Feasibility and Effectiveness of Personalized Amygdala-related Neurofeedback for Post-Traumatic Stress Disorder
| Autor: | Jaljuli I, Krasnoshtein M, Keynan Jn, Routledge E, Hendler T, Avihay Cohen, Drori G, Fruchtman T |
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| Rok vydání: | 2019 |
| Předmět: |
PsyArXiv|Neuroscience|Clinical Neuroscience
medicine.medical_specialty business.industry Traumatic stress Amygdala bepress|Life Sciences|Neuroscience and Neurobiology Text mining Physical medicine and rehabilitation medicine.anatomical_structure PsyArXiv|Neuroscience PsyArXiv|Psychiatry Medicine bepress|Medicine and Health Sciences|Medical Specialties|Psychiatry Neurofeedback business |
| Popis: | Post-traumatic stress disorder (PTSD) is characterized by excessive emotion reactivity and diminished emotion regulation, corresponding to hyperactive amygdala and hypoactive ventro-medial pre-frontal cortex (vmPFC). Non-specific targeting of these process abnormalities might explain the currently moderate efficacy of therapeutic interventions in PTSD. This study introduces a randomized controlled trial (NCT02544971) with a neurofeedback (NF) intervention for PTSD patients, aimed at down-regulating amygdala activity. To target a disorder-specific process we applied individually-tailored trauma-related content as the learning feedback, allowing for personalized process-based NF. The effect of trauma content (Trauma-NF) was evaluated in comparison to a neutral feedback condition (Neutral-NF) and the intervention effect was controlled for by a No-NF condition. To scale-up applicability, neural activity was probed by an fMRI-inspired EEG model of the amygdala; Amygdala Electrical Finger Print (AmygEFP). All PTSD patients were assessed before and after treatment for clinical severity (primary: CAPS-5 and PCL) and neural-target engagement through amygdala fMRI-NF session. Results showed that patients in the treatment arm learned to volitionally down-regulate their AmygEFP signal and demonstrated reduction in PTSD symptoms, compared to the No-NF arm. Intriguingly, NF with personalized trauma interface presented the steepest NF learning over sessions and the largest clinical improvement (NNT=2.7). Superior down-regulation of amygdala BOLD signal during fMRI-NF following the intervention in the treatment arm, compared to No-NF, supported target engagement. These results demonstrate the potential of integrating self-neuromodulation with disorder-specific content to enhance clinical efficacy and specificity, and further establishes the AmygEFP as a mechanism-driven scalable NF intervention for PTSD. |
| Databáze: | OpenAIRE |
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