Alpha oscillation neurofeedback modulates amygdala complex connectivity and arousal in posttraumatic stress disorder

Abstract

ObjectiveElectroencephalogram (EEG) neurofeedback aimed at reducing the amplitude of the alpha-rhythm has been shown to alter neural networks associated with posttraumatic stress disorder (PTSD), leading to symptom alleviation. Critically, the amygdala is thought to be one of the central brain regions mediating PTSD symptoms. In the current study, we compare directly patterns of amygdala complex connectivity using fMRI, before and after EEG neurofeedback, in order to observe subcortical mechanisms associated with behavioural and alpha oscillatory changes among patients.MethodWe examined basolateral (BLA), centromedial (CMA), and superficial (SFA) amygdala complex resting-state functional connectivity using a seed-based approach via SPM Anatomy Toolbox. Amygdala complex connectivity was measured in twenty-one individuals with PTSD, before and after a 30-minute session of EEG neurofeedback targeting alpha desynchronization.ResultsEEG neurofeedback was associated with a shift in amygdala complex connectivity from areas implicated in defensive, emotional, and fear processing/memory retrieval (left BLA and left SFA to the periaqueductal gray, and left SFA to the left hippocampus) to prefrontal areas implicated in emotion regulation/modulation (right CMA to the medial prefrontal cortex). This shift in amygdala complex connectivity was associated with reduced arousal, greater resting alpha synchronization, and was negatively correlated to PTSD symptom severity.ConclusionThese findings have significant implications for developing targeted non-invasive treatment interventions for PTSD patients that utilize alpha oscillatory neurofeedback, showing evidence of neuronal reconfiguration between areas highly implicated in the disorder, in addition to acute symptom alleviation.

The neurobiology of emotion regulation in posttraumatic stress disorder: Amygdala downregulation via real‐time fMRI neurofeedback

“…Interestingly, these rt-fMRI results parallel those found with a different modality of neurofeedback (EEG), where one 30-minute session of alpha desynchronizing EEG-nf was shown to shift amygdala complex connectivity away from fear/defense processing and memory regions towards prefrontal emotion regulation areas after intervention [Nicholson et al, 2016b]. Further, consistent with our predictions, we found that PFC, rostral ACC, and insula activation was correlated negatively to PTSD dissociative symptoms during the transfer run.…”

“…Here, PTSD symptom severity positively correlated to the degree of amygdala downregulation during training runs 1 and 3, suggesting that patients with more severe PTSD symptoms actually decrease amygdala activity more during neurofeedback. Interestingly, these rt-fMRI results parallel those found with a different modality of neurofeedback (EEG), where one 30-minute session of alpha desynchronizing EEG-nf was shown to shift amygdala complex connectivity away from fear/defense processing and memory regions towards prefrontal emotion regulation areas after intervention [Nicholson et al, 2016b].…”

“…Indeed, the efficacy of electroencephalography neurofeedback (EEG-nf) targeting these regions has already been illustrated Reiter et al, 2016]. Specifically, one 30-minute session of alpha desynchronizing EEG-nf was shown to shift amygdala complex connectivity away from fear/defense processing and memory regions towards prefrontal emotion regulation areas after intervention [Nicholson et al, 2016b]. Specifically, one 30-minute session of alpha desynchronizing EEG-nf was shown to shift amygdala complex connectivity away from fear/defense processing and memory regions towards prefrontal emotion regulation areas after intervention [Nicholson et al, 2016b].…”

“…Here, EEG-nf has been shown to plastically modify the aforementioned neural circuitry mediating PTSD, leading to acute symptom alleviation . Specifically, one 30-minute session of alpha desynchronizing EEG-nf was shown to shift amygdala complex connectivity away from fear/defense processing and memory regions towards prefrontal emotion regulation areas after intervention [Nicholson et al, 2016b]. In contrast to EEG-nf, realtime fMRI neurofeedback (rt-fMRI-nf) offers enhanced spatial resolution thereby increasing potential for targeted treatment.…”

Real‐time fMRI neurofeedback of the mediodorsal and anterior thalamus enhances correlation between thalamic BOLD activity and alpha EEG rhythm

“…Studies utilizing EEG-nf for upregulation of alpha (or upper alpha) EEG power have demonstrated improvements in participants' cognitive and memory performance, including working memory and short term memory (Escolano et al, 2014;Hanslmayr, Sauseng, Doppelmayr, Schabus, & Klimesch, 2005;Hsueh, Chen, Chen, & Shaw, 2016;Nan et al, 2012;Zoefel, Huster, & Herrmann, 2011). Changes in resting fMRI functional connectivity following alpha EEG-nf training have also been reported (Kluetsch et al, 2014;Nicholson et al, 2016).…”