Major depressive disorder (MDD) is far from a run-of-the-mill diagnosis. Although different patients report suffering from different subsets of symptoms, most patients are ultimately prescribed the same first-line treatment, usually a selective serotonin reuptake inhibitor (SSRI), regardless of their individual experience. This is important because, as the researchers point out, different symptoms are rooted in different brain disorders, which helps explain why 30 to 50 percent of MDD patients do not respond completely to standard treatments.
The team behind the study set out to tackle this problem head-on using a concept known as “precision psychiatry.” Their central idea is to target the specific neural circuits that are causing each patient’s symptoms and try to return them to a healthier state, rather than applying a comprehensive treatment.
As their first target, they chose rumination, an exhausting mental loop of repetitive, intrusive negative thoughts. Research suggests that this results, in part, from disrupted connections between the posterior cingulate cortex, an area involved in internal self-referential thinking, and the dorsolateral prefrontal cortex, which is associated with external goal-directed behavior. The goal was to use real-time fMRI neurofeedback to train people to revert this connectivity pattern back to that seen in healthy brains.
To make this more approachable, researchers turned brain training into something similar to a video game. All participants had to do was lie in an MRI scanner, observe a green circle on the screen, and use their brain to tell the circle to get bigger. Behind the scenes, their brain scans were being processed in real time, and the size of the circles reflected how close to healthy their neural connections were. Participants got creative in trying to regulate this brain activity, with some doing mental arithmetic, others playing word association games, and still others imagining a little person running around the edge of a circle.
The study conducted multiple sessions with 68 participants and tested variables such as whether training on consecutive days is more effective than spreading out sessions and whether stronger financial incentives would improve performance, to understand not only whether the approach works, but how to best make it work. Those who trained on consecutive days with the highest potential for profit showed the greatest improvement.
The results were promising on a number of fronts. Healthier brain patterns persisted during rest periods, suggesting real changes in brain activity rather than just momentary performance effects. This change extended beyond the two targeted brain regions to the broader networks to which they belonged. Most surprisingly, the more participants’ brain activity improved, the more their rumination and depressive symptoms decreased, while untargeted anxiety symptoms did not change with brain activity. This specificity is exactly what the precision psychiatry framework predicts.
Researchers’ long-term dream is that patients will one day be able to go into a doctor’s office, have their brain scanned, and be prescribed a portable EEG headset for neurofeedback targeted to their specific symptoms, which they can use from the comfort of their own home. This study represents an important step toward that vision.
sauce:
ATR Brain Information and Communication Research Group
Reference magazines:
Taylor, J. Others. (2026). Paving the way to precise treatment of psychiatric symptoms through functional connectivity neurofeedback. translational psychiatry. DOI: 10.1038/s41398-026-04040-3. https://www.nature.com/articles/s41398-026-04040-3
