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Varkevisser T, Geuze E, van Honk J. Amygdala fMRI-A Critical Appraisal of the Extant Literature. Neurosci Insights 2024; 19:26331055241270591. [PMID: 39148643 PMCID: PMC11325331 DOI: 10.1177/26331055241270591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/08/2024] [Indexed: 08/17/2024] Open
Abstract
Even before the advent of fMRI, the amygdala occupied a central space in the affective neurosciences. Yet this amygdala-centred view on emotion processing gained even wider acceptance after the inception of fMRI in the early 1990s, a landmark that triggered a goldrush of fMRI studies targeting the amygdala in vivo. Initially, this amygdala fMRI research was mostly confined to task-activation studies measuring the magnitude of the amygdala's response to emotional stimuli. Later, interest began to shift more towards the study of the amygdala's resting-state functional connectivity and task-based psychophysiological interactions. Later still, the test-retest reliability of amygdala fMRI came under closer scrutiny, while at the same time, amygdala-based real-time fMRI neurofeedback gained widespread popularity. Each of these major subdomains of amygdala fMRI research has left its marks on the field of affective neuroscience at large. The purpose of this review is to provide a critical assessment of this literature. By integrating the insights garnered by these research branches, we aim to answer the question: What part (if any) can amygdala fMRI still play within the current landscape of affective neuroscience? Our findings show that serious questions can be raised with regard to both the reliability and validity of amygdala fMRI. These conclusions force us to cast doubt on the continued viability of amygdala fMRI as a core pilar of the affective neurosciences.
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Affiliation(s)
- Tim Varkevisser
- University Medical Center, Utrecht, The Netherlands
- Brain Research and Innovation Center, Ministry of Defence, Utrecht, The Netherlands
- Utrecht University, Utrecht, The Netherlands
| | - Elbert Geuze
- University Medical Center, Utrecht, The Netherlands
- Brain Research and Innovation Center, Ministry of Defence, Utrecht, The Netherlands
| | - Jack van Honk
- Utrecht University, Utrecht, The Netherlands
- University of Cape Town, Cape Town, South Africa
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Tschentscher N, Tafelmaier JC, Woll CFJ, Pogarell O, Maywald M, Vierl L, Breitenstein K, Karch S. The Clinical Impact of Real-Time fMRI Neurofeedback on Emotion Regulation: A Systematic Review. Brain Sci 2024; 14:700. [PMID: 39061440 PMCID: PMC11274904 DOI: 10.3390/brainsci14070700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/05/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Emotion dysregulation has long been considered a key symptom in multiple psychiatric disorders. Difficulties in emotion regulation have been associated with neural dysregulation in fronto-limbic circuits. Real-time fMRI-based neurofeedback (rt-fMRI-NFB) has become increasingly popular as a potential treatment for emotional dysregulation in psychiatric disorders, as it is able to directly target the impaired neural circuits. However, the clinical impact of these rt-fMRI-NFB protocols in psychiatric populations is still largely unknown. Here we provide a comprehensive overview of primary studies from 2010 to 2023 that used rt-fMRI-NFB to target emotion regulation. We assessed 41 out of 4001 original studies for methodological quality and risk of bias and synthesised concerning the frequency of significant rt-fMRI-NFB-related effects on the neural and behaviour level. Successful modulation of brain activity was reported in between 25 and 50 percent of study samples, while neural effects in clinical samples were more diverse than in healthy samples. Interestingly, the frequency of rt-fMRI-NFB-related behavioural improvement was over 75 percent in clinical samples, while healthy samples showed behavioural improvements between 0 and 25 percent. Concerning clinical subsamples, rt-fMRI-NFB-related behavioural improvement was observed in up to 100 percent of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) samples. Substance use samples showed behavioural benefits ranging between 50 and 75 percent. Neural effects appeared to be less frequent than behavioural improvements: most neural outcomes ranged between 25 and 50 percent for MDD and substance use and between 0 and 25 percent for PTSD. Using multiple individualised regions of interest (ROIs) for rt-fMRI-NFB training resulted in more frequent behavioural benefits than rt-fMRI-NFB solely based on the amygdala or the prefrontal cortex. While a significant improvement in behavioural outcomes was reported in most clinical studies, the study protocols were heterogeneous, which limits the current evaluation of rt-fMRI-NFB as a putative treatment for emotional dysregulation.
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Affiliation(s)
- Nadja Tschentscher
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
| | - Julia C. Tafelmaier
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
| | - Christian F. J. Woll
- Section of Clinical Psychology of Children and Adolescents, Department of Psychology and Educational Sciences, Ludwig Maximilian University of Munich, Leopoldstr. 13, 80802 Munich, Germany;
| | - Oliver Pogarell
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
| | - Maximilian Maywald
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
| | - Larissa Vierl
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
- Section of Clinical Psychology and Psychological Treatment, Department of Psychology and Educational Sciences, Ludwig Maximilian University of Munich, Leopoldstr. 13, 80802 Munich, Germany
| | - Katrin Breitenstein
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
| | - Susanne Karch
- Section of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Nußbaumstr. 7, 80336 Munich, Germany; (N.T.); (J.C.T.); (O.P.)
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Zhang T, Zhang Y, Ren J, Zhou H, Yang M, Li L, Lei D, Gong Q, Zhou D, Yang T. Dynamic alterations of striatal-related functional networks in juvenile absence epilepsy. Epilepsy Behav 2023; 149:109506. [PMID: 37925871 DOI: 10.1016/j.yebeh.2023.109506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE To explore the features of dynamic functional connectivity (dFC) variability of striatal-cortical/subcortical networks in juvenile absence epilepsy (JAE). METHODS We collected resting-state functional magnetic imaging data from 18 JAE patients and 28 healthy controls. The striatum was divided into six pairs of regions: the inferior-ventral striatum (VSi), superior-ventral striatum (VSs), dorsal-caudal putamen, dorsal-rostral putamen, dorsal-caudate (DC) and ventral-rostral putamen. We assessed the dFC variability of each subdivision in the whole brain using the sliding-window method, and correlated altered circuit with clinical variables in JAE patients. RESULTS We found altered dFC variability of striatal-cortical/subcortical networks in patients with JAE. The VSs exhibited decreased dFC variability with subcortical regions, and dFC variability between VSs and thalamus was negatively correlated with epilepsy duration. For the striatal-cortical networks, the dFC variability was decreased in VSi-affective network but increased in DC-executive network. The altered dynamics of striatal-cortical networks involved crucial nodes of the default mode network (DMN). CONCLUSION JAE patients exhibit excessive stability in the striatal-subcortical networks. For striatal-cortical networks in JAE, the striatal-affective circuit was more stable, while the striatal-executive circuit was more variable. Furthermore, crucial nodes of DMN were changed in striatal-cortical networks in JAE.
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Affiliation(s)
- Tianyu Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yingying Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiechuan Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huanyu Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Menghan Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lei Li
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Du Lei
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiyong Gong
- Huaxi MR Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tianhua Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Bressler RA, Raible S, Lührs M, Tier R, Goebel R, Linden DE. No threat: Emotion regulation neurofeedback for police special forces recruits. Neuropsychologia 2023; 190:108699. [PMID: 37816480 DOI: 10.1016/j.neuropsychologia.2023.108699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/15/2023] [Accepted: 10/06/2023] [Indexed: 10/12/2023]
Abstract
Police officers of the Special Forces are confronted with highly demanding situations in terms of stress, high tension and threats to their lives. Their tasks are specifically high-risk operations, such as arrests of armed suspects and anti-terror interventions. Improving the emotion regulation skills of police officers might be a vital investment, supporting them to stay calm and focused. A promising approach is training emotion regulation by using real-time (rt-) fMRI neurofeedback. Specifically, downregulating activity in key areas of the fronto-limbic emotion regulation network in the presence of threatening stimuli. Thirteen recruits of the Dutch police special forces underwent six weekly rt-fMRI sessions, receiving neurofeedback from individualized regions of their emotion regulation network. Their task was to reduce the image size of threatening images, wherein the image size represented their brain activity. A reduction in image size represented successful downregulation. Participants were free to use their preferred regulation strategy. A control group of fifteen recruits received no neurofeedback. Both groups completed behavioural tests (image rating on evoked valence and arousal, questionnaire) before and after the neurofeedback training. We hypothesized that the neurofeedback group would improve in downregulation and would score better than the control group on the behavioural tests after the neurofeedback training. Neurofeedback training resulted in a significant decrease in image size (t(12) = 2.82, p = .015) and a trend towards decreased activation in the target regions (t(10) = 1.82, p = .099) from the first to the last session. Notably, subjects achieved downregulation below the pre-stimulus baseline in the last two sessions. No relevant differences between groups were found in the behavioural tasks. Through the training of rt-fMRI neurofeedback, participants learned to downregulate the activity in individualized areas of the emotion regulation network, by using their own preferred strategies. The lack of behavioural between-group differences may be explained by floor effects. Tasks that are close to real-life situations may be needed to uncover behavioural correlates of this emotion regulation training.
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Affiliation(s)
- Ruben Andreas Bressler
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands.
| | - Sophie Raible
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
| | - Michael Lührs
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands; Brain Innovation, Maastricht, The Netherlands, Oxfordlaan 55, 6229 EV, Maastricht, the Netherlands
| | - Ralph Tier
- Landelijke Eenheid, Dienst Speciale Interventies, Hoofdstraat 54, 3972 LB, Postbus 100, 3970 AC, Driebergen, the Netherlands
| | - Rainer Goebel
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands; Brain Innovation, Maastricht, The Netherlands, Oxfordlaan 55, 6229 EV, Maastricht, the Netherlands
| | - David E Linden
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands
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Nguyen GH, Oh S, Schneider C, Teoh JY, Engstrom M, Santana-Gonzalez C, Porter D, Quevedo K. Neurofeedback and Affect Regulation Circuitry in Depressed and Healthy Adolescents. BIOLOGY 2023; 12:1399. [PMID: 37997998 PMCID: PMC10669603 DOI: 10.3390/biology12111399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023]
Abstract
Neurodevelopmental psychopathology seeks to understand higher-order emotion regulation circuitry to develop new therapies for adolescents with depression. Depressed (N = 34) and healthy youth (N = 19) completed neurofeedback (NF) training and exhibited increased bilateral amygdala and hippocampus activity in the region of interest (ROI) analyses by recalling positive autobiographical memories. We tested factors supportive of the engagement of emotion regulation's neural areas during NF (i.e., parental support, medication, and gender effects upon anterior cingulate cortex (ACC) engagement). Whole-brain analyses yielded effects of NF vs. control condition and effects of diagnosis. Youth showed higher amygdala and hippocampus (AMYHIPPO) activity during the NF vs. control condition, particularly in the left hippocampus. ACC's activity was also higher during NF vs. control. Higher average ACC activity was linked to better parental support, absent depression, female gender, and absent medication. Control youth showed higher average AMYHIPPO and ACC activity throughout the task and a faster decline in activity vs. depressed youths. Whole-brain level analyses showed higher activity in the frontotemporal network during the NF vs. control conditions, suggesting targeting their connectivity in future neurofeedback trials.
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Affiliation(s)
- Giang H. Nguyen
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
| | - Sewon Oh
- Department of Psychology, Institute for Mind and Brain, University of South Carolina, Columbia, SC 29208, USA;
| | - Corey Schneider
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
| | - Jia Y. Teoh
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
| | - Maggie Engstrom
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
| | - Carmen Santana-Gonzalez
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
| | - David Porter
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
| | - Karina Quevedo
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA; (G.H.N.); (C.S.); (J.Y.T.); (M.E.); (C.S.-G.); (D.P.)
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Fleury M, Figueiredo P, Vourvopoulos A, Lécuyer A. Two is better? combining EEG and fMRI for BCI and neurofeedback: a systematic review. J Neural Eng 2023; 20:051003. [PMID: 37879343 DOI: 10.1088/1741-2552/ad06e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 10/25/2023] [Indexed: 10/27/2023]
Abstract
Electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are two commonly used non-invasive techniques for measuring brain activity in neuroscience and brain-computer interfaces (BCI).Objective. In this review, we focus on the use of EEG and fMRI in neurofeedback (NF) and discuss the challenges of combining the two modalities to improve understanding of brain activity and achieve more effective clinical outcomes. Advanced technologies have been developed to simultaneously record EEG and fMRI signals to provide a better understanding of the relationship between the two modalities. However, the complexity of brain processes and the heterogeneous nature of EEG and fMRI present challenges in extracting useful information from the combined data.Approach. We will survey existing EEG-fMRI combinations and recent studies that exploit EEG-fMRI in NF, highlighting the experimental and technical challenges.Main results. We made a classification of the different combination of EEG-fMRI for NF, we provide a review of multimodal analysis methods for EEG-fMRI features. We also survey the current state of research on EEG-fMRI in the different existing NF paradigms. Finally, we also identify some of the remaining challenges in this field.Significance. By exploring EEG-fMRI combinations in NF, we are advancing our knowledge of brain function and its applications in clinical settings. As such, this review serves as a valuable resource for researchers, clinicians, and engineers working in the field of neural engineering and rehabilitation, highlighting the promising future of EEG-fMRI-based NF.
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Affiliation(s)
- Mathis Fleury
- Univ Rennes, Inria, CNRS, Inserm, Empenn ERL U1228 Rennes, France
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia Figueiredo
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Athanasios Vourvopoulos
- ISR-Lisboa/LARSyS and Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Anatole Lécuyer
- Univ Rennes, Inria, CNRS, Inserm, Empenn ERL U1228 Rennes, France
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Dehghani A, Soltanian-Zadeh H, Hossein-Zadeh GA. Neural modulation enhancement using connectivity-based EEG neurofeedback with simultaneous fMRI for emotion regulation. Neuroimage 2023; 279:120320. [PMID: 37586444 DOI: 10.1016/j.neuroimage.2023.120320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/18/2023] Open
Abstract
Emotion regulation plays a key role in human behavior and overall well-being. Neurofeedback is a non-invasive self-brain training technique used for emotion regulation to enhance brain function and treatment of mental disorders through behavioral changes. Previous neurofeedback research often focused on using activity from a single brain region as measured by fMRI or power from one or two EEG electrodes. In a new study, we employed connectivity-based EEG neurofeedback through recalling positive autobiographical memories and simultaneous fMRI to upregulate positive emotion. In our novel approach, the feedback was determined by the coherence of EEG electrodes rather than the power of one or two electrodes. We compared the efficiency of this connectivity-based neurofeedback to traditional activity-based neurofeedback through multiple experiments. The results showed that connectivity-based neurofeedback effectively improved BOLD signal change and connectivity in key emotion regulation regions such as the amygdala, thalamus, and insula, and increased EEG frontal asymmetry, which is a biomarker for emotion regulation and treatment of mental disorders such as PTSD, anxiety, and depression and coherence among EEG channels. The psychometric evaluations conducted both before and after the neurofeedback experiments revealed that participants demonstrated improvements in enhancing positive emotions and reducing negative emotions when utilizing connectivity-based neurofeedback, as compared to traditional activity-based and sham neurofeedback approaches. These findings suggest that connectivity-based neurofeedback may be a superior method for regulating emotions and could be a useful alternative therapy for mental disorders, providing individuals with greater control over their brain and mental functions.
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Affiliation(s)
- Amin Dehghani
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran; Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA.
| | - Hamid Soltanian-Zadeh
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran; Departments of Radiology and Research Administration, Henry Ford Health System, Detroit, MI, USA
| | - Gholam-Ali Hossein-Zadeh
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran; School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
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Koizumi K, Kunii N, Ueda K, Nagata K, Fujitani S, Shimada S, Nakao M. Paving the Way for Memory Enhancement: Development and Examination of a Neurofeedback System Targeting the Medial Temporal Lobe. Biomedicines 2023; 11:2262. [PMID: 37626758 PMCID: PMC10452721 DOI: 10.3390/biomedicines11082262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/01/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Neurofeedback (NF) shows promise in enhancing memory, but its application to the medial temporal lobe (MTL) still needs to be studied. Therefore, we aimed to develop an NF system for the memory function of the MTL and examine neural activity changes and memory task score changes through NF training. We created a memory NF system using intracranial electrodes to acquire and visualise the neural activity of the MTL during memory encoding. Twenty trials of a tug-of-war game per session were employed for NF and designed to control neural activity bidirectionally (Up/Down condition). NF training was conducted with three patients with drug-resistant epilepsy, and we observed an increasing difference in NF signal between conditions (Up-Down) as NF training progressed. Similarities and negative correlation tendencies between the transition of neural activity and the transition of memory function were also observed. Our findings demonstrate NF's potential to modulate MTL activity and memory encoding. Future research needs further improvements to the NF system to validate its effects on memory functions. Nonetheless, this study represents a crucial step in understanding NF's application to memory and provides valuable insights into developing more efficient memory enhancement strategies.
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Affiliation(s)
- Koji Koizumi
- Department of Mechanical Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (K.U.); (M.N.)
| | - Naoto Kunii
- Department of Neurosurgery, The University of Tokyo, Tokyo 113-8655, Japan; (N.K.); (K.N.); (S.F.); (S.S.)
| | - Kazutaka Ueda
- Department of Mechanical Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (K.U.); (M.N.)
| | - Keisuke Nagata
- Department of Neurosurgery, The University of Tokyo, Tokyo 113-8655, Japan; (N.K.); (K.N.); (S.F.); (S.S.)
| | - Shigeta Fujitani
- Department of Neurosurgery, The University of Tokyo, Tokyo 113-8655, Japan; (N.K.); (K.N.); (S.F.); (S.S.)
| | - Seijiro Shimada
- Department of Neurosurgery, The University of Tokyo, Tokyo 113-8655, Japan; (N.K.); (K.N.); (S.F.); (S.S.)
| | - Masayuki Nakao
- Department of Mechanical Engineering, The University of Tokyo, Tokyo 113-8656, Japan; (K.U.); (M.N.)
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Testing the efficacy of real-time fMRI neurofeedback for training people who smoke daily to upregulate neural responses to nondrug rewards. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:440-456. [PMID: 36788202 DOI: 10.3758/s13415-023-01070-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 01/24/2023] [Indexed: 02/16/2023]
Abstract
Although the use of nondrug rewards (e.g., money) to facilitate smoking cessation is widespread, recent research has found that such rewards may be least effective when people who smoke cigarettes are tempted to do so. Specifically, among people who smoke, the neural response to nondrug rewards appears blunted when access to cigarettes is anticipated, and this blunting is linked to a decrease in willingness to refrain from smoking to earn a monetary incentive. Accordingly, methods to enhance the value of nondrug rewards may be theoretically and clinically important. The current proof-of-concept study tested if real-time fMRI neurofeedback training augments the ability to upregulate responses in reward-related brain areas relative to a no-feedback control condition in people who smoke. Adults (n = 44, age range = 20-44) who reported smoking >5 cigarettes per day completed the study. Those in the intervention group (n = 22, 5 females) were trained to upregulate brain responses using feedback of ongoing striatal activity (i.e., a dynamic "thermometer" that reflected ongoing changes of fMRI signal intensity in the striatum) in a single neurofeedback session with three training runs. The control group (n = 22, 5 females) underwent a nearly identical procedure but received no neurofeedback. Those who received neurofeedback training demonstrated significantly greater increases in striatal BOLD activation while attempting to think about something rewarding compared to controls, but this effect was present only during the first training run. Future neurofeedback research with those who smoke should explore how to make neurofeedback training more effective for the self-regulation of reward-related brain activities.
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Dehghani A, Soltanian-Zadeh H, Hossein-Zadeh GA. Probing fMRI brain connectivity and activity changes during emotion regulation by EEG neurofeedback. Front Hum Neurosci 2023; 16:988890. [PMID: 36684847 PMCID: PMC9853008 DOI: 10.3389/fnhum.2022.988890] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 12/13/2022] [Indexed: 01/09/2023] Open
Abstract
Despite the existence of several emotion regulation studies using neurofeedback, interactions among a small number of regions were evaluated, and therefore, further investigation is needed to understand the interactions of the brain regions involved in emotion regulation. We implemented electroencephalography (EEG) neurofeedback with simultaneous functional magnetic resonance imaging (fMRI) using a modified happiness-inducing task through autobiographical memories to upregulate positive emotion. Then, an explorative analysis of whole brain regions was done to understand the effect of neurofeedback on brain activity and the interaction of whole brain regions involved in emotion regulation. The participants in the control and experimental groups were asked to do emotion regulation while viewing positive images of autobiographical memories and getting sham or real (based on alpha asymmetry) EEG neurofeedback, respectively. The proposed multimodal approach quantified the effects of EEG neurofeedback in changing EEG alpha power, fMRI blood oxygenation level-dependent (BOLD) activity of prefrontal, occipital, parietal, and limbic regions (up to 1.9% increase), and functional connectivity in/between prefrontal, parietal, limbic system, and insula in the experimental group. New connectivity links were identified by comparing the brain functional connectivity between experimental conditions (Upregulation and View blocks) and also by comparing the brain connectivity of the experimental and control groups. Psychometric assessments confirmed significant changes in positive and negative mood states in the experimental group by neurofeedback. Based on the exploratory analysis of activity and connectivity among all brain regions involved in emotion regions, we found significant BOLD and functional connectivity increases due to EEG neurofeedback in the experimental group, but no learning effect was observed in the control group. The results reveal several new connections among brain regions as a result of EEG neurofeedback which can be justified according to emotion regulation models and the role of those regions in emotion regulation and recalling positive autobiographical memories.
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Affiliation(s)
- Amin Dehghani
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran,Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States,*Correspondence: Amin Dehghani, ,
| | - Hamid Soltanian-Zadeh
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran,Medical Image Analysis Lab, Department of Radiology and Research Administration, Henry Ford Health System, Detroit, MI, United States,School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Gholam-Ali Hossein-Zadeh
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran,School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
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Tonnaer F, van Zutphen L, Raine A, Cima M. Amygdala connectivity and aggression. HANDBOOK OF CLINICAL NEUROLOGY 2023; 197:87-106. [PMID: 37633721 DOI: 10.1016/b978-0-12-821375-9.00002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
Neurobiological models propose that reactive aggression is predicated on impairments in amygdala-prefrontal connectivity that subserves moral decision-making and emotion regulation. The amygdala is a key component within this neural network that modulates reactive aggression. We provide a review of amygdala dysfunctional brain networks leading to reactive aggressive behavior. We elaborate on key concepts, focusing on moral decision-making and emotion regulation in a developmental context, and brain network connectivity factors relating to amygdala (dys)function-factors which we suggest predispose to reactive aggression. We additionally discuss insights into the latest treatment interventions, providing the utilization of the scientific findings for practice.
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Affiliation(s)
- Franca Tonnaer
- Department of Research, Ventio Crime Prevention Science Institute, Rijckholt, The Netherlands
| | - Linda van Zutphen
- Department of Conditions for LifeLong Learning, Educational Sciences, Open University, Heerlen, The Netherlands
| | - Adrian Raine
- Department of Criminology, Richard Perry University, Berkeley, CA, United States; Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Maaike Cima
- Department of Research, Ventio Crime Prevention Science Institute, Rijckholt, The Netherlands; Department of Developmental Psychopathology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands; Department of Research, VIGO Groep, Nijmegen, The Netherlands.
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Individual- and Connectivity-Based Real-Time fMRI Neurofeedback to Modulate Emotion-Related Brain Responses in Patients with Depression: A Pilot Study. Brain Sci 2022; 12:brainsci12121714. [PMID: 36552173 PMCID: PMC9775232 DOI: 10.3390/brainsci12121714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/08/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Individual real-time functional magnetic resonance imaging neurofeedback (rtfMRI NF) might be a promising adjuvant in treating depressive symptoms. Further studies showed functional variations and connectivity-related changes in the dorsolateral prefrontal cortex (dlPFC) and the insular cortex. OBJECTIVES The aim of this pilot study was to investigate whether individualized connectivity-based rtfMRI NF training can improve symptoms in depressed patients as an adjunct to a psychotherapeutic programme. The novel strategy chosen for this was to increase connectivity between individualized regions of interest, namely the insula and the dlPFC. METHODS Sixteen patients diagnosed with major depressive disorder (MDD, ICD-10) and 19 matched healthy controls (HC) participated in a rtfMRI NF training consisting of two sessions with three runs each, within an interval of one week. RtfMRI NF was applied during a sequence of negative emotional pictures to modulate the connectivity between the dlPFC and the insula. The MDD REAL group was divided into a Responder and a Non-Responder group. Patients with an increased connectivity during the second NF session or during both the first and the second NF session were identified as "MDD REAL Responder" (N = 6). Patients that did not show any increase in connectivity and/or a decreased connectivity were identified as "MDD REAL Non-Responder" (N = 7). RESULTS Before the rtfMRI sessions, patients with MDD showed higher neural activation levels in ventromedial PFC and the insula than HC; by contrast, HC revealed increased hemodynamic activity in visual processing areas (primary visual cortex and visual association cortex) compared to patients with MDD. The comparison of hemodynamic responses during the first compared to during the last NF session demonstrated significantly increased BOLD-activation in the medial orbitofrontal cortex (mOFC) in patients and HC, and additionally in the lateral OFC in patients with MDD. These findings were particularly due to the MDD Responder group, as the MDD Non-Responder group showed no increase in this region during the last NF run. There was a decrease of neural activation in emotional processing brain regions in both groups in the last NF run compared to the first: HC showed differences in the insula, parahippocampal gyrus, basal ganglia, and cingulate gyrus. Patients with MDD demonstrated deceased responses in the parahippocampal gyrus. There was no significant reduction of BDI scores after NF training in patients. CONCLUSIONS Increased neural activation in the insula and vmPFC in MDD suggests an increased emotional reaction in patients with MDD. The activation of the mOFC could be associated with improved control-strategies and association-learning processes. The increased lOFC activation could indicate a stronger sensitivity to failed NF attempts in MDD. A stronger involvement of visual processing areas in HC may indicate better adaptation to negative emotional stimuli after repeated presentation. Overall, the rtfMRI NF had an impact on neurobiological mechanisms, but not on psychometric measures in patients with MDD.
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Kjærstad HL, de Siqueira Rotenberg L, Knudsen GM, Vinberg M, Kessing LV, Macoveanu J, Lafer B, Miskowiak KW. The longitudinal trajectory of emotion regulation and associated neural activity in patients with bipolar disorder: A prospective fMRI study. Acta Psychiatr Scand 2022; 146:568-582. [PMID: 36054343 PMCID: PMC9804505 DOI: 10.1111/acps.13488] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/12/2022] [Accepted: 08/10/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Impaired emotion regulation is a key feature of bipolar disorder (BD) that presents during acute mood episodes and in remission. The neural correlates of voluntary emotion regulation seem to involve deficient prefrontal top-down regulation already at BD illness onset. However, the trajectory of aberrant neuronal activity during emotion regulation in BD is unclear. METHODS We investigated neural activity during emotion regulation in response to aversive pictures from the International Affective Picture System in patients with recently diagnosed BD (n = 43) in full or partial remission and in healthy controls (HC) (n = 38) longitudinally at baseline and 16 months later. RESULTS Patients with BD exhibited stable hypo-activity in the left dorsomedial prefrontal cortex (DMPFC) and right dorsolateral prefrontal cortex (DLPFC) and impaired emotion regulation compared to HC over the 16 months follow-up time. More DLPFC hypo-activity during emotion regulation correlated with less successful down-regulation (r = 0.16, p = 0.045), more subsyndromal depression (r = -0.18, p = 0.02) and more functional impairment (r = -0.24, p = 0.002), while more DMPFC hypo-activity correlated with less efficient emotion regulation (r = 0.16, p = 0.048). Finally, more DMPFC hypo-activity during emotion regulation at baseline was associated with an increased likelihood of subsequent relapse during the 16 months follow-up time (β = -2.26, 95% CI [0.01; 0.99], p = 0.048). CONCLUSION The stable DLPFC and DMPFC hypo-activity during emotion regulation represents a neuronal trait-marker of persistent emotion regulation difficulties in BD. Hypo-activity in the DMPFC may contribute to greater risk of relapse.
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Affiliation(s)
- Hanne Lie Kjærstad
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletDenmark
| | - Luisa de Siqueira Rotenberg
- Bipolar Disorder Program (PROMAN), Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Gitte Moos Knudsen
- Neurobiology Research UnitCopenhagen University HospitalRigshospitaletDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Maj Vinberg
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark,Mental Health Center, Northern ZealandCopenhagen University Hospital – Mental Health Services CPHCopenhagenDenmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletDenmark,Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Julian Macoveanu
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletDenmark
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of PsychiatryUniversity of São Paulo Medical SchoolSão PauloBrazil
| | - Kamilla Woznica Miskowiak
- Copenhagen Affective Disorder research Centre (CADIC), Psychiatric Centre CopenhagenCopenhagen University HospitalRigshospitaletDenmark,Department of PsychologyUniversity of CopenhagenCopenhagenDenmark
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Mosayebi R, Dehghani A, Hossein-Zadeh GA. Dynamic functional connectivity estimation for neurofeedback emotion regulation paradigm with simultaneous EEG-fMRI analysis. Front Hum Neurosci 2022; 16:933538. [PMID: 36188168 PMCID: PMC9524189 DOI: 10.3389/fnhum.2022.933538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/22/2022] [Indexed: 11/15/2022] Open
Abstract
Joint Analysis of EEG and fMRI datasets can bring new insight into brain mechanisms. In this paper, we employed the recently introduced Correlated Coupled Tensor Matrix Factorization (CCMTF) method for analysis of the emotion regulation paradigm based on EEG frontal asymmetry neurofeedback in the alpha frequency band with simultaneous fMRI. CCMTF method assumes that the co-variations of the common dimension (temporal dimension) between EEG and fMRI are correlated and not necessarily identical. The results of the CCMTF method suggested that EEG and fMRI had similar covariations during the transition of brain activities from resting states to task (view and upregulation) states and these covariations followed an increasing trend. The fMRI shared spatial component showed activations in the limbic system, DLPFC, OFC, and VLPC regions, which were consistent with the previous studies and were linked to EEG frequency patterns in the range of 1–15 Hz with a correlation value close to 0.75. The estimated regions from the CCMTF method were then used as the candidate nodes for dynamic functional connectivity (dFC) analysis, in which the changes in connectivity from view to upregulation states were examined. The results of the dFC analysis were compared with a Normalized Mutual information (NMI) based approach in two different frequency ranges (1–15 and 15–40 Hz) as the NMI method was applied to the vectors of dFC nodes of EEG and fMRI data. The results of the two methods illustrated that the relation between EEG and fMRI datasets was mostly in the frequency range of 1–15 Hz. These relations were both in the brain activations and the dFCs between the two modalities. This paper suggests that the CCMTF method is a capable approach for extracting the shared information between EEG and fMRI data and can reveal new information about brain functions and their connectivity without solving the EEG inverse problem or analyzing different frequency bands.
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Affiliation(s)
- Raziyeh Mosayebi
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- *Correspondence: Raziyeh Mosayebi,
| | - Amin Dehghani
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
| | - Gholam-Ali Hossein-Zadeh
- School of Electrical and Computer Engineering, University of Tehran, Tehran, Iran
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
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Using Real-Time fMRI Neurofeedback to Modulate M1-Cerebellum Connectivity. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:8744982. [PMID: 36082347 PMCID: PMC9448559 DOI: 10.1155/2022/8744982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/16/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
Objective The potential of neurofeedback to alter the M1-cerebellum connectivity was explored using motor imagery-based rt-fMRI. These regions were chosen due to their importance in motor performance and motor rehabilitation. Methods Four right-handed individuals were recruited to examine the potential to change the M1-cerebellum neurofeedback link. The University of Glasgow Cognitive Neuroimaging Centre used a 3T MRI scanner from January 2019 to January 2020 to conduct this prospective study. Everyone participated in each fMRI session, which included six NF training runs. Participants were instructed to imagine complicated hand motions during the NF training to raise a thermometer bar's height. To contrast the correlation coefficients between the initial and last NF runs, a t-test was performed post hoc. Results The neurofeedback connection between M1 and the cerebellum was strengthened in each participant. Motor imagery strategy was a significant task in training M1-cerebellum connectivity as participants used it successfully to enhance the activation level between these regions during M1-cerebellum modulation using real-time fMRI. The t-test and linear regression, on the other hand, showed this increase to be insignificant. Conclusion A novel technique to manipulate M1-cerebellum connectivity was discovered using real-time fMRI NF. This study showed that each participant's neurofeedback connectivity between M1 and cerebellum was enhanced. This increase, on the other hand, was insignificant statistically. The results showed that the connectivity between both areas increased positively. Through the integration of fMRI and neurofeedback, M1-cerebellum connectivity can be positively affected.
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Real-time fMRI neurofeedback compared to cognitive behavioral therapy in a pilot study for the treatment of mild and moderate depression. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01462-0. [PMID: 35908116 PMCID: PMC10359372 DOI: 10.1007/s00406-022-01462-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/01/2022] [Indexed: 11/03/2022]
Abstract
Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback was found to reduce depressive symptoms. However, no direct comparison of drug-free patients with an active psychotherapy control group is available. The present study compared rt-fMRI neurofeedback with cognitive behavioral therapy, as the standard treatment in patients declining anti-depressants. Twenty adult, drug-free patients with mild or moderate depression were non-randomly assigned either to a course of eight half-hour sessions of neurofeedback targeting the left medial prefrontal cortex (N = 12) or to a 16-session course of cognitive behavioral therapy (N = 8). Montgomery-Asberg Depression Rating Scale was introduced at baseline, mid-treatment, and end-treatment points. In each group, 8 patients each remained in the study to a mid-treatment evaluation and 6 patients each to the study end-point. ANOVA revealed a depression reduction with a significant effect of Time (F(3,6) = 19.0, p < 0.001, η2 = 0.76). A trend to greater improvement in the cognitive behavioral therapy group compared to neurofeedback emerged (Group × Time; p = 0.078). Percent signal change in the region of interest between up- and down-regulation conditions was significantly correlated with session number (Pearson's r = 0.85, p < 0.001) indicating a learning effect. As limitations, small sample size could lead to insufficient power and non-random allocation to selection bias. Both neurofeedback and cognitive behavioral therapy improved mild and moderate depression. Neurofeedback was not superior to cognitive behavioral therapy. Noteworthy, the neurofeedback training course was associated with continuous improvement in the self-regulation skill, without plateau. This study delivers data to plan clinical trials comparing neurofeedback with cognitive behavioral interventions.
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Goldway N, Jalon I, Keynan JN, Hellrung L, Horstmann A, Paret C, Hendler T. Feasibility and utility of amygdala neurofeedback. Neurosci Biobehav Rev 2022; 138:104694. [PMID: 35623447 DOI: 10.1016/j.neubiorev.2022.104694] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/12/2022] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
Amygdala NeuroFeedback (NF) have the potential of being a valuable non-invasive intervention tool in many psychiatric disporders. However, the feasibility and best practices of this method have not been systematically examined. The current article presents a review of amygdala-NF studies, an analytic summary of study design parameters, and examination of brain mechanisms related to successful amygdala-NF performance. A meta-analysis of 33 publications showed that real amygdala-NF facilitates learned modulation compared to control conditions. In addition, while variability in study dsign parameters is high, these design choices are implicitly organized by the targeted valence domain (positive or negative). However, in most cases the neuro-behavioral effects of targeting such domains were not directly assessed. Lastly, re-analyzing six data sets of amygdala-fMRI-NF revealed that successful amygdala down-modulation is coupled with deactivation of the posterior insula and nodes in the Default-Mode-Network. Our findings suggest that amygdala self-modulation can be acquired using NF. Yet, additional controlled studies, relevant behavioral tasks before and after NF intervention, and neural 'target engagement' measures are critically needed to establish efficacy and specificity. In addition, the fMRI analysis presented here suggest that common accounts regarding the brain network involved in amygdala NF might reflect unsuccessful modulation attempts rather than successful modulation.
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Affiliation(s)
- Noam Goldway
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel-Aviv, Israel; Department of Psychology, New York University, New York, USA
| | - Itamar Jalon
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel; School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
| | - Jackob N Keynan
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA
| | - Lydia Hellrung
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Annette Horstmann
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Faculty of Medicine, University of Leipzig, Leipzig, Germany; Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Christian Paret
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Germany
| | - Talma Hendler
- Sagol Brain Institute, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Centre, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel-Aviv, Israel; School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel; Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel.
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De Filippi E, Marins T, Escrichs A, Gilson M, Moll J, Tovar-Moll F, Deco G. One session of fMRI-Neurofeedback training on motor imagery modulates whole-brain effective connectivity and dynamical complexity. Cereb Cortex Commun 2022; 3:tgac027. [PMID: 36072710 PMCID: PMC9441014 DOI: 10.1093/texcom/tgac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 06/28/2022] [Accepted: 07/03/2022] [Indexed: 11/23/2022] Open
Abstract
In the past decade, several studies have shown that Neurofeedback (NFB) by functional magnetic resonance imaging can alter the functional coupling of targeted and non-targeted areas. However, the causal mechanisms underlying these changes remain uncertain. Here, we applied a whole-brain dynamical model to estimate Effective Connectivity (EC) profiles of resting-state data acquired before and immediately after a single-session NFB training for 17 participants who underwent motor imagery NFB training and 16 healthy controls who received sham feedback. Within-group and between-group classification analyses revealed that only for the NFB group it was possible to accurately discriminate between the 2 resting-state sessions. NFB training-related signatures were reflected in a support network of direct connections between areas involved in reward processing and implicit learning, together with regions belonging to the somatomotor, control, attention, and default mode networks, identified through a recursive-feature elimination procedure. By applying a data-driven approach to explore NFB-induced changes in spatiotemporal dynamics, we demonstrated that these regions also showed decreased switching between different brain states (i.e. metastability) only following real NFB training. Overall, our findings contribute to the understanding of NFB impact on the whole brain’s structure and function by shedding light on the direct connections between brain areas affected by NFB training.
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Affiliation(s)
- Eleonora De Filippi
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Carrer de Ramon Trias Fargas , 25-27, 08005 Barcelona, Catalonia, Spain
| | - Theo Marins
- D’Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo-Rio de Janeiro , 22281-100, Brazil
- Post-Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Citade universitaria da Universidade Federal do Rio de Janeiro , 21941-590, Brazil
| | - Anira Escrichs
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Carrer de Ramon Trias Fargas , 25-27, 08005 Barcelona, Catalonia, Spain
| | - Matthieu Gilson
- Computational Neuroscience Group, Center for Brain and Cognition, Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Carrer de Ramon Trias Fargas , 25-27, 08005 Barcelona, Catalonia, Spain
| | - Jorge Moll
- D’Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo-Rio de Janeiro , 22281-100, Brazil
| | - Fernanda Tovar-Moll
- D’Or Institute for Research and Education (IDOR), Rua Diniz Cordeiro 30, Botafogo-Rio de Janeiro , 22281-100, Brazil
- Post-Graduate Program in Morphological Sciences, Institute of Biomedical Sciences, Federal University of Rio de Janeiro, Citade universitaria da Universidade Federal do Rio de Janeiro , 21941-590, Brazil
| | - Gustavo Deco
- Institució Catalana de la Recerca i Estudis Avançats (ICREA), Passeig de Lluis Companys , 23, 08010, Barcelona, Catalonia, Spain
- Department of Neuropsychology, Max Planck Institute for human Cognitive and Brain Sciences , Stephanstrasse 1a, 04103, Leipzig, Germany
- Turner Institute for Brain and Mental Health, Monash University level 5 , 18 Innovation Walk, Clayton Campus. Wellington Road, Clayton VIC 3800, Australia
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Stress and its sequelae: An active inference account of the etiological pathway from allostatic overload to depression. Neurosci Biobehav Rev 2022; 135:104590. [DOI: 10.1016/j.neubiorev.2022.104590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/06/2022] [Accepted: 02/16/2022] [Indexed: 12/28/2022]
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Liu S, Hao X, Liu X, He Y, Zhang L, An X, Song X, Ming D. Sensorimotor rhythm neurofeedback training relieves anxiety in healthy people. Cogn Neurodyn 2021; 16:531-544. [DOI: 10.1007/s11571-021-09732-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/12/2021] [Accepted: 09/02/2021] [Indexed: 10/19/2022] Open
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Aslam AR, Altaf MAB. A 10.13µJ/Classification 2-Channel Deep Neural Network Based SoC for Negative Emotion Outburst Detection of Autistic Children. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2021; 15:1039-1052. [PMID: 34543203 DOI: 10.1109/tbcas.2021.3113613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
An electroencephalogram (EEG)-based non-invasive 2-channel neuro-feedback SoC is presented to predict and report negative emotion outbursts (NEOB) of Autistic patients. The SoC incorporates area-and-power efficient dual-channel Analog Front-End (AFE), and a deep neural network (DNN) emotion classification processor. The classification processor utilizes only the two-feature vector per channel to minimize the area and overfitting problems. The 4-layers customized DNN classification processor is integrated on-sensor to predict the NEOB. The AFE comprises two entirely shared EEG channels using sampling capacitors to reduce the area by 30%. Moreover, it achieves an overall integrated input-referred noise, NEF, and crosstalk of 0.55 µVRMS, 2.71, and -79 dB, respectively. The 16 mm2 SoC is implemented in 0.18 um 1P6M, CMOS process and consumes 10.13 μJ/classification for 2 channel operation while achieving an average accuracy of >85% on multiple emotion databases and real-time testing.
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Deep Network Pharmacology: Targeting Glutamate Systems as Integrative Treatments for Jump-Starting Neural Networks and Recovery Trajectories. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6. [PMID: 34549091 PMCID: PMC8452258 DOI: 10.20900/jpbs.20210008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Significant advances in pharmacological treatments for mental illness and addiction will require abandoning old monoaminergic theories of psychiatric disorders and traditionally narrow approaches to how we conduct treatment research. Reframing our efforts with a view on integrative treatments that target core neural network function and plasticity may provide new approaches for lifting patients out of chronic psychiatric symptom sets and addiction. For example, we discuss new treatments that target brain glutamate systems at key transition points within longitudinal courses of care that integrate several treatment modalities. A reconsideration of what our novel and already available medications are intended to achieve and how and when we deliver them for patients with complex illness trajectories could be the key to unlocking new advances in general and addiction psychiatry.
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Chang M, Ando H, Maeda T, Naruse Y. Behavioral effect of mismatch negativity neurofeedback on foreign language learning. PLoS One 2021; 16:e0254771. [PMID: 34283873 PMCID: PMC8291684 DOI: 10.1371/journal.pone.0254771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
Listening is critical for foreign language learning. Listening difficulties can occur because of an inability to perceive or recognize sounds while listening to speech, whereas successful listening can boost understanding and improve speaking when learning a foreign language. Previous studies in our laboratory revealed that EEG-neurofeedback (NF) using mismatch negativity event-related brain potential successfully induced unconscious learning in terms of auditory discrimination of speech sounds. Here, we conducted a feasibility study with a small participant group (NF group and control group; six participants each) to examine the practical effects of mismatch negativity NF for improving the perception of speech sounds in a foreign language. Native Japanese speakers completed a task in which they learned to perceive and recognize spoken English words containing the consonants "l" or "r". Participants received neurofeedback training while not explicitly attending to auditory stimuli. The results revealed that NF training significantly improved the proportion of correct in discrimination and recognition trials, even though the training time for each word pair was reduced to 20% of the training time reported in our previous study. The learning effect was not affected by training with three pairs of words with different vowels. The current results indicate that NF resulted in long-term learning that persisted for at least 2 months.
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Affiliation(s)
- Ming Chang
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology and Osaka University, Iwaoka, Iwaoka-cho, Nishi-ku, Kobe, Hyougo, Japan
- Graduate School of Information Science and Technology, Osaka University, Yamadaoka, Suita, Osaka, Japan
| | - Hideyuki Ando
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology and Osaka University, Iwaoka, Iwaoka-cho, Nishi-ku, Kobe, Hyougo, Japan
- Graduate School of Information Science and Technology, Osaka University, Yamadaoka, Suita, Osaka, Japan
| | - Taro Maeda
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology and Osaka University, Iwaoka, Iwaoka-cho, Nishi-ku, Kobe, Hyougo, Japan
- Graduate School of Information Science and Technology, Osaka University, Yamadaoka, Suita, Osaka, Japan
| | - Yasushi Naruse
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology and Osaka University, Iwaoka, Iwaoka-cho, Nishi-ku, Kobe, Hyougo, Japan
- * E-mail:
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Orendáčová M, Kvašňák E. Effects of Transcranial Alternating Current Stimulation and Neurofeedback on Alpha (EEG) Dynamics: A Review. Front Hum Neurosci 2021; 15:628229. [PMID: 34305549 PMCID: PMC8297546 DOI: 10.3389/fnhum.2021.628229] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/03/2021] [Indexed: 12/14/2022] Open
Abstract
Transcranial alternating current stimulation (tACS) and neurofeedback (NFB) are two different types of non-invasive neuromodulation techniques, which can modulate brain activity and improve brain functioning. In this review, we compared the current state of knowledge related to the mechanisms of tACS and NFB and their effects on electroencephalogram (EEG) activity (online period/stimulation period) and on aftereffects (offline period/post/stimulation period), including the duration of their persistence and potential behavioral benefits. Since alpha bandwidth has been broadly studied in NFB and in tACS research, the studies of NFB and tACS in modulating alpha bandwidth were selected for comparing the online and offline effects of these two neuromodulation techniques. The factors responsible for variability in the responsiveness of the modulated EEG activity by tACS and NFB were analyzed and compared too. Based on the current literature related to tACS and NFB, it can be concluded that tACS and NFB differ a lot in the mechanisms responsible for their effects on an online EEG activity but they possibly share the common universal mechanisms responsible for the induction of aftereffects in the targeted stimulated EEG band, namely Hebbian and homeostatic plasticity. Many studies of both neuromodulation techniques report the aftereffects connected to the behavioral benefits. The duration of persistence of aftereffects for NFB and tACS is comparable. In relation to the factors influencing responsiveness to tACS and NFB, significantly more types of factors were analyzed in the NFB studies compared to the tACS studies. Several common factors for both tACS and NFB have been already investigated. Based on these outcomes, we propose several new research directions regarding tACS and NFB.
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Affiliation(s)
- Mária Orendáčová
- Department of Medical Biophysics and Medical Informatics, Third Faculty of Medicine, Charles University in Prague, Prague, Czechia
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Trambaiolli LR, Cassani R, Mehler DMA, Falk TH. Neurofeedback and the Aging Brain: A Systematic Review of Training Protocols for Dementia and Mild Cognitive Impairment. Front Aging Neurosci 2021; 13:682683. [PMID: 34177558 PMCID: PMC8221422 DOI: 10.3389/fnagi.2021.682683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/03/2021] [Indexed: 11/24/2022] Open
Abstract
Dementia describes a set of symptoms that occur in neurodegenerative disorders and that is characterized by gradual loss of cognitive and behavioral functions. Recently, non-invasive neurofeedback training has been explored as a potential complementary treatment for patients suffering from dementia or mild cognitive impairment. Here we systematically reviewed studies that explored neurofeedback training protocols based on electroencephalography or functional magnetic resonance imaging for these groups of patients. From a total of 1,912 screened studies, 10 were included in our final sample (N = 208 independent participants in experimental and N = 81 in the control groups completing the primary endpoint). We compared the clinical efficacy across studies, and evaluated their experimental designs and reporting quality. In most studies, patients showed improved scores in different cognitive tests. However, data from randomized controlled trials remains scarce, and clinical evidence based on standardized metrics is still inconclusive. In light of recent meta-research developments in the neurofeedback field and beyond, quality and reporting practices of individual studies are reviewed. We conclude with recommendations on best practices for future studies that investigate the effects of neurofeedback training in dementia and cognitive impairment.
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Affiliation(s)
- Lucas R Trambaiolli
- Basic Neuroscience Division, McLean Hospital - Harvard Medical School, Boston, MA, United States
| | - Raymundo Cassani
- Institut National de la Recherche Scientifique - Energy, Materials, and Telecommunications Centre (INRS-EMT), University of Québec, Montréal, QC, Canada
| | - David M A Mehler
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Tiago H Falk
- Institut National de la Recherche Scientifique - Energy, Materials, and Telecommunications Centre (INRS-EMT), University of Québec, Montréal, QC, Canada
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26
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Trambaiolli LR, Tiwari A, Falk TH. Affective Neurofeedback Under Naturalistic Conditions: A Mini-Review of Current Achievements and Open Challenges. FRONTIERS IN NEUROERGONOMICS 2021; 2:678981. [PMID: 38235228 PMCID: PMC10790905 DOI: 10.3389/fnrgo.2021.678981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/28/2021] [Indexed: 01/19/2024]
Abstract
Affective neurofeedback training allows for the self-regulation of the putative circuits of emotion regulation. This approach has recently been studied as a possible additional treatment for psychiatric disorders, presenting positive effects in symptoms and behaviors. After neurofeedback training, a critical aspect is the transference of the learned self-regulation strategies to outside the laboratory and how to continue reinforcing these strategies in non-controlled environments. In this mini-review, we discuss the current achievements of affective neurofeedback under naturalistic setups. For this, we first provide a brief overview of the state-of-the-art for affective neurofeedback protocols. We then discuss virtual reality as a transitional step toward the final goal of "in-the-wild" protocols and current advances using mobile neurotechnology. Finally, we provide a discussion of open challenges for affective neurofeedback protocols in-the-wild, including topics such as convenience and reliability, environmental effects in attention and workload, among others.
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Affiliation(s)
- Lucas R. Trambaiolli
- Basic Neuroscience Division, McLean Hospital–Harvard Medical School, Belmont, MA, United States
| | - Abhishek Tiwari
- Institut National de la Recherche Scientifique, University of Quebec, Montreal, QC, Canada
| | - Tiago H. Falk
- Institut National de la Recherche Scientifique, University of Quebec, Montreal, QC, Canada
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Guerrero Moreno J, Biazoli CE, Baptista AF, Trambaiolli LR. Closed-loop neurostimulation for affective symptoms and disorders: An overview. Biol Psychol 2021; 161:108081. [PMID: 33757806 DOI: 10.1016/j.biopsycho.2021.108081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/28/2022]
Abstract
Affective and anxiety disorders are the most prevalent and incident psychiatric disorders worldwide. Therapeutic approaches to these disorders using non-invasive brain stimulation (NIBS) and analogous techniques have been extensively investigated. In this paper, we discuss the combination of NIBS and neurofeedback in closed-loop setups and its application for affective symptoms and disorders. For this, we first provide a rationale for this combination by presenting some of the main original findings of NIBS, with a primary focus on transcranial magnetic stimulation (TMS), and neurofeedback, including protocols based on electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). Then, we provide a scope review of studies combining real-time neurofeedback with NIBS protocols in the so-called closed-loop brain state-dependent neuromodulation (BSDS). Finally, we discuss the concomitant use of TMS and real-time functional near-infrared spectroscopy (fNIRS) as a possible solution to the current limitations of BSDS-based protocols for affective and anxiety disorders.
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Affiliation(s)
- Javier Guerrero Moreno
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - Claudinei Eduardo Biazoli
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil; Department of Psychology, School of Biological and Chemical Sciences, Queen Mary University of London, UK
| | - Abrahão Fontes Baptista
- Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil; Laboratory of Medical Investigations 54 (LIM-54), Universidade de São Paulo, São Paulo, Brazil; NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil; Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Lucas Remoaldo Trambaiolli
- McLean Hospital, Harvard Medical School, Boston, USA; School of Medicine and Dentistry, University of Rochester, Rochester, USA.
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Yu L, Long Q, Tang Y, Yin S, Chen Z, Zhu C, Chen A. Improving Emotion Regulation Through Real-Time Neurofeedback Training on the Right Dorsolateral Prefrontal Cortex: Evidence From Behavioral and Brain Network Analyses. Front Hum Neurosci 2021; 15:620342. [PMID: 33815078 PMCID: PMC8010650 DOI: 10.3389/fnhum.2021.620342] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/24/2021] [Indexed: 11/15/2022] Open
Abstract
We investigated if emotion regulation can be improved through self-regulation training on non-emotional brain regions, as well as how to change the brain networks implicated in this process. During the training period, the participants were instructed to up-regulate their right dorsolateral prefrontal cortex (rDLPFC) activity according to real-time functional near-infrared spectroscopy (fNIRS) neurofeedback signals, and there was no emotional element. The results showed that the training significantly increased emotion regulation, resting-state functional connectivity (rsFC) within the emotion regulation network (ERN) and frontoparietal network (FPN), and rsFC between the ERN and amygdala; however, training did not influence the rsFC between the FPN and the amygdala. However, self-regulation training on rDLPFC significantly improved emotion regulation and generally increased the rsFCs within the networks; the rsFC between the ERN and amygdala was also selectively increased. The present study also described a safe approach that may improve emotion regulation through self-regulation training on non-emotional brain regions.
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Affiliation(s)
- Linlin Yu
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Quanshan Long
- Faculty of Education, Yunnan Normal University, Kunming, China
| | - Yancheng Tang
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Shouhang Yin
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Zijun Chen
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Chaozhe Zhu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.,IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.,Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing, China
| | - Antao Chen
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
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Trambaiolli LR, Kohl SH, Linden DEJ, Mehler DMA. Neurofeedback training in major depressive disorder: A systematic review of clinical efficacy, study quality and reporting practices. Neurosci Biobehav Rev 2021; 125:33-56. [PMID: 33587957 DOI: 10.1016/j.neubiorev.2021.02.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 12/28/2022]
Abstract
Major depressive disorder (MDD) is the leading cause of disability worldwide. Neurofeedback training has been suggested as a potential additional treatment option for MDD patients not reaching remission from standard care (i.e., psychopharmacology and psychotherapy). Here we systematically reviewed neurofeedback studies employing electroencephalography, or functional magnetic resonance-based protocols in depressive patients. Of 585 initially screened studies, 24 were included in our final sample (N = 480 patients in experimental and N = 194 in the control groups completing the primary endpoint). We evaluated the clinical efficacy across studies and attempted to group studies according to the control condition categories currently used in the field that affect clinical outcomes in group comparisons. In most studies, MDD patients showed symptom improvement superior to the control group(s). However, most articles did not comply with the most stringent study quality and reporting practices. We conclude with recommendations on best practices for experimental designs and reporting standards for neurofeedback training.
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Affiliation(s)
- Lucas R Trambaiolli
- Division of Basic Neuroscience, McLean Hospital, Harvard Medical School, Boston, USA.
| | - Simon H Kohl
- JARA Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Germany; Department of Child and Adolescent Psychiatry, Medical Faculty, RWTH Aachen University, Germany
| | - David E J Linden
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
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Direito B, Ramos M, Pereira J, Sayal A, Sousa T, Castelo-Branco M. Directly Exploring the Neural Correlates of Feedback-Related Reward Saliency and Valence During Real-Time fMRI-Based Neurofeedback. Front Hum Neurosci 2021; 14:578119. [PMID: 33613202 PMCID: PMC7893090 DOI: 10.3389/fnhum.2020.578119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/28/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction: The potential therapeutic efficacy of real-time fMRI Neurofeedback has received increasing attention in a variety of psychological and neurological disorders and as a tool to probe cognition. Despite its growing popularity, the success rate varies significantly, and the underlying neural mechanisms are still a matter of debate. The question whether an individually tailored framework positively influences neurofeedback success remains largely unexplored. Methods: To address this question, participants were trained to modulate the activity of a target brain region, the visual motion area hMT+/V5, based on the performance of three imagery tasks with increasing complexity: imagery of a static dot, imagery of a moving dot with two and with four opposite directions. Participants received auditory feedback in the form of vocalizations with either negative, neutral or positive valence. The modulation thresholds were defined for each participant according to the maximum BOLD signal change of their target region during the localizer run. Results: We found that 4 out of 10 participants were able to modulate brain activity in this region-of-interest during neurofeedback training. This rate of success (40%) is consistent with the neurofeedback literature. Whole-brain analysis revealed the recruitment of specific cortical regions involved in cognitive control, reward monitoring, and feedback processing during neurofeedback training. Individually tailored feedback thresholds did not correlate with the success level. We found region-dependent neuromodulation profiles associated with task complexity and feedback valence. Discussion: Findings support the strategic role of task complexity and feedback valence on the modulation of the network nodes involved in monitoring and feedback control, key variables in neurofeedback frameworks optimization. Considering the elaborate design, the small sample size here tested (N = 10) impairs external validity in comparison to our previous studies. Future work will address this limitation. Ultimately, our results contribute to the discussion of individually tailored solutions, and justify further investigation concerning volitional control over brain activity.
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Affiliation(s)
- Bruno Direito
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Manuel Ramos
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
| | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Siemens Healthineers, Lisbon, Portugal
| | - Teresa Sousa
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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The Current Evidence Levels for Biofeedback and Neurofeedback Interventions in Treating Depression: A Narrative Review. Neural Plast 2021; 2021:8878857. [PMID: 33613671 PMCID: PMC7878101 DOI: 10.1155/2021/8878857] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/28/2020] [Accepted: 01/25/2021] [Indexed: 12/22/2022] Open
Abstract
This article is aimed at showing the current level of evidence for the usage of biofeedback and neurofeedback to treat depression along with a detailed review of the studies in the field and a discussion of rationale for utilizing each protocol. La Vaque et al. criteria endorsed by the Association for Applied Psychophysiology and Biofeedback and International Society for Neuroregulation & Research were accepted as a means of study evaluation. Heart rate variability (HRV) biofeedback was found to be moderately supportable as a treatment of MDD while outcome measure was a subjective questionnaire like Beck Depression Inventory (level 3/5, “probably efficacious”). Electroencephalographic (EEG) neurofeedback protocols, namely, alpha-theta, alpha, and sensorimotor rhythm upregulation, all qualify for level 2/5, “possibly efficacious.” Frontal alpha asymmetry protocol also received limited evidence of effect in depression (level 2/5, “possibly efficacious”). Finally, the two most influential real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback protocols targeting the amygdala and the frontal cortices both demonstrate some effectiveness, though lack replications (level 2/5, “possibly efficacious”). Thus, neurofeedback specifically targeting depression is moderately supported by existing studies (all fit level 2/5, “possibly efficacious”). The greatest complication preventing certain protocols from reaching higher evidence levels is a relatively high number of uncontrolled studies and an absence of accurate replications arising from the heterogeneity in protocol details, course lengths, measures of improvement, control conditions, and sample characteristics.
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Upregulation of Supplementary Motor Area Activation with fMRI Neurofeedback during Motor Imagery. eNeuro 2021; 8:ENEURO.0377-18.2020. [PMID: 33376115 PMCID: PMC7877466 DOI: 10.1523/eneuro.0377-18.2020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 11/21/2022] Open
Abstract
Functional magnetic resonance imaging (fMRI) neurofeedback (NF) is a promising tool to study the relationship between behavior and brain activity. It enables people to self-regulate their brain signal. Here, we applied fMRI NF to train healthy participants to increase activity in their supplementary motor area (SMA) during a motor imagery (MI) task of complex body movements while they received a continuous visual feedback signal. This signal represented the activity of participants’ localized SMA regions in the NF group and a prerecorded signal in the control group (sham feedback). In the NF group only, results showed a gradual increase in SMA-related activity across runs. This upregulation was largely restricted to the SMA, while other regions of the motor network showed no, or only marginal NF effects. In addition, we found behavioral changes, i.e., shorter reaction times in a Go/No-go task after the NF training only. These results suggest that NF can assist participants to develop greater control over a specifically targeted motor region involved in motor skill learning. The results contribute to a better understanding of the underlying mechanisms of SMA NF based on MI with a direct implication for rehabilitation of motor dysfunctions.
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Training negative connectivity patterns between the dorsolateral prefrontal cortex and amygdala through fMRI-based neurofeedback to target adolescent socially-avoidant behaviour. Behav Res Ther 2020; 135:103760. [PMID: 33137695 DOI: 10.1016/j.brat.2020.103760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/06/2020] [Accepted: 10/23/2020] [Indexed: 12/28/2022]
Abstract
Social anxiety is prevalent in adolescence. Given its role in maintaining fears, reducing social avoidance through cognitive reappraisal may help attenuate social anxiety. We used fMRI-based neurofeedback (NF) to increase 'adaptive' patterns of negative connectivity between the dorsolateral prefrontal cortex (DLPFC) and the amygdala to change reappraisal ability, and alter social avoidance and approach behaviours in adolescents. Twenty-seven female participants aged 13-17 years with varying social anxiety levels completed a fMRI-based NF training task where they practiced cognitive reappraisal strategies, whilst receiving real-time feedback of DLPFC-amygdala connectivity. All participants completed measures of cognitive reappraisal and social approach-avoidance behaviour before and after NF training. Avoidance of happy faces was associated with greater social anxiety pre-training. Participants who were unable to acquire a more negative pattern of connectivity through NF training displayed significantly greater avoidance of happy faces at post-training compared to pre-training. These 'maladaptive' participants also reported significant decreases in re-appraisal ability from pre to post-training. In contrast, those who were able to acquire a more 'adaptive' connectivity pattern did not show these changes in social avoidance and re-appraisal. Future research could consider using strategies to improve the capacity of NF training to boost youth social-approach behaviour.
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Liu N, Yao L, Zhao X. Evaluating the amygdala network induced by neurofeedback training for emotion regulation using hierarchical clustering. Brain Res 2020; 1740:146853. [PMID: 32339500 DOI: 10.1016/j.brainres.2020.146853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 04/08/2020] [Accepted: 04/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Previous studies have shown that regulating the target region by real-time fMRI-based neurofeedback training can influence the activation of other regions and the functional connectivity between them. However, it is not clear whether the training effect of neurofeedback, especially in emotion regulation, is manifested in local network specialization or global network integration. In the current study, we chose the left amygdala (LA) as the target region to regulate positive emotion through real-time fMRI training. Average-linkage hierarchical clustering was employed to cluster the fMRI data recorded during the training to construct whole-brain networks and the LA network to which the LA belongs. RESULTS The activation in the LA and those in some other regions were significantly up-regulated during the training. The clustering analysis at group level showed that the feedback training did not affect the number of networks in the whole brain but altered the distribution and functional connectivity in the LA network. CONCLUSION These findings suggested that the feedback training effects in emotion regulation pattern reflected by the activity of the target brain network and the connections within the network were robustly embodied in local network specialization instead of in global network integration.
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Affiliation(s)
- Ning Liu
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China
| | - Li Yao
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China
| | - Xiaojie Zhao
- College of Information Science and Technology, Beijing Normal University, Beijing 100875, China.
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Quevedo K, Yuan Teoh J, Engstrom M, Wedan R, Santana-Gonzalez C, Zewde B, Porter D, Cohen Kadosh K. Amygdala Circuitry During Neurofeedback Training and Symptoms' Change in Adolescents With Varying Depression. Front Behav Neurosci 2020; 14:110. [PMID: 32774244 PMCID: PMC7388863 DOI: 10.3389/fnbeh.2020.00110] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 06/04/2020] [Indexed: 12/28/2022] Open
Abstract
Typical adolescents have increased limbic engagement unchecked by regulatory medial prefrontal cortex (PFC) activity as well as heightened self-focus. The resulting emotion dysregulation and self-focused rumination make adolescents more susceptible to depression and suicide attempts. Heightened self-focus converges with mental illness among depressed adolescents, who deploy exaggerated attention to negative self-relevant stimuli and neglect positive ones as part of depression's phenomenology. This results in rigid negative self-representations during an identity formative period with potential lifetime repercussions. Current empirically supported treatments fail to allay recurrent depression. Evidence-based interventions for illnesses linked to suicide ideation and attempts (e.g., depression) underperform across the lifespan. This could be because current treatments are not successful in altering pervasive negative self-representations and affect dysregulation, which is known to be a risk factor of chronic depression. This study departs from the premise that increasing positive self-processing might be protective against chronic depression particularly during adolescence. The present research is a novel investigation of neurofeedback as a potential treatment alternative for adolescent depression. To enhance positive self-processing, we used the happy self-face as a cue to initiate neurofeedback from the bilateral amygdala and hippocampus and adolescents attempted to upregulate that limbic activity through the recall of positive autobiographical memories. We identified limbic functional circuitry engaged during neurofeedback and links to short-term symptoms' change in depression and rumination. We found that depressed youth showed greater right amygdala to right frontocortical connectivity and lower left amygdala to right frontocortical connectivity compared to healthy controls during neurofeedback vs. control conditions. Depressed youth also showed significant symptom reduction. Connectivity between the right amygdala and frontocortical regions was positively correlated with rumination and depression change, but connectivity between frontocortical regions and the left amygdala was negatively correlated with depression change. The results suggest that depressed youth might engage implicit emotion regulation circuitry while healthy youth recruit explicit emotion regulation circuits during neurofeedback. Our findings support a compensatory approach (i.e., target the right amygdala) during future neurofeedback interventions in depressed youth. Future work ought to include a placebo condition or group.
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Affiliation(s)
- Karina Quevedo
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Jia Yuan Teoh
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Maggie Engstrom
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Riley Wedan
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Carmen Santana-Gonzalez
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Betanya Zewde
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - David Porter
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, MN, United States
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Zich C, Johnstone N, Lührs M, Lisk S, Haller SP, Lipp A, Lau JY, Kadosh KC. Modulatory effects of dynamic fMRI-based neurofeedback on emotion regulation networks in adolescent females. Neuroimage 2020; 220:117053. [PMID: 32574803 PMCID: PMC7573536 DOI: 10.1016/j.neuroimage.2020.117053] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 01/01/2023] Open
Abstract
Research has shown that difficulties with emotion regulation abilities in childhood and adolescence increase the risk for developing symptoms of mental disorders, e.g anxiety. We investigated whether functional magnetic resonance imaging (fMRI)-based neurofeedback (NF) can modulate brain networks supporting emotion regulation abilities in adolescent females. We performed three experiments (Experiment 1: N = 18; Experiment 2: N = 30; Experiment 3: N = 20). We first compared different NF implementations regarding their effectiveness of modulating prefrontal cortex (PFC)-amygdala functional connectivity (fc). Further we assessed the effects of fc-NF on neural measures, emotional/metacognitive measures and their associations. Finally, we probed the mechanism underlying fc-NF by examining concentrations of inhibitory and excitatory neurotransmitters. Results showed that NF implementations differentially modulate PFC-amygdala fc. Using the most effective NF implementation we observed important relationships between neural and emotional/metacognitive measures, such as practice-related change in fc was related with change in thought control ability. Further, we found that the relationship between state anxiety prior to the MRI session and the effect of fc-NF was moderated by GABA concentrations in the PFC and anterior cingulate cortex. To conclude, we were able to show that fc-NF can be used in adolescent females to shape neural and emotional/metacognitive measures underlying emotion regulation. We further show that neurotransmitter concentrations moderate fc–NF–effects. Neurofeedback implementations differentially modulate PFC-amygdala connectivity. Functional connectivity neurofeedback affect measures of emotion regulation. Neurotransmitter concentrations moderate neurofeedback effects.
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Affiliation(s)
- Catharina Zich
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK.
| | - Nicola Johnstone
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Michael Lührs
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, 6211 LK, the Netherlands; Department of Research and Development, Brain Innovation, Maastricht, 6229 EV, the Netherlands
| | - Stephen Lisk
- Psychology Department, Institute of Psychiatry, King's College London, London, SE5 8AF, UK
| | - Simone Pw Haller
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
| | - Annalisa Lipp
- School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
| | - Jennifer Yf Lau
- Psychology Department, Institute of Psychiatry, King's College London, London, SE5 8AF, UK
| | - Kathrin Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK; School of Psychology, University of Surrey, Guildford, GU2 7XH, UK
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Fede SJ, Dean SF, Manuweera T, Momenan R. A Guide to Literature Informed Decisions in the Design of Real Time fMRI Neurofeedback Studies: A Systematic Review. Front Hum Neurosci 2020; 14:60. [PMID: 32161529 PMCID: PMC7052377 DOI: 10.3389/fnhum.2020.00060] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 02/07/2020] [Indexed: 11/26/2022] Open
Abstract
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, 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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Affiliation(s)
| | | | | | - Reza Momenan
- Clinical NeuroImaging Research Core, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, United States
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Steinert S, Friedrich O. Wired Emotions: Ethical Issues of Affective Brain-Computer Interfaces. SCIENCE AND ENGINEERING ETHICS 2020; 26:351-367. [PMID: 30868377 PMCID: PMC6978299 DOI: 10.1007/s11948-019-00087-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 01/24/2019] [Indexed: 05/28/2023]
Abstract
Ethical issues concerning brain-computer interfaces (BCIs) have already received a considerable amount of attention. However, one particular form of BCI has not received the attention that it deserves: Affective BCIs that allow for the detection and stimulation of affective states. This paper brings the ethical issues of affective BCIs in sharper focus. The paper briefly reviews recent applications of affective BCIs and considers ethical issues that arise from these applications. Ethical issues that affective BCIs share with other neurotechnologies are presented and ethical concerns that are specific to affective BCIs are identified and discussed.
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Affiliation(s)
- Steffen Steinert
- Department of Values, Technology and Innovation, Faculty of Technology, Policy and Management, Delft University of Technology, Delft, The Netherlands
| | - Orsolya Friedrich
- Institute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-Universität München, Lessingstr. 2, 80336 Munich, Germany
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39
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Mayeli A, Misaki M, Zotev V, Tsuchiyagaito A, Al Zoubi O, Phillips R, Smith J, Stewart JL, Refai H, Paulus MP, Bodurka J. Self-regulation of ventromedial prefrontal cortex activation using real-time fMRI neurofeedback-Influence of default mode network. Hum Brain Mapp 2020; 41:342-352. [PMID: 31633257 PMCID: PMC7267960 DOI: 10.1002/hbm.24805] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 02/03/2023] Open
Abstract
The ventromedial prefrontal cortex (vmPFC) is involved in regulation of negative emotion and decision-making, emotional and behavioral control, and active resilient coping. This pilot study examined the feasibility of training healthy subjects (n = 27) to self-regulate the vmPFC activity using a real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf). Participants in the experimental group (EG, n = 18) were provided with an ongoing vmPFC hemodynamic activity (rtfMRI-nf signal represented as variable-height bar). Individuals were instructed to raise the bar by self-relevant value-based thinking. Participants in the control group (CG, n = 9) performed the same task; however, they were provided with computer-generated sham neurofeedback signal. Results demonstrate that (a) both the CG and the EG show a higher vmPFC fMRI signal at the baseline than during neurofeedback training; (b) no significant positive training effect was seen in the vmPFC across neurofeedback runs; however, the medial prefrontal cortex, middle temporal gyri, inferior frontal gyri, and precuneus showed significant decreasing trends across the training runs only for the EG; (c) the vmPFC rtfMRI-nf signal associated with the fMRI signal across the default mode network (DMN). These findings suggest that it may be difficult to modulate a single DMN region without affecting other DMN regions. Observed decreased vmPFC activity during the neurofeedback task could be due to interference from the fMRI signal within other DMN network regions, as well as interaction with task-positive networks. Even though participants in the EG did not show significant positive increase in the vmPFC activity among neurofeedback runs, they were able to learn to accommodate the demand of self-regulation task to maintain the vmPFC activity with the help of a neurofeedback signal.
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Affiliation(s)
- Ahmad Mayeli
- Laureate Institute for Brain ResearchTulsaOklahoma
- Electrical and Computer Engineering DepartmentUniversity of OklahomaTulsaOklahoma
| | | | - Vadim Zotev
- Laureate Institute for Brain ResearchTulsaOklahoma
| | - Aki Tsuchiyagaito
- Laureate Institute for Brain ResearchTulsaOklahoma
- Japan Society for the Promotion ScienceTokyoJapan
- Research Center for Child DevelopmentChiba UniversityChibaJapan
| | - Obada Al Zoubi
- Laureate Institute for Brain ResearchTulsaOklahoma
- Electrical and Computer Engineering DepartmentUniversity of OklahomaTulsaOklahoma
| | | | - Jared Smith
- Laureate Institute for Brain ResearchTulsaOklahoma
| | | | - Hazem Refai
- Electrical and Computer Engineering DepartmentUniversity of OklahomaTulsaOklahoma
| | | | - Jerzy Bodurka
- Laureate Institute for Brain ResearchTulsaOklahoma
- Stephenson School of Biomedical EngineeringUniversity of OklahomaTulsaOklahoma
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40
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Fernández-Álvarez J, Di Lernia D, Riva G. Virtual Reality for Anxiety Disorders: Rethinking a Field in Expansion. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:389-414. [PMID: 32002939 DOI: 10.1007/978-981-32-9705-0_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The principal aim to this chapter is to present the latest ideas in virtual reality (VR), some of which have already been applied to the field of anxiety disorders, and others are still pending to be materialized. More than 20 years ago, VR emerged as an exposure tool in order to provide patients and therapists with more appealing ways of delivering a technique that was undoubtedly effective but also rejected and thus underused. Throughout these years, many improvements were achieved. The first section of the chapter describes those improvements, both considering the research progresses and the applications in the real world. In a second part, our main interest is to expand the discussion of the new applications of VR beyond its already known role as an exposure tool. In particular, VR is enabling the materialization of numerous ideas that were previously confined to a merely philosophical discussion in the field of cognitive sciences. That is, VR has the enormous potential of providing feasible ways to explore nonclassical ways of cognition, such as embodied and situated information processing. Despite the fact that many of these developments are not fully developed, and not specifically designed for anxiety disorders, we want to introduce these new ideas in a context in which VR is experiencing an enormous transformation.
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Affiliation(s)
| | | | - Giuseppe Riva
- Universita Cattolica del Sacro Cuore, Milan, Italy. .,ATN-P Lab, Istituto Auxologico Italiano, Milan, Italy.
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41
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Hetkamp M, Bender J, Rheindorf N, Kowalski A, Lindner M, Knispel S, Beckmann M, Tagay S, Teufel M. A Systematic Review of the Effect of Neurofeedback in Cancer Patients. Integr Cancer Ther 2019; 18:1534735419832361. [PMID: 30832518 PMCID: PMC6416750 DOI: 10.1177/1534735419832361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction: Neurofeedback (NF) or electroencephalogram (EEG)-Biofeedback is a drug-free form of brain training to directly alter the underlying neural mechanisms of cognition and behavior. It is a technique that measures a subject’s EEG signal, processes it in real time, with the goal to enable a behavioral modification by modulating brain activity. The most common application of the NF technology is in epilepsies, migraine, attention-deficit/hyperactivity disorder, autism spectrum disorder, affective disorders, and psychotic disorders. Few studies have investigated the use of NF in context of psychosomatic illnesses. Little is known about the use in cancer patients or postcancer survivors despite the high number of this patient group. Objectives: We here provide a systematic review of the use and effect of NF on symptoms and burden in cancer patients and long-term cancer survivors. Methods: In conducting this systematic review, we followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Statement. Results: Our search resulted in only 3 experimental studies, 1 observational study, and 2 case reports. Given the heterogeneity of the intervention systems and protocols, no meta-analysis was conducted. Conclusion: Altogether, there is initial evidence that NF is a complementary, drug-free, and noninvasive therapy that has the potential to ameliorate symptoms in this patient group, such as pain, fatigue, depression, and sleep. Further studies are highly needed.
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Affiliation(s)
- Madeleine Hetkamp
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jasmin Bender
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nadine Rheindorf
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Axel Kowalski
- 2 Neurofit Academy for Therapy and Training, Krefeld, Germany
| | - Marion Lindner
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sarah Knispel
- 3 Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Mingo Beckmann
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sefik Tagay
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- 1 Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
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42
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Current progress in real-time functional magnetic resonance-based neurofeedback: Methodological challenges and achievements. Neuroimage 2019; 202:116107. [DOI: 10.1016/j.neuroimage.2019.116107] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/26/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022] Open
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Abstract
Abstract
Purpose of Review
Adolescent depression is a major public health concern associated with severe outcomes. A lack of efficacious interventions has triggered an increase in cognitive neuropsychology research to identify relevant treatment targets for new interventions. This review summarises key neurocognitive findings in adolescent depression and explores the potential of neurocognitive markers as treatment targets in new interventions.
Recent Findings
Studies support difficulties in the voluntary deployment of attention towards and away from emotional stimuli, negative interpretation biases and overgeneralised autobiographical memories in adolescent depression; however, little evidence is given to a general decline in executive function. There is consistent evidence for abnormalities in several distributed neural networks in adolescent depression, including dysfunction in and between the amygdala, medial prefrontal cortex and ventral striatum.
Summary
The relationships between different cognitive biases and abnormalities in specific neural networks remain unclear. Several new experimental interventions targeting these neurocognitive markers await evaluation.
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44
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Wang S, Zhao Y, Li J, Wang X, Luo K, Gong Q. Brain structure links trait conscientiousness to academic performance. Sci Rep 2019; 9:12168. [PMID: 31434943 PMCID: PMC6704183 DOI: 10.1038/s41598-019-48704-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 07/31/2019] [Indexed: 02/05/2023] Open
Abstract
In the long history of identifying factors to predict academic performance, conscientiousness, a so-called ‘big five’ personality trait describing self-regulation and goal-directed behavior, has emerged as a stable predictor for this purpose. However, the neuroanatomical substrates of trait conscientiousness and the underlying brain mechanism linking trait conscientiousness and academic performance are still largely unknown. Here, we examined these issues in 148 high school students within the same grade by estimating cortical gray matter volume (GMV) utilizing a voxel-based morphometry method based on structural magnetic resonance imaging. A whole-brain regression analysis showed that trait conscientiousness was positively associated with the GMV in the bilateral superior parietal lobe (SPL) and was negatively associated with the GMV in the right middle frontal gyrus (MFG). Furthermore, mediation analysis revealed that trait conscientiousness mediated the influences of the SPL and MFG volume on academic performance. Importantly, our results persisted even when we adjusted for general intelligence, family socioeconomic status and ‘big five’ personality traits other than conscientiousness. Altogether, our study suggests that the GMV in the frontoparietal network is a neurostructural marker of adolescents’ conscientiousness and reveals a potential brain-personality-achievement pathway for predicting academic performance in which gray matter structures affect academic performance through trait conscientiousness.
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Affiliation(s)
- Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China.,Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, 610036, China.,Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Yajun Zhao
- School of Sociology and Psychology, Southwest Minzu University, Chengdu, 610041, China
| | - Jingguang Li
- College of Education, Dali University, Dali, 671003, China
| | - Xu Wang
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Kui Luo
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, 610041, China. .,Department of Psychoradiology, Chengdu Mental Health Center, Chengdu, 610036, China. .,Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, 610041, China.
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45
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Colombo D, Fernández-Álvarez J, García Palacios A, Cipresso P, Botella C, Riva G. New Technologies for the Understanding, Assessment, and Intervention of Emotion Regulation. Front Psychol 2019; 10:1261. [PMID: 31275191 PMCID: PMC6591314 DOI: 10.3389/fpsyg.2019.01261] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 05/13/2019] [Indexed: 01/10/2023] Open
Abstract
In the last decades, emotion regulation (ER) received increasing attention and became one of the most studied topics within the psychological field. Nevertheless, this construct has not been fully updated with the latest technological advancements. In this perspective, we will show how diverse technologies, such as virtual reality (VR), wearable biosensors, smartphones, or biofeedback techniques, can be applied to the understanding, assessment, and intervention of ER. After providing a brief overview of the currently available technological developments, we will discuss the benefits of incorporating new technologies in ER field, including ecological validity, intervention personalization, and the integration of understudied facets of ER, such as the implicit and interpersonal dimension.
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Affiliation(s)
- Desirée Colombo
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón de la Plana, Spain
| | | | - Azucena García Palacios
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón de la Plana, Spain
- CIBER of Physiopathology of Obesity and Nutrition, Madrid, Spain
| | - Pietro Cipresso
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano (IRCCS), Milan, Italy
| | - Cristina Botella
- Department of Basic Psychology, Clinical and Psychobiology, Jaume I University, Castellón de la Plana, Spain
- CIBER of Physiopathology of Obesity and Nutrition, Madrid, Spain
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano (IRCCS), Milan, Italy
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46
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Linhartová P, Látalová A, Kóša B, Kašpárek T, Schmahl C, Paret C. fMRI neurofeedback in emotion regulation: A literature review. Neuroimage 2019; 193:75-92. [DOI: 10.1016/j.neuroimage.2019.03.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 03/03/2019] [Accepted: 03/05/2019] [Indexed: 12/23/2022] Open
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Pedale T, Macaluso E, Santangelo V. Enhanced insular/prefrontal connectivity when resisting from emotional distraction during visual search. Brain Struct Funct 2019; 224:2009-2026. [PMID: 31111208 PMCID: PMC6591190 DOI: 10.1007/s00429-019-01873-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 04/11/2019] [Indexed: 01/26/2023]
Abstract
Previous literature demonstrated that the processing of emotional stimuli can interfere with goal-directed behavior. This has been shown primarily in the context of working memory tasks, but “emotional distraction” may affect also other processes, such as the orienting of visuo-spatial attention. During fMRI, we presented human subjects with emotional stimuli embedded within complex everyday life visual scenes. Emotional stimuli could be either the current target to be searched for or task-irrelevant distractors. Behavioral and eye-movement data revealed faster detection of emotional than neutral targets. Emotional distractors were found to be fixated later and for a shorter duration than emotional targets, suggesting efficient top-down control in avoiding emotional distraction. The fMRI data demonstrated that negative (but not positive) stimuli were mandatorily processed by limbic/para-limbic regions (namely, the right amygdala and the left insula), irrespective of current task relevance: that is, these regions activated for both emotional targets and distractors. However, analyses of inter-regional connectivity revealed a functional coupling between the left insula and the right prefrontal cortex that increased specifically during search in the presence of emotional distractors. This indicates that increased functional coupling between affective limbic/para-limbic regions and control regions in the frontal cortex can attenuate emotional distraction, permitting the allocation of spatial attentional resources toward task-relevant neutral targets in the presence of distracting emotional signals.
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Affiliation(s)
- Tiziana Pedale
- Department of Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00158, Rome, Italy. .,Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy. .,Umeå Center for Functional Brain Imaging (UFBI), Department of Integrative Medical Biology, Umeå University, 901 87, Umeå, Sweden.
| | - Emiliano Macaluso
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy.,ImpAct Team, Lyon Neuroscience Research Center, 16, av. du Doyen Lépine, 69676, Bron Cedex, France
| | - Valerio Santangelo
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Via Ardeatina, 306, 00179, Rome, Italy. .,Department of Philosophy, Social Sciences and Education, University of Perugia, Piazza G. Ermini, 1, 06123, Perugia, Italy.
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48
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Neurofeedback mithilfe funktioneller Magnetresonanztomographie in Echtzeit. PSYCHOTHERAPEUT 2019. [DOI: 10.1007/s00278-019-0352-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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49
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Xia M, Si T, Sun X, Ma Q, Liu B, Wang L, Meng J, Chang M, Huang X, Chen Z, Tang Y, Xu K, Gong Q, Wang F, Qiu J, Xie P, Li L, He Y. Reproducibility of functional brain alterations in major depressive disorder: Evidence from a multisite resting-state functional MRI study with 1,434 individuals. Neuroimage 2019; 189:700-714. [DOI: 10.1016/j.neuroimage.2019.01.074] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/18/2019] [Accepted: 01/30/2019] [Indexed: 01/14/2023] Open
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50
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Barreiros AR, Almeida I, Baía BC, Castelo-Branco M. Amygdala Modulation During Emotion Regulation Training With fMRI-Based Neurofeedback. Front Hum Neurosci 2019; 13:89. [PMID: 30971906 PMCID: PMC6444080 DOI: 10.3389/fnhum.2019.00089] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 02/25/2019] [Indexed: 11/25/2022] Open
Abstract
Available evidence suggests that individuals can enhance their ability to modulate brain activity in target regions, within the Emotion Regulation network, using fMRI-based neurofeedback. However, there is no systematic review that investigates the effectiveness of this method on amygdala modulation, a core region within this network. The major goal of this study was to systematically review and analyze the effects of real-time fMRI-Neurofeedback concerning the neuromodulation of the amygdala during Emotion Regulation training. A search was performed in PubMed, Science Direct, and Web of Science with the following key terms: ≪(“neurofeedback” or “neuro feedback” or “neuro-feedback”) and (“emotion regulation”) and (fMRI OR “functional magnetic resonance”),≫ and afterwards two additional searches were performed, replacing the term “emotion regulation” for “amygdala” and “neurofeedback” for “feedback.” Of the 531 identified articles, only 19 articles reported results of amygdala modulation during Emotional Regulation training through rtfMRI-NF, using healthy participants or patients, in original research articles. The results, systematically reviewed here, provide evidence for amygdala's modulation during rtfMRI-NF training, although studies' heterogeneity precluded a quantitative meta-analysis—the included studies relied on different outcome measures to infer the success of neurofeedback intervention. Thus, a qualitative analysis was done instead. We identified critical features influencing inference on the quality of the intervention as: the inclusion of a Practice Run, a Transfer Run and a Control Group in the protocol, and to choose adequate Emotion Regulation strategies—in particular, the effective recall of autobiographic memories. Surprisingly, the Regulated vs. Control Condition was lacking in most of the studies, precluding valid inference of amygdala neuromodulation within Session. The best controlled studies nevertheless showed positive effects. The type of stimulus/interface did not seem critical for amygdala modulation. We also identified potential effects of lateralization of amygdala responses following Up- or Down-Regulation, and the impact of fMRI parameters for data acquisition and analysis. Despite qualitative evidence for amygdala modulation during rtfMRI-NF, there are still important limitations in the design of a clear conceptual framework of NF-training research. Future studies should focus on more homogeneous guidelines concerning design, protocol structure and, particularly, harmonized outcome measures to provide quantitative estimates of neuromodulatory effects in the amygdala.
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Affiliation(s)
- Ana Rita Barreiros
- CIBIT, ICNAS-Institute of Nuclear Sciences Applied to Health-and CNC.IBILI-Faculty of Medicine, Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Inês Almeida
- CIBIT, ICNAS-Institute of Nuclear Sciences Applied to Health-and CNC.IBILI-Faculty of Medicine, Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Bárbara Correia Baía
- CIBIT, ICNAS-Institute of Nuclear Sciences Applied to Health-and CNC.IBILI-Faculty of Medicine, Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Miguel Castelo-Branco
- CIBIT, ICNAS-Institute of Nuclear Sciences Applied to Health-and CNC.IBILI-Faculty of Medicine, Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
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