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Article summary:
1. This systematic review evaluates the evidence of randomized control trials (RCTs) available on the clinical application of real-time functional magnetic resonance imaging neurofeedback (rt-fMRI-nf) training on participants with clinical depression.
2. The effect of rt-fMRI-nf on improving the severity of clinical depression scores demonstrated a tendency to favor the intervention; however, the general effect was not significant.
3. Whole-brain analyses suggests that rt-fMRI nf may alter activity patterns in brain networks, but more studies are needed to evaluate quality of life, acceptability, adverse effects, cognitive tasks, and physiology measures.
Article analysis:
The article is a systematic review of randomized control trials (RCTs) available on the clinical application of real-time functional magnetic resonance imaging neurofeedback (rt-fMRI-nf) training on participants with clinical depression. The authors conducted electronic searches in Pubmed, Embase, CENTRAL, rtFIN database, Epistemonikos, trial registers, reference lists, other systematic reviews, conference abstracts and cross citation in Google Scholar to identify relevant studies for inclusion in their review. After selection process 11 reports corresponding to four RCTs were included in the review.
The authors found that the effect of rt-fMRI-nf on improving the severity of clinical depression scores demonstrated a tendency to favor the intervention; however, the general effect was not significant. Whole brain analyses suggested that rt-fMRI nf may alter activity patterns in brain networks; however more studies are needed to evaluate quality of life, acceptability and adverse effects as well as cognitive tasks and physiology measures.
The authors concluded that current evidence on the effect of rt-fMRI nf training for decision making outcomes in patients with clinical depression is still based on low certainty evidence.
The article is generally reliable and trustworthy as it follows PRISMA guidelines and was submitted to PROSPERO registration for systematic reviews and meta analysis protocols. The authors have also provided detailed information about their search strategy which increases its trustworthiness further. Furthermore they have used GRADE framework to judge certainty of evidence which adds credibility to their findings. However there are some limitations which should be noted such as small sample size which could lead to bias due to lack of power or potential confounding factors which could affect results if not accounted for properly or adequately controlled for during analysis phase. Additionally there is no mention about blinding procedures used during study design or data collection phase which could lead to bias due to observer expectation or researcher bias if not taken into consideration properly while designing study protocol or collecting data from participants respectively