Functional connectivity and activation-based neurofeedback using reappraisal and mindfulness strategies for Depression and Early Life Adversity

COEX 

Disrupted neural patterns are linked to psychiatric vulnerabilities, such as Repetitive Negative Thinking (RNT) in depression and disturbances due to early life adversity (ELA). Neuroanatomically targeted fMRI neurofeedback (NF) has shown promise in safely and non-invasively mitigating the disrupted neural patterns through learned self-regulation of brain activity. I will present two studies that use real-time fMRI NF (with real-time physiological correction using RTPSpy) employing different mental strategies to target 2 main types of clinical cohorts, i.e., depression (reappraisal technique), and ELA (mindfulness). These studies use 2 distinct methods of neurofeedback – functional connectivity-based neurofeedback (FC-NF), and BOLD activation-based feedback.
Study 1: Evidence has shown that enhanced resting-state FC between the precuneus/posterior cingulate cortex (PCC) and right temporoparietal junction (rTPJ) correlates with increased rumination (RNT). Therefore, we employed fMRI neurofeedback to modulate PCC-rTPJ FC in individuals (N=39) with MDD. We found that MDD patients receiving active neurofeedback showed significant reductions in negative rumination (RNT) and enhancement in quality of daily-life mental strategies.
Study 2: ELA disrupts activity in the default-mode network, which influences emotional awareness. Hence, we employed neurofeedback-augmented mindfulness training (NAMT) to modulate the DMN by specifically targeting PCC BOLD activation. 43 ELA (randomized to active or sham NF) and 40 healthy (active NF) adolescents underwent NAMT. We found that although ELA-exposed adolescents experienced greater difficulty in down-regulating their PCC activation compared to healthy controls, they showed improvements in state-mindfulness and affective responses post-neurofeedback training.

These investigations highlight the utility of FC and BOLD activation-based real-time NF aimed at patients and at-risk populations. While FC neurofeedback with cognitive reappraisal shows promise in mitigating RNT in depression, activation-based neurofeedback with mindfulness aimed at adolescents with ELA may need further tailoring for effective translation. The overarching theme of my talk is the promising avenue of personalized neurofeedback treatments for varied patient groups.