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Am J Psychiatry. 2017 Aug 1;174(8):748-755. doi: 10.1176/appi.ajp.2017.16060637. Epub 2017 Apr 14.

Randomized Clinical Trial of Real-Time fMRI Amygdala Neurofeedback for Major Depressive Disorder: Effects on Symptoms and Autobiographical Memory Recall.

Author information

1
From the Laureate Institute for Brain Research, Tulsa, Okla.; the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh; the Stephenson School of Biomedical Engineering, University of Oklahoma, Norman; Janssen Research and Development, New Brunswick, N.J.; and the Biomedical Engineering Center, University of Oklahoma College of Engineering, Norman.

Abstract

OBJECTIVE:

Patients with depression show blunted amygdala hemodynamic activity to positive stimuli, including autobiographical memories. The authors examined the therapeutic efficacy of real-time functional MRI neurofeedback (rtfMRI-nf) training aimed at increasing the amygdala's hemodynamic response to positive memories in patients with depression.

METHOD:

In a double-blind, placebo-controlled, randomized clinical trial, unmedicated adults with depression (N=36) were randomly assigned to receive two sessions of rtfMRI-nf either from the amygdala (N=19) or from a parietal control region not involved in emotional processing (N=17). Clinical scores and autobiographical memory performance were assessed at baseline and 1 week after the final rtfMRI-nf session. The primary outcome measure was change in score on the Montgomery-Åsberg Depression Rating Scale (MADRS), and the main analytic approach consisted of a linear mixed-model analysis.

RESULTS:

In participants in the experimental group, the hemodynamic response in the amygdala increased relative to their own baseline and to the control group. Twelve participants in the amygdala rtfMRI-nf group, compared with only two in the control group, had a >50% decrease in MADRS score. Six participants in the experimental group, compared with one in the control group, met conventional criteria for remission at study end, resulting in a number needed to treat of 4. In participants receiving amygdala rtfMRI-nf, the percent of positive specific memories recalled increased relative to baseline and to the control group.

CONCLUSIONS:

rtfMRI-nf training to increase the amygdala hemodynamic response to positive memories significantly decreased depressive symptoms and increased the percent of specific memories recalled on an autobiographical memory test. These data support a role of the amygdala in recovery from depression.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02079610.

KEYWORDS:

Brain Imaging Techniques; Emotion; Memory; Mood Disorders-Unipolar; Other Psychosocial Techniques/Treatments; fMRI neurofeedback

Comment in

PMID:
28407727
PMCID:
PMC5538952
DOI:
10.1176/appi.ajp.2017.16060637
[Indexed for MEDLINE]
Free PMC Article

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