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Mou S, Yan S, Shen S, Shuai Y, Li G, Shen Z, Shen P. Prolonged Disease Course Leads to Impaired Brain Function in Anxiety Disorder: A Resting State EEG Study. Neuropsychiatr Dis Treat 2024; 20:1409-1419. [PMID: 39049937 PMCID: PMC11268773 DOI: 10.2147/ndt.s458106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 07/03/2024] [Indexed: 07/27/2024] Open
Abstract
Objective Anxiety disorder (AD) is a common disabling disease. The prolonged disease course may lead to impaired cognitive performance, brain function, and a bad prognosis. Few studies have examined the effect of disease course on brain function by electroencephalogram (EEG). Methods Resting-state EEG analysis was performed in 34 AD patients. The 34 patients with AD were divided into two groups according to the duration of their illness: anxious state (AS) and generalized anxiety disorder (GAD). Then, EEG features, including univariate power spectral density (PSD), fuzzy entropy (FE), and multivariable functional connectivity (FC), were extracted and compared between AS and GAD. These features were evaluated by three previously validated machine learning methods to test the accuracy of classification in AS and GAD. Results Significant decreased PSD and FE in GAD were detected compared with AS, especially in the Alpha 2 band. In addition, FC analysis indicated that GAD patients' connection between the left and right hemispheres decreased. Based on machine learning, AS and GAD are classified on a six-month criterion with the highest classification accuracy of up to 0.99 ± 0.0015. Conclusion The brain function of patients is more severely impaired in AD patients with longer illness duration. Resting-state EEG demonstrated to be a promising examination in the classification in GAD and AS using machine learning methods with better classification accuracy.
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Affiliation(s)
- Shaoqi Mou
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Shiyu Yan
- Department of Psychiatry, Wenzhou Medical University, Wenzhou, People’s Republic of China
| | - Shanhong Shen
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
| | - Yibin Shuai
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
| | - Gang Li
- College of Engineering, Zhejiang Normal University, Jinhua, People’s Republic of China
| | - Zhongxia Shen
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
| | - Ping Shen
- Department of Sleep Medical Center, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, People’s Republic of China
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Li J, Li X, Chen F, Li W, Chen J, Zhang B. Studying the Alzheimer's disease continuum using EEG and fMRI in single-modality and multi-modality settings. Rev Neurosci 2024; 35:373-386. [PMID: 38157429 DOI: 10.1515/revneuro-2023-0098] [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: 08/28/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024]
Abstract
Alzheimer's disease (AD) is a biological, clinical continuum that covers the preclinical, prodromal, and clinical phases of the disease. Early diagnosis and identification of the stages of Alzheimer's disease (AD) are crucial in clinical practice. Ideally, biomarkers should reflect the underlying process (pathological or otherwise), be reproducible and non-invasive, and allow repeated measurements over time. However, the currently known biomarkers for AD are not suitable for differentiating the stages and predicting the trajectory of disease progression. Some objective parameters extracted using electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) are widely applied to diagnose the stages of the AD continuum. While electroencephalography (EEG) has a high temporal resolution, fMRI has a high spatial resolution. Combined EEG and fMRI (EEG-fMRI) can overcome single-modality drawbacks and obtain multi-dimensional information simultaneously, and it can help explore the hemodynamic changes associated with the neural oscillations that occur during information processing. This technique has been used in the cognitive field in recent years. This review focuses on the different techniques available for studying the AD continuum, including EEG and fMRI in single-modality and multi-modality settings, and the possible future directions of AD diagnosis using EEG-fMRI.
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Affiliation(s)
- Jing Li
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, Jiangsu, 210008, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Xin Li
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, Jiangsu, 210008, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Futao Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, Jiangsu, 210008, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Weiping Li
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, Jiangsu, 210008, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Jiu Chen
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, Jiangsu, 210008, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
| | - Bing Zhang
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, 210008, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, Jiangsu, 210008, China
- Medical Imaging Center, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210008, China
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing, Jiangsu, 210008, China
- Institute of Brain Science, Nanjing University, Nanjing, Jiangsu, 210008, China
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Jindal M, Chhetri A, Ludhiadch A, Singh P, Peer S, Singh J, Brar RS, Munshi A. Neuroimaging Genomics a Predictor of Major Depressive Disorder (MDD). Mol Neurobiol 2024; 61:3427-3440. [PMID: 37989980 DOI: 10.1007/s12035-023-03775-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
Depression is a complex psychiatric disorder influenced by various genetic and environmental factors. Strong evidence has established the contribution of genetic factors in depression through twin studies and the heritability rate for depression has been reported to be 37%. Genetic studies have identified genetic variations associated with an increased risk of developing depression. Imaging genetics is an integrated approach where imaging measures are combined with genetic information to explore how specific genetic variants contribute to brain abnormalities. Neuroimaging studies allow us to examine both structural and functional abnormalities in individuals with depression. This review has been designed to study the correlation of the significant genetic variants with different regions of neural activity, connectivity, and structural alteration in the brain as detected by imaging techniques to understand the scope of biomarkers in depression. This might help in developing novel therapeutic interventions targeting specific genetic pathways or brain circuits and the underlying pathophysiology of depression based on this integrated approach can be established at length.
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Affiliation(s)
- Manav Jindal
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Aakash Chhetri
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India
| | - Abhilash Ludhiadch
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India
| | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Sameer Peer
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, India
| | - Jawahar Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bathinda, India
| | - Rahatdeep Singh Brar
- Department of Diagnostic and Interventional Radiology, Homi Bhabha Cancer Hospital & Research Center, Mohali, India
| | - Anjana Munshi
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151401, India.
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Wu YC, Yu HE, Yen CF, Yeh YC, Jian CR, Lin CW, Lin IM. The effects of swLORETA Z-score neurofeedback for patients comorbid with major depressive disorder and anxiety symptoms. J Affect Disord 2024; 350:340-349. [PMID: 38199411 DOI: 10.1016/j.jad.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 11/28/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Patients with major depressive disorder (MDD) exhibit atypical brain activities in the frontal, temporal, and parietal lobes. The study aimed to investigate the effects of standardized weighted low-resolution electromagnetic tomography Z-score neurofeedback (swLZNFB) on symptoms of depression and anxiety, electroencephalography (EEG) parameters, and deep brain activities in patients with MDD. METHOD Forty-eight patients with MDD comorbid with anxiety symptoms were assigned to the swLZNFB group and the control group. Participants completed the Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI) and a 5-minute resting EEG at the pre-and post-tests. The swLZNFB group received ten sessions of one-hour treatment twice weekly. The control group received treatment as usual. The scores for BDI-II and BAI, number of EEG abnormalities, percentage of EEG abnormalities, and current source density (CSD) measured in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), posterior cingulate cortex (PCC), and amygdala were compared at pre-and post-tests between the two groups. RESULTS There were decreased scores of BDI-II and BAI, number of EEG abnormalities, and percentage of EEG abnormalities at post-test compared with pre-test in the swLZNFB group, and lower scores of BDI-II and BAI at post-test in the swLZNFB group compared with the control group. Moreover, decreased CSD of beta1 and beta3 in the PFC, ACC, PCC, and amygdala at post-test compared to pre-test in the swLZNFB group. LIMITATIONS Not a randomized controlled trial. CONCLUSION Ten sessions of swLZNFB reduced clinical symptoms and atypical brain activities, it serves as a potential psychological intervention for patients with MDD.
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Affiliation(s)
- Yin-Chen Wu
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan
| | - Hong-En Yu
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Chun Yeh
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan; Graduate Institute of Medicine, Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cian-Ruei Jian
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - Chien-Wen Lin
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
| | - I-Mei Lin
- Department of Psychology, College of Humanities and Social Sciences, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
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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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Tian S, Wang Q, Zhang S, Chen Z, Dai Z, Zhang W, Yao Z, Lu Q. Local and large-scale resting-state oscillatory dysfunctions for early antidepressant response prediction in major depressive disorder. J Affect Disord 2023; 340:751-757. [PMID: 37597781 DOI: 10.1016/j.jad.2023.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/05/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Magnetoencephalography (MEG) could explore and resolve brain signals with realistic temporal resolution to investigate the underlying electrophysiology of major depressive disorder (MDD) and the treatment efficacy. Here, we explore whether neuro-electrophysiological features of MDD at baseline can be used as a neural marker to predict their early antidepressant response. METHODS Sixty-six medication-free patients with MDD and 48 healthy controls were enrolled and underwent resting-state MEG scans. Hamilton depression rating scale (HAMD-17) was assessed at both baseline and after two-week pharmacotherapy. We measured local and large-scale resting-state oscillatory dysfunctions with a data-driven model, the Fitting Oscillations & One-Over F algorithm. Then, we quantified band-limited regional power and functional connectivity between brain regions. RESULTS After two-week follow-up, 52 patients completed the re-interviews. Thirty-one patients showed early response (ER) to pharmacotherapy and 21 patients did not. Treatment response was defined as at least 50 % reduction of severity reflected by HAMD-17. We observed decreased regional periodic power in patients with MDD comparing to controls. However, patients with ER exhibited that functional couplings across brain regions in both alpha and beta band were increased and significantly correlated with severity of depressive symptoms after treatment. Receiver operating characteristic curves (ROC) further confirmed the predictive ability of baseline large-scale functional connectivity for early antidepressant efficacy (AUC = 0.9969). LIMITATIONS Relatively small sample size and not a double-blind design. CONCLUSIONS The current study demonstrated the electrophysiological dysfunctions of local neural oscillatory related with depression and highlighted the identification ability of large-scale couplings biomarkers in early antidepressant response prediction.
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Affiliation(s)
- Shui Tian
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qiang Wang
- Department of Medical Psychology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Siqi Zhang
- Insitut des Sciences Cognitives, Marc Jeannerod, CNRS, France
| | - Zhilu Chen
- Department of Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhongpeng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Wei Zhang
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China
| | - Zhijian Yao
- Department of Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing 210029, China; School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Nanjing Brain Hospital, Medical School of Nanjing University, Nanjing 210093, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, China.
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Dobbins ICDS, Bastos M, Ratis RC, Silva WCFND, Bonini JS. Effects of neurofeedback on major depressive disorder: a systematic review. EINSTEIN-SAO PAULO 2023; 21:eRW0253. [PMID: 37493834 PMCID: PMC10356125 DOI: 10.31744/einstein_journal/2023rw0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/31/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Major depressive disorder is a difficult-to-treat psychological disorder. Approximately 30% of patients with major depressive disorder do not respond to conventional therapies; thus, the efficacy of alternative therapies for treating major depressive disorder, such as neurofeedback, a non-invasive neuromodulation method used in the treatment of psychiatric diseases, must be investigated. OBJECTIVE We aimed to evaluate the efficacy of neurofeedback in minimizing and treating major depressive disorder and its application as a substitute to or an adjuvant with conventional therapies. METHODS We searched for experimental studies published between 1962-2021 in Scopus, PubMed, Web of Science, and Embase databases and identified 1,487 studies, among which 13 met the inclusion exclusion criteria. RESULTS We noted that not all patients responded to neurofeedback. Based on depression scales, major depressive disorder significantly improved in response to neurofeedback only in a few individuals. Additionally, the number of training sessions did not influence the results. CONCLUSION Neurofeedback can reduce depression symptoms in patients; however, not all patients respond to the treatment. Therefore, further studies must be conducted to validate the effectiveness of neurofeedback in treating major depressive disorder.
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Affiliation(s)
| | - Murilo Bastos
- Department of Pharmaceutics Science, Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | - Renan Cassiano Ratis
- Department of Pharmaceutics Science, Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
| | | | - Juliana Sartori Bonini
- Department of Pharmaceutics Science, Universidade Estadual do Centro-Oeste, Guarapuava, PR, Brazil
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Imperatori C, Massullo C, De Rossi E, Carbone GA, Theodorou A, Scopelliti M, Romano L, Del Gatto C, Allegrini G, Carrus G, Panno A. Exposure to nature is associated with decreased functional connectivity within the distress network: A resting state EEG study. Front Psychol 2023; 14:1171215. [PMID: 37151328 PMCID: PMC10158085 DOI: 10.3389/fpsyg.2023.1171215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction Despite the well-established evidence supporting the restorative potential of nature exposure, the neurophysiological underpinnings of the restorative cognitive/emotional effect of nature are not yet fully understood. The main purpose of the current study was to investigate the association between exposure to nature and electroencephalography (EEG) functional connectivity in the distress network. Methods Fifty-three individuals (11 men and 42 women; mean age 21.38 ± 1.54 years) were randomly assigned to two groups: (i) a green group and (ii) a gray group. A slideshow consisting of images depicting natural and urban scenarios were, respectively, presented to the green and the gray group. Before and after the slideshow, 5 min resting state (RS) EEG recordings were performed. The exact low-resolution electromagnetic tomography (eLORETA) software was used to execute all EEG analyses. Results Compared to the gray group, the green group showed a significant increase in positive emotions (F 1; 50 = 9.50 p = 0.003) and in the subjective experience of being full of energy and alive (F 1; 50 = 4.72 p = 0.035). Furthermore, as compared to urban pictures, the exposure to natural images was associated with a decrease of delta functional connectivity in the distress network, specifically between the left insula and left subgenual anterior cingulate cortex (T = -3.70, p = 0.023). Discussion Our results would seem to be in accordance with previous neurophysiological studies suggesting that experiencing natural environments is associated with brain functional dynamics linked to emotional restorative processes.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Chiara Massullo
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, Rome, Italy
| | - Elena De Rossi
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Giuseppe Alessio Carbone
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
- Department of Psychology, University of Turin, Turin, Italy
- *Correspondence: Giuseppe Alessio Carbone,
| | - Annalisa Theodorou
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, Rome, Italy
| | | | - Luciano Romano
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Claudia Del Gatto
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Giorgia Allegrini
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
| | - Giuseppe Carrus
- Experimental Psychology Laboratory, Department of Education, Roma Tre University, Rome, Italy
| | - Angelo Panno
- Cognitive and Clinical Psychology Laboratory, Department of Human Sciences, European University of Rome, Rome, Italy
- Angelo Panno,
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Ciccarelli G, Federico G, Mele G, Di Cecca A, Migliaccio M, Ilardi CR, Alfano V, Salvatore M, Cavaliere C. Simultaneous real-time EEG-fMRI neurofeedback: A systematic review. Front Hum Neurosci 2023; 17:1123014. [PMID: 37063098 PMCID: PMC10102573 DOI: 10.3389/fnhum.2023.1123014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/15/2023] [Indexed: 04/18/2023] Open
Abstract
Neurofeedback (NF) is a biofeedback technique that teaches individuals self-control of brain functions by measuring brain activations and providing an online feedback signal to modify emotional, cognitive, and behavioral functions. NF approaches typically rely on a single modality, such as electroencephalography (EEG-NF) or a brain imaging technique, such as functional magnetic resonance imaging (fMRI-NF). The introduction of simultaneous EEG-fMRI tools has opened up the possibility of combining the high temporal resolution of EEG with the high spatial resolution of fMRI, thereby increasing the accuracy of NF. However, only a few studies have actively combined both techniques. In this study, we conducted a systematic review of EEG-fMRI-NF studies (N = 17) to identify the potential and effectiveness of this non-invasive treatment for neurological conditions. The systematic review revealed a lack of homogeneity among the studies, including sample sizes, acquisition methods in terms of simultaneity of the two procedures (unimodal EEG-NF and fMRI-NF), therapeutic targets field, and the number of sessions. Indeed, because most studies are based on a single session of NF, it is difficult to draw any conclusions regarding the therapeutic efficacy of NF. Therefore, further research is needed to fully understand non-clinical and clinical potential of EEG-fMRI-NF.
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Godet A, Fortier A, Bannier E, Coquery N, Val-Laillet D. Interactions between emotions and eating behaviors: Main issues, neuroimaging contributions, and innovative preventive or corrective strategies. Rev Endocr Metab Disord 2022; 23:807-831. [PMID: 34984602 DOI: 10.1007/s11154-021-09700-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 12/13/2022]
Abstract
Emotional eating is commonly defined as the tendency to (over)eat in response to emotion. Insofar as it involves the (over)consumption of high-calorie palatable foods, emotional eating is a maladaptive behavior that can lead to eating disorders, and ultimately to metabolic disorders and obesity. Emotional eating is associated with eating disorder subtypes and with abnormalities in emotion processing at a behavioral level. However, not enough is known about the neural pathways involved in both emotion processing and food intake. In this review, we provide an overview of recent neuroimaging studies, highlighting the brain correlates between emotions and eating behavior that may be involved in emotional eating. Interaction between neural and neuro-endocrine pathways (HPA axis) may be involved. In addition to behavioral interventions, there is a need for a holistic approach encompassing both neural and physiological levels to prevent emotional eating. Based on recent imaging, this review indicates that more attention should be paid to prefrontal areas, the insular and orbitofrontal cortices, and reward pathways, in addition to regions that play a major role in both the cognitive control of emotions and eating behavior. Identifying these brain regions could allow for neuromodulation interventions, including neurofeedback training, which deserves further investigation.
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Affiliation(s)
- Ambre Godet
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - Alexandra Fortier
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - Elise Bannier
- CRNS, INSERM, IRISA, INRIA, Univ Rennes, Empenn Rennes, France
- Radiology Department, Rennes University Hospital, Rennes, France
| | - Nicolas Coquery
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France
| | - David Val-Laillet
- Nutrition Metabolisms and Cancer (NuMeCan), INRAE, INSERM, Univ Rennes, St Gilles, France.
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Warbrick T. Simultaneous EEG-fMRI: What Have We Learned and What Does the Future Hold? SENSORS (BASEL, SWITZERLAND) 2022; 22:2262. [PMID: 35336434 PMCID: PMC8952790 DOI: 10.3390/s22062262] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/11/2022] [Accepted: 03/13/2022] [Indexed: 02/01/2023]
Abstract
Simultaneous EEG-fMRI has developed into a mature measurement technique in the past 25 years. During this time considerable technical and analytical advances have been made, enabling valuable scientific contributions to a range of research fields. This review will begin with an introduction to the measurement principles involved in EEG and fMRI and the advantages of combining these methods. The challenges faced when combining the two techniques will then be considered. An overview of the leading application fields where EEG-fMRI has made a significant contribution to the scientific literature and emerging applications in EEG-fMRI research trends is then presented.
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Affiliation(s)
- Tracy Warbrick
- Brain Products GmbH, Zeppelinstrasse 7, 82205 Gilching, Germany
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Editorial: Clinical Neurofeedback. NEUROIMAGE: CLINICAL 2022; 35:102905. [PMID: 34866039 PMCID: PMC9421443 DOI: 10.1016/j.nicl.2021.102905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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13
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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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14
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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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Keller M, Zweerings J, Klasen M, Zvyagintsev M, Iglesias J, Mendoza Quiñones R, Mathiak K. fMRI Neurofeedback-Enhanced Cognitive Reappraisal Training in Depression: A Double-Blind Comparison of Left and Right vlPFC Regulation. Front Psychiatry 2021; 12:715898. [PMID: 34497546 PMCID: PMC8419460 DOI: 10.3389/fpsyt.2021.715898] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/29/2021] [Indexed: 01/09/2023] Open
Abstract
Affective disorders are associated with maladaptive emotion regulation strategies. In particular, the left more than the right ventrolateral prefrontal cortex (vlPFC) may insufficiently regulate emotion processing, e.g., in the amygdala. A double-blind cross-over study investigated NF-supported cognitive reappraisal training in major depression (n = 42) and age- and gender-matched controls (n = 39). In a randomized order, participants trained to upregulate either the left or the right vlPFC during cognitive reappraisal of negative images on two separate days. We wanted to confirm regional specific NF effects with improved learning for left compared to right vlPFC (ClinicalTrials.gov NCT03183947). Brain responses and connectivity were studied with respect to training progress, gender, and clinical outcomes in a 4-week follow-up. Increase of vlPFC activity was stronger after NF training from the left- than the right-hemispheric ROI. This regional-specific NF effect during cognitive reappraisal was present across patients with depression and controls and supports a central role of the left vlPFC for cognitive reappraisal. Further, the activity in the left target region was associated with increased use of cognitive reappraisal strategies (r = 0.48). In the 4-week follow-up, 75% of patients with depression reported a successful application of learned strategies in everyday life and 55% a clinically meaningful symptom improvement suggesting clinical usability.
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Affiliation(s)
- Micha Keller
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany
| | - Martin Klasen
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,Interdisciplinary Training Centre for Medical Education and Patient Safety-AIXTRA, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Mikhail Zvyagintsev
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany
| | - Jorge Iglesias
- Department of Cognitive Neuroscience, Cuban Center for Neuroscience, Havana, Cuba
| | | | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.,JARA-Brain, Research Center Jülich, Jülich, Germany
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Zotev V, Mayeli A, Misaki M, Bodurka J. Emotion self-regulation training in major depressive disorder using simultaneous real-time fMRI and EEG neurofeedback. Neuroimage Clin 2020; 27:102331. [PMID: 32623140 PMCID: PMC7334611 DOI: 10.1016/j.nicl.2020.102331] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 12/11/2022]
Abstract
Simultaneous real-time fMRI and EEG neurofeedback (rtfMRI-EEG-nf) is an emerging neuromodulation approach, that enables simultaneous volitional regulation of both hemodynamic (BOLD fMRI) and electrophysiological (EEG) brain activities. Here we report the first application of rtfMRI-EEG-nf for emotion self-regulation training in patients with major depressive disorder (MDD). In this proof-of-concept study, MDD patients in the experimental group (n = 16) used rtfMRI-EEG-nf during a happy emotion induction task to simultaneously upregulate two fMRI and two EEG activity measures relevant to MDD. The target measures included BOLD activities of the left amygdala (LA) and left rostral anterior cingulate cortex (rACC), and frontal EEG asymmetries in the alpha band (FAA, [7.5-12.5] Hz) and high-beta band (FBA, [21-30] Hz). MDD patients in the control group (n = 8) were provided with sham feedback signals. An advanced procedure for improved real-time EEG-fMRI artifact correction was implemented. The experimental group participants demonstrated significant upregulation of the LA BOLD activity, FAA, and FBA during the rtfMRI-EEG-nf task, as well as significant enhancement in fMRI connectivity between the LA and left rACC. Average individual FAA changes during the rtfMRI-EEG-nf task positively correlated with depression and anhedonia severities, and negatively correlated with after-vs-before changes in depressed mood ratings. Temporal correlations between the FAA and FBA time courses and the LA BOLD activity were significantly enhanced during the rtfMRI-EEG-nf task. The experimental group participants reported significant mood improvements after the training. Our results suggest that the rtfMRI-EEG-nf may have potential for treatment of MDD.
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Affiliation(s)
- Vadim Zotev
- Laureate Institute for Brain Research, Tulsa, OK, USA.
| | - Ahmad Mayeli
- Laureate Institute for Brain Research, Tulsa, OK, USA; Electrical and Computer Engineering, University of Oklahoma, Tulsa, OK, USA
| | - Masaya Misaki
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, USA; Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA.
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