Introduction: Repetitive negative thinking (RNT) is a cognitive process focusing on self-relevant and negative experiences, leading to a poor prognosis of major depressive disorder (MDD). We previously identified that connectivity between the precuneus/posterior cingulate cortex (PCC) and right temporoparietal junction (rTPJ) was positively correlated with levels of RNT. Objective: In this double-blind, randomized, sham-controlled, proof-of-concept trial, we employed real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) to delineate the neural processes that may be causally linked to RNT and could potentially become treatment targets for MDD. Methods: MDD-affected individuals were assigned to either active (n = 20) or sham feedback group (n = 19). RNT was measured by the Ruminative Response Scale-brooding subscale (RRS-B) before and 1 week after the intervention. Results: Individuals in the active but not in the sham group showed a significant reduction in the RRS-B; however, a greater reduction in the PCC-rTPJ connectivity was unrelated to a greater reduction in the RRS-B. Exploratory analyses revealed that a greater reduction in the retrosplenial cortex (RSC)-rTPJ connectivity yielded a more pronounced reduction in the RRS-B in the active but not in the sham group. Conclusions: RtfMRI-nf was effective in reducing RNT. Considering the underlying mechanism of rtfMIR-nf, the RSC and rTPJ could be part of a network (i.e., default mode network) that might collectively affect the intensity of RNT. Understanding the relationship between the functional organization of targeted neural changes and clinical metrics, such as RNT, has the potential to guide the development of mechanism-based treatment of MDD.
Psychother Psychosom

中文翻译：

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实时 fMRI 功能连接性神经反馈减少抑郁症中的重复性消极思维：一项双盲、随机、假对照的概念验证试验

简介：重复性消极思维 (RNT) 是一种专注于自我相关和消极经历的认知过程，会导致重度抑郁症 (MDD) 的预后不良。我们之前发现楔前叶/后扣带皮层 (PCC) 和右颞顶交界处 (rTPJ) 之间的连通性与 RNT 水平呈正相关。目标：在这项双盲、随机、假对照、概念验证试验中，我们采用实时功能磁共振成像神经反馈 (rtfMRI-nf) 来描述可能与 RNT 有因果关系的神经过程，并且可以可能成为 MDD 的治疗目标。方法：受 MDD 影响的个体被分配到任一活动组（ n= 20) 或假反馈组 ( n = 19)。在干预前和干预后 1 周，通过反刍反应量表-育雏子量表 (RRS-B) 测量 RNT。结果：活动组中的个体而非假组中的个体显示出 RRS-B 显着降低；然而，PCC-rTPJ 连通性的大幅降​​低与 RRS-B 的大幅降低无关。探索性分析表明，压后皮层 (RSC)-rTPJ 连接性的更大程度减少导致 RRS-B 在活动组中更明显的减少，但在假手术组中没有。结论：RtfMRI-nf 可有效减少 RNT。考虑到 rtfMIR-nf 的底层机制，RSC 和 rTPJ 可能是网络（即默认模式网络）的一部分，可能共同影响 RNT 的强度。了解目标神经变化的功能组织与临床指标（如 RNT）之间的关系，有可能指导基于机制的 MDD 治疗的发展。
心理医生