Mendi for ADHD: Exploring the Science of fNIRS Neurofeedback

Understanding ADHD and the Search for Alternatives
At Alpine Psychiatry, we’re always seeking innovative, evidence-based tools that support our patients living with ADHD. While stimulant medications remain the standard of care, not every individual responds well to them. That’s why we keep a close eye on emerging technologies—including neurofeedback devices like Mendi, which claim to improve attention through brain training.

Mendi uses a form of neurofeedback powered by functional near-infrared spectroscopy (fNIRS). This non-invasive technique measures blood flow and oxygen levels in the brain’s prefrontal cortex and delivers real-time feedback to help users “train” focus. But does it work?

Let’s explore the science behind Mendi, how it compares to traditional neurofeedback, and what current research says about its effectiveness in ADHD care.

What Is Neurofeedback?

Neurofeedback is a type of biofeedback therapy that helps individuals self-regulate brain activity. It’s often used in ADHD treatment to target underactivity in the prefrontal cortex, which governs attention, planning, and emotional regulation.

The most common form of neurofeedback uses electroencephalography (EEG) to measure brainwaves. During a typical session, patients complete simple tasks (like playing a video game) while sensors monitor their brain activity. When desirable patterns appear—such as increased focus or reduced impulsivity—the patient receives positive reinforcement through visual or auditory cues.

Over time, this feedback loop can strengthen neural pathways associated with executive function. In many ways, neurofeedback resembles reinforced mindfulness: helping individuals become more aware of their mental states and gently guiding them toward sustained attention.

How Is Mendi Different?

Mendi replaces EEG with fNIRS, a technique that uses near-infrared light to monitor blood flow changes in the brain. When a person focuses, blood flow to the prefrontal cortex increases. Mendi uses this physiological signal to infer concentration and provides real-time visual feedback to help users stay engaged.

In theory, this approach offers a simple and accessible way to build focus—especially for those looking for non-medication ADHD tools.

But there are important differences between EEG and fNIRS:

What Does the Research Say?

The science behind neurofeedback is promising—but nuanced. While many patients report improvements in focus and emotional regulation, large-scale studies show mixed results, and effectiveness may vary across individuals.

Recent findings on fNIRS neurofeedback include:

• A 2023 systematic review of 22 studies found that fNIRS-based training improved inhibitory control and reduced ADHD symptoms in both children and adults.

• Neuropsychiatric trials using fNIRS showed benefits in disorders like social anxiety, with improved regulation of prefrontal activity.

• A study on hemoencephalography (HEG)—a subtype of fNIRS neurofeedback—demonstrated users could modulate blood oxygenation in targeted brain regions with consistent training.

• Other articles reviewed how neurofeedback may enhance executive function tasks like memory, planning, and impulse control through targeted brain modulation.

Still, most of this research has been conducted in controlled laboratory settings, often using professional-grade equipment. Mendi is marketed as a consumer device, and while it is built on fNIRS principles, its data precision and training protocols have not yet been validated through peer-reviewed clinical trials.

Clinical Considerations: What We Tell Our Patients

At Alpine Psychiatry, we believe in meeting patients where they are—whether that’s medication management, therapy, or integrative approaches. Here’s how we approach devices like Mendi in ADHD treatment:

• Hopeful, but cautious: While fNIRS neurofeedback shows potential, the clinical data on Mendi’s specific implementation is still limited.

• No harm, but limited evidence: Like traditional neurofeedback, Mendi appears safe. Some may benefit, while others may not notice significant changes.

• Mindfulness overlap: Mendi reinforces focused awareness—similar to mindfulness practices we often recommend to patients with ADHD.

• Screen time concerns: For children and teens already struggling with excessive digital exposure, any increase in screen time should be balanced with other activities.

We advise families to treat Mendi as a supplemental tool, not a replacement for therapy, behavioral interventions, or medication when needed. For some, it may offer useful biofeedback cues that enhance focus. For others, it may serve as a gateway into broader self-regulation practices.

Final Thoughts

The future of ADHD treatment lies in personalization. While Mendi and other neurofeedback devices hold promise, they are best used within a broader, integrative treatment plan—one that might include therapy, supplements, functional testing, and even nutritional interventions when appropriate.

At Alpine Psychiatry, we continue to monitor the research and welcome thoughtful discussions about emerging tools. If you’re curious about neurofeedback, integrative ADHD care, or how we tailor treatment to your unique needs, reach out to us here.