fMRI neurofeedback for the modulation of the neural networks associated with depression.

Objectives: Functional magnetic resonance imaging (fMRI) neurofeedback has emerged as a potential treatment modality for depression, but little is known about its mechanism of action. This study aims to investigate the efficacy of fMRI neurofeedback in modulating neural networks in depression.

Methods: Following PRISMA guidelines, a systematic review was conducted focusing on fMRI neurofeedback interventions in depression. A comprehensive search across multiple databases yielded 16 eligible studies for review.

Results: The review demonstrated that fMRI neurofeedback can modulate BOLD activity even in strategy-free protocols and within a single session, with a significant learning effect evident over sessions. Neurofeedback targeting specific regions led to changes in connectivity across broad neural networks, including the default-mode and executive control networks, with effects being region-specific. However, methodological diversity and the absence of standardized protocols in the reviewed studies highlighted the need for more uniform research approaches.

Conclusions: fMRI neurofeedback shows promise as a modulatory technique for depression, with the potential to induce significant changes in neural activity and connectivity of networks implicated in depression.

Significance: The review underscores the necessity for standardized, reproducible neurofeedback protocols with control groups to enhance research comparability and generalizability.