Closed-loop fMRI neurofeedback to reduce negative attentional bias in depression

Depressed individuals show an attentional bias toward negatively valenced stimuli and thoughts. Here we present a novel closed-loop neurofeedback procedure that seeks to remediate this bias. Internal attentional states were detected by applying machine learning techniques to fMRI data in real-time, and externalized using a visually presented stimulus that the participant could learn to control. We trained 15 depressed and 12 healthy control participants over three fMRI sessions, preceded and followed by behavioral and clinical assessments. Initially, depressed participants were more likely than non-depressed participants to get "stuck" in negative attentional states, but this diminished with neurofeedback training relative to controls. Depression severity also decreased from pre- to post-training. These results demonstrate that our method is sensitive to the negative attentional bias in depressed individuals, and its reduction after training showcases the potential of this method as a treatment in the future.