Maintenance of Voluntary Self-regulation Learned through Real-Time fMRI Neurofeedback

Robineau, Fabien; Meskaldji, Djalel Eddine; Koush, Yury; Rieger, Sebastian Walter; Mermoud, Christophe; Morgenthaler, Stephan; Ville, Dimitri Van De; Vuilleumier, Patrik; Scharnowski, Frank

doi:10.3389/fnhum.2017.00131

Cited by 28 publications

(39 citation statements)

References 44 publications

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“…These findings are in line with previous studies evaluating transfer and maintenance effects of rt-fMRI NF-assisted control over regional brain activity [31, 75], and additionally suggest that successful neuromodulatory control on the pathway level can last beyond the duration of the initial training and thus transfer to contexts outside of the MRI environment. However, despite maintenance of the neural training success, attenuation of anxiety levels following the training of the target pathway as observed on day 1 was not maintained over the follow-up period [for similar results, see 31].…”

Section: Discussionsupporting

confidence: 80%

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Zhao

Yao

et al. 2019

Psychother Psychosom

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Background: Deficient emotion regulation and exaggerated anxiety represent a major transdiagnostic psychopathological marker. On the neural level these deficits have been closely linked to impaired, yet treatment-sensitive, prefrontal regulatory control over the amygdala. Gaining direct control over these pathways could therefore provide an innovative and promising intervention to regulate exaggerated anxiety. To this end the current proof-of-concept study evaluated the feasibility, functional relevance and maintenance of a novel connectivity-informed real-time fMRI neurofeedback training. Methods: In a randomized crossover sham-controlled design, 26 healthy subjects with high anxiety underwent real-time fMRI-guided neurofeedback training to enhance connectivity between the ventrolateral prefrontal cortex (vlPFC) and the amygdala (target pathway) during threat exposure. Maintenance of regulatory control was assessed after 3 days and in the absence of feedback. Training-induced changes in functional connectivity of the target pathway and anxiety ratings served as primary outcomes. Results: Training of the target, yet not the sham control, pathway significantly increased amygdala-vlPFC connectivity and decreased levels of anxiety. Stronger connectivity increases were significantly associated with higher anxiety reduction on the group level. At the follow-up, volitional control over the target pathway was maintained in the absence of feedback. Conclusions: The present results demonstrate for the first time that successful self-regulation of amygdala-prefrontal top-down regulatory circuits may represent a novel intervention to control anxiety. As such, the present findings underscore both the critical contribution of amygdala-prefrontal circuits to emotion regulation and the therapeutic potential of connectivity-informed real-time neurofeedback.

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Section: Discussionsupporting

confidence: 80%

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Zhao

Yao

et al. 2019

Psychother Psychosom

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“…Of particular relevance for the application of NF-training approaches in clinical practice (30,60,61), the present study observed that subjects were able to maintain the control over the emotion regulation pathway and its effect on anxiety decrease in the absence of feedback and for a period of at least three days. These findings are in line with previous studies evaluating transfer and maintenance effects of rt-fMRI NF-assisted control over regional brain activity (31,62), and additionally suggest that successful neuro-modulatory control on the pathway-level can last beyond the duration of the initial training and thus transfer to contexts outside of the MRI-environment.…”

Section: Discussionsupporting

confidence: 91%

Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety

Zhao

Yao

et al. 2018

Preprint

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Deficient emotion regulation and exaggerated anxiety represent a major transdiagnostic psychopathological marker. On the neural level these deficits have been closely linked to impaired, yet treatment-sensitive, prefrontal regulatory control over the amygdala. Gaining direct control over these pathways could therefore provide an innovative and promising strategy to regulate exaggerated anxiety. To this end the current proof-of-concept study evaluated the feasibility, functional relevance and maintenance of a novel connectivityinformed real-time fMRI neurofeedback training. In a randomized within-subject shamcontrolled design high anxious subjects (n = 26) underwent real-time fMRI-guided training to enhance connectivity between the ventrolateral prefrontal cortex (vlPFC) and the amygdala (target pathway) during threat exposure. Maintenance of regulatory control was assessed after three days and in the absence of feedback. Training-induced changes in functional connectivity of the target pathway and anxiety ratings served as primary outcomes. Training of the target, yet not the sham-control, pathway significantly increased amygdala-vlPFC connectivity and decreased subjective anxiety levels. On the individual level stronger connectivity increases were significantly associated with anxiety reduction. At follow-up, volitional control over the target pathway and decreased anxiety level were maintained in the absence of feedback. The present results demonstrate for the first time that successful self-regulation of amygdala-prefrontal top-down regulatory circuits may represent a novel strategy to control anxiety. As such, the present findings underscore both the critical contribution of amygdala-prefrontal circuits to emotion regulation and the therapeutic potential of connectivity-informed real-time neurofeedback.

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“…This continued improvement after neurofeedback training has been demonstrated in as little time as 1 day (Harmelech et al, 2013). Ability to regulate neural activity in a transfer task after rt-fMRI neurofeedback has been demonstrated to be maintained as long as 14 months (Robineau et al, 2017). Despite this, only 41 of the published studies collected and reported follow-up data (see Figure 8B for the distribution of time to follow up for these studies).…”

Section: Discussionmentioning

confidence: 99%

A Guide to Literature Informed Decisions in the Design of Real Time fMRI Neurofeedback Studies: A Systematic Review

Fede

Dean

Manuweera

et al. 2020

Front. Hum. Neurosci.

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Background: Although biofeedback using electrophysiology has been explored extensively, the approach of using neurofeedback corresponding to hemodynamic response is a relatively young field. Real time functional magnetic resonance imaging-based neurofeedback (rt-fMRI-NF) uses sensory feedback to operantly reinforce patterns of neural response. It can be used, for example, to alter visual perception, increase brain connectivity, and reduce depression symptoms. Within recent years, interest in rt-fMRI-NF in both research and clinical contexts has expanded considerably. As such, building a consensus regarding best practices is of great value. Objective: This systematic review is designed to describe and evaluate the variations in methodology used in previous rt-fMRI-NF studies to provide recommendations for rt-fMRI-NF study designs that are mostly likely to elicit reproducible and consistent effects of neurofeedback. Methods: We conducted a database search for fMRI neurofeedback papers published prior to September 26th, 2019. Of 558 studies identified, 146 met criteria for inclusion. The following information was collected from each study: sample size and type, task used, neurofeedback calculation, regulation procedure, feedback, whether feedback was explicitly related to changing brain activity, feedback timing, control group for active neurofeedback, how many runs and sessions of neurofeedback, if a follow-up was conducted, and the results of neurofeedback training. Results: rt-fMRI-NF is typically upregulation practice based on hemodynamic response from a specific region of the brain presented using a continually updating thermometer display. Most rt-fMRI-NF studies are conducted in healthy samples and half evaluate its effect on immediate changes in behavior or affect. The most popular control group method is to provide sham signal from another region; however, many studies do not compare use a comparison group. Conclusions: We make several suggestions for designs of future rt-fMRI-NF studies. Researchers should use feedback calculation methods that consider neural response across regions (i.e., SVM or connectivity), which should be conveyed as intermittent, Fede et al. Neurofeedback Guide auditory feedback. Participants should be given explicit instructions and should be assessed on individual differences. Future rt-fMRI-NF studies should use clinical samples; effectiveness of rt-fMRI-NF should be evaluated on clinical/behavioral outcomes at follow-up time points in comparison to both a sham and no feedback control group.

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Maintenance of Voluntary Self-regulation Learned through Real-Time fMRI Neurofeedback

Cited by 28 publications

References 44 publications

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety

A Guide to Literature Informed Decisions in the Design of Real Time fMRI Neurofeedback Studies: A Systematic Review

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