Sheba Clinicians Help Advance Neurofeedback Research for Depression

Inside the Neurofeedback Protocol

The Brain Sciences study recruited 49 adults across four medical institutions throughout Israel, Sheba among them, who had all been diagnosed with major depressive disorder and exhibit symptoms of anhedonia. The working premise was neurobiological: anhedonia stems from deficient activation of the ventral striatum, a core aspect in the brain’s reward circuitry system, and that an intervention, designed to modify that process, might offer greater relief from anhedonia than medication alone.

The GrayMatters Health’s Prism for Depression™ targets that mechanism through a novel integration of EEG and fMRI neurofeedback data. Using machine learning to estimate fMRI activity in the ventral striatum while simultaneously recording EEG data, a set of coefficients, called the Reward System EEG–fMRI Pattern (RS-EFP) is derived. This EFP provides an fMRI-informed measure of EEG signals associated with reward system activity during the processing of pleasurable stimuli.

The patients had a total of 10 sessions of RS-EFP-NF twice a week on nonconsecutive days. During each session, patients wore a wireless EEG headset and engaged with an audio-visual scenario designed to activate reward-related mental states. The system read their neural activity continuously and adjusted the scenario in response, training patients to self-regulate their own reward system over the course of ten sessions delivered twice weekly.

What the Data Showed

Out of the original group, 34 participants completed the full protocol. The average depression severity for these patients fell by eight points as measured by the HDRS-17. The clinical improvement rate was 78.47%, and 32.25% of participants achieved full remission. Anhedonia scores improved by an average of 6.3 points, with more than three-quarters of participants achieving at least a 50% reduction. From a medical point of view, these results were substantial.

Two details made the findings particularly notable. Two-thirds of participants were already taking prescribed antidepressants, such as SSRIs or SNRIs, at the time of the study, and these still showed robust reductions in both depression and anhedonia. This substantiated the initial hypothesis that self-neuromodulation could address depressive symptoms that pharmaceutical methods had failed to. On the personal level, more than 85% of participants reported satisfaction with the treatment and said they would recommend it to others.

A Hopeful Direction for Care

Taken together, the findings open a hopeful new path for people living with major depressive disorder and anhedonia. By helping patients train the brain’s reward system in real time, this approach appears to reach the parts of depression that are often the hardest to improve, offering something different for people who have not fully found relief through standard treatment.

What makes these results especially encouraging is that they were accompanied by clear improvements in both depression and anhedonia, as well as strong participant satisfaction. That kind of response matters, because it suggests the treatment was not only clinically meaningful, but also experienced by patients as something worth continuing and recommending.

For Dr. Raz Gross and Dr. Nadav Goldental, the study fits into a broader effort to better understand the biology of depression and turn that understanding into more effective care. Sheba’s involvement reflects the institution’s commitment to innovation that is not abstract or theoretical, but grounded in the real hope of helping patients feel better and enrich their lives. 

That commitment to research, innovation, and patient-centered care is part of what has earned Sheba the recognition from Newsweek as one of the World’s Best Hospitals for eight consecutive years.