Control over brain activation and pain learned by using real-time functional MRI

Abstract

If an individual can learn to directly control activation of localized regions within the brain, this approach might provide control over the neurophysiological mechanisms that mediate behavior and cognition and could potentially provide a different route for treating disease. Control over the endogenous pain modulatory system is a particularly important target because it could enable a unique mechanism for clinical control over pain. Here, we found that by using real-time functional MRI (rtfMRI) to guide training, subjects were able to learn to control activation in the rostral anterior cingulate cortex (rACC), a region putatively involved in pain perception and regulation. When subjects deliberately induced increases or decreases in rACC fMRI activation, there was a corresponding change in the perception of pain caused by an applied noxious thermal stimulus. Control experiments demonstrated that this effect was not observed after similar training conducted without rtfMRI information, or using rtfMRI information derived from a different brain region, or sham rtfMRI information derived previously from a different subject. Chronic pain patients were also trained to control activation in rACC and reported decreases in the ongoing level of chronic pain after training. These findings show that individuals can gain voluntary control over activation in a specific brain region given appropriate training, that voluntary control over activation in rACC leads to control over pain perception, and that these effects were powerful enough to impact severe, chronic clinical pain.anterior cingulate cortex ͉ plasticity

The self-regulating brain and neurofeedback: Experimental science and clinical promise

“…One of the early and most notable rtfMRI-nf studies implemented a careful design and reported robust findings that subsequently sparked considerable enthusiasm (deCharms et al, 2005). This study demonstrated that individuals who suffered from chronic pain and received veritable rtfMRI-nf learned to modulate neural activity in the rostral ACC.…”

“…Likewise, multiple experiments train down-regulation of the ACC to mitigate pain (deCharms et al, 2005;Guan et al, 2015) or inhibit cigarette cravings (Canterberry et al, 2013;Li et al, 2012), while others encourage ACC activity to heighten valence ratings (Gröne et al, 2015) or limit the effects of cognitive interference (Mathiak et al, 2010). Thus, researchers are already training regulation in opposite directions, but shy away from directly comparing the behavioral effects of up-versus down-regulation using a specific pattern of brain activity.…”

Neurofeedback fMRI‐mediated learning and consolidation of regional brain activation during motor imagery

“…In addition to its excellent spatial resolution and its non-invasive nature, real-time (rtfMRI) or near real-time processing of fMRI data [Cox et al, 1995;Yoo et al, 1999] has provided a means for individuals to receive information relating to the state of their own brain activity [Posse et al, 2003;Weiskopf et al, 2003]. For example, fMRI was applied for the regulation of painrelated activity in rostral-ventral/dorsal parts of the anterior cingulate cortex [deCharms et al, 2005]. Posse et al [2003] studied the feasibility of inducing human emotion by measuring the MR signal changes associated with amygdala activation.…”

Real‐time fMRI using brain‐state classification

“…Simultaneously, continued advances in MR imaging systems and experimental sophistication with blood oxygenation level dependent (BOLD) [Ogawa et al, 1990a,b] imaging have led to the emergence of real-time fMRI as a viable tool for real-time biofeedback [deCharms et al, 2004[deCharms et al, , 2005Posse et al, 2003;Weiskopf et al, 2003;Yoo et al, 2004;Yoo and Jolesz, 2002]. The most recent work of deCharms et al [2005] represents a particularly compelling example of the utility of real-time fMRI for therapeutic applications.…”