{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:28:40Z","timestamp":1790674120461,"version":"4.1.0"},"reference-count":119,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"F\u00f6rderprogramm f\u00fcr Forschung und Lehre (F\u00f6FoLe)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Introduction: Individual real-time functional magnetic resonance imaging neurofeedback (rtfMRI NF) might be a promising adjuvant in treating depressive symptoms. Further studies showed functional variations and connectivity-related changes in the dorsolateral prefrontal cortex (dlPFC) and the insular cortex. Objectives: The aim of this pilot study was to investigate whether individualized connectivity-based rtfMRI NF training can improve symptoms in depressed patients as an adjunct to a psychotherapeutic programme. The novel strategy chosen for this was to increase connectivity between individualized regions of interest, namely the insula and the dlPFC. Methods: Sixteen patients diagnosed with major depressive disorder (MDD, ICD-10) and 19 matched healthy controls (HC) participated in a rtfMRI NF training consisting of two sessions with three runs each, within an interval of one week. RtfMRI NF was applied during a sequence of negative emotional pictures to modulate the connectivity between the dlPFC and the insula. The MDD REAL group was divided into a Responder and a Non-Responder group. Patients with an increased connectivity during the second NF session or during both the first and the second NF session were identified as \u201cMDD REAL Responder\u201d (N = 6). Patients that did not show any increase in connectivity and\/or a decreased connectivity were identified as \u201cMDD REAL Non-Responder\u201d (N = 7). Results: Before the rtfMRI sessions, patients with MDD showed higher neural activation levels in ventromedial PFC and the insula than HC; by contrast, HC revealed increased hemodynamic activity in visual processing areas (primary visual cortex and visual association cortex) compared to patients with MDD. The comparison of hemodynamic responses during the first compared to during the last NF session demonstrated significantly increased BOLD-activation in the medial orbitofrontal cortex (mOFC) in patients and HC, and additionally in the lateral OFC in patients with MDD. These findings were particularly due to the MDD Responder group, as the MDD Non-Responder group showed no increase in this region during the last NF run. There was a decrease of neural activation in emotional processing brain regions in both groups in the last NF run compared to the first: HC showed differences in the insula, parahippocampal gyrus, basal ganglia, and cingulate gyrus. Patients with MDD demonstrated deceased responses in the parahippocampal gyrus. There was no significant reduction of BDI scores after NF training in patients. Conclusions: Increased neural activation in the insula and vmPFC in MDD suggests an increased emotional reaction in patients with MDD. The activation of the mOFC could be associated with improved control-strategies and association-learning processes. The increased lOFC activation could indicate a stronger sensitivity to failed NF attempts in MDD. A stronger involvement of visual processing areas in HC may indicate better adaptation to negative emotional stimuli after repeated presentation. Overall, the rtfMRI NF had an impact on neurobiological mechanisms, but not on psychometric measures in patients with MDD.<\/jats:p>","DOI":"10.3390\/brainsci12121714","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T01:52:30Z","timestamp":1671069150000},"page":"1714","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Individual- and Connectivity-Based Real-Time fMRI Neurofeedback to Modulate Emotion-Related Brain Responses in Patients with Depression: A Pilot Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Maximilian","family":"Maywald","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4916-851X","authenticated-orcid":false,"given":"Marco","family":"Paolini","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4547-6240","authenticated-orcid":false,"given":"Boris Stephan","family":"Rauchmann","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"},{"name":"Department of Radiology, University Hospital LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Gerz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Lars","family":"Heppe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Wolf","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Lerchenberger","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Tominschek","sequence":"additional","affiliation":[{"name":"Psychosomatic Day Care Unit Westend, Westendstra\u00dfe 185, 80686 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"St\u00f6cklein","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Reidler","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadja","family":"Tschentscher","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Ertl-Wagner","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6455-4190","authenticated-orcid":false,"given":"Oliver","family":"Pogarell","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0244-1024","authenticated-orcid":false,"given":"Daniel","family":"Keeser","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"},{"name":"Department of Radiology, University Hospital LMU Munich, Marchioninistra\u00dfe 15, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Karch","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Nu\u00dfbaumstr. 7, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0022-3999(02)00304-5","article-title":"Depression and public health: An overview","volume":"53","author":"Cassano","year":"2002","journal-title":"J. Psychosom. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1016\/S0140-6736(18)32279-7","article-title":"Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"392","author":"James","year":"2018","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.cpr.2009.09.003","article-title":"Psychotherapy for chronic major depression and dysthymia: A meta-analysis","volume":"30","author":"Cuijpers","year":"2010","journal-title":"Clin. Psychol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jad.2008.03.018","article-title":"A meta-analysis of psychotherapy and medication in unipolar depression and dysthymia","volume":"110","author":"Imel","year":"2008","journal-title":"J. Affect Disord."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Von Wolff, A., Holzel, L.P., Westphal, A., Harter, M., and Kriston, L. (2012). Combination of pharmacotherapy and psychotherapy in the treatment of chronic depression: A systematic review and meta-analysis. BMC Psychiatry, 12.","DOI":"10.1186\/1471-244X-12-61"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1016\/S0165-1781(14)70003-4","article-title":"Pharmacological approaches to manage persistent symptoms of major depressive disorder: Rationale and therapeutic strategies","volume":"220","author":"Epstein","year":"2014","journal-title":"Psychiatry Res."},{"key":"ref_7","first-page":"CD012855","article-title":"Comparative effectiveness of continuation and maintenance treatments for persistent depressive disorder in adults","volume":"5","author":"Machmutow","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1037\/a0015238","article-title":"Continuation-phase cognitive therapy\u2019s effects on remission and recovery from depression","volume":"77","author":"Vittengl","year":"2009","journal-title":"J. Consult Clin. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1177\/0269881106069938","article-title":"The other face of depression, reduced positive affect: The role of catecholamines in causation and cure","volume":"21","author":"Nutt","year":"2007","journal-title":"J. Psychopharmacol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1038\/mp.2016.60","article-title":"Cortical abnormalities in adults and adolescents with major depression based on brain scans from 20 cohorts worldwide in the ENIGMA Major Depressive Disorder Working Group","volume":"22","author":"Schmaal","year":"2017","journal-title":"Mol. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1002\/hbm.20426","article-title":"A meta-analytic study of changes in brain activation in depression","volume":"29","author":"Fitzgerald","year":"2008","journal-title":"Hum. Brain Mapp."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1001\/jamapsychiatry.2014.2206","article-title":"Identification of a common neurobiological substrate for mental illness","volume":"72","author":"Goodkind","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1176\/appi.ajp.2019.18111271","article-title":"Identification of common neural circuit disruptions in emotional processing across psychiatric disorders","volume":"177","author":"McTeague","year":"2020","journal-title":"Am. J. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1176\/appi.ajp.2019.19050560","article-title":"Multimodal abnormalities of brain structure and function in major depressive disorder: A meta-analysis of neuroimaging studies","volume":"177","author":"Gray","year":"2020","journal-title":"Am. J. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.biopsych.2018.11.011","article-title":"Common dysfunction of large-scale neurocognitive networks across psychiatric disorders","volume":"85","author":"Sha","year":"2019","journal-title":"Biol. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1001\/jamapsychiatry.2019.3351","article-title":"Shared neural phenotypes for mood and anxiety disorders: A meta-analysis of 226 task-related functional imaging studies","volume":"77","author":"Janiri","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1038\/s41380-019-0477-2","article-title":"White matter disturbances in major depressive disorder: A coordinated analysis across 20 international cohorts in the ENIGMA MDD working group","volume":"25","author":"Kelly","year":"2020","journal-title":"Mol. Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8582","DOI":"10.1073\/pnas.1900801116","article-title":"Childhood trauma history is linked to abnormal brain connectivity in major depression","volume":"116","author":"Yu","year":"2019","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1038\/nrn.2016.164","article-title":"Closed-loop brain training: The science of neurofeedback","volume":"18","author":"Sitaram","year":"2017","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"7498","DOI":"10.1523\/JNEUROSCI.2118-07.2007","article-title":"Direct instrumental conditioning of neural activity using functional magnetic resonance imaging-derived reward feedback","volume":"27","author":"Bray","year":"2007","journal-title":"J. Neurosci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1089\/brain.2014.0262","article-title":"Resting-state functional connectivity modulation and sustained changes after real-time functional magnetic resonance imaging neurofeedback training in depression","volume":"4","author":"Yuan","year":"2014","journal-title":"Brain Connect."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/j.neuroimage.2009.07.056","article-title":"Neurofeedback: A promising tool for the self-regulation of emotion networks","volume":"49","author":"Johnston","year":"2010","journal-title":"Neuroimage"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/S1053-8119(03)00004-1","article-title":"Real-time fMRI of temporolimbic regions detects amygdala activation during single-trial self-induced sadness","volume":"18","author":"Posse","year":"2003","journal-title":"Neuroimage"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1016\/j.neuroimage.2007.01.018","article-title":"Regulation of anterior insular cortex activity using real-time fMRI","volume":"35","author":"Caria","year":"2007","journal-title":"Neuroimage"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.neuroimage.2013.10.069","article-title":"Self-regulation of the anterior insula: Reinforcement learning using real-time fMRI neurofeedback","volume":"88","author":"Lawrence","year":"2014","journal-title":"Neuroimage"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1002\/hbm.20997","article-title":"Modulation of subgenual anterior cingulate cortex activity with real-time neurofeedback","volume":"32","author":"Hamilton","year":"2011","journal-title":"Hum. Brain Mapp."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Karch, S., Paolini, M., Gschwendtner, S., Jeanty, H., Reckenfelderb\u00e4umer, A., Yaseen, O., Maywald, M.K.U., Fuchs, C., Rauchmann, B.-S., and Chrobok, A. (2019). Real-time fMRI neurofeedback in patients with tobacco use disorder during smoking cessation: Functional differences and implications of the first training session in regard to future abstinence or relapse. Front. Hum. Neurosci., 13.","DOI":"10.3389\/fnhum.2019.00065"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Karch, S., Keeser, D., H\u00fcmmer, S., Paolini, M., Kirsch, V., Karali, T., Kupka, M., Rauchmann, B.-S., Chrobok, A., and Blautzik, J. (2015). Modulation of craving related brain responses using real-time fMRI in patients with alcohol use disorder. PLoS One.","DOI":"10.1371\/journal.pone.0133034"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hampson, M., Stoica, T., Saksa, J., Scheinost, D., Qiu, M., Bhawnani, J., Pittenger, C., Papademetris, X., and Constable, T. (2012). Real-time fMRI biofeedback targeting the orbitofrontal cortex for contamination anxiety. JoVE (J. Vis. Exp.), e3535.","DOI":"10.3791\/3535"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3389\/fnbeh.2015.00148","article-title":"fMRI neurofeedback facilitates anxiety regulation in females with spider phobia","volume":"9","author":"Zilverstand","year":"2015","journal-title":"Front. Behav. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1159\/000496057","article-title":"Real-time functional connectivity-informed neurofeedback of amygdala-frontal pathways reduces anxiety","volume":"88","author":"Zhao","year":"2019","journal-title":"Psychother. Psychosom."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Young, K.D., Zotev, V., Phillips, R., Misaki, M., Yuan, H., Drevets, W.C., and Bodurka, J. (2014). Real-time FMRI neurofeedback training of amygdala activity in patients with major depressive disorder. PloS ONE, 9.","DOI":"10.1371\/journal.pone.0088785"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Linden, D.E., Habes, I., Johnston, S.J., Linden, S., Tatineni, R., Subramanian, L., Sorger, B., Healy, D., and Goebel, R. (2012). Real-time self-regulation of emotion networks in patients with depression. PloS ONE, 7.","DOI":"10.1371\/journal.pone.0038115"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.jad.2020.03.080","article-title":"Antidepressive effect of left dorsolateral prefrontal cortex neurofeedback in patients with major depressive disorder: A preliminary report","volume":"271","author":"Takamura","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1176\/appi.ajp.2017.16060637","article-title":"Randomized clinical trial of real-time fMRI amygdala neurofeedback for major depressive disorder: Effects on symptoms and autobiographical memory recall","volume":"174","author":"Young","year":"2017","journal-title":"Am. J. Psychiatry"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2578","DOI":"10.1038\/s41386-018-0126-5","article-title":"Targeting the affective brain\u2014a randomized controlled trial of real-time fMRI neurofeedback in patients with depression","volume":"43","author":"Mehler","year":"2018","journal-title":"Neuropsychopharmacology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1111\/pcn.12665","article-title":"Amygdala real-time functional magnetic resonance imaging neurofeedback for major depressive disorder: A review","volume":"72","author":"Young","year":"2018","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ahrweiler, N., Santana-Gonzalez, C., Zhang, N., Quandt, G., Ashtiani, N., Liu, G., Engstrom, M., Schultz, E., Liengswangwong, R., and Teoh, J.Y. (2022). Neural Activity Associated with Symptoms Change in Depressed Adolescents following Self-Processing Neurofeedback. Brain Sci., 12.","DOI":"10.3390\/brainsci12091128"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"60","DOI":"10.3389\/fnhum.2020.00060","article-title":"A Guide to Literature Informed Decisions in the Design of Real Time fMRI Neurofeedback Studies: A Systematic Review","volume":"14","author":"Fede","year":"2020","journal-title":"Front. Hum. Neurosci."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1162\/jocn_a_00802","article-title":"The inclusion of functional connectivity information into fMRI-based neurofeedback improves its efficacy in the reduction of cigarette cravings","volume":"27","author":"Kim","year":"2015","journal-title":". J. Cogn. Neurosci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3389\/fpsyt.2018.00083","article-title":"Altered resting state effective connectivity of anterior insula in depression","volume":"9","author":"Kandilarova","year":"2018","journal-title":"Front. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1001\/jamapsychiatry.2015.0071","article-title":"Large-scale network dysfunction in major depressive disorder: A meta-analysis of resting-state functional connectivity","volume":"72","author":"Kaiser","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"930","DOI":"10.3389\/fnhum.2013.00930","article-title":"Insular dysfunction within the salience network is associated with severity of symptoms and aberrant inter-network connectivity in major depressive disorder","volume":"7","author":"Manoliu","year":"2014","journal-title":"Front. Hum. Neurosci."},{"key":"ref_44","unstructured":"Miller, B.L. (2007). The human frontal lobe: An introduction. The Human Frontal Lobes: Functions and Disorders, The Guilford Press."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1126\/science.283.5408.1657","article-title":"Storage and executive processes in the frontal lobes","volume":"283","author":"Smith","year":"1999","journal-title":"Science"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.neulet.2009.10.005","article-title":"Distinct control networks for cognition and emotion in the prefrontal cortex","volume":"467","author":"Kompus","year":"2009","journal-title":"Neurosci. Lett."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1002\/hbm.20291","article-title":"Regulation of emotional responses elicited by threat-related stimuli","volume":"28","author":"Eippert","year":"2007","journal-title":"Hum. Brain Mapp."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.tics.2005.03.010","article-title":"The cognitive control of emotion","volume":"9","author":"Ochsner","year":"2005","journal-title":"Trends Cogn. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/S0006-3223(02)01817-6","article-title":"Neural circuitry underlying voluntary suppression of sadness","volume":"53","author":"Eugene","year":"2003","journal-title":"Biol. Psychiatry"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.brat.2014.07.017","article-title":"Predicting rapid response to cognitive-behavioural treatment for panic disorder: The role of hippocampus, insula, and dorsolateral prefrontal cortex","volume":"62","author":"Reinecke","year":"2014","journal-title":"Behav. Res. Ther."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.bbr.2009.03.004","article-title":"The functional neuroanatomy of depression: Distinct roles for ventromedial and dorsolateral prefrontal cortex","volume":"201","author":"Koenigs","year":"2009","journal-title":"Behav. Brain Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.biopsych.2006.05.048","article-title":"Increased amygdala and decreased dorsolateral prefrontal BOLD responses in unipolar depression: Related and independent features","volume":"61","author":"Siegle","year":"2007","journal-title":"Biol. Psychiatry"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1503\/jpn.160198","article-title":"Prefrontal brain responsiveness to negative stimuli distinguishes familial risk for major depression from acute disorder","volume":"42","author":"Opel","year":"2017","journal-title":"J. Psychiatry Neurosci. JPN"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Stratmann, M., Konrad, C., Kugel, H., Krug, A., Sch\u00f6ning, S., Ohrmann, P., Uhlmann, C., Postert, C., Suslow, T., and Heindel, W. (2014). Insular and hippocampal gray matter volume reductions in patients with major depressive disorder. PloS One, 9.","DOI":"10.1371\/journal.pone.0102692"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jad.2011.04.004","article-title":"The insular cortex and the neuroanatomy of major depression","volume":"133","author":"Sprengelmeyer","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s00429-010-0255-z","article-title":"A link between the systems: Functional differentiation and integration within the human insula revealed by meta-analysis","volume":"214","author":"Kurth","year":"2010","journal-title":"Brain Struct. Funct."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1038\/nrn2555","article-title":"How do you feel--now? The anterior insula and human awareness","volume":"10","author":"Craig","year":"2009","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.bbr.2016.05.048","article-title":"The anatomy of empathy: Vicarious experience and disorders of social cognition","volume":"311","author":"Lockwood","year":"2016","journal-title":"Behav. Brain Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1176\/appi.ajp.2012.11071105","article-title":"Functional neuroimaging of major depressive disorder: A meta-analysis and new integration of baseline activation and neural response data","volume":"169","author":"Hamilton","year":"2012","journal-title":"Am. J. Psychiatry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"470","DOI":"10.3758\/CABN.10.4.470","article-title":"Neural correlates of rumination in depression","volume":"10","author":"Cooney","year":"2010","journal-title":"Cogn. Affect. Behav. Neurosci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"323","DOI":"10.3389\/fnhum.2012.00323","article-title":"Major depressive disorder and alterations in insular cortical activity: A review of current functional magnetic imaging research","volume":"6","author":"Sliz","year":"2012","journal-title":"Front. Hum. Neurosci."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jad.2010.09.032","article-title":"Brain effects of antidepressants in major depression: A meta-analysis of emotional processing studies","volume":"130","author":"Delaveau","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.pnpbp.2007.06.030","article-title":"The neural substrates of affective processing toward positive and negative affective pictures in patients with major depressive disorder","volume":"31","author":"Lee","year":"2007","journal-title":"Prog. Neuro-Psychopharmacol. Biol. Psychiatry"},{"key":"ref_64","unstructured":"Beck, A.T., Steer, R.A., and Brown, G.K. (1987). Beck Depression Inventory, Harcourt Brace Jovanovich."},{"key":"ref_65","unstructured":"Schmidt, K., and Metzler, P. (1992). WST-Wortschatztest, Beltz Test."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1037\/1040-3590.4.1.5","article-title":"Normal personality assessment in clinical practice: The NEO Personality Inventory","volume":"4","author":"Costa","year":"1992","journal-title":"Psychol. Assess."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"195","DOI":"10.3758\/s13428-018-01193-y","article-title":"PsychoPy2: Experiments in behavior made easy","volume":"51","author":"Peirce","year":"2019","journal-title":"Behav. Res. Methods"},{"key":"ref_68","unstructured":"Brain Innovation (2022, September 01). Turbo-BrainVoyager. Available online: https:\/\/www.brainvoyager.com\/TurboBrainVoyager.html."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Ulmer, S. (2010). Neuroanatomy and cortical landmarks. fMRI, Springer.","DOI":"10.1007\/978-3-540-68132-8"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1016\/j.biopsych.2017.03.013","article-title":"Real-time functional magnetic resonance imaging amygdala neurofeedback changes positive information processing in major depressive disorder","volume":"82","author":"Young","year":"2017","journal-title":"Biol. Psychiatry"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1177\/1073191110382848","article-title":"The NEO Five-Factor Inventory: Latent structure and relationships with dimensions of anxiety and depressive disorders in a large clinical sample","volume":"18","author":"Rosellini","year":"2011","journal-title":"Assessment"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jad.2013.05.075","article-title":"Big Five personality and depression diagnosis, severity and age of onset in older adults","volume":"151","author":"Koorevaar","year":"2013","journal-title":"J. Affect. Disord."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jad.2008.05.022","article-title":"Decreased functional coupling of the amygdala and supragenual cingulate is related to increased depression in unmedicated individuals with current major depressive disorder","volume":"111","author":"Matthews","year":"2008","journal-title":"J. Affect. Disord."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1093\/cercor\/10.3.206","article-title":"The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans","volume":"10","author":"Price","year":"2000","journal-title":"Cereb. Cortex"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1002\/cne.10609","article-title":"Architectonic subdivision of the human orbital and medial prefrontal cortex","volume":"460","author":"Ferry","year":"2003","journal-title":"J. Comp. Neurol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.biopsych.2006.10.011","article-title":"Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert","volume":"62","author":"Milad","year":"2007","journal-title":"Biol. Psychiatry"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1016\/j.biopsych.2006.03.010","article-title":"Prefrontal mechanisms in extinction of conditioned fear","volume":"60","author":"Quirk","year":"2006","journal-title":"Biol. Psychiatry"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.conb.2010.02.005","article-title":"Prefrontal control of fear: More than just extinction","volume":"20","author":"Quirk","year":"2010","journal-title":"Curr. Opin. Neurobiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.biopsych.2006.09.020","article-title":"Resting-state functional connectivity in major depression: Abnormally increased contributions from subgenual cingulate cortex and thalamus","volume":"62","author":"Greicius","year":"2007","journal-title":"Biol. Psychiatry"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/S0006-3223(00)01036-2","article-title":"Regional metabolic effects of fluoxetine in major depression: Serial changes and relationship to clinical response","volume":"48","author":"Mayberg","year":"2000","journal-title":"Biol. Psychiatry"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1177\/0269881108093589","article-title":"Neural markers of symptomatic improvement during antidepressant therapy in severe depression: Subgenual cingulate and visual cortical responses to sad, but not happy, facial stimuli are correlated with changes in symptom score","volume":"23","author":"Keedwell","year":"2009","journal-title":"J. Psychopharmacol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.neuron.2005.02.014","article-title":"Deep brain stimulation for treatment-resistant depression","volume":"45","author":"Mayberg","year":"2005","journal-title":"Neuron"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1162\/089892905774597182","article-title":"Analysis of single-unit responses to emotional scenes in human ventromedial prefrontal cortex","volume":"17","author":"Kawasaki","year":"2005","journal-title":"J. Cogn. Neurosci."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1073\/pnas.042457199","article-title":"Brain activity in ventromedial prefrontal cortex correlates with individual differences in negative affect","volume":"99","author":"Zald","year":"2002","journal-title":"Proc. Natl. Acad. Sci."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.tins.2006.04.001","article-title":"Feature-based attention in visual cortex","volume":"29","author":"Maunsell","year":"2006","journal-title":"Trends Neurosci."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1038\/369525a0","article-title":"fMRI of human visual cortex","volume":"326","author":"Engel","year":"1994","journal-title":"Nature"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"230","DOI":"10.3389\/fnhum.2014.00230","article-title":"Independent and collaborative contributions of the cerebral hemispheres to emotional processing","volume":"8","author":"Shobe","year":"2014","journal-title":"Front. Hum. Neurosci."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/s41398-022-02113-7","article-title":"Brain structural correlates of recurrence following the first episode in patients with major depressive disorder","volume":"12","author":"Lemke","year":"2022","journal-title":"Transl Psychiatry"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jad.2016.12.032","article-title":"Characterization of brain blood flow and the amplitude of low-frequency fluctuations in major depressive disorder- a multimodal meta-analysis","volume":"210","author":"Li","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/j.neuroimage.2017.12.071","article-title":"Neurofeedback with fMRI: A critical systematic review","volume":"172","author":"Thibault","year":"2018","journal-title":"Neuroimage"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jad.2009.06.017","article-title":"Rostral anterior cingulate cortex activity mediates the relationship between the depressive symptoms and the medial prefrontal cortex activity","volume":"122","author":"Yoshimura","year":"2010","journal-title":"J. Affect. Disord."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1016\/j.neuron.2004.08.042","article-title":"Extinction learning in humans: Role of the amygdala and vmPFC","volume":"43","author":"Phelps","year":"2004","journal-title":"Neuron"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1002\/cne.903630408","article-title":"Limbic connections of the orbital and medial prefrontal cortex in macaque monkeys","volume":"363","author":"Carmichael","year":"1995","journal-title":"J. Comp. Neurol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.pneurobio.2004.03.006","article-title":"The functional neuroanatomy of the human orbitofrontal cortex: Evidence from neuroimaging and neuropsychology","volume":"72","author":"Kringelbach","year":"2004","journal-title":"Prog. Neurobiol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1093\/cercor\/10.3.220","article-title":"The anatomical connections of the macaque monkey orbitofrontal cortex. A review","volume":"10","author":"Cavada","year":"2000","journal-title":"Cereb. Cortex"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"75","DOI":"10.31887\/DCNS.2014.16.1\/mbeauregard","article-title":"Functional neuroimaging studies of the effects of psychotherapy","volume":"16","author":"Beauregard","year":"2014","journal-title":"Dialogues Clin. Neurosci."},{"key":"ref_97","first-page":"563","article-title":"Emotional processing in obsessive-compulsive disorder: A systematic review and meta-analysis of 25 functional neuroimaging studies","volume":"3","author":"Thorsen","year":"2018","journal-title":"Biol. Psychiatry Cogn. Neurosci. Neuroimaging"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1176\/ajp.152.3.341","article-title":"Brain activity during transient sadness and happiness in healthy women","volume":"152","author":"George","year":"1995","journal-title":"Am. J. Psychiatry"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.pscychresns.2008.11.005","article-title":"Long-term effects of cognitive behavior therapy on brain activation in spider phobia","volume":"172","author":"Schienle","year":"2009","journal-title":"Psychiatry Res. Neuroimaging"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.neubiorev.2016.05.007","article-title":"A non-reward attractor theory of depression","volume":"68","author":"Rolls","year":"2016","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.biopsych.2010.01.027","article-title":"Reward and punishment processing in depression","volume":"68","author":"Eshel","year":"2010","journal-title":"Biol. Psychiatry"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/YCO.0000000000000122","article-title":"Reward processing dysfunction in major depression, bipolar disorder and schizophrenia","volume":"28","author":"Whitton","year":"2015","journal-title":"Curr. Opin. Psychiatry"},{"key":"ref_103","first-page":"101","article-title":"Increased positive emotional memory after repetitive transcranial magnetic stimulation over the orbitofrontal cortex","volume":"31","author":"Schutter","year":"2006","journal-title":"J. Psychiatry Neurosci."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1176\/appi.ajp.160.5.990","article-title":"Toward a neuropsychological theory of antidepressant drug action: Increase in positive emotional bias after potentiation of norepinephrine activity","volume":"160","author":"Harmer","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_105","unstructured":"Lewinsohn, P.M. (1974). A behavioral approach to depression. Essential Papers on Depression, NYU Press."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0006-3223(01)01117-9","article-title":"Brain metabolic changes associated with symptom factor improvement in major depressive disorder","volume":"50","author":"Brody","year":"2001","journal-title":"Biol. Psychiatry"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.neuroimage.2015.08.074","article-title":"Enhanced control of dorsolateral prefrontal cortex neurophysiology with real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback training and working memory practice","volume":"124","author":"Sherwood","year":"2016","journal-title":"Neuroimage"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1055\/s-2004-828410","article-title":"Changes in the emotional processing in depressive patients: A study with functional magnetoresonance tomography under the employment of pictures with affective contents","volume":"31","author":"Wagner","year":"2004","journal-title":"Psychiatr. Prax."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.biopsych.2007.05.031","article-title":"The neural bases of emotion regulation: Reappraisal and suppression of negative emotion","volume":"63","author":"Goldin","year":"2008","journal-title":"Biol. Psychiatry"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1093\/bmb\/65.1.193","article-title":"Modulating dysfunctional limbic-cortical circuits in depression: Towards development of brain-based algorithms for diagnosis and optimised treatment","volume":"65","author":"Mayberg","year":"2003","journal-title":"Br. Med. Bull."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/j.pneurobio.2011.01.006","article-title":"The prefrontal\u2013limbic network in depression: Modulation by hypothalamus, basal ganglia and midbrain","volume":"93","author":"Bennett","year":"2011","journal-title":"Prog. Neurobiol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1093\/brain\/aws059","article-title":"Identifying major depression using whole-brain functional connectivity: A multivariate pattern analysis","volume":"135","author":"Zeng","year":"2012","journal-title":"Brain"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1002\/hbm.22234","article-title":"The parahippocampal gyrus links the default-mode cortical network with the medial temporal lobe memory system","volume":"35","author":"Ward","year":"2014","journal-title":"Hum. Brain Mapp."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"466","DOI":"10.2174\/1570159X13666150416224801","article-title":"Brain functional effects of psychopharmacological treatment in major depression: A focus on neural circuitry of affective processing","volume":"13","author":"Wessa","year":"2015","journal-title":"Curr. Neuropharmacol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.jneumeth.2007.05.030","article-title":"Spatial frequencies or emotional effects? A systematic measure of spatial frequencies for IAPS pictures by a discrete wavelet analysis","volume":"165","author":"Delplanque","year":"2007","journal-title":"J. Neurosci. Methods"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1016\/j.neuroimage.2003.08.006","article-title":"Amygdala modulation of parahippocampal and frontal regions during emotionally influenced memory storage","volume":"20","author":"Kilpatrick","year":"2003","journal-title":"Neuroimage"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.biopsych.2008.04.033","article-title":"Neural responses to sad facial expressions in major depression following cognitive behavioral therapy","volume":"64","author":"Fu","year":"2008","journal-title":"Biol. Psychiatry"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.neulet.2016.04.037","article-title":"Affective responses across psychiatric disorders\u2014A dimensional approach","volume":"623","author":"Friedel","year":"2016","journal-title":"Neurosci. Lett."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"116751","DOI":"10.1016\/j.neuroimage.2020.116751","article-title":"The function of the hippocampus and middle temporal gyrus in forming new associations and concepts during the processing of novelty and usefulness features in creative designs","volume":"214","author":"Ren","year":"2020","journal-title":"Neuroimage"}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/12\/1714\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:27Z","timestamp":1760146887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/12\/12\/1714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":119,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["brainsci12121714"],"URL":"https:\/\/doi.org\/10.3390\/brainsci12121714","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}