Real-Time Self-Regulation of Emotion Networks in Patients with Depression

Many patients show no or incomplete responses to current pharmacological or psychological therapies for depression. Here we explored the feasibility of a new brain self-regulation technique that integrates psychological and neurobiological approaches through neurofeedback with functional magnetic resonance imaging (fMRI). In a proof-of-concept study, eight patients with depression learned to upregulate brain areas involved in the generation of positive emotions (such as the ventrolateral prefrontal cortex (VLPFC) and insula) during four neurofeedback sessions. Their clinical symptoms, as assessed with the 17-item Hamilton Rating Scale for Depression (HDRS), improved significantly. A control group that underwent a training procedure with the same cognitive strategies but without neurofeedback did not improve clinically. Randomized blinded clinical trials are now needed to exclude possible placebo effects and to determine whether fMRI-based neurofeedback might become a useful adjunct to current therapies for depression.

Operant (biofeedback) Control of Left-right Frontal Alpha Power Differences: Potential Neurotherapy for Affective Disorders.

Two experiments were done with subjects from a paid pool of undergraduates. In each study, there were five 1-hour sessions on each of 5 days: (1) Baseline: Rewards given for randomly selected 20% of the 700-ms sequential epochs; mean and SD of baseline power differences determined. 2) Exploration: Subjects were rewarded when right minus left alpha differences in an epoch were greater than the baseline mean plus about .85 SD (p = .20); subjects told to discover how to generate rewards. (3)-(5). Training: Subjects were paid (over and above the $8/h flat rate) in proportion to their hit rates. In the first study (in which active filters passed 8-12 Hz activity, and the rectified, integrated amplitude was utilized), 6 of 8 subjects met learning criteria (a significant difference between baseline and training scores). In the second study (in which on-line FFTs were used to extract alpha power), 3 of 5 subjects met learning criteria.

Alpha-theta brainwave neurofeedback training: an effective treatment for male and female alcoholics with depressive symptoms

This was an experimental study of 14 alcoholic outpatients using the Peniston and Kulkosky (1989, 1991) brainwave treatment protocol for alcohol abuse. After temperature biofeedback pretraining, experimental subjects completed 20 40-minute sessions of alpha-theta brainwave neurofeedback training (BWNT). Experimentally treated alcoholics with depressive syndrome showed sharp reductions in self-assessed depression (Beck’s Depression Inventory). On the Millon Clinical Multiaxial Inventory-I, the experimental subjects showed significant decreases on the BR scores: schizoid, avoidant, dependent, histrionic, passive-aggression, schizotypal, borderline, anxiety, somatoform, hypomanic, dysthmic, alcohol abuse, drug abuse, psychotic thinking, and psychotic depression. Twenty-one-month follow-up data indicated sustained prevention of relapse in alcoholics who completed BWNT.