Mindfulness-based real-time fMRI neurofeedback: a randomized controlled trial to optimize dosing for depressed adolescents.
Mindfulness-based real-time fMRI neurofeedback: a randomized controlled trial to optimize dosing for depressed adolescents.
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DOI：
10.1186/s12888-023-05223-8
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发表时间：
2023-10-17
期刊：
影响因子：
4.4
通讯作者：
Auerbach, Randy P.
中科院分区：
文献类型：
--
作者：
Bloom, Paul A.;Pagliaccio, David;Zhang, Jiahe;Bauer, Clemens C. C.;Kyler, Mia;Greene, Keara D.;Treves, Isaac;Morfini, Francesca;Durham, Katherine;Cherner, Rachel;Bajwa, Zia;Wool, Emma;Olafsson, Valur;Lee, Ray F.;Bidmead, Fred;Cardona, Jonathan;Kirshenbaum, Jaclyn S.;Ghosh, Satrajit;Hinds, Oliver;Wighton, Paul;Galfalvy, Hanga;Simpson, H. Blair;Whitfield-Gabrieli, Susan;Auerbach, Randy P.
青春期的特点是患重度抑郁症（MDD）的易感性增加，而目前的治疗方法对大约一半的患有MDD的青少年有效。因此，迫切需要新的干预措施。本研究旨在确立基于正念的实时功能性磁共振成像神经反馈（mbNF）作为一种下调默认模式网络（DMN）的非侵入性方法，以减少反刍过程和抑郁症状。
90名年龄在13 - 18岁之间、目前被诊断患有MDD的青少年将在一项平行组、双臂、优效性试验中被随机分组，以1:1的分配比例接受15分钟或30分钟的mbNF。当参与者在扫描仪中进行正念练习时，基于额顶叶网络（FPN）相对于DMN的激活的实时神经反馈将通过电脑屏幕上一个球的移动展示给参与者。我们假设在接受mbNF后，DMN内部（内侧前额叶皮质[mPFC]与后扣带回皮质[PCC]）的功能连接性将会降低（目标1：靶向参与）。此外，我们假设在30分钟mbNF条件下的参与者将在DMN内部功能连接性上表现出更大程度的降低（目标2：剂量对靶向参与的影响）。目标1将把所有参与者的数据作为单一组进行分析，目标2将利用随机分组把数据作为平行组试验进行分析。次要分析将探究抑郁症状和反刍的变化。
这项研究的结果将确定mbNF是否会降低患有MDD的青少年的DMN内部的功能连接性，并且关键的是，将确定关于DMN调节以及抑郁症状和反刍减少的最佳剂量。
本研究已在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）
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).
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