Adolescents with major depressive disorder (MDD) may benefit from a non-invasive technique that combines mindfulness with real-time fMRI neurofeedback (mbNF) to reduce activity in the default mode network (DMN), a brain network linked to rumination. In a planned trial, 90 adolescents aged 13–18 with MDD will be randomly assigned to receive either 15 or 30 minutes of mbNF. During the procedure, participants practice mindfulness while a ball on a screen moves based on their brain activity, targeting the frontoparietal network relative to the DMN. The study will test whether mbNF reduces functional connectivity within the DMN and whether longer dosing produces greater effects, with secondary outcomes including changes in depressive symptoms and rumination.
Auditory hallucinations affect 60-80% of schizophrenia patients and often resist antipsychotic treatment. This randomized, sham-controlled trial tested whether real-time fMRI neurofeedback targeting the superior temporal gyrus, combined with mindfulness meditation, produces specific neural changes beyond placebo. Twenty-three adults with medication-resistant hallucinations practiced mindfulness meditation while receiving neurofeedback from either the superior temporal gyrus or motor cortex. Both groups reported reduced hallucinations after neurofeedback, with no group differences in symptom reduction. However, real neurofeedback produced greater reductions in secondary auditory cortex activation and connectivity between auditory cortex and cognitive control regions (dorsolateral prefrontal cortex and anterior cingulate), which persisted in a crossover condition. Mindfulness meditation independently reduced primary auditory cortex activation. Region-specific neurofeedback targeting modulates auditory-cognitive control networks, potentially restoring the balance between bottom-up sensory processing and top-down control.