Pilot study into the effectiveness of neurofeedback as a treatment for major depressive disorder

Major depressive disorder is a high-prevalent psychiatric disorder. Despite
current available treatments, primarily pharmacotherapy and psychotherapy,
partial remission and treatment resistance are common. Moreover,
pharmacotherapy is associated with a number of undesirable side-effects.
Apparently, there is quite some room for improvement. Neurofeedback (NF) for
the treatment of depression has received increased attention in recent years.
Within an operant paradigm, patients are connected to an EEG device that helps
them, after analysis of brain-activity, to change brainactivity in certain
areas. Feedback is given with a visual stimulus based on real-time analysis of
the EEG.
Although there are widespread claims about its effectiveness, there is no
scientific evidence that support these claims. No studies into the
effectiveness have been carried out. There is some evidence from fundamental
research into the neurophysiology of depression that NF may be helpfull indeed.
Additionally, heart-rate variability (HV) appears to decreased in depression.
In this study, an ECG will be made prior and after NF treatment to investigate
whether NF is associated with increase in HV.

The main objective of this pilot-study is to examine the effectiveness of NF in
the treatment of major depression.

The current study is a open pilot-study in 10 depressed (according to the
criteria of DSM-IV) patients.

Participants will be treated with a maximum of 30 NF sessions in a frequency of
3 sessions each week. The maximum study duration in each participant will be 10
weeks. NF will be done on the basis of an alpha-asymmetry protocol. In this
protocol, participants will learn through operant conditioning to decrease
alpha-activity in left prefrontal regions and to increase alpha-activity in
right prefrontal regions.

Neurofeedback sessions and filling-out self-report instruments do not
constitute a burden or risk for the participants.