Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept
| Autor: | Michael Krasnoshtein, Tom Fruchtman-Steinbok, Talma Hendler, Iman Jaljuli, Avihay Cohen, Efrat Routledge, Rebecca Playle, Shiri Mermelstein, David Edmund Johannes Linden, Jackob N. Keynan, Gadi Drori |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Cognitive Neuroscience Computer applications to medicine. Medical informatics Spontaneous recovery education R858-859.7 Electroencephalography Traumatic memories Placebo Amygdala behavioral disciplines and activities law.invention Stress Disorders Post-Traumatic Physical medicine and rehabilitation Randomized controlled trial law Medicine Humans Learning Radiology Nuclear Medicine and imaging EEG RC346-429 Limbic activity medicine.diagnostic_test business.industry Neuromodulation fMRI Traumatic stress Regular Article Neurofeedback Magnetic Resonance Imaging medicine.anatomical_structure Neurology nervous system Self-regulation Neurology. Diseases of the nervous system Neurology (clinical) business psychological phenomena and processes |
| Zdroj: | NeuroImage : Clinical NeuroImage: Clinical, Vol 32, Iss, Pp 102859-(2021) |
| ISSN: | 2213-1582 |
| Popis: | Highlights • 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. |
| Databáze: | OpenAIRE |
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