Reducing default mode network connectivity with mindfulness-based fMRI neurofeedback: a pilot study among adolescents with affective disorder history.

Adolescents with a lifetime history of depression or anxiety (n = 9) participated in a proof-of-concept study using personalized mindfulness-based fMRI neurofeedback to reduce default mode network hyperconnectivity, a neural mechanism linked to depressive symptoms. After a resting state fMRI localizer to map each adolescent's default mode and central executive networks, a brief mindfulness training and neurofeedback session followed. The neurofeedback successfully engaged the target brain state, with participants spending more time with default mode network activation lower than central executive network activation. Within-default mode network connectivity decreased in all nine adolescents, correlating with increased state mindfulness after the session. Reduced within-default mode network connectivity mediated the link between better neurofeedback performance and increased state mindfulness, suggesting this non-invasive method can modulate networks involved in adolescent depression.

Study at a glance

Abstract

Adolescents experience alarmingly high rates of major depressive disorder (MDD), however, gold-standard treatments are only effective for ~50% of youth. Accordingly, there is a critical need to develop novel interventions, particularly ones that target neural mechanisms believed to potentiate depressive symptoms. Directly addressing this gap, we developed mindfulness-based fMRI neurofeedback (mbNF) for adolescents that aims to reduce default mode network (DMN) hyperconnectivity, which has been implicated in the onset and maintenance of MDD. In this proof-of-concept study, adolescents (n = 9) with a lifetime history of depression and/or anxiety were administered clinical interviews and self-report questionnaires, and each participant's DMN and central executive network (CEN) were personalized using a resting state fMRI localizer. After the localizer scan, adolescents completed a brief mindfulness training followed by a mbNF session in the scanner wherein they were instructed to volitionally reduce DMN relative to CEN activation by practicing mindfulness meditation. Several promising findings emerged. First, mbNF successfully engaged the target brain state during neurofeedback; participants spent more time in the target state with DMN activation lower than CEN activation. Second, in each of the nine adolescents, mbNF led to significantly reduced within-DMN connectivity, which correlated with post-mbNF increases in state mindfulness. Last, a reduction of within-DMN connectivity mediated the association between better mbNF performance and increased state mindfulness. These findings demonstrate that personalized mbNF can effectively and non-invasively modulate the intrinsic networks associated with the emergence and persistence of depressive symptoms during adolescence.