Participant Performance Factors and Improvement in Depressive Symptoms Following Real-Time fMRI Amygdala Neurofeedback Training

Background and Purpose: We have developed real time fMRI (rt-fMRI) neurofeedback training, which increases amygdala activation using positive autobiographical memory recall, to reduce depressive symptoms. In an effort to improve the efficacy of this new intervention, we assessed potential factors associated with participants’ improvements in depressive symptoms.

Methods: 80 participants completed two rt-fMRI training sessions, as well as self-report measures on their perceived experience following each scan. After the intervention, participants were followed up for 12 weeks using the Beck Depression Inventory-II (BDI-II). Change from baseline in BDI scores was used to evaluate depressive symptom improvement. The relationship between BDI score change and perceived experiences reported during the post-scan surveys was examined.

Results: Overall, participants' BDI scores decreased by an average of 16.9 (12.7SD) points and increased their amygdala activity by 0.34% (0.03SD). We entered the following variables into a regression model with BDI change as the dependent variable: perceived control over brain activity, effectiveness of efforts at task, frustration during neurofeedback task, motivation to successfully complete task, desire to feel positive emotions, and the desire to feel intense emotions of any kind. For BDI scores, the overall model was significant (F(13,63)= 2.13, p= 0.025) and explained 30% of the variance. From the post-scan measures entered, BDI change was significantly correlated with motivation to successfully complete the NF task (t(63)= -2.777, p= 0.007) as well as the desire to feel intense, positive emotions (t(63)= 2.91, p= 0.007), and the desire to feel intense emotions of any kind was marginally significant (t(63)= -1.88, p= 0.65).

Conclusions and Implications: In using post-scan data to examine the impact of individualized experiences on BDI score change, the motivation to successfully complete the NF task, the desire to feel intense positive emotions, and the desire to feel intense emotions of any kind were significant. These findings ultimately inform future neurofeedback research and interventions so that these variables may be modified to increase neurofeedback training effects on reducing individual depressive symptoms.