Objective: Patients with depression show blunted amygdala hemodynamic activity to positive stimuli, including autobiographical memories. The authors examined the therapeutic efficacy of real-time functional MRI neurofeedback (rtfMRI-nf) training aimed at increasing the amygdala’s hemodynamic response to positive memories in patients with depression.
Method: In a double-blind, placebo-controlled, randomized clinical trial, unmedicated adults with depression (N=36) were randomly assigned to receive two sessions of rtfMRI-nf either from the amygdala (N=19) or from a parietal control region not involved in emotional processing (N=17). Clinical scores and autobiographical memory performance were assessed at baseline and 1 week after the final rtfMRI-nf session. The primary outcome measure was change in score on the Montgomery-Åsberg Depression Rating Scale (MADRS), and the main analytic approach consisted of a linear mixed-model analysis.
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The participant will explain the relationship of amygdala hypoactivity to positive stimuli in the treatment of depression, in terms of changes in symptoms and in autobiographical memory processing.
This program is designed for all psychiatrists in clinical practice, residents in Graduate Medical Education programs, medical students interested in psychiatry, and other physicians who wish to advance their current knowledge of clinical medicine.
Duration: 1 hour
Begin Date: August 1, 2017
End Date: July 31, 2019
In order to earn CME credit, subscribers should read through the material presented in the article. After reading the article, complete the quiz and submit your evaluation and study hours (up to 1 AMA PRA Category 1 Credit™). A score of 60% or higher is required to receive credit.
The American Psychiatric Association (APA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The APA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Title: Randomized Clinical Trial of Real-Time fMRI Amygdala Neurofeedback for Major Depressive Disorder: Effects on Symptoms and Autobiographical Memory Recall
Authors: Kymberly D. Young, Ph.D., Greg J. Siegle, Ph.D., Vadim Zotev, Ph.D., Raquel Phillips, B.S., Masaya Misaki, Ph.D., Han Yuan, Ph.D., Wayne C. Drevets, M.D., Jerzy Bodurka, Ph.D.
Affiliations: From the Laureate Institute for Brain Research, Tulsa, Okla. (K.D.Y., V.Z., R.P., M.M., H.Y., J.B.); the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh (K.D.Y., G.J.S.); the Stephenson School of Biomedical Engineering, University of Oklahoma, Norman (H.Y., J.B.); Janssen Research and Development, New Brunswick, N.J. (W.C.D.); and the Biomedical Engineering Center, University of Oklahoma College of Engineering, Norman (J.B.).
Disclosures: Dr. Drevets is an employee of Janssen Research and Development (of Johnson & Johnson) and is a stockholder in Johnson & Johnson. The other authors report no financial relationships with commercial interests.
Discussion of unapproved or investigational use of products*: No.
*APA policy requires disclosure by CME authors of unapproved or investigational use of products discussed in CME programs. Off-label use of medications by individual physicians is permitted and common. Decisions about off-label use can be guided by scientific literature and clinical experience.
Robert Freedman, M.D. (Editor-in-Chief, AJP); Susan K. Schultz, M.D. (Deputy Editor, AJP); Michael D. Roy (Editorial Director, AJP); Michael A. Pogachar (Online Content Manager, Journals).
Dr. Schultz has received research support from the Alzheimer’s Disease Cooperative Study for projects conducted in partnership with Toyama Chemical Company and in partnership with Eli Lilly and Company. Dr. Freedman, Mr. Roy, and Mr. Pogachar report no financial relationships with commercial interests.
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