Reward System EEG–fMRI Pattern Neurofeedback for Major Depressive Disorder with Anhedonia: A Multicenter Pilot Study 

 

Amita D, Gross R, Goldental N, Fruchter E, Yaron-Wachtel H, Tendler A, Stern Y, Deutsch L, Voigt J.D., Hendler T, Harmelech T, Singer N, Sharon H. Brain Sci. 2025, 15, 476.

 

Up to 75% of patients with major depressive disorder (MDD) exhibit persistent anhedonia symptoms related to abnormalities in the positive valence system. Cumulative evidence points to dysfunction in the reward system (RS), including in the ventral striatum, of MDD with anhedonia.  

 

This study aims to evaluate the safety and efficacy of a novel device (Prism) which incorporates the fMRI-Informed biomarker of the reward system (RS-EFP) for use in self-neuromodulation training to alleviate symptoms of MDD with anhedonia in patients.  

 

A total of 34 adults with a DSM-5 diagnosis of MDD with anhedonia (per a SHAPS-C score ≥ 25) completed ten sessions of self-neuromodulation (RS-EFP-NF). Depression and anhedonia severity was assessed, respectively, by HDRS-17 and SHAPS-C at baseline, midway, and at the end of treatment.  

 

No device-related adverse events were serious or required treatment. Depression symptoms were reduced at end of treatment as indicated by an average reduction of eight points (HDRS), a clinical improvement rate of 78%, and a remission rate of 32%. Additionally, anhedonia, as indicated by the SHAPS-C score, showed an average reduction of 6.3 points.  

 

Self-neuromodulation using the reward-system EFP biomarker is a promising and safe treatment for MDD with anhedonia. The intervention demonstrates substantial clinical effects on both depression and anhedonia symptoms, with high patient acceptability and retention. 

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To read the full article in Brain Sciences - https://www.mdpi.com/2076-3425/15/5/476