Amygdala real‐time functional magnetic resonance imaging neurofeedback for major depressive disorder: A review

Abstract

Advances in imaging technologies have allowed for the analysis of functional magnetic resonance imaging data in real-time (rtfMRI), leading to the development of neurofeedback (nf) training. This rtfMRI-nf training utilizes functional magnetic resonance imaging (fMRI) tomographic localization capacity to allow a person to see and regulate the localized hemodynamic signal from his or her own brain. In this review, we summarize the results of several studies that have developed and applied neurofeedback training to healthy and depressed individuals with the amygdala as the neurofeedback target and the goal to increase the hemodynamic response during positive autobiographical memory recall. We review these studies and highlight some of the challenges and advances in developing an rtfMRI-nf paradigm for broader use in psychiatric populations. The work described focuses on our line of research aiming to develop the rtfMRI-nf into an intervention, and includes a discussion of the selection of a region of interest for feedback, selecting a control condition, behavioral and cognitive effects of training, and predicting which participants are most likely to respond well to training. While the results of these studies are encouraging and suggest the clinical potential of amygdala rtfMRI-nf in alleviating symptoms of major depressive disorder, larger studies are warranted to confirm its efficacy.

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

“…Connectivity-based NF comes at the cost of longer delay times and higher dimensionality [71] so that learning with this signal may be more demanding, possibly limiting efficacy in patients with cognitive impairments. In line with initial studies successfully evaluating the clinical potential of amygdala activity NFTs in patient populations [82], repeated training sessions may be necessary to alleviate symptoms in patient populations [30] or to maintain effects on the behavioral level. Finally, a small number of participants reported increased anxiety after the intervention.…”

Current understanding of bipolar disorder: Toward integration of biological basis and treatment strategies

“…An RCT of real‐time neurofeedback treatment targeting the amygdala showed a significant efficacy on depression . In this trial, participants were instructed to activate the amygdala during recall of a positive memory . This protocol was chosen due to several reasons, including theoretical, technical, and ethical issues .…”

Neurofeedback training in major depressive disorder: a systematic review of clinical efficacy, study quality and reporting practices

“…Given the growing number of studies investigating neurofeedback applications as a treatment for MDD over the last decades, we aim here to (I) summarize and compare current findings, (II) evaluate the quality of these studies, and (III) provide guidelines for future research that can accelerate the field. Different from previous reviews [63,78,79], we note that the present study comprises to our knowledge the first attempt of a systematic investigation of EEG and fMRI neurofeedback training protocols using EEG or fMRI in MDD patients. Also, to assess study design and reporting quality, we employed the Joanna Briggs Institute (JBI) critical appraisal tools [80] and "Consensus on the Reporting and Experimental Design of Neurofeedback studies" (CRED-nf) checklist [81].…”