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

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.

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.