontal theta synchronization (ERS) and posterior alpha desynchronization (ERD) under both load conditions. Notably, theta–alpha phase–amplitude coupling (PAC) was significantly stronger for valid than neutral retro-cues under low load, whereas under high load, PAC did not significantly differ between cue conditions. Conclusions: Together, these findings suggest that target enhancement serves as a stable mechanism for representational prioritization, whereas non-target suppression critically depends on resource availability. VWM load systematically shapes representational prioritization through modulation of oscillatory timing characteristics and inter-regional neural coordination. Full article

This study explores the potential of unsupervised machine learning algorithms to identify latent cardiac risk profiles by analyzing ECG-derived parameters from two general groups: clinically healthy individuals (Norm dataset, n = 14,863) and patients hospitalized with heart failure (patients’ dataset, n = 8220). Each dataset includes 153 ECG and heart rate variability (HRV) features, including both conventional and novel diagnostic parameters obtained using a Universal Scoring System. The study aims to apply unsupervised clustering algorithms to ECG data to detect latent risk profiles related to heart failure, based on distinctive ECG features. The focus is on identifying patterns that correlate with cardiac health risks, potentially aiding in early detection and personalized care. We applied a combination of Uniform Manifold Approximation and Projection (UMAP) for dimensionality reduction and Hierarchical Density-Based Spatial Clustering (HDBSCAN) for unsupervised clustering. Models trained on one dataset were applied to the other to explore structural differences and detect latent predispositions to cardiac disorders. Both Euclidean and Manhattan distance metrics were evaluated. Features such as the QRS angle in the frontal plane, Detrended Fluctuation Analysis (DFA), High-Frequency power (HF), and others were analyzed for their ability to distinguish different patient clusters. In the Norm dataset, Euclidean distance clustering identified two main clusters, with Cluster 0 indicating a lower risk of heart failure. Key discriminative features included the “ALPHA QRS ANGLE IN THE FRONTAL PLANE” and DFA. In the patients’ dataset, three clusters emerged, with Cluster 1 identified as potentially high-risk. Manhattan distance clustering provided additional insights, highlighting features like “ST DISLOCATION” and “T AMP NORMALIZED” as significant for distinguishing between clusters. The analysis revealed distinct clusters that correspond to varying levels of heart failure risk. In the Norm dataset, two main clusters were identified, with one associated with a lower risk profile. In the patients’ dataset, a three-cluster structure emerged, with one subgroup displaying markedly elevated risk indicators such as high-frequency power (HF) and altered QRS angle values. Cross-dataset clustering confirmed consistent feature shifts between groups. These findings demonstrate the feasibility of ECG-based unsupervised clustering for early risk stratification. The results offer a non-invasive tool for personalized cardiac monitoring and merit further clinical validation. These findings emphasize the potential for clustering techniques to contribute to early heart failure detection and personalized monitoring. Future research should aim to validate these results in other populations and integrate these methods into clinical decision-making frameworks. Full article

Introduction: Combat sport athletes are exposed to repetitive head impacts yet also develop distinct performance-related brain adaptations. Electroencephalography (EEG) provides millisecond-level insight into both processes; however, findings are dispersed across decades of heterogeneous studies. This mechanistic review consolidates and interprets EEG evidence to elucidate how participation in combat sports shapes brain function and to identify research gaps that impede clinical translation. Methods: A structured search was conducted in March 2025 across PubMed/MEDLINE, Scopus, Cochrane Library, ResearchGate, Google Scholar, and related databases for English-language clinical studies published between January 1980 and March 2025. Eligible studies recorded raw resting or task-related EEG in athletes engaged in boxing, wrestling, judo, karate, taekwondo, kickboxing, or mixed martial arts. Titles, abstracts, and full texts were independently screened by two reviewers. Twenty-three studies, encompassing approximately 650 combat sport athletes and 430 controls, met the inclusion criteria and were included in the qualitative synthesis. Results: Early visual EEG and perfusion studies linked prolonged competitive exposure in professional boxers to focal hypoperfusion and low-frequency slowing. More recent quantitative studies refined these findings: across boxing, wrestling, and kickboxing cohorts, chronic participation was associated with reduced alpha and theta power, excess slow-wave activity, and disrupted small-world network topology—alterations that often preceded cognitive or structural impairments. In contrast, elite athletes in karate, fencing, and kickboxing consistently demonstrated neural efficiency patterns, including elevated resting alpha power, reduced task-related event-related desynchronization (ERD), and streamlined cortico-muscular coupling during cognitive and motor tasks. Acute bouts elicited transient increases in frontal–occipital delta and high beta power proportional to head impact count and cortisol elevation, while brief judo chokes triggered short-lived slow-wave bursts without lasting dysfunction. Methodological heterogeneity—including variations in channel count (1 to 64), reference schemes, and frequency band definitions—limited cross-study comparability. Conclusions: EEG effectively captures both the adverse effects of repetitive head trauma and the cortical adaptations associated with high-level combat sport training, underscoring its potential as a rapid, portable tool for brain monitoring. Standardizing acquisition protocols, integrating EEG into longitudinal multimodal studies, and establishing sex- and age-specific normative data are essential for translating these insights into practical applications in concussion management, performance monitoring, and regulatory policy. Full article

Background: Cognitive resilience is a critical factor in high-performance environments such as military operations, where sustained stress can impair attention and decision-making. In the present study, we utilized EEG and machine learning to assess cognitive resilience in elite military personnel. Methods: For this purpose, EEG signals were recorded from elite military personnel during stress-inducing attention-related and emotional tasks. The EEG signals were segmented into two temporal windows corresponding to the initial stress response (baseline) and the adaptive/recovery phase, extracting power spectral density features across delta, theta, alpha, beta, and gamma bands. Different machine learning models (Decision Tree, Random Forest, AdaBoost, XGBoost) were trained to classify temporal phases. Results: XGBoost achieved the highest accuracy (0.95), while Shapley Additive Explanations (SHAP) analysis identified delta and alpha bands (particularly in frontal and parietal regions) as key features associated with adaptive mental states. Conclusions: Our findings indicate that resilience-related neural responses can be successfully distinguished and that interpretable AI frameworks can be used for monitoring cognitive adaptation in high-stress environments. Full article

Background: This study investigates the electrophysiological (EEG) correlates underlying negotiation dynamics in dyads engaged in a shared decision-making process. Methods: Using EEG hyperscanning, we examined single-brain and inter-brain neural activity in 26 participants (13 dyads) during a structured negotiation task. The participants, selected for their group-oriented decision-making preference, discussed a realistic group decisional scenario while their EEG activity was recorded. EEG frequency bands (delta, theta, alpha, beta, and gamma) were analyzed and Euclidean Distances were computed for measuring dissimilarity at the inter-brain neural level. Results: At the single-brain level, the results show increased delta and theta power in frontal regions, reflecting emotional engagement and goal-directed control, alongside heightened beta and gamma activity in parieto-occipital areas, linked to cognitive integration and decision-monitoring during the negotiation process. At the inter-brain neural level, we observed significant dissimilarity in frontal delta activity compared to temporo-central and parieto-occipital one, suggesting that negotiation involves independent cognitive regulation within the members of the dyads rather than complete neural synchrony. Conclusions: These findings highlight the dual role of negotiation as both a cooperative and cognitively demanding process, requiring emotional alignment and strategic adaptation. This study advances our understanding of the neurophysiological bases of negotiation and provides insights into how inter-brain dynamics shape collaborative decision-making. Full article

Background and Objectives: Neuropsychiatric disorders, including schizophrenia, bipolar disorder, and major depression, constitute a leading global public health challenge due to their high prevalence, chronicity, and profound cognitive and functional impact. This systematic review explores the role of electroencephalography (EEG)-based cognitive biomarkers in improving the understanding, diagnosis, monitoring, and treatment of these conditions. It evaluates how EEG-derived markers can reflect neuro-cognitive dysfunction and inform personalized and scalable mental health interventions. Materials and Methods: A systematic review was conducted following PRISMA guidelines. The databases searched included PubMed, Scopus, PsycINFO, and Web of Science for peer-reviewed empirical studies published between 2014 and 2025. Inclusion criteria focused on EEG-based investigations in clinical populations with neuropsychiatric diagnoses, emphasizing studies that assessed associations with cognitive function, symptom severity, treatment response, or functional outcomes. Of the 447 initially identified records, 132 studies were included in the final synthesis. Results: This review identifies several EEG markers—such as mismatch negativity (MMN), P300, frontal alpha asymmetry, and theta/beta ratios—as reliable indicators of cognitive impairments across psychiatric populations. These biomarkers are associated with deficits in attention, memory, and executive functioning, and show predictive utility for treatment outcomes and disease progression. Methodological trends indicate an increasing use of machine learning and multimodal neuroimaging integration to enhance diagnostic specificity. While many studies exhibit moderate risk of bias, the overall findings support EEG biomarkers’ reproducibility and translational relevance. Conclusions: EEG-based cognitive biomarkers offer a valuable, non-invasive means of capturing the neurobiological underpinnings of psychiatric disorders. Their diagnostic and prognostic potential, as well as high temporal resolution and portability, supports their use in clinical and public health contexts. The field, however, requires further standardization, cross-validation, and investment in scalable applications. Advancing EEG biomarker research holds promise for precision psychiatry and proactive mental health strategies at the population level. Full article

Background/Objectives: Transcranial Direct Current Stimulation (tDCS) has proven to be a promising intervention for major depressive disorder (MDD). Even so, the specific neurophysiological mechanisms underlying its therapeutic effects, particularly regarding frontal EEG markers, remain insufficiently understood. This pilot study investigated both the clinical efficacy and neurophysiological impact of frontal tDCS in individuals with mild to severe depression, with particular focus on mood changes and alterations in Frontal Alpha Asymmetry (FAA), Beta Symmetry, and Theta/Alpha Ratios at the F3 and F4 electrode sites. Methods: A total of thirty–one participants were enrolled and completed a standardized Flow Neuroscience tDCS protocol targeting the dorsolateral prefrontal cortex using a bilateral F3/F4 montage. The intervention included an active phase of five stimulations per week for three weeks, followed by a Strengthening Phase with two stimulations per week. Clinical outcomes were assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS), while neurophysiological changes were evaluated via standardized quantitative EEG (QEEG) recordings obtained before and after the treatment course. Among the participants, fourteen individuals had a baseline MADRS score of ≥20, indicating moderate to severe depressive symptoms. Results: Following tDCS treatment, significant reductions in MADRS scores were observed across the cohort, with clinical response rates notably higher in the moderate/severe group (71.4%) compared to the mild depression group (20.0%). Neurophysiological effects were modest: no significant changes were detected in FAA or Beta Symmetry measures. However, a substantial reduction in the Theta/Alpha Ratio at F4 was found in participants with moderate to severe depression (p = 0.018, Cohen’s d = −0.72), suggesting enhanced frontal cortical activation associated with clinical improvement. Conclusions: These findings indicate that frontal tDCS is effective in reducing depressive symptoms, particularly in cases of moderate to severe depression. While improvements in FAA and Beta Symmetry were not significant, changes in the Theta/Alpha Ratio at F4 point toward dynamic neurophysiological reorganization potentially linked to therapeutic outcomes. The Theta/Alpha Ratio may serve as a promising biomarker for tracking tDCS response, whereas other EEG metrics might represent more stable trait characteristics. Future research should prioritize individualized stimulation protocols and incorporate more sensitive neurophysiological assessments, including functional connectivity analyses and task-evoked EEG paradigms, to understand the mechanisms underlying clinical improvements. Full article