Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies.

Anger Brodmann Area 25 anterior temporal lobe guilt major depressive disorder neurofeedback psychotherapy real-time fMRI social cognition subgenual cingulate cortex

Journal

Psychological medicine
ISSN: 1469-8978
Titre abrégé: Psychol Med
Pays: England
ID NLM: 1254142

Informations de publication

Date de publication:
May 2023
Historique:
medline: 17 7 2023
pubmed: 3 12 2021
entrez: 2 12 2021
Statut: ppublish

Résumé

Overgeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and have previously been associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal cortices. Another study showed that remitted MDD patients were able to modulate this neural signature using functional magnetic resonance imaging (fMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown. This single-blind pre-registered randomised controlled pilot trial probed a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (BA25) fMRI neurofeedback, targeting self-blaming emotions in people with insufficiently recovered MDD and early treatment-resistance ( As predicted, neurofeedback led to a training-induced reduction in rSATL-BA25 connectivity for self-blame These findings suggest that self-blame-rebalance neurofeedback may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. Simple self-guided strategies tackling self-blame were beneficial, but need to be compared against treatment-as-usual in further trials. https://doi.org/10.1186/ISRCTN10526888.

Sections du résumé

BACKGROUND BACKGROUND
Overgeneralised self-blame and worthlessness are key symptoms of major depressive disorder (MDD) and have previously been associated with self-blame-selective changes in connectivity between right superior anterior temporal lobe (rSATL) and subgenual frontal cortices. Another study showed that remitted MDD patients were able to modulate this neural signature using functional magnetic resonance imaging (fMRI) neurofeedback training, thereby increasing their self-esteem. The feasibility and potential of using this approach in symptomatic MDD were unknown.
METHOD METHODS
This single-blind pre-registered randomised controlled pilot trial probed a novel self-guided psychological intervention with and without additional rSATL-posterior subgenual cortex (BA25) fMRI neurofeedback, targeting self-blaming emotions in people with insufficiently recovered MDD and early treatment-resistance (
RESULTS RESULTS
As predicted, neurofeedback led to a training-induced reduction in rSATL-BA25 connectivity for self-blame
CONCLUSIONS CONCLUSIONS
These findings suggest that self-blame-rebalance neurofeedback may be superior over a solely psychological intervention in non-anxious MDD, although further confirmatory studies are needed. Simple self-guided strategies tackling self-blame were beneficial, but need to be compared against treatment-as-usual in further trials. https://doi.org/10.1186/ISRCTN10526888.

Identifiants

pubmed: 34852855
doi: 10.1017/S0033291721004797
pii: S0033291721004797
pmc: PMC10235657
doi:

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2831-2841

Auteurs

Tanja Jaeckle (T)

Department of Psychological Medicine, Centre for Affective Disorders, London, UK.

Steven C R Williams (SCR)

Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Gareth J Barker (GJ)

Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Rodrigo Basilio (R)

Cognitive and Behavioral Neuroscience Unit and Neuroinformatics Workgroup, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.

Ewan Carr (E)

Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Kimberley Goldsmith (K)

Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Alessandro Colasanti (A)

Department of Psychological Medicine, Centre for Affective Disorders, London, UK.

Vincent Giampietro (V)

Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Anthony Cleare (A)

Department of Psychological Medicine, Centre for Affective Disorders, London, UK.

Allan H Young (AH)

Department of Psychological Medicine, Centre for Affective Disorders, London, UK.
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK.

Jorge Moll (J)

Cognitive and Behavioral Neuroscience Unit and Neuroinformatics Workgroup, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.

Roland Zahn (R)

Department of Psychological Medicine, Centre for Affective Disorders, London, UK.
Cognitive and Behavioral Neuroscience Unit and Neuroinformatics Workgroup, D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK.

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Classifications MeSH