Development Clinical Studies - fMRI-based neurofeedback as a treatment tool for depression

Lead Research Organisation: Cardiff University
Department Name: School of Medicine

Abstract

Depression is the second most common illness in primary health care and disrupts the everyday functioning of over 100 million people worldwide. Depression is a severe mood disorder that is characterised by clinical features such as anhedonia (a loss of pleasure in previously enjoyable activities), cognitive and emotional impairment, psychomotor retardation, and disturbances in sleep and appetite. 20-40% of all patients do not benefit from traditional treatment methods such as psychotherapy or anti-depressant medication. This project will investigate a potential new treatment method: functional magnetic resonance imaging (fMRI)-based neurofeedback. In this method people undergo fMRI-scanning and receive continuously updated feedback about the activity level in a certain brain area, which they use to learn to control their own brain activity. It has previously been shown that chronic pain patients experienced considerably less pain after exercising control over a brain area involved in pain processing. In our project feedback from a region involved in positive emotion processing will be provided so that depressed patients can learn to regulate their emotional state. A pilot study of this method from our group has shown that depressed patients are both able to regulate their emotional network and experience significant improvements in mood.

Technical Summary

Depression is the second most common illness in primary health care and disrupts the everyday functioning of over 100 million people worldwide. Depression is a severe mood disorder that is characterised by clinical features such as loss of interest and pleasure in previously enjoyable activities, cognitive and emotional impairment, psychomotor retardation, and disturbances in sleep and appetite. 20-40% of all patients do not benefit from traditional treatment methods such as psychotherapy or anti-depressant medication. This project will investigate a potential new treatment method: functional magnetic resonance imaging (fMRI)-based neurofeedback. In this method people undergo fMRI-scanning and receive continuously updated feedback about the activity level in a certain brain area, which they use to learn to control their own brain activity. It has previously been shown that chronic pain patients experienced considerably less pain after exercising control over a brain area involved in pain processing. In our project feedback from a region involved in positive emotion processing will be provided so that depressed patients can learn to regulate their emotional state. A pilot study of this method from our group has shown that depressed patients are both able to regulate their emotion network and experience significant improvements in mood. The present project will investigate this new method of neurofeedback of emotion regions (NFE) in a larger group of patients and compare its effects with those of a control intervention with ?sham? feedback [neurofeedback control: NFC]). We expect that the active neurofeedback procedure will produce clinical benefits, as measured with clinical scales, self-rating questionnaires and quality of life scales, which are superior to those produced by the sham intervention. The whole-brain neuroimaging data that will be acquired as part of the project will elucidate the brain mechanisms through which this intervention operates. The project will also include the development of a framework for a future trial to assess the cost effectiveness of the intervention and strategies for its implementation in clinical practice.

Publications

10 25 50
 
Description Bilateral (Germany): The neural substrates of social comparison
Amount £212,155 (GBP)
Funding ID ES/F025831/2 
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 03/2011 
End 04/2011
 
Description CUBRIC 2 - Cardiff University Brain Research Imaging Centre
Amount £1,000,000 (GBP)
Organisation The Wolfson Foundation 
Sector Charity/Non Profit
Country United Kingdom
Start 06/2014 
End 11/2017
 
Description DEFINE - Defining endophenotypes from integrated neuroscience
Amount £5,234,843 (GBP)
Funding ID 100202/Z/12/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 10/2013 
End 09/2018
 
Description EEG nuerofeedback as a treatment method for Parkinson's disease?
Amount £58,974 (GBP)
Funding ID HS-14-20 
Organisation Health and Care Research Wales 
Sector Public
Country United Kingdom
Start 10/2014 
End 09/2017
 
Description Excitatory-inhibitory balance in adolescents at high genetic risk of mental disorder: A study of cortical gamma oscillations and GABA concentrations in 22q11.2 delection syndrome
Amount £307,019 (GBP)
Funding ID 102003/Z/13/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 09/2013 
End 08/2016
 
Description Framework Program 7
Amount € 5,900,000 (EUR)
Funding ID 602186 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 11/2013 
End 10/2017
 
Description Functional magnetic resonance imaging based neurofeedback as a treatment method for depression
Amount £59,320 (GBP)
Funding ID HS-10-25 
Organisation Health and Care Research Wales 
Sector Public
Country United Kingdom
Start 04/2011 
End 03/2014
 
Description Neurostimulation Therapy - Review of Business Plan
Amount £765 (GBP)
Organisation Arthurian Life Sciences 
Sector Private
Country United Kingdom
Start 07/2014 
End 07/2014
 
Description Project to dissect the biology of schizophrenia into clusters of intermediate phenotypes
Amount £7,487 (GBP)
Funding ID C0465 
Organisation Medical Research Council (MRC) 
Department Medical Research Foundation
Sector Charity/Non Profit
Country United Kingdom
Start 08/2013 
End 09/2014
 
Description Real-time fMRI neurofeedback as a treatment for Parkinson's Disease (PD)
Amount £45,000 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2012 
End 06/2013
 
Description Taking imaging into the therapeutic domain: self-regulation of brain systems for mental disorders
Amount £1,056,470 (GBP)
Funding ID FP7-HEALTH-F2-2013-602186 
Organisation European Commission 
Sector Public
Country European Union (EU)
Start 11/2013 
End 10/2017
 
Description The neurobiology of human working memory for threat: A multimethod approach
Amount £19,273 (GBP)
Organisation Biotechnology and Biological Sciences Research Council (BBSRC) 
Sector Public
Country United Kingdom
Start 01/2011 
End 03/2013
 
Title Neurofeedback manual 
Description Manual for data transfer, monitoring and analysis and homework exercises for neurofeedback in depression 
Type Of Material Physiological assessment or outcome measure 
Provided To Others? No  
Impact We are planning to make this material more widely available after its evaluation in the current study 
 
Description BrainTrain Consortium 
Organisation BrainTrain Consortium
Country Netherlands 
Sector Charity/Non Profit 
PI Contribution co-ordinator of EU grant
Collaborator Contribution partners in EU grant
Impact acquired eu grant funding.
Start Year 2013
 
Description European collaboration on neurofeedback and new technologies 
Organisation Central Institute for Mental Health
Country Germany 
Sector Hospitals 
PI Contribution Provided knowhow on clinical neurofeedback paradigms for multi-centre studies/ European grant applications
Collaborator Contribution Clinical neurofeedback expertise in affective and personality disorders (Mannheim and Aachen) and virtual reality (Barcelona)
Impact ERA-NET grant application (2018)
Start Year 2018
 
Description European collaboration on neurofeedback and new technologies 
Organisation RWTH Aachen University
Country Germany 
Sector Academic/University 
PI Contribution Provided knowhow on clinical neurofeedback paradigms for multi-centre studies/ European grant applications
Collaborator Contribution Clinical neurofeedback expertise in affective and personality disorders (Mannheim and Aachen) and virtual reality (Barcelona)
Impact ERA-NET grant application (2018)
Start Year 2018
 
Description European collaboration on neurofeedback and new technologies 
Organisation University of Barcelona
Country Spain 
Sector Academic/University 
PI Contribution Provided knowhow on clinical neurofeedback paradigms for multi-centre studies/ European grant applications
Collaborator Contribution Clinical neurofeedback expertise in affective and personality disorders (Mannheim and Aachen) and virtual reality (Barcelona)
Impact ERA-NET grant application (2018)
Start Year 2018
 
Title NFD 
Description Neurofeedback training, based on real-time functional magnetic resonance imaging signals, for patients with depression 
Type Therapeutic Intervention - Psychological/Behavioural
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2014
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Increase in research activities in clinical neurofeedback worldwide 
URL https://clinicaltrials.gov/show/NCT01544205
 
Title Neurofeedback and Depression 
Description Ongoing clinical trial 
Type Therapeutic Intervention - Psychological/Behavioural
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2013
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Unknown 
URL http://public.ukcrn.org.uk/Search/StudyDetail.aspx?StudyID=10901
 
Description Brain control: new developments in neurofeedback and neuromodulation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Delivered a seminar entitled Brain control: new developments in neurofeedback and neuromodulation



unknown
Year(s) Of Engagement Activity 2014
URL https://www.mrc-cbu.cam.ac.uk/?event=chaucer-club-seminar-david-linden-cardiff-university
 
Description Cardiff Brain Games 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Co-organiser of the Cardiff Brain Games (sponsored by the Wellcome Trust)

Date: Sunday 17th March
Venue: Amgueddfa Cymru - National Museum Wales
Time: 11am-4pm
FREE ADMISSION

this featured explanations of neurofeedback to primary school children


Aimed at Key Stage 2 pupils (aged 8-11), The Brain Games form a set of fun and interactive competitive activities offering primary school children the chance to collect points and win prizes.
Year(s) Of Engagement Activity 2013,2014
URL http://psych.cf.ac.uk/cubric/braingames/
 
Description Depression treatment press release 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact http://www.cardiff.ac.uk/news/articles/dealing-with-depression-8958.html

27 shares on twitter
Year(s) Of Engagement Activity 2012
URL http://www.cardiff.ac.uk/news/articles/dealing-with-depression-8958.html
 
Description Joint meeting of the Welsh Psychiatric Society and the Royal College of Psychiatrists in Wales 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Delivered talk entitled - Brain Control: Between manipulation and therapy

unknown
Year(s) Of Engagement Activity 2014
URL http://www.wps.swan.ac.uk/conferences.htm?id=12
 
Description Magnetic Resonance Summer School - Bristol 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Provided a talk entitled "Brain computer interface and MR" at the 2013 MR Summer School in Social Sciences building complex of University of Bristol.
The lecture schedule for three day first days of the Summer School is open to all interested academic, clinical researchers, post-doctoral fellows and postgraduate students.

unknown
Year(s) Of Engagement Activity 2013
URL http://www.bris.ac.uk/expsych/events/2013/115.html
 
Description PD Event 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Participants in your research and patient groups
Results and Impact information meeting with PD patients from ongoing research projects to inform design of new research

further engagement with local PD community
Year(s) Of Engagement Activity 2014
 
Description Royal College of Psychiatrists Annual Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Delivered 3 symposium talks at Royal College of Psychiatrists Annual Meeting

unknown
Year(s) Of Engagement Activity 2014
 
Description Talks on neurofeedback 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact The PhD student (David Mehler) gave a series of talks on neurofeedback in neurorehabilitation at Universities/ graduate schools in the USA.
Year(s) Of Engagement Activity 2018
 
Description WSJ 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Inform a piece in the Wall Street Journal on psychiatric application of neurofeedback

Improved the linkup of this journalistic piece with published scientific evidence
Year(s) Of Engagement Activity 2015
URL http://www.wsj.com/articles/brain-training-for-anxiety-depression-and-other-mental-conditions-145314...