Depression is a common but often debilitating mental illness for adolescents, and many existing treatment options are not effective for a significant number of people. A study published in Molecular Psychiatry suggests that a new treatment called mindfulness-based neurofeedback may be promising, particularly for targeting hyperconnectivity in the default mode network (DMN) of the brain.
Major depressive disorder often starts in youth or adolescence and is linked to various negative outcomes, including worsened physical and mental health, decreased productivity, and suicidality. Despite its severity, most standard treatments are only about 50% effective for young people, indicating a dire need for new and innovative treatment approaches.
At the neurological level, major depressive disorder is associated with increased resting state connectivity in the default mode network (DMN), a group of brain regions that become active when an individual is not focused on the external world and the brain is at rest. The DMN includes brain areas that are more active during internal thoughts, self-reflection, daydreaming, or imagination, rather than when responding to external stimuli or performing specific tasks.
The study aimed to explore previous research suggesting that fMRI neurofeedback might be a suitable treatment by testing its impact on connectivity and mindfulness.
Jiahe Zhang and colleagues conducted the study with 9 adolescent participants, aged 17 to 19, who had a history of major depressive disorder and/or anxiety disorders. The participants attended two sessions. In the first session, they underwent a clinical interview, self-report measures on depression and anxiety symptoms, and an MRI. In the second session, they participated in a 15-minute mindfulness meditation training, neurofeedback MRI session, and pre- and post-scan mindfulness assessments.
The results demonstrated that mindfulness-based fMRI neurofeedback effectively reduced connectivity in the default mode network compared to the central executive network (CEN). This is a crucial finding, as hyperconnectivity is a neurological marker of major depressive disorder.
Moreover, the mindfulness-based fMRI intervention increased state mindfulness in a single session. It also enhanced central executive network regulation, which could help strengthen the central executive network’s control over the default mode network.
The study’s findings also suggest that reduced default mode network connectivity acted as a mediator for the relationship between neurofeedback performance and state mindfulness. This study offers a promising new direction for treating adolescent depression.
The study highlights the potential of mindfulness-based neurofeedback training as a non-invasive technique that enables individuals to monitor and regulate brain function, especially for reducing DMN connectivity. The results indicate that such interventions may create favorable conditions for acquiring mindfulness, which could help decrease repetitive negative thinking and depression symptoms.
While this study took essential steps in exploring new treatment options for major depression, it has limitations. One limitation is the small sample size of only 9 participants, making it hard to assess generalizability. Additionally, there was no control group for comparison. Future research could expand the sample to include more diversity and a control group.
The study, “Reducing default mode network connectivity with mindfulness-based fMRI neurofeedback: a pilot study among adolescents with affective disorder history“, was authored by Jiahe Zhang, Jovicarole Raya, Francesca Morfini, Zoi Urban, David Pagliaccio, Anastasia Yendiki, Randy P. Auerbach, Clemens C. C. Bauer, and Susan Whitfield-Gabrieli.