Mindfulness-based real-time fMRI neurofeedback: a randomized controlled trial to optimize dosing for depressed adolescents.
Paul A Bloom, David Pagliaccio, Jiahe Zhang, Clemens C C Bauer, Mia Kyler, Keara D Greene, Isaac Treves, Francesca Morfini, Katherine Durham, Rachel Cherner, Zia Bajwa, Emma Wool, Valur Olafsson, Ray F Lee, Fred Bidmead, Jonathan Cardona, Jaclyn S Kirshenbaum, Satrajit Ghosh, Oliver Hinds, Paul Wighton, Hanga Galfalvy, H Blair Simpson, Susan Whitfield-Gabrieli, Randy P Auerbach
BMC psychiatry October 17, 2023 DOI: 10.1186/s12888-023-05223-8 via PubMed
Summary
AI-generated from the abstractAdolescents with major depressive disorder (MDD) may benefit from a non-invasive technique that combines mindfulness with real-time fMRI neurofeedback (mbNF) to reduce activity in the default mode network (DMN), a brain network linked to rumination. In a planned trial, 90 adolescents aged 13–18 with MDD will be randomly assigned to receive either 15 or 30 minutes of mbNF. During the procedure, participants practice mindfulness while a ball on a screen moves based on their brain activity, targeting the frontoparietal network relative to the DMN. The study will test whether mbNF reduces functional connectivity within the DMN and whether longer dosing produces greater effects, with secondary outcomes including changes in depressive symptoms and rumination.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 90 |
| Population | Adolescents aged 13-18 with a current diagnosis of Major Depressive Disorder |
| Intervention | Mindfulness-based real-time fMRI neurofeedback (mbNF) |
| Topics | Default mode network Depression Meditation |
| Keywords | Adolescence Fpn |
| Citations | 17 |
| Registration | NCT05617495 |
| Key finding | The study aims to determine whether mindfulness-based real-time fMRI neurofeedback reduces functional connectivity within the default mode network in adolescents with MDD and to identify the optimal dosing for DMN modulation and symptom reduction. |
Abstract
Adolescence is characterized by a heightened vulnerability for Major Depressive Disorder (MDD) onset, and currently, treatments are only effective for roughly half of adolescents with MDD. Accordingly, novel interventions are urgently needed. This study aims to establish mindfulness-based real-time fMRI neurofeedback (mbNF) as a non-invasive approach to downregulate the default mode network (DMN) in order to decrease ruminatory processes and depressive symptoms. Adolescents (N = 90) with a current diagnosis of MDD ages 13-18-years-old will be randomized in a parallel group, two-arm, superiority trial to receive either 15 or 30 min of mbNF with a 1:1 allocation ratio. Real-time neurofeedback based on activation of the frontoparietal network (FPN) relative to the DMN will be displayed to participants via the movement of a ball on a computer screen while participants practice mindfulness in the scanner. We hypothesize that within-DMN (medial prefrontal cortex [mPFC] with posterior cingulate cortex [PCC]) functional connectivity will be reduced following mbNF (Aim 1: Target Engagement). Additionally, we hypothesize that participants in the 30-min mbNF condition will show greater reductions in within-DMN functional connectivity (Aim 2: Dosing Impact on Target Engagement). Aim 1 will analyze data from all participants as a single-group, and Aim 2 will leverage the randomized assignment to analyze data as a parallel-group trial. Secondary analyses will probe changes in depressive symptoms and rumination. Results of this study will determine whether mbNF reduces functional connectivity within the DMN among adolescents with MDD, and critically, will identify the optimal dosing with respect to DMN modulation as well as reduction in depressive symptoms and rumination. This study has been registered with clinicaltrials.gov, most recently updated on July 6, 2023 (trial identifier: NCT05617495).