Prevent breaking bad: A proof of concept study of rebalancing the brain's rumination circuit with real‐time fMRI functional connectivity neurofeedback

Abstract

Rumination, repetitively thinking about the causes, consequences, and one's negative affect, has been considered as an important factor of depression. The intrusion of ruminative thoughts is not easily controlled, and it may be useful to visualize one's neural activity related to rumination and to use that information to facilitate one's self‐control. Real‐time fMRI neurofeedback (rtfMRI‐nf) enables one to see and regulate the fMRI signal from their own brain. This proof‐of concept study utilized connectivity‐based rtfMRI‐nf (cnf) to normalize brain functional connectivity (FC) associated with rumination. Healthy participants were instructed to brake or decrease FC between the precuneus and the right temporoparietal junction (rTPJ), associated with high levels of rumination, while engaging in a self‐referential task. The cnf group (n = 14) showed a linear decrease in the precuneus‐rTPJ FC across neurofeedback training (trend [112] = −0.180, 95% confidence interval [CI] −0.330 to −0.031, while the sham group (n = 14) showed a linear increase in the target FC (trend [112] = 0.151, 95% CI 0.017 to 0.299). Although the cnf group showed a greater reduction in state‐rumination compared to the sham group after neurofeedback training (p < .05), decoupled precuneus‐rTPJ FC did not predict attenuated state‐rumination. We did not find any significant aversive effects of rtfMRI‐nf in all study participants. These results suggest that cnf has the capacity to influence FC among precuneus and rTPJ of a ruminative brain circuit. This approach can be applied to mood and anxiety patients to determine the clinical benefits of reduction in maladaptive rumination.

Reduction of brooding and more general depressive symptoms after fMRI neurofeedback targeting a melancholic functional-connectivity biomarker

“…Targeting the particular FC(s) related to the particular subset(s) of symptoms that a patient displays (and not those related to subsets of symptoms that they do not display) should allow for better neurofeedback precision. A recent study by Tsuchiyagaito et al (2020) also found rumination scores to be reduced after FCNef. The targeted FC in this study was that between the temporoparietal junction and precuneus, both within DMN; it therefore shared one ROI (precuneus) with our own.…”

“…Several ‘proof of concept’ studies have already shown the potential effectiveness of real-time fMRI neurofeedback paradigms for depression (Linden et al 2012, Young et al 2014, 2017). Recently, a new type of real-time fMRI neurofeedback called functional connectivity neurofeedback (FCNef) has been developed (Koush et al 2013, Megumi et al 2015, Koush et al 2017, Ramot et al 2017, Yamada et al 2017, Yamashita et al 2017, Tsuchiyagaito et al 2020), where participants are trained to modulate functional connectivity (FC) between selected regions of interest (ROIs). This type of neurofeedback has proven effective in changing the resting-state connectivity between intrinsic brain networks in the long-term (Megumi et al 2015) and in leading to an improvement in aberrant behaviors related to neurobiological disorders (Ramot et al 2017, Yamada et al 2017, Tsuchiyagaito et al 2020).…”

The impact of real-time fMRI denoising on online evaluation of brain activity and functional connectivity

“…Thus, even a less robust estimate of brain activation could be useful in training participants to self-regulate their brain state. Indeed, studies with the two-point dynamic FC neurofeedback, which is one extreme window width focusing on feedback timeliness, demonstrated successful training in self-regulating functional connectivity [30, 66].…”

Common Brain Networks Between Major Depressive-Disorder Diagnosis and Symptoms of Depression That Are Validated for Independent Cohorts

“…The 16 FCs discovered in this study are promising candidates as theranostic biomarkers for depression symptoms. Future work should investigate whether modulation of FCs could be an effective treatment for depression symptoms by using an intervention method with regard to FCs, such as functional connectivity neurofeedback training (53)(54)(55)(56)(57)(58)(59).…”