RT Journal Article
SR Electronic
T1 Real-time functional magnetic resonance imaging neurofeedback training of amygdala upregulation increases affective flexibility in depression
JF Journal of Psychiatry and Neuroscience
JO JPN
FD Canadian Medical Association
SP E232
OP E239
DO 10.1503/jpn.220208
VO 48
IS 3
A1 Compère, Laurie
A1 Siegle, Greg J.
A1 Lazzaro, Sair
A1 Strege, Marlene
A1 Canovali, Gia
A1 Barb, Scott
A1 Huppert, Theodore
A1 Young, Kymberly
YR 2023
UL http://jpn.ca/content/48/3/E232.abstract
AB Background: Decreased affective flexibility is associated with depression symptoms, and it has been suggested that common interventions may target this mechanism. To explore this hypothesis, we evaluated whether real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) training to increase the amygdala responses during positive memory recall resulted in both symptom improvements, as has been observed previously, and flexibility to decrease amygdala reactivity in response to a cognitive task among patients with major depressive disorder (MDD).Methods: In a double-blind, placebo-controlled, randomized clinical trial, adults with MDD received 2 sessions of rtfMRI-nf training to increase their amygdala (experimental group) or parietal (control group) responses during positive autobiographical memory recall. We evaluated signal changes in the amygdala during both the positive memory neurofeedback and a subsequent counting condition.Results: We included 38 adults with MDD, including 16 in the experimental group and 22 in the control group. In the experimental group, amygdala activity increased (t > 2.01, df < 27, p < 0.05, d > 0.5) and depressive symptoms decreased (−8.57, 95 % confidence interval [CI] −15.12 to −2.59; t13 = −3.06, p = 0.009, d = 1). Amygdala activity during the count condition decreased after rtfMRI-nf (−0.16, 95 % CI −0.23 to −0.09; t396 = 4.73, p < 0.001, d = 0.48) and was correlated with decreased depression scores (r = 0.46, p = 0.01). We replicated previous results and extended them to show decreased amygdala reactivity to a cognitive task during which no neurofeedback was provided.Limitations: The count condition was reported by participants as negative, but emotionality or accuracy during this condition was not assessed.Conclusion: These results suggest that nominally targeting unidimensional change in neural mechanisms could have implications for bidirectional control, increasing the likely reach and explanatory framework for how common depression interventions work.Trial registration: ClinicalTrials.gov NCT02709161.