Someone may seek neurofeedback treatment to help with one or more depressive symptoms such as low mood, loss of interest or pleasure in most activities, sleep disturbance, loss of energy or fatigue, poor concentration, feelings of worthlessness, or suicidal ideation. The neurofeedback approach to depression has mostly focused on emotion regulation and the overlap between the cognitive and emotional domains.
The target areas for this approach are mainly in the frontal lobe; with found reduced activation in left frontal regions and increased activation in the right frontal areas. To achieve improved emotional regulation, EEG neurofeedback targets EEG power asymmetry to help the brain become more balanced.
Another approach focuses primarily on the idea that those with depression are impaired in their ability to react to rewards or to have generally positive experiences (lack of pleasure in previously enjoyed activities). Functional imaging studies in humans have exhibited that areas including the midbrain, striatum, and frontal cortex are linked anatomically through the medial forebrain through the neurotransmitter dopamine, which is responsible for the ability to learn from rewards.
Neurofeedback can therefore help to train the brain’s reward circuits to function in a more normative form.
A recent meta-analysis found that major depressive disorder is associated with specific deviances in functional connectivity, including hypo-connectivity within the fronto-parietal network and hyper-connectivity within the default mode network.
One study found that found that hypo-connectivity of the left amygdala with anterior cingulate cortex normalized following localized neurofeedback, suggesting that neurofeedback can change resting-state functional connectivity in depression and affective disorders.
Research has found that when the left hemisphere is basically ‘‘stuck’’ in an alpha idling rhythm, individuals display more deficits in positive affect and more withdrawal behavior; typically seen in depressed presentation.
This biologic predisposition to depression is also found in research findings that have shown that infants of depressed mothers display this same reduced left frontal EEG activation. This frontal alpha asymmetry may represent a state marker of depression, as well as reflecting a biological or trait marker of a vulnerability.
Neurofeedback asymmetry training in depression has also been linked to improvements in executive functioning skills and emotional regulation compared to control groups. Neurofeedback may be used in conjunction with psychotherapy or medication to help improve functioning and reduce depressive symptoms.