Real-Time fMRI Neurofeedback with War Veterans with Chronic PTSD: A Feasibility Study

Gerin, Mattia Indi; Fichtenholtz, Harlan M.; Roy, Alicia; Walsh, Christopher J.; Krystal, John H.; Southwick, Steven M.; Hampson, Michelle

doi:10.3389/fpsyt.2016.00111

Cited by 65 publications

(92 citation statements)

References 85 publications

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“…This could include cognitive and behavioral interventions (i.e., mindfulness or cognitive training to enhance regulation of attention), as well as neuromodulation techniques. Recent studies suggest that fMRI-based amygdala neurofeedback may beneficially impact depression (Yuan et al, 2014; Zotev et al, 2016) and PTSD (Gerin et al, 2016). Additionally, there have been recent developments supporting the use of neurofeedback with entire networks (i.e., DMN) rather than individual regions (Ruiz, Buyukturkoglu, Rana, Birbaumer, & Sitaram, 2014).…”

Section: Discussionmentioning

confidence: 99%

PTSD and cognitive symptoms relate to inhibition-related prefrontal activation and functional connectivity

et al. 2017

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Background Posttraumatic stress disorder (PTSD) is associated with reduced executive functioning and verbal memory performance, as well as abnormal task-specific activity in prefrontal (PFC) and anterior cingulate cortices (ACC). The current study examined how PTSD symptoms and neuropsychological performance in combat veterans relates to 1) medial PFC and ACC activity during cognitive inhibition, and 2) task-independent PFC functional connectivity. Methods Thirty-nine male combat veterans with varying levels of PTSD symptoms completed the multisource interference task during functional magnetic resonance imaging. Robust regression analyses were used to assess relationships between percent signal change (PSC: Incongruent-Congruent) and both PTSD severity and neuropsychological performance. Analyses were conducted voxel-wise and for PSC extracted from medial PFC and ACC regions of interest. Resting state scans were available for veterans with PTSD. Regions identified via task-based analyses were used as seeds for resting state connectivity analyses. Results Worse PTSD severity and neuropsychological performance related to less medial PFC and rostral ACC activity during interference processing, driven partly by increased activation to congruent trials. Worse PTSD severity related to reduced functional connectivity between these regions and bilateral, lateral PFC (Brodmann area 10). Worse neuropsychological performance related to reduced functional connectivity between these regions and the inferior frontal gyrus. Conclusions PTSD and associated neuropsychological deficits may result from difficulties regulating medial PFC regions associated with “default mode”, or self-referential processing. Further clarification of functional coupling deficits between default mode and executive control networks in PTSD may enhance understanding of neuropsychological and emotional symptoms and provide novel treatment targets.

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Section: Discussionmentioning

confidence: 99%

PTSD and cognitive symptoms relate to inhibition-related prefrontal activation and functional connectivity

et al. 2017

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“…Although some evidence suggests that this technique reduces emotional reactivity to the trauma memory [95], findings in this newer area of research are very preliminary and somewhat conflicted [39]. Innovative treatments outside the realms of psychotherapy and pharmacotherapy, such as neuronal feedback and brain stimulation techniques [96], are also being explored and may help reduce PTSD symptoms, particularly in treatment-resistant patients. …”

Section: Summary and Future Directionsmentioning

confidence: 99%

Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment

Lancaster

Teeters

Grös

et al. 2016

JCM

131

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Posttraumatic stress disorder (PTSD) is a chronic psychological disorder that can develop after exposure to a traumatic event. This review summarizes the literature on the epidemiology, assessment, and treatment of PTSD. We provide a review of the characteristics of PTSD along with associated risk factors, and describe brief, evidence-based measures that can be used to screen for PTSD and monitor symptom changes over time. In regard to treatment, we highlight commonly used, evidence-based psychotherapies and pharmacotherapies for PTSD. Among psychotherapeutic approaches, evidence-based approaches include cognitive-behavioral therapies (e.g., Prolonged Exposure and Cognitive Processing Therapy) and Eye Movement Desensitization and Reprocessing. A wide variety of pharmacotherapies have received some level of research support for PTSD symptom alleviation, although selective serotonin reuptake inhibitors have the largest evidence base to date. However, relapse may occur after the discontinuation of pharmacotherapy, whereas PTSD symptoms typically remain stable or continue to improve after completion of evidence-based psychotherapy. After reviewing treatment recommendations, we conclude by describing critical areas for future research.

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“…More clinically, neurofeedback has been used to teach war veterans suffering from post-traumatic stress disorder (PTSD) to regulate activity in their amygdala (responsible for emotion) to produce a meaningful decrease in clinical symptomatology [47]. Additionally, a set of patients with post-herpetic neuralgia (chronic nerve pain) were taught via neurofeedback to regulate the regional activity of the rostral anterior cingulate cortex (thought to be involved in pain perception), to successfully decrease their level of perceived pain [48].…”

Section: Neurofeedback In Diseasementioning

confidence: 99%

A network neuroscience of neurofeedback for clinical translation

Murphy

Bassett

2017

Current Opinion in Biomedical Engineering

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In the emerging field of network neuroscience, the brain is represented as a network of discrete yet functionally and structurally interconnected areas. Mathematical and computational tools to characterize the organization of this network can provide insights into the principles guiding brain structure and function, and can pinpoint differences between healthy individuals and individuals suffering from psychiatric disease or neurological disorders. The field is now faced with the question of how to devise clinical interventions that target these network alterations. Potential solutions to this question include the combination of emerging theories of network control with cutting-edge interventions such as neurofeedback. Each of these techniques may now be mature enough to combine to obtain a theoretically-motivated framework informing viable neuropsychiatric therapies.

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Real-Time fMRI Neurofeedback with War Veterans with Chronic PTSD: A Feasibility Study

Cited by 65 publications

References 85 publications

PTSD and cognitive symptoms relate to inhibition-related prefrontal activation and functional connectivity

PTSD and cognitive symptoms relate to inhibition-related prefrontal activation and functional connectivity

Posttraumatic Stress Disorder: Overview of Evidence-Based Assessment and Treatment

A network neuroscience of neurofeedback for clinical translation

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