A protocol for MIndfulness-based Neurofeedback to augment DBT psychotherapy for adults with Borderline Personality Disorder (MIND-BPD).
Katherine G Jones, Marlee M Vandewouw, Jitendra Awasthi, Alexandra A Alario, Clemens C C Bauer, Beth Brewer, Nicole A Campbell, Dominic Denning, Keara D Greene, Jude Hammoud, Oliver Hinds, Sarah Huffman, Connie Maerker, Sarah Paprotna, Maolin Qiu, Benjamin Swinchoski, Anna Taylor, Elinor Waite, Paul Wighton, Maya Whaley, Jillian Papa, Katherine Dixon-Gordon, Michelle Hampson, Susan Whitfield-Gabrieli, Sarah K. Fineberg
PLoS One March 20, 2026 DOI: 10.1371/journal.pone.0338002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Clinical protocol Peer reviewed |
|---|---|
| Sample size | 52 |
| Population | Adults with borderline personality disorder |
| Interventions | Mindfulness-based real-time neurofeedback (mbNF) dialectical behavior therapy (DBT) |
| Duration | One neurofeedback session followed by a 6-month DBT psychotherapy group; resting-state scans pre- and post-neurofeedback |
| Topics | Meditation |
| Keywords | Humans Magnetic resonance imaging Treatment outcome Borderline personality disorder Middle aged Female Young adult Neurofeedback Dialectical behavior therapy |
| Registration | NCT06446765 |
| Key points | The protocol proposes testing whether one session of mindfulness-based real-time neurofeedback, compared with sham, changes resting-state default mode network connectivity in people with borderline personality disorder prior to a six-month DBT group. The primary outcome is increased within-network connectivity between the medial prefrontal cortex and posterior cingulate cortex, and increased connectivity between the medial prefrontal cortex and dorsolateral prefrontal cortex; change in self-reported mindfulness is a secondary outcome. |
Abstract
Borderline personality disorder (BPD) is a severe psychiatric condition associated with high rates of suicide and poor interpersonal functioning. There are no FDA-approved medications, and evidence-based psychotherapies such as dialectical behavior therapy (DBT) are difficult to access and vulnerable to patient dropout. Novel treatment directions are urgently needed. Mindfulness is the core skill in DBT. Our team has developed a mindfulness-based real-time neurofeedback (mbNF) paradigm where individuals learn to reduce default mode network (DMN) versus control network activation in order to increase present-moment awareness. Here, we describe the study protocol for the MIndfulness-based Neurofeedback to Augment DBT Psychotherapy for Borderline Personality Disorder (MIND-BPD) trial. Participants with BPD (N = 52) enrolled in the study will be randomly assigned (1:1 ratio) to receive one session of either real or sham mbNF. Following neurofeedback, all participants will be enrolled in a 6-month DBT psychotherapy group. Supported by a R61/R33 grant from the NIH, the primary outcome of the R61 phase of this trial is change in DMN connectivity between pre- and post-NF resting-state scans, as defined by increased within-network connectivity between the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC), and increased connectivity between the mPFC and dorsolateral prefrontal coftex (dlPFC). Change in self-reported mindfulness between pre- and post-NF is a key secondary outcome. This study is registered in the US Clinical Trials Registry (NCT06446765).