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Functional MRI training improves memory, depression in MDD

Real-time functional MRI neurofeedback training that targeted the amygdala increased the percentage of specific memories recalled and decreased depressive symptoms among adults with major depressive disorder.

“With approximately two-thirds of patients not responding fully to treatment, investigation into novel therapeutic approaches is warranted. One novel approach is real-time functional MRI neurofeedback, in which an individual receives information about the blood-oxygen level–dependent (BOLD) signal from their brain in real time and learns to self-modulate this signal,” Kymberly D. Young, PhD, of the Laureate Institute for Brain Research, Tulsa, Oklahoma, and colleagues wrote. “Emerging evidence suggests that [real-time functional MRI neurofeedback] has clinical utility in chronic pain, smoking cessation, anxiety, and depression.”

To determine therapeutic efficacy of real-time functional MRI neurofeedback training to increase the amygdala’s hemodynamic response to positive memories among individuals with depression, researchers conducted a double-blind, placebo-controlled, randomized clinical trial. The study cohort included 36 adults with depression who were not medicated. Participants were randomly assigned to receive two sessions of real-time functional MRI neurofeedback from the amygdala (n = 19) or a parietal control region not involved with emotional processing (n = 17). Clinical scores and autobiographical memory were evaluated at baseline and 1 week after the final real-time functional MRI neurofeedback session.

Participants who received amygdala real-time functional MRI neurofeedback exhibited increased hemodynamic response in the amygdala, compared with those who received the intervention in a region unassociated with emotional processing.

Twelve participants in the experimental group exhibited a decrease of 50% or more in Montgomery-Åsberg Depression Rating Scale scores, compared with two participants in the control.

Six participants in the experimental group met criteria for remission at study end, compared with one in the control group. This indicated a number needed to treat of four.

Participants in the experimental group had a higher percentage of positive specific memories recalled, compared with the control group.

“This neurofeedback intervention targets a specific fundamental mechanism identified by neuroimaging research (blunted amygdala activity during positive memory recall), it appears safe and well tolerated, and it gives patients a sense of control over their treatment and symptom improvement,” the researchers wrote. “This novel intervention, therefore, merits further testing as a potential treatment for depression, and it can serve as a model for novel neuroscience-based interventions.” – by Amanda Oldt

Disclosure: Young reports no relevant financial disclosures. Please see the study for a full list of relevant financial disclosures.