Depression

The purpose of this article is to review the evidence for the efficacy of treating major depressive disorder with neurofeedback using an electroencephalogram (EEG) and/or functional magnetic resonance imaging (fMRI), as well as with biofeedback using electromyography (EMG) and heart rate variability (HRV). We summarized 33 peer-reviewed manuscripts reporting on the efficacy of one or more of these protocols, organized by randomized control trials (RCTs), quasi-experimental designs, and case studies of various designs. We evaluated these manuscripts by mapping them onto the “Template for Developing Guidelines for the Evaluation of Clinical Efficacy of Psychophysiological Interventions” (LaVaque et al., 2002). In summary, at least two RCTs have shown that both neurofeedback and biofeedback are superior to bona fide treatments in treating participants diagnosed with major depressive disorder. As such, both neurofeedback and biofeedback meet the LaVaque and colleagues' criteria for Level 5 – Efficacious and Specific. The details for efficacy are discussed within the context of the protocols, participant characteristics, and study design.