Predictors of neurofeedback treatment outcome in binge‐eating disorder: An exploratory study

Abstract

ObjectiveKnowledge on predictors for treatment response to psychotherapy in binge‐eating disorder (BED) is mixed and not yet available for increasingly popular neurofeedback (NF) treatment targeting self‐regulation of aberrant brain activity. This study examined eating disorder‐ and psychopathology‐related predictors for NF treatment success in BED.MethodPatients with BED (N = 78) were randomized to 12 sessions of real‐time functional near‐infrared spectroscopy (rtfNIRS)‐NF, targeting individual prefrontal cortex signal up‐regulation, electroencephalography (EEG)‐NF, targeting down‐regulation of fronto‐central beta activity, or waitlist (WL). The few studies assessing predictors for clinical outcomes after NF and evidenced predictors for psychotherapy guided the selection of baseline eating disorder‐related predictors, including objective binge‐eating (OBE) frequency, eating disorder psychopathology (EDP), food cravings, and body mass index (BMI), and general psychopathology‐related predictors, including depressive and anxiety symptoms, impulsivity, emotion dysregulation, and self‐efficacy. These questionnaire‐based or objectively assessed (BMI) predictors were regressed on outcomes OBE frequency and EDP as key features of BED at post‐treatment (t1) and 6‐month follow‐up (t2) in preregistered generalized mixed models (https://osf.io/4aktp).ResultsHigher EDP, food cravings, and BMI predicted worse outcomes across all groups at t1 and t2. General psychopathology‐related predictors did not predict outcomes at t1 and t2. Explorative analyses indicated that lower OBE frequency and higher self‐efficacy predicted lower OBE frequency, and lower EDP predicted lower EDP after the waiting period in WL.DiscussionConsistent with findings for psychotherapy, higher eating disorder‐related predictors were associated with higher EDP and OBE frequency. The specificity of psychopathological predictors for NF treatment success warrants further examination.Public SignificanceThis exploratory study firstly assessed eating disorder‐ and psychopathology‐related predictors for neurofeedback treatment outcome in binge‐eating disorder and overweight. Findings showed an association between higher eating disorder symptoms and worse neurofeedback outcomes, indicating special needs to be considered in neurofeedback treatment for patients with a higher binge‐eating disorder symptom burden. In general, outcomes and assignment to neurofeedback treatment may be improved upon consideration of baseline psychological variables.

From Lab to Life: Challenges and Perspectives of fNIRS for Hemodynamic-based Neurofeedback in Real-World Environments

“…A first RCT has demonstrated feasibility of DLPFC fMRI neurofeedback in obese individuals within a single training session [84]. An initial 12session clinical trial of fNIRS neurofeedback of the DLPFC provided promising results in reducing binge-eating episodes in related disorders, improving secondary symptoms and executive functions, and thereby demonstrating the high potential of fNIRS for the clinical translation [85]. FMRI neurofeedback of the DLPFC has also shown positive results for emotion regulation in depressed patients, including one RCT [80,86].…”