Improved emotion regulation after neurofeedback: A single-arm trial in patients with borderline personality disorder

Highlights• To date it has been unclear which aspects of psychopathology and emotion regulation may change with neurofeedback-aided amygdala down-regulation. The present study provides an empirical basis for informed decision-making on primary outcome measures for larger clinical trials of amygdala neurofeedback training. • Participants were able to down-regulate their amygdala BOLD response with neurofeedback. • After neurofeedback training, there was a decrease of borderline symptoms as assessed with the Zanarini rating Scale for Borderline Personality Disorder (ZAN-BPD). • Patients also indicated less affective instability, indicated by lower variability in negative affect and inner tension in daily life after training. • After training, patients showed decreased emotion-modulated startle to negative pictures, indicative of increased emotion regulation abilities.