Resting State Functional Connectivity Modulation and Sustained Changes after Real-Time fMRI Neurofeedback Training in Depression.

Brain Connect. 2014 Oct 20;

Authors: Yuan H, Young KD, Phillips R, Zotev V, Misaki M, Bodurka J

Abstract
Amygdala hemodynamic responses to positive stimuli are attenuated in major depressive disorder (MDD) and normalize with remission. Real-time fMRI neurofeedback (rtfMRI-nf) training with the goal of upregulating amygdala activity during recall of happy autobiographical memories (AMs) has been suggested, and recently explored, as a novel therapeutic approach which resulted in improvement in self-reported mood in depressed subjects. In the present study we assessed the possibility of sustained brain changes as well as the neuromodulatory effects of rtfMRI-nf training of the amygdala during recall of positive AMs in MDD and matched healthy subjects. MDD and healthy subjects went through one visit of rtfMRI neurofeedback training. Subjects were assigned to receive active neurofeedback from the left amygdala or from a control region putatively not modulated by AM recall or emotion regulation, i.e. the left horizontal segment of the intraparietal sulcus. To assess lasting effects of neurofeedback in MDD, the resting state functional connectivity before and after rtfMRI-nf in 27 depressed subjects, as well as in 27 matched healthy subjects before rtfMRI-nf was measured. Results show that abnormal hypo-connectivity with left amygdala in MDD is reversed after rtfMRI-nf training by recalling positive AMs. Although such neuromodulatory changes are observed in both MDD groups receiving feedback from respective active and control brain regions, only in the active group are larger decreases of depression severity associated with larger increases of amygdala connectivity and a significant, positive correlation is found between the connectivity changes and the days after neurofeedback. Additionally, active neurofeedback training of the amygdala enhances connectivity with temporal cortical regions including the hippocampus. These results demonstrate lasting brain changes induced by amygdala rtfMRI-nf training and suggest the importance of reinforcement learning in rehabilitating emotion regulation in depression.

PMID: 25329241 [PubMed - as supplied by publisher]