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Infraslow Closed-Loop Brain Training for Anxiety and Depression (ISAD): A pilot randomised, sham-controlled trial in adult females with internalizing disorders

STS Instructor Authored by Mark Smith

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Check out this Knowledge Base article from StressTherapy Solutions: Infraslow Closed-Loop Brain Training for Anxiety and Depression (ISAD): A pilot randomised, sham-controlled trial in adult females with internalizing disorders.

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Study at a glance

Area
Depression & Mood
Study type
Randomized controlled trial
Authors
Perez TM, Adhia DB, Glue P, Zeng J, Dillingham P, Navid MS, Niazi IK, Young CK, Smith ML, De Ridder D
Journal
Cognitive, Affective, & Behavioral Neuroscience
Year
2025
Participants
60 (3 arms: two active protocols and sham)
Population
Adults
Protocol
source-localised infraslow neurofeedback (posterior cingulate target)
Sessions
6

Key findings

  • All three groups, sham included, showed clinically important drops in anxiety and depression scores after six sessions
  • No difference in symptom change between active and sham groups, so no specific training effect was shown
  • Single-region training lowered slow and delta activity at the posterior cingulate relative to sham, but infraslow band activity and connectivity did not differ between groups
  • Reductions in depression scores tracked with changes in slow and delta activity in the anterior cingulate

Sixty women with anxiety and/or depression were randomly assigned to one of two source-localised infraslow neurofeedback protocols or to sham feedback, under double-blind conditions, and completed six sessions. Anxiety and depression scores fell by a clinically meaningful amount in every group, including sham, so the benefit could not be credited to the active training itself. Training did reduce slow and delta activity at the targeted posterior cingulate region compared with sham, but it did not change infraslow activity or connectivity differently from sham. The authors conclude that the short-term gains were probably driven by nonspecific or placebo-type factors and suggest design changes for future trials.