Department of Psychiatry, Columbia University, New York, NY, USA.
Department of Psychology, Northeastern University, Boston, MA, USA.
BMC Psychiatry. 2023 Oct 17;23(1):757. doi: 10.1186/s12888-023-05223-8.
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).
青春期是重度抑郁障碍（MDD）发病的高危险期，目前，治疗方法对大约一半的 MDD 青少年有效。因此，迫切需要新的干预措施。本研究旨在建立基于正念的实时功能磁共振神经反馈（mbNF）作为一种非侵入性方法，以下调默认模式网络（DMN），从而减少反刍过程和抑郁症状。
将目前患有 MDD 的 13-18 岁青少年（N=90）随机分为两组，每组 15 或 30 分钟的 mbNF，分配比例为 1:1。基于相对于 DMN 的额顶网络（FPN）的激活，通过计算机屏幕上球的移动向参与者显示实时神经反馈，而参与者在扫描仪中练习正念。我们假设 mbNF 后 DMN 内（内侧前额叶皮质[mPFC]与后扣带回皮质[PCC]）功能连接将减少（目标 1：靶向结合）。此外，我们假设在 30 分钟 mbNF 条件下的参与者将表现出更大的 DMN 内功能连接减少（目标 2：对靶向结合的剂量影响）。目标 1 将分析所有参与者的单一组数据，目标 2 将利用随机分配来分析作为平行组试验的数据。次要分析将探讨抑郁症状和反刍的变化。
本研究的结果将确定 mbNF 是否能降低 MDD 青少年 DMN 内的功能连接，关键是确定 DMN 调节以及抑郁症状和反刍减少的最佳剂量。
该研究已在 clinicaltrials.gov 上注册，最近一次更新是在 2023 年 7 月 6 日（试验标识符：NCT05617495）。
