Improving emotion regulation in depression using real-time fMRI-based neurofeedback

Abstract

Major depressive disorders (MDD), commonly known as depression, have a high prevalence worldwide. Patients suffering from depression have deficits in emotion-processing brain regions and networks. This highlights emotional biases in depression patients, as patients show selective or enhanced brain reactions to negative emotions, while the processing of positive emotions is reduced. Modern neuroimaging methods such as real-time fMRI-based neurofeedback can help patients self-regulate their dysfunctional brain regions by presenting them with feedback on their own brain activity. By modulating brain responses through appropriate cognitive strategies, patients can improve their emotion regulation skills. Based on these findings, we aimed to address positive and negative emotional biases in depression. In this experimental MRI-based intervention, patients are shown faces with different emotions ranging from fearful to happy. They are asked to make neutral faces more happy by actively using positive strategies while decreasing facial fearfulness to reduce anxiety symptoms. This approach serves as a therapeutic measure by allowing patients to learn to control their dysfunctional brain activity. It is non-invasive and has no major side effects, hence it is safe. Most importantly, it focuses on a fundamental human trait, our ability to learn. This study aims to evaluate the effectiveness of such an innovative neurofeedback modality in improving the symptoms associated with depression