Abstract
Cognitive deficits are core symptoms of depression. This study aims to investigate whether neurofeedback (NF) training can improve working memory (WM) performance in patients with major depressive disorder (MDD). The NF group (n = 40) underwent eight NF sessions and was compared to a non-interventional control group (n = 20). The NF protocol aimed to increase the individual upper alpha power in the parieto-occipital area of the scalp. Main cognitive variable was WM, which was measured pre- and post- training along with other variables such as attention and executive functions. EEG was recorded in both eyes closed resting state and eyes open task-related activity, pre- and post- NF training, and pre- and post- the NF trials within each session. A power EEG analysis and an alpha asymmetry analysis were conducted at the sensor level. Frequency domain standardized low resolution tomography (sLORETA) was used to assess the effect at brain source level. Correlation analysis between the clinical/cognitive and EEG measurements was conducted at both the sensor and brain source level. The NF group showed increased performance as well as improved processing speed in a WM test after the training. The NF group showed pre-post enhancement in the upper alpha power after the training, better visible in task-related activity as compared to resting state. A current density increase appeared in the alpha band (8–12 Hz) for the NF group, localized in the subgenual anterior cingulate cortex (sgACC, BA 25). A positive correlation was found for the NF group between the improvement in processing speed and the increase of beta power at both the sensor and brain source level. These results show the effectiveness of this NF protocol in improving WM performance in patients with MDD.
Highlights
Major depressive disorder (MDD) is a severe, chronic, mood disorder characterized by episodes of sadness, loss of interest and motivation, pessimism, and suicidal thoughts (DeRubeis et al, 2008)
A significant Group × Time ANOVA interaction appeared in the PASAT test [# errors: F(1, 46) = 5.42, p = 0.024; time: F(1, 46) = 4.97, p = 0.031], showing an improvement in working memory (WM) performance and processing speed for the NF group only [# errors: t(30) = −5.21, p < 0.001; time: t(30) = −4.91, p < 0.001]
The objective of the current work was to explore whether the cognitive symptoms of patients with major depressive disorder (MDD) can be alleviated by EEG-based NF training
Summary
Major depressive disorder (MDD) is a severe, chronic, mood disorder characterized by episodes of sadness, loss of interest and motivation, pessimism, and suicidal thoughts (DeRubeis et al, 2008). The current standard treatment for depression is antidepressant medication. With this treatment about 33% of patients fail to achieve remission (Anderson et al, 2008). The patient compliance to the treatment can decrease due to the side effects such as sexual dysfunction, gastrointestinal problems, and weight gain (Brunoni et al, 2009). For this reason, the development of new treatments is constantly explored. Recently there has been a renewed interest on neuromodulation techniques such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and neurofeedback (DeRubeis et al, 2008; Brunoni et al, 2009)
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