Neurofeedback and Affect Regulation Circuitry in Depressed and Healthy Adolescents

SIMPLE SUMMARY: Adolescent depression represents a risk for chronic’ illness when current treatments fail. Given the modest effectiveness of extant therapies, there is a keen need to develop treatments for depression. We used neurofeedback training and positive autobiographical memory retrieval to modulate neural networks that enable emotion regulation and autobiographical memories (amygdala and hippocampus, anterior cingulate cortex) in youth. Our goal was to understand how depressed and control youth engage those regions during emotion regulation and memory recall. Our results showed engagement of the targeted areas as well as differences between diagnostic groups. Future work ought to examine neurofeedback training’s dosage in depressed youth and target cortico-limbic connectivity involved in positive memory recall. ABSTRACT: Neurodevelopmental psychopathology seeks to understand higher-order emotion regulation circuitry to develop new therapies for adolescents with depression. Depressed (N = 34) and healthy youth (N = 19) completed neurofeedback (NF) training and exhibited increased bilateral amygdala and hippocampus activity in the region of interest (ROI) analyses by recalling positive autobiographical memories. We tested factors supportive of the engagement of emotion regulation’s neural areas during NF (i.e., parental support, medication, and gender effects upon anterior cingulate cortex (ACC) engagement). Whole-brain analyses yielded effects of NF vs. control condition and effects of diagnosis. Youth showed higher amygdala and hippocampus (AMYHIPPO) activity during the NF vs. control condition, particularly in the left hippocampus. ACC’s activity was also higher during NF vs. control. Higher average ACC activity was linked to better parental support, absent depression, female gender, and absent medication. Control youth showed higher average AMYHIPPO and ACC activity throughout the task and a faster decline in activity vs. depressed youths. Whole-brain level analyses showed higher activity in the frontotemporal network during the NF vs. control conditions, suggesting targeting their connectivity in future neurofeedback trials.