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Popovova J, Mazloum R, Macauda G, Stämpfli P, Vuilleumier P, Frühholz S, Scharnowski F, Menon V, Michels L. Enhanced attention-related alertness following right anterior insular cortex neurofeedback training. iScience 2024; 27:108915. [PMID: 38318347 PMCID: PMC10839684 DOI: 10.1016/j.isci.2024.108915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/15/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
The anterior insular cortex, a central node of the salience network, plays a critical role in cognitive control and attention. Here, we investigated the feasibility of enhancing attention using real-time fMRI neurofeedback training that targets the right anterior insular cortex (rAIC). 56 healthy adults underwent two neurofeedback training sessions. The experimental group received feedback from neural responses in the rAIC, while control groups received sham feedback from the primary visual cortex or no feedback. Cognitive functioning was evaluated before, immediately after, and three months post-training. Our results showed that only the rAIC neurofeedback group successfully increased activity in the rAIC. Furthermore, this group showed enhanced attention-related alertness up to three months after the training. Our findings provide evidence for the potential of rAIC neurofeedback as a viable approach for enhancing attention-related alertness, which could pave the way for non-invasive therapeutic strategies to address conditions characterized by attention deficits.
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Affiliation(s)
- Jeanette Popovova
- Department of Neuroradiology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
- Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
| | - Reza Mazloum
- Department of Neuroradiology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
- Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
| | - Gianluca Macauda
- Department of Neuroradiology, University Hospital of Zurich, 8091 Zurich, Switzerland
| | - Philipp Stämpfli
- MR-Center of the Department of Psychiatry, Psychotherapy and Psychosomatics and the Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland
| | - Patrik Vuilleumier
- Department of Neurosciences and Clinic of Neurology, Laboratory for Neurology and Imaging of Cognition, University of Geneva, 1211 Geneva, Switzerland
| | - Sascha Frühholz
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
- Department of Psychology, University of Oslo, 0851 Oslo, Norway
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, 1010 Vienna, Austria
| | - Vinod Menon
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Department of Neurology & Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Wu Tsai Neurosciences Institute, Stanford University School of Medicine, Stanford, CA, USA
| | - Lars Michels
- Department of Neuroradiology, University Hospital of Zurich, 8091 Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
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Fine NB, Neuman Fligelman E, Carlton N, Bloch M, Hendler T, Helpman L, Seligman Z, Armon DB. Integration of limbic self-neuromodulation with psychotherapy for complex post-traumatic stress disorder: treatment rationale and case study. Eur J Psychotraumatol 2024; 15:2256206. [PMID: 38166532 PMCID: PMC10769120 DOI: 10.1080/20008066.2023.2256206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/24/2023] [Indexed: 01/04/2024] Open
Abstract
Treatment Rationale: Exposure to repeated sexual trauma, particularly during childhood, often leads to protracted mental health problems. Childhood adversity is specifically associated with complex posttraumatic stress disorder (PTSD) presentation, which is particularly tenacious and treatment refractory, and features severe emotion dysregulation. Augmentation approaches have been suggested to enhance treatment efficacy in PTSD thus integrating first-line psychotherapy with mechanistically informed self-neuromodulation procedures (i.e. neurofeedback) may pave the way to enhanced clinical outcomes. A central neural mechanism of PTSD and emotion dysregulation involves amygdala hyperactivity that can be volitionally regulated by neurofeedback. We outline a treatment rationale that includes a detailed justification for the potential of combining psychotherapy and NF and delineate mechanisms of change. We illustrate key processes of reciprocal interactions between neurofeedback engagement and therapeutic goals.Case Study: We describe a clinical case of a woman with complex PTSD due to early and repetitive childhood sexual abuse using adjunctive neurofeedback as an augmentation to an ongoing, stable, traditional treatment plan. The woman participated in (a) ten sessions of neurofeedback by the use of an fMRI-inspired EEG model of limbic related activity (Amygdala Electrical-Finger-Print; AmygEFP-NF), (b) traditional weekly individual psychotherapy, (c) skills group. Before and after NF training period patient was blindly assessed for PTSD symptoms, followed by a 1, 3- and 6-months self-report follow-up. We demonstrate mechanisms of change as well as the clinical effectiveness of adjunctive treatment as indicated by reduced PTSD symptoms and improved daily functioning within this single case.Conclusions: We outline an integrative neuropsychological framework for understanding the unique mechanisms of change conferring value to conjoining NF applications with trauma-focused psychotherapy in complex PTSD.
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Affiliation(s)
- Naomi B. Fine
- Faculty of Social Sciences, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Ellie Neuman Fligelman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Nora Carlton
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Miki Bloch
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Talma Hendler
- Faculty of Social Sciences, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Liat Helpman
- Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Zivya Seligman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
| | - Daphna Bardin Armon
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Sourasky Medical Center, Tel Aviv, Israel
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Fine NB, Helpman L, Armon DB, Gurevitch G, Sheppes G, Seligman Z, Hendler T, Bloch M. Amygdala-related electroencephalogram neurofeedback as add-on therapy for treatment-resistant childhood sexual abuse posttraumatic stress disorder: feasibility study. Psychiatry Clin Neurosci 2024; 78:19-28. [PMID: 37615935 DOI: 10.1111/pcn.13591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 08/25/2023]
Abstract
AIM Childhood sexual abuse (CSA) among women is an alarmingly prevalent traumatic experience that often leads to debilitating and treatment-refractory posttraumatic stress disorder (PTSD), raising the need for novel adjunctive therapies. Neuroimaging investigations systematically report that amygdala hyperactivity is the most consistent and reliable neural abnormality in PTSD and following childhood abuse, raising the potential of implementing volitional neural modulation using neurofeedback (NF) aimed at down-regulating amygdala activity. This study aimed to reliably probe limbic activity but overcome the limited applicability of functional magnetic resonance imaging (fMRI) NF by using a scalable electroencephalogram NF probe of amygdala-related activity, termed amygdala electrical-finger-print (amyg-EFP) in a randomized controlled trial. METHOD Fifty-five women with CSA-PTSD who were in ongoing intensive trauma-focused psychotherapy for a minimum of 1 year but still met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD criteria were randomized to either 10 add-on sessions of amyg-EFP-NF training (test group) or continuing psychotherapy (control group). Participants were blindly assessed for PTSD symptoms before and after the NF training period, followed by self-reported clinical follow-up at 1, 3, and 6 months, as well as one session of amygdala real-time fMRI-NF before and after NF training period. RESULTS Participants in the test group compared with the control group demonstrated a marginally significant immediate reduction in PTSD symptoms, which progressively improved during the follow-up period. In addition, successful neuromodulation during NF training was demonstrated. CONCLUSION This feasibility study for patients with treatment-resistant CSA-PTSD indicates that amyg-EFP-NF is a viable and efficient intervention.
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Affiliation(s)
- Naomi B Fine
- School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Liat Helpman
- Womens' Reproductive Mental Health research Unit, Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Department of Counseling and Human Development, University of Haifa, Haifa, Israel
| | - Daphna Bardin Armon
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Guy Gurevitch
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gal Sheppes
- School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Zivya Seligman
- Lotem Center for Treatment of Sexual Trauma, Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Talma Hendler
- School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel Aviv, Israel
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Miki Bloch
- Womens' Reproductive Mental Health research Unit, Psychiatric Department, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Donantueno C, Yger P, Cabestaing F, Jardri R. fMRI-based neurofeedback strategies and the way forward to treating phasic psychiatric symptoms. Front Neurosci 2023; 17:1275229. [PMID: 38125404 PMCID: PMC10731299 DOI: 10.3389/fnins.2023.1275229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/17/2023] [Indexed: 12/23/2023] Open
Abstract
Auditory verbal hallucinations (AVH) are the perfect illustration of phasic symptoms in psychiatric disorders. For some patients and in some situations, AVH cannot be relieved by standard therapeutic approaches. More advanced treatments are needed, among which neurofeedback, and more specifically fMRI-based neurofeedback, has been considered. This paper discusses the different possibilities to approach neurofeedback in the specific context of phasic symptoms, by highlighting the strengths and weaknesses of the available neurofeedback options. It concludes with the added value of the recently introduced information-based neurofeedback. Although requiring an online fMRI signal classifier, which can be quite complex to implement, this neurofeedback strategy opens a door toward an alternative treatment option for complex phasic symptomatology.
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Affiliation(s)
- Candela Donantueno
- University of Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Center, Plasticity & SubjectivitY Team, Fontan Hospital, Lille, France
| | - Pierre Yger
- University of Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Center, Plasticity & SubjectivitY Team, Fontan Hospital, Lille, France
| | | | - Renaud Jardri
- University of Lille, INSERM U-1172, CHU Lille, Lille Neuroscience & Cognition Center, Plasticity & SubjectivitY Team, Fontan Hospital, Lille, France
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Singer N, Poker G, Dunsky-Moran N, Nemni S, Reznik Balter S, Doron M, Baker T, Dagher A, Zatorre RJ, Hendler T. Development and validation of an fMRI-informed EEG model of reward-related ventral striatum activation. Neuroimage 2023; 276:120183. [PMID: 37225112 PMCID: PMC10300238 DOI: 10.1016/j.neuroimage.2023.120183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/06/2023] [Accepted: 05/22/2023] [Indexed: 05/26/2023] Open
Abstract
Reward processing is essential for our mental-health and well-being. In the current study, we developed and validated a scalable, fMRI-informed EEG model for monitoring reward processing related to activation in the ventral-striatum (VS), a significant node in the brain's reward system. To develop this EEG-based model of VS-related activation, we collected simultaneous EEG/fMRI data from 17 healthy individuals while listening to individually-tailored pleasurable music - a highly rewarding stimulus known to engage the VS. Using these cross-modal data, we constructed a generic regression model for predicting the concurrently acquired Blood-Oxygen-Level-Dependent (BOLD) signal from the VS using spectro-temporal features from the EEG signal (termed hereby VS-related-Electrical Finger Print; VS-EFP). The performance of the extracted model was examined using a series of tests that were applied on the original dataset and, importantly, an external validation dataset collected from a different group of 14 healthy individuals who underwent the same EEG/FMRI procedure. Our results showed that the VS-EFP model, as measured by simultaneous EEG, predicted BOLD activation in the VS and additional functionally relevant regions to a greater extent than an EFP model derived from a different anatomical region. The developed VS-EFP was also modulated by musical pleasure and predictive of the VS-BOLD during a monetary reward task, further indicating its functional relevance. These findings provide compelling evidence for the feasibility of using EEG alone to model neural activation related to the VS, paving the way for future use of this scalable neural probing approach in neural monitoring and self-guided neuromodulation.
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Affiliation(s)
- Neomi Singer
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada; Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, 6 Weizman St. Tel Aviv, 64239, Israel; Sagol school of Neuroscience, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel
| | - Gilad Poker
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, 6 Weizman St. Tel Aviv, 64239, Israel
| | - Netta Dunsky-Moran
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, 6 Weizman St. Tel Aviv, 64239, Israel; Sagol school of Neuroscience, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel
| | - Shlomi Nemni
- Sagol school of Neuroscience, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel; School of Psychological Sciences, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel
| | - Shira Reznik Balter
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, 6 Weizman St. Tel Aviv, 64239, Israel
| | - Maayan Doron
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada; Sackler School of Medicine, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel
| | - Travis Baker
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada; Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, NJ, USA
| | - Alain Dagher
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada
| | - Robert J Zatorre
- Montreal Neurological Institute, McGill University, 3801 Rue University, Montréal, QC H3A 2B4, Canada; International Laboratory for Brain, Music, and Sound Research (BRAMS), Canada
| | - Talma Hendler
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, 6 Weizman St. Tel Aviv, 64239, Israel; Sagol school of Neuroscience, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel; School of Psychological Sciences, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel; Sackler School of Medicine, Tel-Aviv University, PO Box 39040, Tel Aviv 6997801, Israel.
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Shany O, Dunsky N, Gilam G, Greental A, Gilboa-Schechtman E, Hendler T. Self-evaluation of social-rank in socially anxious individuals associates with enhanced striatal reward function. Psychol Med 2023; 53:4569-4579. [PMID: 35698849 PMCID: PMC10388315 DOI: 10.1017/s0033291722001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/21/2022] [Accepted: 05/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Negative self-views, especially in the domain of power (i.e. social-rank), characterize social anxiety (SA). Neuroimaging studies on self-evaluations in SA have mainly focused on subcortical threat processing systems. Yet, self-evaluation may concurrently invoke diverse affective processing, as motivational systems related to desired self-views may also be activated. To investigate the conflictual nature that may accompany self-evaluation of certain social domains in SA, we examined brain activity related to both threat and reward processing. METHODS Participants (N = 74) differing in self-reported SA-severity underwent fMRI while completing a self-evaluation task, wherein they judged the self-descriptiveness of high- v. low-intensity traits in the domains of power and affiliation (i.e. social connectedness). Participants also completed two auxiliary fMRI tasks designated to evoke reward- and threat-related activations in the ventral striatum (VS) and amygdala, respectively. We hypothesized that self-evaluations in SA, particularly in the domain of power, involve aberrant brain activity related to both threat and reward processing. RESULTS SA-severity was more negatively associated with power than with affiliation self-evaluations. During self-evaluative judgment of high-power (e.g. dominant), SA-severity associated with increased activity in the VS and ventromedial prefrontal cortex. Moreover, SA-severity correlated with higher similarity between brain activity patterns activated by high-power traits and patterns activated by incentive salience (i.e. reward anticipation) in the VS during the reward task. CONCLUSIONS Our findings indicate that self-evaluation of high-power in SA involves excessive striatal reward-related activation, and pinpoint the downregulation of VS-VMPFC activity within such self-evaluative context as a potential neural outcome for therapeutic interventions.
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Affiliation(s)
- Ofir Shany
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Netta Dunsky
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Gadi Gilam
- Faculty of Dental Medicine, The Institute of Biomedical and Oral Research, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ayam Greental
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology and the Gonda Brain Science Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Talma Hendler
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
- Sagol Brain Institute, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Patil AU, Lin C, Lee SH, Huang HW, Wu SC, Madathil D, Huang CM. Review of EEG-based neurofeedback as a therapeutic intervention to treat depression. Psychiatry Res 2023; 329:111591. [PMID: 36682174 PMCID: PMC9837232 DOI: 10.1016/j.pscychresns.2023.111591] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 11/24/2022] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
Depression, or major depressive disorder, is a common mental disorder that affects individuals' behavior, mood, and physical health, and its prevalence has increased during the lockdowns implemented to curb the COVID-19 pandemic. There is an urgent need to update the treatment recommendations for mental disorders during such crises. Conventional interventions to treat depression include long-term pharmacotherapy and cognitive behavioral therapy. Electroencephalogram-neurofeedback (EEG-NF) training has been suggested as a non-invasive option to treat depression with minimal side effects. In this systematic review, we summarize the recent literature on EEG-NF training for treating depression. The 12 studies included in our final sample reported that despite several issues related to EEG-NF practices, patients with depression showed significant cognitive, clinical, and neural improvements following EEG-NF training. Given its low cost and the low risk of side effects due to its non-invasive nature, we suggest that EEG-NF is worth exploring as an augmented tool for patients who already receive standard medications but remain symptomatic, and that EEG-NF training may be an effective intervention tool that can be utilized as a supplementary treatment for depression. We conclude by providing some suggestions related to experimental designs and standards to improve current EEG-NF training practices for treating depression.
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Affiliation(s)
- Abhishek Uday Patil
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Center for Intelligent Drug Systems and Smart Bio-devices (IDS(2)B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chemin Lin
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Shwu-Hua Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsu-Wen Huang
- Department of Linguistics and Translation, City University of Hong Kong, Hong Kong
| | - Shun-Chi Wu
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Deepa Madathil
- Jindal Institute of Behavioural Sciences, O.P. Jindal Global University, Haryana, India.
| | - Chih-Mao Huang
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; Center for Intelligent Drug Systems and Smart Bio-devices (IDS(2)B), National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
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Neural and functional validation of fMRI-informed EEG model of right inferior frontal gyrus activity. Neuroimage 2023; 266:119822. [PMID: 36535325 DOI: 10.1016/j.neuroimage.2022.119822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/17/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
The right inferior frontal gyrus (rIFG) is a region involved in the neural underpinning of cognitive control across several domains such as inhibitory control and attentional allocation process. Therefore, it constitutes a desirable neural target for brain-guided interventions such as neurofeedback (NF). To date, rIFG-NF has shown beneficial ability to rehabilitate or enhance cognitive functions using functional Magnetic Resonance Imaging (fMRI-NF). However, the utilization of fMRI-NF for clinical purposes is severely limited, due to its poor scalability. The present study aimed to overcome the limited applicability of fMRI-NF by developing and validating an EEG model of fMRI-defined rIFG activity (hereby termed "Electrical FingerPrint of rIFG"; rIFG-EFP). To validate the computational model, we employed two experiments in healthy individuals. The first study (n = 14) aimed to test the target engagement of the model by employing rIFG-EFP-NF training while simultaneously acquiring fMRI. The second study (n = 41) aimed to test the functional outcome of two sessions of rIFG-EFP-NF using a risk preference task (known to depict cognitive control processes), employed before and after the training. Results from the first study demonstrated neural target engagement as expected, showing associated rIFG-BOLD signal changing during simultaneous rIFG-EFP-NF training. Target anatomical specificity was verified by showing a more precise prediction of the rIFG-BOLD by the rIFG-EFP model compared to other EFP models. Results of the second study suggested that successful learning to up-regulate the rIFG-EFP signal through NF can reduce one's tendency for risk taking, indicating improved cognitive control after two sessions of rIFG-EFP-NF. Overall, our results confirm the validity of a scalable NF method for targeting rIFG activity by using an EEG probe.
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Taylor SF, Martz ME. Real-time fMRI neurofeedback: the promising potential of brain-training technology to advance clinical neuroscience. Neuropsychopharmacology 2023; 48:238-239. [PMID: 35915228 PMCID: PMC9700826 DOI: 10.1038/s41386-022-01397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | - Meghan E Martz
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Kvamme TL, Ros T, Overgaard M. Can neurofeedback provide evidence of direct brain-behavior causality? Neuroimage 2022; 258:119400. [PMID: 35728786 DOI: 10.1016/j.neuroimage.2022.119400] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 01/01/2023] Open
Abstract
Neurofeedback is a procedure that measures brain activity in real-time and presents it as feedback to an individual, thus allowing them to self-regulate brain activity with effects on cognitive processes inferred from behavior. One common argument is that neurofeedback studies can reveal how the measured brain activity causes a particular cognitive process. The causal claim is often made regarding the measured brain activity being manipulated as an independent variable, similar to brain stimulation studies. However, this causal inference is vulnerable to the argument that other upstream brain activities change concurrently and cause changes in the brain activity from which feedback is derived. In this paper, we outline the inference that neurofeedback may causally affect cognition by indirect means. We further argue that researchers should remain open to the idea that the trained brain activity could be part of a "causal network" that collectively affects cognition rather than being necessarily causally primary. This particular inference may provide a better translation of evidence from neurofeedback studies to the rest of neuroscience. We argue that the recent advent of multivariate pattern analysis, when combined with implicit neurofeedback, currently comprises the strongest case for causality. Our perspective is that although the burden of inferring direct causality is difficult, it may be triangulated using a collection of various methods in neuroscience. Finally, we argue that the neurofeedback methodology provides unique advantages compared to other methods for revealing changes in the brain and cognitive processes but that researchers should remain mindful of indirect causal effects.
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Affiliation(s)
- Timo L Kvamme
- Cognitive Neuroscience Research Unit, CFIN/MINDLab, Aarhus University, Universitetsbyen 3, Aarhus, Denmark; Centre for Alcohol and Drug Research (CRF), Aarhus University, Aarhus, Denmark.
| | - Tomas Ros
- Departments of Neuroscience and Psychiatry, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Morten Overgaard
- Cognitive Neuroscience Research Unit, CFIN/MINDLab, Aarhus University, Universitetsbyen 3, Aarhus, Denmark
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Lubianiker N, Paret C, Dayan P, Hendler T. Neurofeedback through the lens of reinforcement learning. Trends Neurosci 2022; 45:579-593. [PMID: 35550813 DOI: 10.1016/j.tins.2022.03.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/11/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022]
Abstract
Despite decades of experimental and clinical practice, the neuropsychological mechanisms underlying neurofeedback (NF) training remain obscure. NF is a unique form of reinforcement learning (RL) task, during which participants are provided with rewarding feedback regarding desired changes in neural patterns. However, key RL considerations - including choices during practice, prediction errors, credit-assignment problems, or the exploration-exploitation tradeoff - have infrequently been considered in the context of NF. We offer an RL-based framework for NF, describing different internal states, actions, and rewards in common NF protocols, thus fashioning new proposals for characterizing, predicting, and hastening the course of learning. In this way we hope to advance current understanding of neural regulation via NF, and ultimately to promote its effectiveness, personalization, and clinical utility.
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Affiliation(s)
- Nitzan Lubianiker
- School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
| | - Christian Paret
- School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Peter Dayan
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany; University of Tübingen, Tübingen, Germany
| | - Talma Hendler
- School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol school of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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12
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Asai T, Hamamoto T, Kashihara S, Imamizu H. Real-Time Detection and Feedback of Canonical Electroencephalogram Microstates: Validating a Neurofeedback System as a Function of Delay. Front Syst Neurosci 2022; 16:786200. [PMID: 35283737 PMCID: PMC8913511 DOI: 10.3389/fnsys.2022.786200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Recent neurotechnology has developed various methods for neurofeedback (NF), in which participants observe their own neural activity to be regulated in an ideal direction. EEG-microstates (EEGms) are spatially featured states that can be regulated through NF training, given that they have recently been indicated as biomarkers for some disorders. The current study was conducted to develop an EEG-NF system for detecting “canonical 4 EEGms” in real time. There are four representative EEG states, regardless of the number of channels, preprocessing procedures, or participants. Accordingly, our 10 Hz NF system was implemented to detect them (msA, B, C, and D) and audio-visually inform participants of its detection. To validate the real-time effect of this system on participants’ performance, the NF was intentionally delayed for participants to prevent their cognitive control in learning. Our results suggest that the feedback effect was observed only under the no-delay condition. The number of Hits increased significantly from the baseline period and increased from the 1- or 20-s delay conditions. In addition, when the Hits were compared among the msABCD, each cognitive or perceptual function could be characterized, though the correspondence between each microstate and psychological ability might not be that simple. For example, msD should be generally task-positive and less affected by the inserted delay, whereas msC is more delay-sensitive. In this study, we developed and validated a new EEGms-NF system as a function of delay. Although the participants were naive to the inserted delay, the real-time NF successfully increased their Hit performance, even within a single-day experiment, although target specificity remains unclear. Future research should examine long-term training effects using this NF system.
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Affiliation(s)
- Tomohisa Asai
- Cognitive Mechanisms Laboratories, Advanced Telecommunications Research Institute International (ATR), Kyoto, Japan
- *Correspondence: Tomohisa Asai,
| | - Takamasa Hamamoto
- Cognitive Mechanisms Laboratories, Advanced Telecommunications Research Institute International (ATR), Kyoto, Japan
- Graduate School of Frontier Biosciences, Osaka University, Osaka, Japan
| | - Shiho Kashihara
- Cognitive Mechanisms Laboratories, Advanced Telecommunications Research Institute International (ATR), Kyoto, Japan
| | - Hiroshi Imamizu
- Cognitive Mechanisms Laboratories, Advanced Telecommunications Research Institute International (ATR), Kyoto, Japan
- Department of Psychology, Graduate School of Humanities and Sociology, The University of Tokyo, Tokyo, Japan
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13
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Taylor JE, Yamada T, Kawashima T, Kobayashi Y, Yoshihara Y, Miyata J, Murai T, Kawato M, Motegi T. Depressive symptoms reduce when dorsolateral prefrontal cortex-precuneus connectivity normalizes after functional connectivity neurofeedback. Sci Rep 2022; 12:2581. [PMID: 35173179 PMCID: PMC8850610 DOI: 10.1038/s41598-022-05860-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 01/18/2022] [Indexed: 11/09/2022] Open
Abstract
Depressive disorders contribute heavily to global disease burden; This is possibly because patients are often treated homogeneously, despite having heterogeneous symptoms with differing underlying neural mechanisms. A novel treatment that can directly influence the neural circuit relevant to an individual patient's subset of symptoms might more precisely and thus effectively aid in the alleviation of their specific symptoms. We tested this hypothesis in a proof-of-concept study using fMRI functional connectivity neurofeedback. We targeted connectivity between the left dorsolateral prefrontal cortex/middle frontal gyrus and the left precuneus/posterior cingulate cortex, because this connection has been well-established as relating to a specific subset of depressive symptoms. Specifically, this connectivity has been shown in a data-driven manner to be less anticorrelated in patients with melancholic depression than in healthy controls. Furthermore, a posterior cingulate dominant state-which results in a loss of this anticorrelation-is expected to specifically relate to an increase in rumination symptoms such as brooding. In line with predictions, we found that, with neurofeedback training, the more a participant normalized this connectivity (restored the anticorrelation), the more related (depressive and brooding symptoms), but not unrelated (trait anxiety), symptoms were reduced. Because these results look promising, this paradigm next needs to be examined with a greater sample size and with better controls. Nonetheless, here we provide preliminary evidence for a correlation between the normalization of a neural network and a reduction in related symptoms. Showing their reproducibility, these results were found in two experiments that took place several years apart by different experimenters. Indicative of its potential clinical utility, effects of this treatment remained one-two months later.Clinical trial registration: Both experiments reported here were registered clinical trials (UMIN000015249, jRCTs052180169).
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Affiliation(s)
- Jessica Elizabeth Taylor
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International (ATR), Hikaridai 2-2-2. Seika-cho, Soraku, Kyoto, 619-0237, Japan
| | - Takashi Yamada
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International (ATR), Hikaridai 2-2-2. Seika-cho, Soraku, Kyoto, 619-0237, Japan.,Department of Cognitive, Linguistic and Psychological Sciences, Brown University, Providence, USA.,Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Takahiko Kawashima
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yuko Kobayashi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yujiro Yoshihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuo Kawato
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International (ATR), Hikaridai 2-2-2. Seika-cho, Soraku, Kyoto, 619-0237, Japan
| | - Tomokazu Motegi
- Department of Decoded Neurofeedback (DecNef), Computational Neuroscience Laboratories, Advanced Telecommunications Research Institute International (ATR), Hikaridai 2-2-2. Seika-cho, Soraku, Kyoto, 619-0237, Japan. .,Department of Psychiatry and Neuroscience, Gunma University Graduate School of Medicine, Gunma, Japan.
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14
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Ramot M, Martin A. Closed-loop neuromodulation for studying spontaneous activity and causality. Trends Cogn Sci 2022; 26:290-299. [PMID: 35210175 PMCID: PMC9396631 DOI: 10.1016/j.tics.2022.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 01/01/2023]
Abstract
Having established that spontaneous brain activity follows meaningful coactivation patterns and correlates with behavior, researchers have turned their attention to understanding its function and behavioral significance. We suggest closed-loop neuromodulation as a neural perturbation tool uniquely well suited for this task. Closed-loop neuromodulation has primarily been viewed as an interventionist tool to teach subjects to directly control their own brain activity. We examine an alternative operant conditioning model of closed-loop neuromodulation which, through implicit feedback, can manipulate spontaneous activity at the network level, without violating the spontaneous or endogenous nature of the signal, thereby providing a direct test of network causality.
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15
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Stirner M, Gurevitch G, Lubianiker N, Hendler T, Schmahl C, Paret C. An Investigation of Awareness and Metacognition in Neurofeedback with the Amygdala Electrical Fingerprint. Conscious Cogn 2022; 98:103264. [PMID: 35026688 DOI: 10.1016/j.concog.2021.103264] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 11/24/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022]
Abstract
Awareness theory posits that individuals connected to a brain-computer interface can learn to estimate and discriminate their brain states. We used the amygdala Electrical Fingerprint (amyg-EFP) - a functional Magnetic Resonance Imaging-inspired Electroencephalogram surrogate of deep brain activation - to investigate whether participants could accurately estimate their own brain activation. Ten participants completed up to 20 neurofeedback runs and estimated their amygdala-EFP activation (depicted as a thermometer) and confidence in this rating during each trial. We analysed data using multilevel models, predicting the real thermometer position with participant rated position and adjusted for activation during the previous trial. Hypotheses on learning regulation and improvement of estimation were not confirmed. However, participant ratings were significantly associated with the amyg-EFP signal. Higher rating accuracy also predicted higher subjective confidence in the rating. This proof-of-concept study introduces an approach to study awareness with fMRI-informed neurofeedback and provides initial evidence for metacognition in neurofeedback.
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Affiliation(s)
- Madita Stirner
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Guy Gurevitch
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center and School of Psychological Sciences, Tel-Aviv University, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Nitzan Lubianiker
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center and School of Psychological Sciences, Tel-Aviv University, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Israel
| | - Talma Hendler
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center and School of Psychological Sciences, Tel-Aviv University, Israel; Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel-Aviv University, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Israel
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Christian Paret
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany; Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center and School of Psychological Sciences, Tel-Aviv University, Israel.
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16
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Mercer Lindsay N, Chen C, Gilam G, Mackey S, Scherrer G. Brain circuits for pain and its treatment. Sci Transl Med 2021; 13:eabj7360. [PMID: 34757810 DOI: 10.1126/scitranslmed.abj7360] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Nicole Mercer Lindsay
- Department of Cell Biology and Physiology, UNC Neuroscience Center, Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.,Department of Biology, CNC Program, Department of Applied Physics, Stanford University, Stanford, CA 94305, USA
| | - Chong Chen
- Department of Cell Biology and Physiology, UNC Neuroscience Center, Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gadi Gilam
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Sean Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Grégory Scherrer
- Department of Cell Biology and Physiology, UNC Neuroscience Center, Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.,New York Stem Cell Foundation-Robertson Investigator, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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17
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Fruchtman-Steinbok T, Keynan JN, Cohen A, Jaljuli I, Mermelstein S, Drori G, Routledge E, Krasnoshtein M, Playle R, Linden DEJ, Hendler T. Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept. NEUROIMAGE-CLINICAL 2021; 32:102859. [PMID: 34689055 PMCID: PMC8551212 DOI: 10.1016/j.nicl.2021.102859] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/21/2022]
Abstract
Randomized clinical trial with a novel self-neuromodulation training in PTSD. Demonstration of feasibility of an fMRI-informed EEG model of Amygdala modulation (AmygEFP). Individually-tailored trauma-related content as the training feedback interface. Results showed reduction of PTSD symptoms following AmygEFP trauma-related feedback training.
Background Amygdala activity dysregulation plays a central role in post-traumatic stress disorder (PTSD). Hence learning to self-regulate one's amygdala activity may facilitate recovery. PTSD is further characterized by abnormal contextual processing related to the traumatic memory. Therefore, provoking the personal traumatic narrative while training amygdala down-regulation could enhance clinical efficacy. We report the results of a randomized controlled trial (NCT02544971) of a novel self-neuromodulation procedure (i.e. NeuroFeedback) for PTSD, aimed at down-regulating limbic activity while receiving feedback from an auditory script of a personal traumatic narrative. To scale-up applicability, neural activity was probed by an fMRI-informed EEG model of amygdala activity, termed Amygdala Electrical Finger-Print (AmygEFP). Methods Fifty-nine adults meeting DSM-5 criteria for PTSD were randomized between three groups: Trauma-script feedback interface (Trauma-NF) or Neutral feedback interface (Neutral-NF), and a control group of No-NF (to control for spontaneous recovery). Before and immediately after 15 NF training sessions patients were blindly assessed for PTSD symptoms and underwent one session of amygdala fMRI-NF for transferability testing. Follow-up clinical assessment was performed at 3- and 6-months following NF treatment. Results Patients in both NF groups learned to volitionally down-regulate AmygEFP signal and demonstrated a greater reduction in PTSD symptoms and improved down-regulation of the amygdala during fMRI-NF, compared to the No-NF group. The Trauma-NF group presented the largest immediate clinical improvement. Conclusions This proof-of-concept study indicates the feasibility of the AmygEFP-NF process-driven as a scalable intervention for PTSD and illustrates its clinical potential. Further investigation is warranted to elucidate the contribution of AmygEFP-NF beyond exposure and placebo effects.
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Affiliation(s)
- Tom Fruchtman-Steinbok
- Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Jackob N Keynan
- Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; Department of Psychiatry & Behavioral Science, Stanford University School of Medicine, Stanford, CA, USA
| | - Avihay Cohen
- Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Iman Jaljuli
- Department of Statistics and Operations Research, School of Mathematical Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Gadi Drori
- Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Efrat Routledge
- Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel
| | | | - Rebecca Playle
- Center for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, UK
| | - David E J Linden
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Talma Hendler
- Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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18
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Grosselin F, Breton A, Yahia-Cherif L, Wang X, Spinelli G, Hugueville L, Fossati P, Attal Y, Navarro-Sune X, Chavez M, George N. Alpha activity neuromodulation induced by individual alpha-based neurofeedback learning in ecological context: a double-blind randomized study. Sci Rep 2021; 11:18489. [PMID: 34531416 PMCID: PMC8445968 DOI: 10.1038/s41598-021-96893-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023] Open
Abstract
The neuromodulation induced by neurofeedback training (NFT) remains a matter of debate. Investigating the modulation of brain activity specifically associated with NF requires controlling for multiple factors, such as reward, performance, congruency between task and targeted brain activity. This can be achieved using sham feedback (FB) control condition, equating all aspects of the experiment but the link between brain activity and FB. We aimed at investigating the modulation of individual alpha EEG activity induced by NFT in a double-blind, randomized, sham-controlled study. Forty-eight healthy participants were assigned to either NF (n = 25) or control (n = 23) group and performed alpha upregulation training (over 12 weeks) with a wearable EEG device. Participants of the NF group received FB based on their individual alpha activity. The control group received the auditory FB of participants of the NF group. An increase of alpha activity across training sessions was observed in the NF group only (p < 0.001). This neuromodulation was selective in that there was no evidence for similar effects in the theta (4-8 Hz) and low beta (13-18 Hz) bands. While alpha upregulation was found in the NF group only, psychological outcome variables showed overall increased feeling of control, decreased anxiety level and increased relaxation feeling, without any significant difference between the NF and the control groups. This is interpreted in terms of learning context and placebo effects. Our results pave the way to self-learnt, NF-based neuromodulation with light-weighted, wearable EEG systems.
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Affiliation(s)
- Fanny Grosselin
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Equipe Aramis, 75013, Paris, France.
- myBrain Technologies, 75010, Paris, France.
- INRIA, Aramis Project-Team, 75013, Paris, France.
| | | | - Lydia Yahia-Cherif
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Xi Wang
- myBrain Technologies, 75010, Paris, France
| | | | - Laurent Hugueville
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
| | - Philippe Fossati
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe CIA-Cognitive Control, Interoception, Attention, 75013, Paris, France
- AP-HP, Hôpital Pitié-Salpêtrière, Service de Psychiatrie Adulte, 75013, Paris, France
| | | | | | | | - Nathalie George
- Institut du Cerveau-Paris Brain Institute-ICM, Centre MEG-EEG, Paris, France
- CNRS, UMR 7225, F-75013, Paris, France
- Inserm, U 1127, Paris, France
- Sorbonne Université, Paris, France
- Institut du Cerveau-Paris Brain Institute-ICM, Equipe Experimental Neurosurgery, 75013, Paris, France
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19
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Cortese A. Metacognitive resources for adaptive learning⋆. Neurosci Res 2021; 178:10-19. [PMID: 34534617 DOI: 10.1016/j.neures.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Abstract
Biological organisms display remarkably flexible behaviours. This is an area of active investigation, in particular in the fields of artificial intelligence, computational and cognitive neuroscience. While inductive biases and broader cognitive functions are undoubtedly important, the ability to monitor and evaluate one's performance or oneself -- metacognition -- strikes as a powerful resource for efficient learning. Often measured as decision confidence in neuroscience and psychology experiments, metacognition appears to reflect a broad range of abstraction levels and downstream behavioural effects. Within this context, the formal investigation of how metacognition interacts with learning processes is a recent endeavour. Of special interest are the neural and computational underpinnings of confidence and reinforcement learning modules. This review discusses a general hierarchy of confidence functions and their neuro-computational relevance for adaptive behaviours. It then introduces novel ways to study the formation and use of meta-representations and nonconscious mental representations related to learning and confidence, and concludes with a discussion on outstanding questions and wider perspectives.
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Affiliation(s)
- Aurelio Cortese
- Computational Neuroscience Labs, ATR Institute International, 619-0288 Kyoto, Japan.
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20
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Cortese A, Yamamoto A, Hashemzadeh M, Sepulveda P, Kawato M, De Martino B. Value signals guide abstraction during learning. eLife 2021; 10:68943. [PMID: 34254586 PMCID: PMC8331191 DOI: 10.7554/elife.68943] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/12/2021] [Indexed: 12/22/2022] Open
Abstract
The human brain excels at constructing and using abstractions, such as rules, or concepts. Here, in two fMRI experiments, we demonstrate a mechanism of abstraction built upon the valuation of sensory features. Human volunteers learned novel association rules based on simple visual features. Reinforcement-learning algorithms revealed that, with learning, high-value abstract representations increasingly guided participant behaviour, resulting in better choices and higher subjective confidence. We also found that the brain area computing value signals – the ventromedial prefrontal cortex – prioritised and selected latent task elements during abstraction, both locally and through its connection to the visual cortex. Such a coding scheme predicts a causal role for valuation. Hence, in a second experiment, we used multivoxel neural reinforcement to test for the causality of feature valuation in the sensory cortex, as a mechanism of abstraction. Tagging the neural representation of a task feature with rewards evoked abstraction-based decisions. Together, these findings provide a novel interpretation of value as a goal-dependent, key factor in forging abstract representations.
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Affiliation(s)
- Aurelio Cortese
- Computational Neuroscience Labs, ATR Institute International, Kyoto, Japan.,Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Asuka Yamamoto
- Computational Neuroscience Labs, ATR Institute International, Kyoto, Japan.,School of Information Science, Nara Institute of Science and Technology, Nara, Japan
| | - Maryam Hashemzadeh
- Department of Computing Science, University of Alberta, Edmonton, Canada
| | - Pradyumna Sepulveda
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Mitsuo Kawato
- Computational Neuroscience Labs, ATR Institute International, Kyoto, Japan.,RIKEN Center for Artificial Intelligence Project, Kyoto, Japan
| | - Benedetto De Martino
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
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21
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Orendáčová M, Kvašňák E. Effects of Transcranial Alternating Current Stimulation and Neurofeedback on Alpha (EEG) Dynamics: A Review. Front Hum Neurosci 2021; 15:628229. [PMID: 34305549 PMCID: PMC8297546 DOI: 10.3389/fnhum.2021.628229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/03/2021] [Indexed: 12/14/2022] Open
Abstract
Transcranial alternating current stimulation (tACS) and neurofeedback (NFB) are two different types of non-invasive neuromodulation techniques, which can modulate brain activity and improve brain functioning. In this review, we compared the current state of knowledge related to the mechanisms of tACS and NFB and their effects on electroencephalogram (EEG) activity (online period/stimulation period) and on aftereffects (offline period/post/stimulation period), including the duration of their persistence and potential behavioral benefits. Since alpha bandwidth has been broadly studied in NFB and in tACS research, the studies of NFB and tACS in modulating alpha bandwidth were selected for comparing the online and offline effects of these two neuromodulation techniques. The factors responsible for variability in the responsiveness of the modulated EEG activity by tACS and NFB were analyzed and compared too. Based on the current literature related to tACS and NFB, it can be concluded that tACS and NFB differ a lot in the mechanisms responsible for their effects on an online EEG activity but they possibly share the common universal mechanisms responsible for the induction of aftereffects in the targeted stimulated EEG band, namely Hebbian and homeostatic plasticity. Many studies of both neuromodulation techniques report the aftereffects connected to the behavioral benefits. The duration of persistence of aftereffects for NFB and tACS is comparable. In relation to the factors influencing responsiveness to tACS and NFB, significantly more types of factors were analyzed in the NFB studies compared to the tACS studies. Several common factors for both tACS and NFB have been already investigated. Based on these outcomes, we propose several new research directions regarding tACS and NFB.
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Affiliation(s)
- Mária Orendáčová
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
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22
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Trambaiolli LR, Cassani R, Mehler DMA, Falk TH. Neurofeedback and the Aging Brain: A Systematic Review of Training Protocols for Dementia and Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:682683. [PMID: 34177558 PMCID: PMC8221422 DOI: 10.3389/fnagi.2021.682683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/03/2021] [Indexed: 11/24/2022] Open
Abstract
Dementia describes a set of symptoms that occur in neurodegenerative disorders and that is characterized by gradual loss of cognitive and behavioral functions. Recently, non-invasive neurofeedback training has been explored as a potential complementary treatment for patients suffering from dementia or mild cognitive impairment. Here we systematically reviewed studies that explored neurofeedback training protocols based on electroencephalography or functional magnetic resonance imaging for these groups of patients. From a total of 1,912 screened studies, 10 were included in our final sample (N = 208 independent participants in experimental and N = 81 in the control groups completing the primary endpoint). We compared the clinical efficacy across studies, and evaluated their experimental designs and reporting quality. In most studies, patients showed improved scores in different cognitive tests. However, data from randomized controlled trials remains scarce, and clinical evidence based on standardized metrics is still inconclusive. In light of recent meta-research developments in the neurofeedback field and beyond, quality and reporting practices of individual studies are reviewed. We conclude with recommendations on best practices for future studies that investigate the effects of neurofeedback training in dementia and cognitive impairment.
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Affiliation(s)
- Lucas R Trambaiolli
- Basic Neuroscience Division, McLean Hospital - Harvard Medical School, Boston, MA, United States
| | - Raymundo Cassani
- Institut National de la Recherche Scientifique - Energy, Materials, and Telecommunications Centre (INRS-EMT), University of Québec, Montréal, QC, Canada
| | - David M A Mehler
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tiago H Falk
- Institut National de la Recherche Scientifique - Energy, Materials, and Telecommunications Centre (INRS-EMT), University of Québec, Montréal, QC, Canada
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23
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Cortese A, Tanaka SC, Amano K, Koizumi A, Lau H, Sasaki Y, Shibata K, Taschereau-Dumouchel V, Watanabe T, Kawato M. The DecNef collection, fMRI data from closed-loop decoded neurofeedback experiments. Sci Data 2021; 8:65. [PMID: 33623035 PMCID: PMC7902847 DOI: 10.1038/s41597-021-00845-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/29/2021] [Indexed: 12/12/2022] Open
Abstract
Decoded neurofeedback (DecNef) is a form of closed-loop functional magnetic resonance imaging (fMRI) combined with machine learning approaches, which holds some promises for clinical applications. Yet, currently only a few research groups have had the opportunity to run such experiments; furthermore, there is no existing public dataset for scientists to analyse and investigate some of the factors enabling the manipulation of brain dynamics. We release here the data from published DecNef studies, consisting of 5 separate fMRI datasets, each with multiple sessions recorded per participant. For each participant the data consists of a session that was used in the main experiment to train the machine learning decoder, and several (from 3 to 10) closed-loop fMRI neural reinforcement sessions. The large dataset, currently comprising more than 60 participants, will be useful to the fMRI community at large and to researchers trying to understand the mechanisms underlying non-invasive modulation of brain dynamics. Finally, the data collection size will increase over time as data from newly run DecNef studies will be added. Measurement(s) | functional brain measurement | Technology Type(s) | 3 T MRI scanner • functional magnetic resonance imaging • Neurofeedback • machine learning | Factor Type(s) | type of task performed: visual, preference, perceptual, or memory task | Sample Characteristic - Organism | Homo sapiens |
Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.13578008
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Affiliation(s)
- Aurelio Cortese
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.
| | - Saori C Tanaka
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan
| | - Kaoru Amano
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, 565-0871, Osaka, Japan
| | - Ai Koizumi
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology, 565-0871, Osaka, Japan.,Sony Computer Science Laboratories, Inc., 141-0022, Tokyo, Japan
| | - Hakwan Lau
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,Department of Psychology, UCLA, 90095, Los Angeles, CA, USA.,Brain Research Institute, UCLA, 90095, Los Angeles, CA, USA.,Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong.,State Key Laboratory for Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Yuka Sasaki
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 02912, Providence, RI, USA
| | - Kazuhisa Shibata
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,RIKEN Center for Brain Science, 351-0198, Saitama, Japan
| | - Vincent Taschereau-Dumouchel
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,Department of Psychology, UCLA, 90095, Los Angeles, CA, USA
| | - Takeo Watanabe
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan.,Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 02912, Providence, RI, USA
| | - Mitsuo Kawato
- Computational Neuroscience Labs, ATR Institute International, 619-0288, Kyoto, Japan. .,RIKEN Center for Advanced Intelligence Project, 619-0288, Kyoto, Japan.
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24
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Trambaiolli LR, Kohl SH, Linden DEJ, Mehler DMA. Neurofeedback training in major depressive disorder: A systematic review of clinical efficacy, study quality and reporting practices. Neurosci Biobehav Rev 2021; 125:33-56. [PMID: 33587957 DOI: 10.1016/j.neubiorev.2021.02.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 12/28/2022]
Abstract
Major depressive disorder (MDD) is the leading cause of disability worldwide. Neurofeedback training has been suggested as a potential additional treatment option for MDD patients not reaching remission from standard care (i.e., psychopharmacology and psychotherapy). Here we systematically reviewed neurofeedback studies employing electroencephalography, or functional magnetic resonance-based protocols in depressive patients. Of 585 initially screened studies, 24 were included in our final sample (N = 480 patients in experimental and N = 194 in the control groups completing the primary endpoint). We evaluated the clinical efficacy across studies and attempted to group studies according to the control condition categories currently used in the field that affect clinical outcomes in group comparisons. In most studies, MDD patients showed symptom improvement superior to the control group(s). However, most articles did not comply with the most stringent study quality and reporting practices. We conclude with recommendations on best practices for experimental designs and reporting standards for neurofeedback training.
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Affiliation(s)
- Lucas R Trambaiolli
- Division of Basic Neuroscience, McLean Hospital, Harvard Medical School, Boston, USA.
| | - Simon H Kohl
- JARA Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Germany; Department of Child and Adolescent Psychiatry, Medical Faculty, RWTH Aachen University, Germany
| | - David E J Linden
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
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25
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Direito B, Ramos M, Pereira J, Sayal A, Sousa T, Castelo-Branco M. Directly Exploring the Neural Correlates of Feedback-Related Reward Saliency and Valence During Real-Time fMRI-Based Neurofeedback. Front Hum Neurosci 2021; 14:578119. [PMID: 33613202 PMCID: PMC7893090 DOI: 10.3389/fnhum.2020.578119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/28/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction: The potential therapeutic efficacy of real-time fMRI Neurofeedback has received increasing attention in a variety of psychological and neurological disorders and as a tool to probe cognition. Despite its growing popularity, the success rate varies significantly, and the underlying neural mechanisms are still a matter of debate. The question whether an individually tailored framework positively influences neurofeedback success remains largely unexplored. Methods: To address this question, participants were trained to modulate the activity of a target brain region, the visual motion area hMT+/V5, based on the performance of three imagery tasks with increasing complexity: imagery of a static dot, imagery of a moving dot with two and with four opposite directions. Participants received auditory feedback in the form of vocalizations with either negative, neutral or positive valence. The modulation thresholds were defined for each participant according to the maximum BOLD signal change of their target region during the localizer run. Results: We found that 4 out of 10 participants were able to modulate brain activity in this region-of-interest during neurofeedback training. This rate of success (40%) is consistent with the neurofeedback literature. Whole-brain analysis revealed the recruitment of specific cortical regions involved in cognitive control, reward monitoring, and feedback processing during neurofeedback training. Individually tailored feedback thresholds did not correlate with the success level. We found region-dependent neuromodulation profiles associated with task complexity and feedback valence. Discussion: Findings support the strategic role of task complexity and feedback valence on the modulation of the network nodes involved in monitoring and feedback control, key variables in neurofeedback frameworks optimization. Considering the elaborate design, the small sample size here tested (N = 10) impairs external validity in comparison to our previous studies. Future work will address this limitation. Ultimately, our results contribute to the discussion of individually tailored solutions, and justify further investigation concerning volitional control over brain activity.
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Affiliation(s)
- Bruno Direito
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Manuel Ramos
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
| | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Siemens Healthineers, Lisbon, Portugal
| | - Teresa Sousa
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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26
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The Current Evidence Levels for Biofeedback and Neurofeedback Interventions in Treating Depression: A Narrative Review. Neural Plast 2021; 2021:8878857. [PMID: 33613671 PMCID: PMC7878101 DOI: 10.1155/2021/8878857] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/28/2020] [Accepted: 01/25/2021] [Indexed: 12/22/2022] Open
Abstract
This article is aimed at showing the current level of evidence for the usage of biofeedback and neurofeedback to treat depression along with a detailed review of the studies in the field and a discussion of rationale for utilizing each protocol. La Vaque et al. criteria endorsed by the Association for Applied Psychophysiology and Biofeedback and International Society for Neuroregulation & Research were accepted as a means of study evaluation. Heart rate variability (HRV) biofeedback was found to be moderately supportable as a treatment of MDD while outcome measure was a subjective questionnaire like Beck Depression Inventory (level 3/5, “probably efficacious”). Electroencephalographic (EEG) neurofeedback protocols, namely, alpha-theta, alpha, and sensorimotor rhythm upregulation, all qualify for level 2/5, “possibly efficacious.” Frontal alpha asymmetry protocol also received limited evidence of effect in depression (level 2/5, “possibly efficacious”). Finally, the two most influential real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback protocols targeting the amygdala and the frontal cortices both demonstrate some effectiveness, though lack replications (level 2/5, “possibly efficacious”). Thus, neurofeedback specifically targeting depression is moderately supported by existing studies (all fit level 2/5, “possibly efficacious”). The greatest complication preventing certain protocols from reaching higher evidence levels is a relatively high number of uncontrolled studies and an absence of accurate replications arising from the heterogeneity in protocol details, course lengths, measures of improvement, control conditions, and sample characteristics.
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27
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Lipp A, Cohen Kadosh K. Training the anxious brain: using fMRI-based neurofeedback to change brain activity in adolescence. Dev Med Child Neurol 2020; 62:1239-1244. [PMID: 32638360 DOI: 10.1111/dmcn.14611] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/20/2020] [Accepted: 05/20/2020] [Indexed: 12/17/2022]
Abstract
Anxiety disorders are a leading cause of morbidity and entail a lot of costs. Adolescence is characterized by social fears and poor emotion regulation abilities which together increase the likelihood of the emergence of anxiety disorders. This emotion dysregulation is potentially caused by the emotion regulating brain areas, such as the prefrontal cortex and temporal cortex, that are still undergoing developmental changes throughout late adolescence. Recently, new approaches have used functional magnetic resonance imaging-based neurofeedback to help participants gain control over emotion regulation brain networks by receiving real-time feedback on their brain activity and to use effective emotion regulation abilities. In this review, we provide an overview of the developmental changes in the brain and the corresponding behavioural changes, and explore how these can be influenced during adolescence using neurofeedback. We conclude that recent studies show promising results that children and adolescents can self-regulate emotion regulation brain networks thereby supporting the development of effective emotion regulation abilities. WHAT THIS PAPER ADDS: Functional magnetic resonance imaging-based neurofeedback can be used for brain self-regulation in development. The emotion regulation networks play a key role in treating social anxiety with neurofeedback.
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Affiliation(s)
- Annalisa Lipp
- School of Psychology, University of Surrey, Guildford, UK
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28
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Siehl S, Wicking M, Pohlack S, Winkelmann T, Zidda F, Steiger-White F, King J, Burgess N, Flor H, Nees F. Structural white and gray matter differences in a large sample of patients with Posttraumatic Stress Disorder and a healthy and trauma-exposed control group: Diffusion tensor imaging and region-based morphometry. NEUROIMAGE-CLINICAL 2020; 28:102424. [PMID: 32977211 PMCID: PMC7511745 DOI: 10.1016/j.nicl.2020.102424] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/04/2020] [Accepted: 09/07/2020] [Indexed: 11/02/2022]
Abstract
Differences in structural white and gray matter in survivors of traumatic experiences have been related to the development and maintenance of Posttraumatic Stress Disorder (PTSD). However, there are very few studies on diffusion tensor imaging and region based morphometry comparing patients with PTSD to two control groups, namely healthy individuals with or without trauma experience. It is also unknown if differences in white and gray matter are associated. In this cross-sectional study, we examined white- and gray matter differences between 44 patients with PTSD, 49 trauma control and 61 healthy control subjects. We compared the groups applying Tract-Based Spatial Statistics (TBSS) for a whole brain white matter analysis as well as region of interest analyses for white and gray matter. First, trauma control subjects in comparison to patients with PTSD and healthy control subjects showed significantly a) higher fractional anisotropy (FA) in the left corticospinal tract and inferior fronto-occipital fasciculus than patients with PTSD, b) higher FA in the left inferior fronto-occipital-, right inferior- and right superior longitudinal fasciculi, c) higher FA in the forceps minor and d) higher volume of the left and right anterior insulae. Second, we show significant correlations between the FA in the forceps minor and the gray matter volume in the left and right anterior insulae. Third, the mean FA value in the forceps minor correlated negatively with symptom severity of PTSD and depression as well as trait anxiety, whereas the gray matter volume in the left anterior insula correlated negatively with symptom severity in PTSD. Our findings underline the importance of brain structures critically involved in emotion regulation and salience mapping. While previous studies associated these processes primarily to functional and task-based differences in brain activity, we argue that morphometrical white and gray matter differences could serve as targets in neuroscientifically-informed prevention and treatment interventions for PTSD.
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Affiliation(s)
- Sebastian Siehl
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Graduate School of Economic and Social Sciences, University of Mannheim, Mannheim, Germany; UCL Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
| | - Manon Wicking
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Department of Pain Medicine, BG University Hospital Bergmannsheil GmbH, Ruhr University, Bochum, Germany
| | - Sebastian Pohlack
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Tobias Winkelmann
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Francesca Zidda
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Frauke Steiger-White
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - John King
- UCL Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Clinical, Education and Health Psychology, University College London, London, United Kingdom
| | - Neil Burgess
- UCL Institute of Cognitive Neuroscience, University College London, London, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany
| | - Frauke Nees
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Mannheim, Germany; Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany.
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29
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Kohl SH, Mehler DMA, Lührs M, Thibault RT, Konrad K, Sorger B. The Potential of Functional Near-Infrared Spectroscopy-Based Neurofeedback-A Systematic Review and Recommendations for Best Practice. Front Neurosci 2020; 14:594. [PMID: 32848528 PMCID: PMC7396619 DOI: 10.3389/fnins.2020.00594] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/14/2020] [Indexed: 01/04/2023] Open
Abstract
Background: The effects of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI)-neurofeedback on brain activation and behaviors have been studied extensively in the past. More recently, researchers have begun to investigate the effects of functional near-infrared spectroscopy-based neurofeedback (fNIRS-neurofeedback). FNIRS is a functional neuroimaging technique based on brain hemodynamics, which is easy to use, portable, inexpensive, and has reduced sensitivity to movement artifacts. Method: We provide the first systematic review and database of fNIRS-neurofeedback studies, synthesizing findings from 22 peer-reviewed studies (including a total of N = 441 participants; 337 healthy, 104 patients). We (1) give a comprehensive overview of how fNIRS-neurofeedback training protocols were implemented, (2) review the online signal-processing methods used, (3) evaluate the quality of studies using pre-set methodological and reporting quality criteria and also present statistical sensitivity/power analyses, (4) investigate the effectiveness of fNIRS-neurofeedback in modulating brain activation, and (5) review its effectiveness in changing behavior in healthy and pathological populations. Results and discussion: (1–2) Published studies are heterogeneous (e.g., neurofeedback targets, investigated populations, applied training protocols, and methods). (3) Large randomized controlled trials are still lacking. In view of the novelty of the field, the quality of the published studies is moderate. We identified room for improvement in reporting important information and statistical power to detect realistic effects. (4) Several studies show that people can regulate hemodynamic signals from cortical brain regions with fNIRS-neurofeedback and (5) these studies indicate the feasibility of modulating motor control and prefrontal brain functioning in healthy participants and ameliorating symptoms in clinical populations (stroke, ADHD, autism, and social anxiety). However, valid conclusions about specificity or potential clinical utility are premature. Conclusion: Due to the advantages of practicability and relatively low cost, fNIRS-neurofeedback might provide a suitable and powerful alternative to EEG and fMRI neurofeedback and has great potential for clinical translation of neurofeedback. Together with more rigorous research and reporting practices, further methodological improvements may lead to a more solid understanding of fNIRS-neurofeedback. Future research will benefit from exploiting the advantages of fNIRS, which offers unique opportunities for neurofeedback research.
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Affiliation(s)
- Simon H Kohl
- JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany.,Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - David M A Mehler
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Michael Lührs
- Brain Innovation B.V., Research Department, Maastricht, Netherlands.,Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Robert T Thibault
- School of Psychological Science, University of Bristol, Bristol, United Kingdom.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Kerstin Konrad
- JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Jülich, Germany.,Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Bettina Sorger
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
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30
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Martz ME, Hart T, Heitzeg MM, Peltier SJ. Neuromodulation of brain activation associated with addiction: A review of real-time fMRI neurofeedback studies. Neuroimage Clin 2020; 27:102350. [PMID: 32736324 PMCID: PMC7394772 DOI: 10.1016/j.nicl.2020.102350] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023]
Abstract
Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) has emerged in recent years as an imaging modality used to examine volitional control over targeted brain activity. rtfMRI-nf has also been applied clinically as a way to train individuals to self-regulate areas of the brain, or circuitry, involved in various disorders. One such application of rtfMRI-nf has been in the domain of addictive behaviors, including substance use. Given the pervasiveness of substance use and the challenges of existing treatments to sustain abstinence, rtfMRI-nf has been identified as a promising treatment tool. rtfMRI-nf has also been used in basic science research in order to test the ability to modulate brain function involved in addiction. This review focuses first on providing an overview of recent rtfMRI-nf studies in substance-using populations, specifically nicotine, alcohol, and cocaine users, aimed at reducing craving-related brain activation. Next, rtfMRI-nf studies targeting reward responsivity and emotion regulation in healthy samples are reviewed in order to examine the extent to which areas of the brain involved in addiction can be self-regulated using neurofeedback. We propose that future rtfMRI-nf studies could be strengthened by improvements to study design, sample selection, and more robust strategies in the development and assessment of rtfMRI-nf as a clinical treatment. Recommendations for ways to accomplish these improvements are provided. rtfMRI-nf holds much promise as an imaging modality that can directly target key brain regions involved in addiction, however additional studies are needed in order to establish rtfMRI-nf as an effective, and practical, treatment for addiction.
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Affiliation(s)
- Meghan E Martz
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
| | - Tabatha Hart
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Mary M Heitzeg
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Scott J Peltier
- Functional MRI Laboratory, USA; Department of Biomedical Engineering, Bonisteel Interdisciplinary Research Building, 2360 Bonisteel Blvd, Ann Arbor, MI 48109, USA
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31
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Dobrushina OR, Vlasova RM, Rumshiskaya AD, Litvinova LD, Mershina EA, Sinitsyn VE, Pechenkova EV. Modulation of Intrinsic Brain Connectivity by Implicit Electroencephalographic Neurofeedback. Front Hum Neurosci 2020; 14:192. [PMID: 32655386 PMCID: PMC7324903 DOI: 10.3389/fnhum.2020.00192] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/28/2020] [Indexed: 12/01/2022] Open
Abstract
Despite the increasing popularity of neurofeedback, its mechanisms of action are still poorly understood. This study aims to describe the processes underlying implicit electroencephalographic neurofeedback. Fifty-two healthy volunteers were randomly assigned to a single session of infra-low frequency neurofeedback or sham neurofeedback, with electrodes over the right middle temporal gyrus and the right inferior parietal lobule. They observed a moving rocket, the speed of which was modulated by the waveform derived from a band-limited infra-low frequency filter. Immediately before and after the session, the participants underwent a resting-state fMRI. Network-based statistical analysis was applied, comparing post- vs. pre-session and real vs. sham neurofeedback conditions. As a result, two phenomena were observed. First, we described a brain circuit related to the implicit neurofeedback process itself, consisting of the lateral occipital cortex, right dorsolateral prefrontal cortex, left orbitofrontal cortex, right ventral striatum, and bilateral dorsal striatum. Second, we found increased connectivity between key regions of the salience, language, and visual networks, which is indicative of integration in sensory processing. Thus, it appears that a single session of implicit infra-low frequency electroencephalographic neurofeedback leads to significant changes in intrinsic brain connectivity.
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Affiliation(s)
- Olga R Dobrushina
- Third Neurological Department, Research Center of Neurology, Moscow, Russia.,International Institute of Psychosomatic Health, Moscow, Russia
| | - Roza M Vlasova
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | | | - Liudmila D Litvinova
- Radiology Department, Federal Center of Treatment and Rehabilitation, Moscow, Russia
| | - Elena A Mershina
- Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Valentin E Sinitsyn
- Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Ekaterina V Pechenkova
- Laboratory for Cognitive Research, National Research University Higher School of Economics, Moscow, Russia
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32
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Simões M, Abreu R, Direito B, Sayal A, Castelhano J, Carvalho P, Castelo-Branco M. How much of the BOLD-fMRI signal can be approximated from simultaneous EEG data: relevance for the transfer and dissemination of neurofeedback interventions. J Neural Eng 2020; 17:046007. [DOI: 10.1088/1741-2552/ab9a98] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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33
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Zich C, Johnstone N, Lührs M, Lisk S, Haller SP, Lipp A, Lau JY, Kadosh KC. Modulatory effects of dynamic fMRI-based neurofeedback on emotion regulation networks in adolescent females. Neuroimage 2020; 220:117053. [PMID: 32574803 PMCID: PMC7573536 DOI: 10.1016/j.neuroimage.2020.117053] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 01/01/2023] Open
Abstract
Research has shown that difficulties with emotion regulation abilities in childhood and adolescence increase the risk for developing symptoms of mental disorders, e.g anxiety. We investigated whether functional magnetic resonance imaging (fMRI)-based neurofeedback (NF) can modulate brain networks supporting emotion regulation abilities in adolescent females. We performed three experiments (Experiment 1: N = 18; Experiment 2: N = 30; Experiment 3: N = 20). We first compared different NF implementations regarding their effectiveness of modulating prefrontal cortex (PFC)-amygdala functional connectivity (fc). Further we assessed the effects of fc-NF on neural measures, emotional/metacognitive measures and their associations. Finally, we probed the mechanism underlying fc-NF by examining concentrations of inhibitory and excitatory neurotransmitters. Results showed that NF implementations differentially modulate PFC-amygdala fc. Using the most effective NF implementation we observed important relationships between neural and emotional/metacognitive measures, such as practice-related change in fc was related with change in thought control ability. Further, we found that the relationship between state anxiety prior to the MRI session and the effect of fc-NF was moderated by GABA concentrations in the PFC and anterior cingulate cortex. To conclude, we were able to show that fc-NF can be used in adolescent females to shape neural and emotional/metacognitive measures underlying emotion regulation. We further show that neurotransmitter concentrations moderate fc–NF–effects. Neurofeedback implementations differentially modulate PFC-amygdala connectivity. Functional connectivity neurofeedback affect measures of emotion regulation. Neurotransmitter concentrations moderate neurofeedback effects.
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Affiliation(s)
- Catharina Zich
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK.
| | - Nicola Johnstone
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Michael Lührs
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, 6211 LK, the Netherlands; Department of Research and Development, Brain Innovation, Maastricht, 6229 EV, the Netherlands
| | - Stephen Lisk
- Psychology Department, Institute of Psychiatry, King's College London, London, SE5 8AF, UK
| | - Simone Pw Haller
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
| | - Annalisa Lipp
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Jennifer Yf Lau
- Psychology Department, Institute of Psychiatry, King's College London, London, SE5 8AF, UK
| | - Kathrin Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK; School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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Drori G, Bar-Tal P, Stern Y, Zvilichovsky Y, Salomon R. UnReal? Investigating the Sense of Reality and Psychotic Symptoms with Virtual Reality. J Clin Med 2020; 9:jcm9061627. [PMID: 32481568 PMCID: PMC7355917 DOI: 10.3390/jcm9061627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 12/28/2022] Open
Abstract
Distortions of reality, such as hallucinations, are common symptoms of many psychiatric conditions. Accordingly, sense of reality (SoR), the ability to discriminate between true and false perceptions, is a central criterion in the assessment of neurological and psychiatric health. Despite the critical role of the SoR in daily life, little is known about how this is formed in the mind. Here, we propose a novel theoretical and methodological framework to study the SoR and its relation to psychotic symptoms. In two experiments, we employed a specialized immersive virtual reality (VR) environment allowing for well-controlled manipulations of visual reality. We first tested the impact of manipulating visual reality on objective perceptual thresholds (just noticeable differences). In a second experiment, we tested how these manipulations affected subjective judgments of reality. The results revealed that the objective perceptual thresholds were robust and replicable, demonstrating that SoR is a stable psychometric property that can be measured experimentally. Furthermore, reality alterations reduced subjective reality judgments across all manipulated visual aspects. Finally, reduced sensitivity to changes in visual reality was related to self-reported prodromal psychotic symptoms. These results provide evidence for the relevance of SoR in the assessment of psychosis and other mental disorders in which reality is distorted.
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Affiliation(s)
- Gad Drori
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (P.B.-T.); (Y.S.); (Y.Z.); (R.S.)
- Correspondence:
| | - Paz Bar-Tal
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (P.B.-T.); (Y.S.); (Y.Z.); (R.S.)
| | - Yonatan Stern
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (P.B.-T.); (Y.S.); (Y.Z.); (R.S.)
- Psychology Department, University of Haifa, Haifa 3498838, Israel
| | - Yair Zvilichovsky
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (P.B.-T.); (Y.S.); (Y.Z.); (R.S.)
| | - Roy Salomon
- Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel; (P.B.-T.); (Y.S.); (Y.Z.); (R.S.)
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Bacomics: a comprehensive cross area originating in the studies of various brain-apparatus conversations. Cogn Neurodyn 2020; 14:425-442. [PMID: 32655708 DOI: 10.1007/s11571-020-09577-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/17/2020] [Accepted: 03/05/2020] [Indexed: 12/20/2022] Open
Abstract
The brain is the most important organ of the human body, and the conversations between the brain and an apparatus can not only reveal a normally functioning or a dysfunctional brain but also can modulate the brain. Here, the apparatus may be a nonbiological instrument, such as a computer, and the consequent brain-computer interface is now a very popular research area with various applications. The apparatus may also be a biological organ or system, such as the gut and muscle, and their efficient conversations with the brain are vital for a healthy life. Are there any common bases that bind these different scenarios? Here, we propose a new comprehensive cross area: Bacomics, which comes from brain-apparatus conversations (BAC) + omics. We take Bacomics to cover at least three situations: (1) The brain is normal, but the conversation channel is disabled, as in amyotrophic lateral sclerosis. The task is to reconstruct or open up new channels to reactivate the brain function. (2) The brain is in disorder, such as in Parkinson's disease, and the work is to utilize existing or open up new channels to intervene, repair and modulate the brain by medications or stimulation. (3) Both the brain and channels are in order, and the goal is to enhance coordinated development between the brain and apparatus. In this paper, we elaborate the connotation of BAC into three aspects according to the information flow: the issue of output to the outside (BAC-1), the issue of input to the brain (BAC-2) and the issue of unity of brain and apparatus (BAC-3). More importantly, there are no less than five principles that may be taken as the cornerstones of Bacomics, such as feedforward and feedback control, brain plasticity, harmony, the unity of opposites and systems principles. Clearly, Bacomics integrates these seemingly disparate domains, but more importantly, opens a much wider door for the research and development of the brain, and the principles further provide the general framework in which to realize or optimize these various conversations.
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Misaki M, Tsuchiyagaito A, Al Zoubi O, Paulus M, Bodurka J. Connectome-wide search for functional connectivity locus associated with pathological rumination as a target for real-time fMRI neurofeedback intervention. Neuroimage Clin 2020; 26:102244. [PMID: 32193171 PMCID: PMC7082218 DOI: 10.1016/j.nicl.2020.102244] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/28/2020] [Accepted: 03/11/2020] [Indexed: 02/08/2023]
Abstract
Real-time fMRI neurofeedback (rtfMRI-nf) enables noninvasive targeted intervention in brain activation with high spatial specificity. To achieve this promise of rtfMRI-nf, we introduced and demonstrated a data-driven framework to design a rtfMRI-nf intervention through the discovery of precise target location associated with clinical symptoms and neurofeedback signal optimization. Specifically, we identified the functional connectivity locus associated with rumination symptoms, utilizing a connectome-wide search in resting-state fMRI data from a large cohort of mood and anxiety disorder individuals (N = 223) and healthy controls (N = 45). Then, we performed a rtfMRI simulation analysis to optimize the online functional connectivity neurofeedback signal for the identified functional connectivity. The connectome-wide search was performed in the medial prefrontal cortex and the posterior cingulate cortex/precuneus brain regions to identify the precise location of the functional connectivity associated with rumination severity as measured by the ruminative response style (RRS) scale. The analysis found that the functional connectivity between the loci in the precuneus (-6, -54, 48 mm in MNI) and the right temporo-parietal junction (RTPJ; 49, -49, 23 mm) was positively correlated with RRS scores (depressive, p < 0.001; brooding, p < 0.001; reflective, p = 0.002) in the mood and anxiety disorder group. We then performed a rtfMRI processing simulation to optimize the online computation of the precuneus-RTPJ connectivity. We determined that the two-point method without a control region was appropriate as a functional connectivity neurofeedback signal with less dependence on signal history and its accommodation of head motion. The present study offers a discovery framework for the precise location of functional connectivity targets for rtfMRI-nf intervention, which could help directly translate neuroimaging findings into clinical rtfMRI-nf interventions.
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Affiliation(s)
- Masaya Misaki
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, United States.
| | - Aki Tsuchiyagaito
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, United States; Japan Society for the Promotion of Science, Tokyo, Japan
| | - Obada Al Zoubi
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, United States; Department of Electrical and Computer Engineering, University of Oklahoma, Tulsa, Oklahoma, United States
| | - Martin Paulus
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, 6655 South Yale Avenue, Tulsa, OK 74136, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.
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De Raedt R. Contributions from neuroscience to the practice of Cognitive Behaviour Therapy: Translational psychological science in service of good practice. Behav Res Ther 2020; 125:103545. [DOI: 10.1016/j.brat.2019.103545] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/25/2019] [Accepted: 12/29/2019] [Indexed: 01/12/2023]
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Morgenroth E, Saviola F, Gilleen J, Allen B, Lührs M, W Eysenck M, Allen P. Using connectivity-based real-time fMRI neurofeedback to modulate attentional and resting state networks in people with high trait anxiety. NEUROIMAGE-CLINICAL 2020; 25:102191. [PMID: 32044712 PMCID: PMC7013190 DOI: 10.1016/j.nicl.2020.102191] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 11/25/2022]
Abstract
Controlled experiment on functional connectivity-based real-time fMRI neurofeedback. Reduced anxiety levels in the experimental group after neurofeedback training. Altered activity and connectivity in neurofeedback ROIs in the experimental group. Increased resting state functional connectivity in the PCC in the experimental group.
High levels of trait anxiety are associated with impaired attentional control, changes in brain activity during attentional control tasks and altered network resting state functional connectivity (RSFC). Specifically, dorsolateral prefrontal cortex to anterior cingulate cortex (DLPFC – ACC) functional connectivity, thought to be crucial for effective and efficient attentional control, is reduced in high trait anxious individuals. The current study examined the potential of connectivity-based real-time functional magnetic imaging neurofeedback (rt-fMRI-nf) for enhancing DLPFC – ACC functional connectivity in trait anxious individuals. We specifically tested if changes in DLPFC - ACC connectivity were associated with reduced anxiety levels and improved attentional control. Thirty-two high trait anxious participants were assigned to either an experimental group (EG), undergoing veridical rt-fMRI-nf, or a control group (CG) that received sham (yoked) feedback. RSFC (using resting state fMRI), anxiety levels and Stroop task performance were assessed pre- and post-rt-fMRI-nf training. Post-rt-fMRI-nf training, relative to the CG, the EG showed reduced anxiety levels and increased DLPFC-ACC functional connectivity as well as increased RSFC in the posterior default mode network. Moreover, in the EG, changes in DLPFC – ACC functional connectivity during rt-fMRI-nf training were associated with reduced anxiety levels. However, there were no group differences in Stroop task performance. We conclude that rt-fMRI-nf targeting DLPFC – ACC functional connectivity can alter network connectivity and interactions and is a feasible method for reducing trait anxiety.
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Affiliation(s)
- Elenor Morgenroth
- Ecole Polytechnique Federale, Lausanne, Switzerland; Department of Psychology, University of Roehampton, Whitelands College, Hollybourne Avenue, London SW15 4JD, UK.
| | - Francesca Saviola
- CIMeC, Center for Mind/Brain Sciences, University of Trento, Rovereto (Trento), Italy
| | - James Gilleen
- Department of Psychology, University of Roehampton, Whitelands College, Hollybourne Avenue, London SW15 4JD, UK
| | - Beth Allen
- Department of Psychology, Royal Holloway University of London, London, UK
| | - Michael Lührs
- Research Department, Brain Innovation B.V., Maastricht, Netherlands; Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Michael W Eysenck
- Department of Psychology, University of Roehampton, Whitelands College, Hollybourne Avenue, London SW15 4JD, UK; Department of Psychology, Royal Holloway University of London, London, UK
| | - Paul Allen
- Department of Psychology, University of Roehampton, Whitelands College, Hollybourne Avenue, London SW15 4JD, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Combined Universities Brain Imaging Centre, London, UK; Icahn School of Medicine, Mount Sinai Hospital, New York, NY, USA
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Misaki M, Phillips R, Zotev V, Wong CK, Wurfel BE, Krueger F, Feldner M, Bodurka J. Brain activity mediators of PTSD symptom reduction during real-time fMRI amygdala neurofeedback emotional training. Neuroimage Clin 2019; 24:102047. [PMID: 31711031 PMCID: PMC6849428 DOI: 10.1016/j.nicl.2019.102047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/08/2019] [Accepted: 10/21/2019] [Indexed: 11/20/2022]
Abstract
Self-regulation of brain activation with real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) is emerging as a promising treatment for psychiatric disorders. The association between the regulation and symptom reduction, however, has not been consistent, and the mechanisms underlying the symptom reduction remain poorly understood. The present study investigated brain activity mediators of the amygdala rtfMRI-nf training effect on combat veterans' PTSD symptom reduction. The training was designed to increase a neurofeedback signal either from the left amygdala (experimental group; EG) or from a control region not implicated in emotion regulation (control group; CG) during positive autobiographical memory recall. We employed a structural equation model mapping analysis to identify brain regions that mediated the effects of the rtfMRI-nf training on PTSD symptoms. Symptom reduction was mediated by low activation in the dorsomedial prefrontal cortex (DMPFC) and the middle cingulate cortex. There was a trend toward less activation in these regions for the EG compared to the CG. Low activation in the precuneus, the right superior parietal, the right insula, and the right cerebellum also mediated symptom reduction while their effects were moderated by the neurofeedback signal; a higher signal was linked to less effect on symptom reduction. This moderation was not specific to the EG. MDD comorbidity was associated with high DMPFC activation, which resulted in less effective regulation of the feedback signal. These results indicated that symptom reduction due to the neurofeedback training was not specifically mediated by the neurofeedback target activity, but broad regions were involved in the process.
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Affiliation(s)
- Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Raquel Phillips
- Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Chung-Ki Wong
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Brent E Wurfel
- Laureate Institute for Brain Research, Tulsa, OK, United States; Laureate Psychiatric Clinic and Hospital, Tulsa, OK, United States
| | - Frank Krueger
- Neuroscience Department, George Mason University, Fairfax, VA, United States
| | - Matthew Feldner
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, United States.
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