Real-time fMRI neurofeedback training as a neurorehabilitation approach on depressive disorders : a systematic review of randomized control trials
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Date
2021
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Abstract
Question: Real-time functional magnetic resonance imaging neurofeedback (rt-fMRI-nf) training is an emerging
intervention with potential to neurorehabilitation. We aim to evaluate the evidence of randomized control trials
on the clinical application of rt-fMRI-nf training on participants with clinical depression.
Study selection and analysis: We searched in Pubmed, Embase, CENTRAL, rtFIN database, Epistemonikos,
trial registers, reference lists, other systematic reviews, conference abstracts, and cross-citation in Google Scholar.
Two reviewers independently selected studies, extracted data and assessed the risk of bias. The certainty of the
evidence was judged using the GRADE recommendations, a Summary of Findings table is presented. This review
complies with PRISMA guidelines and was submitted to PROSPERO registration.
Findings: 435 results. After selection process, we included 11 reports corresponding to 4 RCTs. The effect of rtfMRI-nf on improving severity of depression clinical scores showed tendency to favors intervention; however the
overall effect was not significant. At end of treatment, SMD(standardized mean difference): -0.32 (95%CI -0.73
to 0.10). At follow-up, SMD: -0.33 (95%CI -0.91, 1.25). All the studies demonstrated changes in BOLD fMRI
activation after training; however, only one study demonstrated regulation success during a transfer run. Wholebrain analyses suggests that rt-fMRI nf alters activity patterns not only in a single brain region, but brain networks.
More studies are needed to provide an estimated effect on quality of life, acceptability, adverse effects, cognitive
tasks, and physiology measures.
Conclusions: The current evidence of RCTs about the impact of rt-fMRI-nf training for decision-making
outcomes in patients with clinical depression is still insufficient
Description
Tesis (Magíster en Ciencias de la Salud)--Pontificia Universidad Católica de Chile, 2021