Adolescents with major depressive disorder (MDD) may benefit from a non-invasive technique that combines mindfulness with real-time fMRI neurofeedback (mbNF) to reduce activity in the default mode network (DMN), a brain network linked to rumination. In a planned trial, 90 adolescents aged 13–18 with MDD will be randomly assigned to receive either 15 or 30 minutes of mbNF. During the procedure, participants practice mindfulness while a ball on a screen moves based on their brain activity, targeting the frontoparietal network relative to the DMN. The study will test whether mbNF reduces functional connectivity within the DMN and whether longer dosing produces greater effects, with secondary outcomes including changes in depressive symptoms and rumination.
In a small pilot trial, five adolescents with obsessive-compulsive disorder (OCD) who had not responded to first-line treatments received a single intravenous infusion of ketamine. All participants experienced mild dissociative symptoms in the 40 minutes after the infusion, but there were no abnormal vital signs, deaths, or suicidal thoughts during the two-week follow-up. Obsessive-compulsive symptom severity decreased immediately after the infusion but was not sustained over the study period. The average score on the Children's Yale-Brown Obsessive Compulsive Scale fell from 29 before treatment to 26.2 fourteen days later. The results suggest ketamine is well-tolerated in this population and warrants further testing of its efficacy.