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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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2
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Sangchooli A, Zare-Bidoky M, Fathi Jouzdani A, Schacht J, Bjork JM, Claus ED, Prisciandaro JJ, Wilson SJ, Wüstenberg T, Potvin S, Ahmadi P, Bach P, Baldacchino A, Beck A, Brady KT, Brewer JA, Childress AR, Courtney KE, Ebrahimi M, Filbey FM, Garavan H, Ghahremani DG, Goldstein RZ, Goudriaan AE, Grodin EN, Hanlon CA, Haugg A, Heilig M, Heinz A, Holczer A, Van Holst RJ, Joseph JE, Juliano AC, Kaufman MJ, Kiefer F, Khojasteh Zonoozi A, Kuplicki RT, Leyton M, London ED, Mackey S, McClernon FJ, Mellick WH, Morley K, Noori HR, Oghabian MA, Oliver JA, Owens M, Paulus MP, Perini I, Rafei P, Ray LA, Sinha R, Smolka MN, Soleimani G, Spanagel R, Steele VR, Tapert SF, Vollstädt-Klein S, Wetherill RR, Witkiewitz K, Yuan K, Zhang X, Verdejo-Garcia A, Potenza MN, Janes AC, Kober H, Zilverstand A, Ekhtiari H. Parameter Space and Potential for Biomarker Development in 25 Years of fMRI Drug Cue Reactivity: A Systematic Review. JAMA Psychiatry 2024; 81:414-425. [PMID: 38324323 PMCID: PMC11304510 DOI: 10.1001/jamapsychiatry.2023.5483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Importance In the last 25 years, functional magnetic resonance imaging drug cue reactivity (FDCR) studies have characterized some core aspects in the neurobiology of drug addiction. However, no FDCR-derived biomarkers have been approved for treatment development or clinical adoption. Traversing this translational gap requires a systematic assessment of the FDCR literature evidence, its heterogeneity, and an evaluation of possible clinical uses of FDCR-derived biomarkers. Objective To summarize the state of the field of FDCR, assess their potential for biomarker development, and outline a clear process for biomarker qualification to guide future research and validation efforts. Evidence Review The PubMed and Medline databases were searched for every original FDCR investigation published from database inception until December 2022. Collected data covered study design, participant characteristics, FDCR task design, and whether each study provided evidence that might potentially help develop susceptibility, diagnostic, response, prognostic, predictive, or severity biomarkers for 1 or more addictive disorders. Findings There were 415 FDCR studies published between 1998 and 2022. Most focused on nicotine (122 [29.6%]), alcohol (120 [29.2%]), or cocaine (46 [11.1%]), and most used visual cues (354 [85.3%]). Together, these studies recruited 19 311 participants, including 13 812 individuals with past or current substance use disorders. Most studies could potentially support biomarker development, including diagnostic (143 [32.7%]), treatment response (141 [32.3%]), severity (84 [19.2%]), prognostic (30 [6.9%]), predictive (25 [5.7%]), monitoring (12 [2.7%]), and susceptibility (2 [0.5%]) biomarkers. A total of 155 interventional studies used FDCR, mostly to investigate pharmacological (67 [43.2%]) or cognitive/behavioral (51 [32.9%]) interventions; 141 studies used FDCR as a response measure, of which 125 (88.7%) reported significant interventional FDCR alterations; and 25 studies used FDCR as an intervention outcome predictor, with 24 (96%) finding significant associations between FDCR markers and treatment outcomes. Conclusions and Relevance Based on this systematic review and the proposed biomarker development framework, there is a pathway for the development and regulatory qualification of FDCR-based biomarkers of addiction and recovery. Further validation could support the use of FDCR-derived measures, potentially accelerating treatment development and improving diagnostic, prognostic, and predictive clinical judgments.
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Affiliation(s)
- Arshiya Sangchooli
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Mehran Zare-Bidoky
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Fathi Jouzdani
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Joseph Schacht
- Department of Psychiatry, University of Colorado School of Medicine, Aurora
| | - James M Bjork
- Institute for Drug and Alcohol Studies, Department of Psychiatry, Virginia Commonwealth University, Richmond
| | - Eric D Claus
- Department of Biobehavioral Health, The Pennsylvania State University, University Park
| | - James J Prisciandaro
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Stephen J Wilson
- Department of Psychology, The Pennsylvania State University, State College
| | - Torsten Wüstenberg
- Field of Focus IV, Core Facility for Neuroscience of Self-Regulation (CNSR), Heidelberg University, Heidelberg, Germany
| | - Stéphane Potvin
- Department of Psychiatry and Addiction, Université de Montréal, Montréal, Quebec, Canada
| | - Pooria Ahmadi
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick Bach
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alex Baldacchino
- School of Medicine, University of St Andrews, St Andrews, Scotland
| | - Anne Beck
- Faculty of Health, Health and Medical University, Potsdam, Germany
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kathleen T Brady
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Judson A Brewer
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | | | | | - Mohsen Ebrahimi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Francesca M Filbey
- Center for BrainHealth, School of Behavioral and Brain Sciences, University of Texas at Dallas
| | - Hugh Garavan
- Department of Psychiatry, University of Vermont, Burlington
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Rita Z Goldstein
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anneke E Goudriaan
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Erica N Grodin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Colleen A Hanlon
- Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, North Carolina
- BrainsWay Inc, Winston-Salem, North Carolina
| | - Amelie Haugg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Adrienn Holczer
- Department of Neurology, Albert Szent-Györgyi Health Centre, University of Szeged, Szeged, Hungary
| | - Ruth J Van Holst
- Amsterdam Institute for Addiction Research, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jane E Joseph
- Department of Neuroscience, Medical University of South Carolina, Charleston
| | | | - Marc J Kaufman
- McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Falk Kiefer
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Marco Leyton
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Scott Mackey
- Department of Psychiatry, University of Vermont, Burlington
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
| | - William H Mellick
- Addiction Sciences Division, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston
| | - Kirsten Morley
- Specialty of Addiction Medicine, Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Hamid R Noori
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Jason A Oliver
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Max Owens
- Department of Psychiatry, University of Vermont, Burlington
| | | | - Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Parnian Rafei
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Lara A Ray
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Michael N Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Ghazaleh Soleimani
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Rainer Spanagel
- Institute of Psychopharmacology, Central Institute of Mental Health, Mannheim, Germany
| | - Vaughn R Steele
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego
| | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health (CIMH), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Kai Yuan
- School of Life Science and Technology, Xidian University, Xi'an, China
| | - Xiaochu Zhang
- Department of Psychology, School of Humanities and Social Science, University of Science and Technology of China, Anhui, China
| | | | - Marc N Potenza
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - Amy C Janes
- Cognitive and Pharmacological Neuroimaging Unit, National Institute on Drug Abuse, Baltimore, Maryland
| | - Hedy Kober
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Anna Zilverstand
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Hamed Ekhtiari
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
- Laureate Institute for Brain Research, Tulsa, Oklahoma
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3
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Tosti B, Corrado S, Mancone S, Di Libero T, Rodio A, Andrade A, Diotaiuti P. Integrated use of biofeedback and neurofeedback techniques in treating pathological conditions and improving performance: a narrative review. Front Neurosci 2024; 18:1358481. [PMID: 38567285 PMCID: PMC10985214 DOI: 10.3389/fnins.2024.1358481] [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: 12/19/2023] [Accepted: 03/01/2024] [Indexed: 04/04/2024] Open
Abstract
In recent years, the scientific community has begun tо explore the efficacy оf an integrated neurofeedback + biofeedback approach іn various conditions, both pathological and non-pathological. Although several studies have contributed valuable insights into its potential benefits, this review aims tо further investigate its effectiveness by synthesizing current findings and identifying areas for future research. Our goal іs tо provide a comprehensive overview that may highlight gaps іn the existing literature and propose directions for subsequent studies. The search for articles was conducted on the digital databases PubMed, Scopus, and Web of Science. Studies to have used the integrated neurofeedback + biofeedback approach published between 2014 and 2023 and reviews to have analyzed the efficacy of neurofeedback and biofeedback, separately, related to the same time interval and topics were selected. The search identified five studies compatible with the objectives of the review, related to several conditions: nicotine addiction, sports performance, Autism Spectrum Disorder (ASD), and Attention Deficit Hyperactivity Disorder (ADHD). The integrated neurofeedback + biofeedback approach has been shown to be effective in improving several aspects of these conditions, such as a reduction in the presence of psychiatric symptoms, anxiety, depression, and withdrawal symptoms and an increase in self-esteem in smokers; improvements in communication, imitation, social/cognitive awareness, and social behavior in ASD subjects; improvements in attention, alertness, and reaction time in sports champions; and improvements in attention and inhibitory control in ADHD subjects. Further research, characterized by greater methodological rigor, is therefore needed to determine the effectiveness of this method and the superiority, if any, of this type of training over the single administration of either. This review іs intended tо serve as a catalyst for future research, signaling promising directions for the advancement оf biofeedback and neurofeedback methodologies.
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Affiliation(s)
- Beatrice Tosti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Tommaso Di Libero
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
| | - Alexandro Andrade
- Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino, Cassino, Lazio, Italy
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Palmer AM, Carpenter MJ, Baker NL, Froeliger B, Foster MG, Garland EL, Saladin ME, Toll BA. Development of two novel treatments to promote smoking cessation: Savor and retrieval-extinction training pilot clinical trial findings. Exp Clin Psychopharmacol 2024; 32:16-26. [PMID: 36913266 PMCID: PMC10497721 DOI: 10.1037/pha0000644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Despite decades of progress, cigarette smoking remains a significant contributor to disease burden. This effect is especially pronounced for specific priority populations, such as individuals who live in rural communities, in that the burden of tobacco smoking is greater among these groups than in urban areas and the general population. The present study aims to evaluate the feasibility and acceptability of two novel tobacco treatment interventions delivered through remote telehealth procedures to individuals who smoke in the state of South Carolina. Results also include exploratory analyses of smoking cessation outcomes. Study I evaluated savoring, a strategy based on mindfulness practices, alongside nicotine replacement therapy (NRT). Study II evaluated retrieval-extinction training (RET), a memory-modification paradigm alongside NRT. In Study I (savoring), recruitment and retention data showed high interest and engagement in the intervention components, and participants who received this intervention decreased cigarette smoking throughout the course of the treatment (ps < .05). In Study II (RET), results showed high interest and moderate engagement in treatment, although exploratory outcome analyses did not demonstrate significant treatment effects on smoking behaviors. Overall, both studies showed promise in generating interest among individuals who smoke in participating in remotely delivered, telehealth smoking cessation interventions with novel therapeutic targets. A brief savoring intervention appeared to have effects on cigarette smoking throughout treatment, whereas RET did not. Gaining insight from the present pilot study, future studies may improve the efficacy of these procedures and incorporate the treatment components into more robust available treatments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Amanda M. Palmer
- Department of Public Health Sciences, Medical University of South Carolina
| | - Matthew J. Carpenter
- Department of Public Health Sciences, Medical University of South Carolina
- Department of Psychiatry, Medical University of South Carolina
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina
| | - Nathaniel L. Baker
- Department of Public Health Sciences, Medical University of South Carolina
| | - Brett Froeliger
- Department of Psychiatry, University of Missouri School of Medicine
- Department of Psychological Sciences, University of Missouri School of Medicine
| | - Madeline G. Foster
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina
| | - Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah
- Supportive Oncology and Survivorship, Huntsman Cancer Institute, University of Utah Health
| | - Michael E. Saladin
- Department of Psychiatry, Medical University of South Carolina
- Department of Health Sciences and Research, Medical University of South Carolina
| | - Benjamin A. Toll
- Department of Public Health Sciences, Medical University of South Carolina
- Department of Psychiatry, Medical University of South Carolina
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina
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Li X, Caulfield KA, Hartwell KJ, Henderson S, Brady KT, George MS. Reduced executive and reward connectivity is associated with smoking cessation response to repetitive transcranial magnetic stimulation: A double-blind, randomized, sham-controlled trial. Brain Imaging Behav 2024; 18:207-219. [PMID: 37996557 PMCID: PMC11005027 DOI: 10.1007/s11682-023-00820-3] [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] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) can reduce cue-elicited craving, decrease cigarette consumption, and increase the abstinence rate in tobacco use disorders (TUDs). We used functional magnetic resonance imaging (fMRI) to investigate the effect of 10 sessions of rTMS on cortical activity and neural networks in treatment-seeking smokers. Smoking cue exposure fMRI scans were acquired before and after the 10 sessions of active or sham rTMS (10 Hz, 3000 pulses per session) to the left dorsal lateral prefrontal cortex (DLPFC) in 42 treatment-seeking smokers (≥ 10 cigarettes per day). Brain activity and functional connectivity were compared before and after 10 sessions of rTMS. Ten sessions of rTMS significantly reduced the number of cigarettes consumed per day (62.93%) compared to sham treatment (39.43%) at the end of treatment (p = 0.027). fMRI results showed that the rTMS treatment increased brain activity in the dorsal anterior cingulate cortex (dACC) and DLPFC, but decreased brain activity in the bilateral medial orbitofrontal cortex (mOFC). The lower strength of dACC and mOFC connectivity was associated with quitting smoking (Wald score = 5.00, p = 0.025). The reduction of cigarette consumption significantly correlated with the increased brain activation in the dACC (r = 0.76, p = 0.0001). By increasing the brain activity in the dACC and prefrontal cortex and decreasing brain activity in the mOFC, 10 sessions of rTMS significantly reduced cigarette consumption and increased quit rate. Reduced drive-reward and executive control functional connectivity was associated with the smoking cessation effect from rTMS. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02401672.
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Affiliation(s)
- Xingbao Li
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA.
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, 29425, USA.
| | - Kevin A Caulfield
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Karen J Hartwell
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, 29425, USA
| | - Scott Henderson
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Kathleen T Brady
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, 29425, USA
| | - Mark S George
- Brain Stimulation Division, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, 29425, USA
- Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC, 29425, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, 29425, USA
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Watve A, Haugg A, Frei N, Koush Y, Willinger D, Bruehl AB, Stämpfli P, Scharnowski F, Sladky R. Facing emotions: real-time fMRI-based neurofeedback using dynamic emotional faces to modulate amygdala activity. Front Neurosci 2024; 17:1286665. [PMID: 38274498 PMCID: PMC10808718 DOI: 10.3389/fnins.2023.1286665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Maladaptive functioning of the amygdala has been associated with impaired emotion regulation in affective disorders. Recent advances in real-time fMRI neurofeedback have successfully demonstrated the modulation of amygdala activity in healthy and psychiatric populations. In contrast to an abstract feedback representation applied in standard neurofeedback designs, we proposed a novel neurofeedback paradigm using naturalistic stimuli like human emotional faces as the feedback display where change in the facial expression intensity (from neutral to happy or from fearful to neutral) was coupled with the participant's ongoing bilateral amygdala activity. Methods The feasibility of this experimental approach was tested on 64 healthy participants who completed a single training session with four neurofeedback runs. Participants were assigned to one of the four experimental groups (n = 16 per group), i.e., happy-up, happy-down, fear-up, fear-down. Depending on the group assignment, they were either instructed to "try to make the face happier" by upregulating (happy-up) or downregulating (happy-down) the amygdala or to "try to make the face less fearful" by upregulating (fear-up) or downregulating (fear-down) the amygdala feedback signal. Results Linear mixed effect analyses revealed significant amygdala activity changes in the fear condition, specifically in the fear-down group with significant amygdala downregulation in the last two neurofeedback runs as compared to the first run. The happy-up and happy-down groups did not show significant amygdala activity changes over four runs. We did not observe significant improvement in the questionnaire scores and subsequent behavior. Furthermore, task-dependent effective connectivity changes between the amygdala, fusiform face area (FFA), and the medial orbitofrontal cortex (mOFC) were examined using dynamic causal modeling. The effective connectivity between FFA and the amygdala was significantly increased in the happy-up group (facilitatory effect) and decreased in the fear-down group. Notably, the amygdala was downregulated through an inhibitory mechanism mediated by mOFC during the first training run. Discussion In this feasibility study, we intended to address key neurofeedback processes like naturalistic facial stimuli, participant engagement in the task, bidirectional regulation, task congruence, and their influence on learning success. It demonstrated that such a versatile emotional face feedback paradigm can be tailored to target biased emotion processing in affective disorders.
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Affiliation(s)
- Apurva Watve
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
| | - Amelie Haugg
- Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Nada Frei
- Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| | - Yury Koush
- Magnetic Resonance Research Center (MRRC), Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, United States
| | - David Willinger
- Department of Child and Adolescent Psychiatry, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
- Division of Psychodynamics, Department of Psychology and Psychodynamics, Karl Landsteiner University of Health Sciences, Krems an der Donau, Lower Austria, Austria
- Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology, Zürich, Switzerland
| | - Annette Beatrix Bruehl
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
- Center for Affective, Stress and Sleep Disorders, Psychiatric University Hospital Basel, Basel, Switzerland
| | - Philipp Stämpfli
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
| | - Frank Scharnowski
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
- Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology, Zürich, Switzerland
- Zurich Center for Integrative Human Physiology, Faculty of Medicine, University of Zürich, Zürich, Switzerland
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Ronald Sladky
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital, University of Zürich, Zürich, Switzerland
- Social, Cognitive and Affective Neuroscience Unit, Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria
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Hou L, Meng Y, Gao J, Li M, Zhou R. Women with more severe premenstrual syndrome have an enhanced anticipatory reward processing: a magnetoencephalography study. Arch Womens Ment Health 2023; 26:803-817. [PMID: 37730923 DOI: 10.1007/s00737-023-01368-3] [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: 04/04/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Laboratory studies reveal that young women with premenstrual syndrome (PMS) often exhibit decreased reward processing during the late luteal phase. However, studies based on the self-reports find opposite results (e.g., higher craving for high-sweet-fat food). These differences may lie in the difference between the stimulus used and measuring the different aspects of the reward. The present study was designed to expand previous work by using a classic monetary reward paradigm, simultaneously examining the motivational (i.e., reward anticipation, "wanting") and emotional (i.e., reward outcome, "liking") components of reward processing in women with high premenstrual symptoms (High PMS). College female students in their early twenties with High PMS (n = 20) and low premenstrual symptoms (Low PMS, n = 20) completed a monetary incentive delay task during their late luteal phase when the premenstrual symptoms typically peak. Brain activities in the reward anticipation phase and outcome phase were recorded using the magnetoencephalographic (MEG) imaging technique. No group differences were found in various behavioral measurements. For the MEG results, in the anticipation phase, when High PMS participants were presented with cues that predicted the upcoming monetary gains, they showed higher event-related magnetic fields (ERFs) than when they were presented with neutral non-reward cues. This pattern was reversed in Low PMS participants, as they showed lower reward cue-elicited ERFs than non-reward cue-elicited ones (cluster mass = 2560, cluster size = 891, p = .03, corrected for multiple comparisons), mainly in the right medial orbitofrontal and lateral orbitofrontal cortex (cluster mass = 375, cluster size = 140, p = .03, corrected for multiple comparisons). More importantly, women with High PMS had an overall significantly higher level of ERFs than women with Low PMS (cluster mass = 8039, cluster size = 2937, p = .0009, corrected for multiple comparisons) in the bilateral precentral gyrus, right postcentral gyrus, and left superior temporal gyrus (right: cluster mass = 410, cluster size = 128, p = .03; left: cluster mass = 352, cluster size = 98, p = .05; corrected for multiple comparisons). In the outcome phase, women with High PMS showed significantly lower theta power than the Low PMS ones for the expected non-reward feedback in the bilateral temporal-parietal regions (cluster mass = 47620, cluster size = 18308, p = .01, corrected for multiple comparisons). These findings reveal that the severity of PMS might alter reward anticipation. Specifically, women with High PMS displayed increased brain activities to reward-predicting cues and increased action preparation after the cues appear.
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Affiliation(s)
- Lulu Hou
- Department of Psychology, Nanjing University, Nanjing, 210023, China
- Department of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Yao Meng
- Department of Psychology, Nanjing University, Nanjing, 210023, China
- School of Nursing, Nanjing Medical University, Nanjing, 211166, China
| | - Jiahong Gao
- Beijing City Key Lab for Medical Physics and Engineering, Institution of Heavy Ion Physics, School of Physics, Peking University, Beijing, 100871, China
- Center for MRI Research, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, 100871, China
- McGovern Institute for Brain Research, Peking University, Beijing, 100871, China
| | - Ming Li
- Department of Psychology, Nanjing University, Nanjing, 210023, China
| | - Renlai Zhou
- Department of Psychology, Nanjing University, Nanjing, 210023, China.
- Department of Radiology, the Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China.
- State Key Laboratory of Media Convergence Production Technology and Systems, Beijing, 100803, China.
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8
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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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9
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Luo M, Gan Q, Fu Y, Chen Z. Cue-reactivity targeted smoking cessation intervention in individuals with tobacco use disorder: a scoping review. Front Psychiatry 2023; 14:1167283. [PMID: 37743997 PMCID: PMC10512743 DOI: 10.3389/fpsyt.2023.1167283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
Objectives Cue-reactivity is a critical step leading to the emergence of addictive psychology and the triggering of addictive behaviors within the framework of addiction theory and is considered a significant risk factor for addiction-related behaviors. However, the effect of cue-reactivity targeted smoking cessation intervention and the cue-reactivity paradigms used in the randomized controlled trials varies, which introduces more heterogeneity and makes a side-by-side comparison of cessation responses difficult. Therefore, the scoping review aims to integrate existing research and identify evidence gaps. Methods We searched databases in English (PubMed and Embase) and Chinese (CNKI and Wanfang) using terms synonymous with 'cue' and 'tobacco use disorder (TUD)' to April 2023, and via hand-searching and reference screening of included studies. Studies were included if they were randomized controlled trials taking cue-reactivity as an indicator for tobacco use disorder (TUD) defined by different kinds of criteria. Results Data were extracted on each study's country, population, methods, timeframes, outcomes, cue-reactivity paradigms, and so on. Of the 2,944 literature were retrieved, 201 studies met the criteria and were selected for full-text screening. Finally, 67 pieces of literature were selected for inclusion and data extraction. The results mainly revealed that non-invasive brain stimulation and exercise therapy showed a trend of greater possibility in reducing subjective craving compared to the remaining therapies, despite variations in the number of research studies conducted in each category. And cue-reactivity paradigms vary in materials and mainly fall into two main categories: behaviorally induced craving paradigm or visually induced craving paradigm. Conclusion The current studies are still inadequate in terms of comparability due to their heterogeneity, cue-reactivity can be conducted in the future by constructing a standard library of smoking cue materials. Causal analysis is suggested in order to adequately screen for causes of addiction persistence, and further explore the specific objective cue-reactivity-related indicators of TUD.
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Affiliation(s)
- Miaoling Luo
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Quan Gan
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Yu Fu
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
| | - Zhuangfei Chen
- Medical School, Kunming University of Science and Technology, Kunming, China
- Brain Science and Visual Cognition Research Center, Medical School of Kunming University of Science and Technology, Kunming, China
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10
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Abstract
This chapter covers how repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) presently affects smoking cessation. 14 human studies have examined the efficacy of rTMS on cue craving, cigarette consumption, or smoking cessation using a variety of different coils, locations, and treatment parameters. These studies included 7 randomized-controlled trials (RCT) and 7 experimental studies. Most studies (12/14) reported that rTMS reduced cue-induced craving, 5 showed that it decreased cigarette consumption, and 3/4 reported that multiple sessions of rTMS increased the quit rate. In contrast to rTMS, tDCS has 6 RCT studies, of which only 2 studies reported that tDCS reduced craving, and only 1 reported that it reduced cigarette consumption. Three studies failed to find an effect of tDCS on cravings. No tDCS studies reported changing quitting rates in people who smoke. Despite the early positive results of tDCS on nicotine dependence symptoms, 2 larger RCTs recently failed to find a therapeutic effect of tDCS for smoking cessation. In conclusion, rTMS studies demonstrate that multiple sessions help quit smoking, and it has gained FDA approval for that purpose. However, more studies are needed to examine the effect of tDCS with different treatment parameters.
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Affiliation(s)
- Xingbao Li
- Brain Stimulation Division, Psychiatry Department, Medical University of South Carolina, Charleston, SC, USA
| | - Mark S George
- Brain Stimulation Division, Psychiatry Department, Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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11
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Aslan M, Sala M, Gueorguieva R, Garrison KA. A Network Analysis of Cigarette Craving. Nicotine Tob Res 2023; 25:1155-1163. [PMID: 36757093 PMCID: PMC10202645 DOI: 10.1093/ntr/ntad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/25/2023] [Accepted: 02/06/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Craving is considered a central process to addictive behavior including cigarette smoking, although the clinical utility of craving relies on how it is defined and measured. Network analysis enables examining the network structure of craving symptoms, identifying the most central symptoms of cigarette craving, and improving our understanding of craving and its measurement. AIMS AND METHODS This study used network analysis to identify the central symptoms of self-reported cigarette craving as measured by the Craving Experience Questionnaire, which assesses both craving strength and craving frequency. Data were obtained from baseline of a randomized controlled trial of mindfulness training for smoking cessation. RESULTS The most central symptoms in an overall cigarette craving network were the frequency of imagining its smell, imagining its taste, and intrusive thoughts. The most central symptoms of both craving frequency and craving strength sub-networks were imagining its taste, the urge to have it, and intrusive thoughts. CONCLUSIONS The most central craving symptoms reported by individuals in treatment for cigarette smoking were from the frequency domain, demonstrating the value of assessing craving frequency along with craving strength. Central craving symptoms included multisensory imagery (taste, smell), intrusive thoughts, and urge, providing additional evidence that these symptoms may be important to consider in craving measurement and intervention. Findings provide insight into the symptoms that are central to craving, contributing to a better understanding of cigarette cravings, and suggesting potential targets for clinical interventions. IMPLICATIONS This study used network analysis to identify central symptoms of cigarette craving. Both craving frequency and strength were assessed. The most central symptoms of cigarette craving were related to craving frequency. Central symptoms included multisensory imagery, intrusive thoughts, and urge. Central symptoms might be targeted by smoking cessation treatment.
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Affiliation(s)
- Mihaela Aslan
- Cooperative Studies Program Clinical Epidemiology Research Center (CSP-CERC), VA CT Healthcare System, West Haven, CT, USA
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Margaret Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, The Bronx, NY, USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
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12
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Kahnt T. Computationally Informed Interventions for Targeting Compulsive Behaviors. Biol Psychiatry 2023; 93:729-738. [PMID: 36464521 PMCID: PMC9989040 DOI: 10.1016/j.biopsych.2022.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/04/2022] [Accepted: 08/30/2022] [Indexed: 11/02/2022]
Abstract
Compulsive behaviors are central to addiction and obsessive-compulsive disorder and can be understood as a failure of adaptive decision making. Particularly, they can be conceptualized as an imbalance in behavioral control, such that behavior is guided predominantly by learned rather than inferred outcome expectations. Inference is a computational process required for adaptive behavior, and recent work across species has identified the neural circuitry that supports inference-based decision making. This includes the orbitofrontal cortex, which has long been implicated in disorders of compulsive behavior. Inspired by evidence that modulating orbitofrontal cortex activity can alter inference-based behaviors, here we discuss noninvasive approaches to target these circuits in humans. Specifically, we discuss the potential of network-targeted transcranial magnetic stimulation and real-time neurofeedback to modulate the neural underpinnings of inference. Both interventions leverage recent advances in our understanding of the neurocomputational mechanisms of inference-based behavior and may be used to complement current treatment approaches for behavioral disorders.
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Affiliation(s)
- Thorsten Kahnt
- National Institute on Drug Abuse Intramural Research Program, Baltimore, Maryland.
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13
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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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14
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Pandria N, Athanasiou A, Styliadis C, Terzopoulos N, Mitsopoulos K, Paraskevopoulos E, Karagianni M, Pataka A, Kourtidou-Papadeli C, Makedou K, Iliadis S, Lymperaki E, Nimatoudis I, Argyropoulou-Pataka P, Bamidis PD. Does combined training of biofeedback and neurofeedback affect smoking status, behavior, and longitudinal brain plasticity? Front Behav Neurosci 2023; 17:1096122. [PMID: 36778131 PMCID: PMC9911884 DOI: 10.3389/fnbeh.2023.1096122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/02/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction: Investigations of biofeedback (BF) and neurofeedback (NF) training for nicotine addiction have been long documented to lead to positive gains in smoking status, behavior and to changes in brain activity. We aimed to: (a) evaluate a multi-visit combined BF/NF intervention as an alternative smoking cessation approach, (b) validate training-induced feedback learning, and (c) document effects on resting-state functional connectivity networks (rsFCN); considering gender and degree of nicotine dependence in a longitudinal design. Methods: We analyzed clinical, behavioral, and electrophysiological data from 17 smokers who completed five BF and 20 NF sessions and three evaluation stages. Possible neuroplastic effects were explored comparing whole-brain rsFCN by phase-lag index (PLI) for different brain rhythms. PLI connections with significant change across time were investigated according to different resting-state networks (RSNs). Results: Improvements in smoking status were observed as exhaled carbon monoxide levels, Total Oxidative Stress, and Fageström scores decreased while Vitamin E levels increased across time. BF/NF promoted gains in anxiety, self-esteem, and several aspects of cognitive performance. BF learning in temperature enhancement was observed within sessions. NF learning in theta/alpha ratio increase was achieved across baselines and within sessions. PLI network connections significantly changed across time mainly between or within visual, default mode and frontoparietal networks in theta and alpha rhythms, while beta band RSNs mostly changed significantly after BF sessions. Discussion: Combined BF/NF training positively affects the clinical and behavioral status of smokers, displays benefit in smoking harm reduction, plays a neuroprotective role, leads to learning effects and to positive reorganization of RSNs across time. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02991781.
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Affiliation(s)
- Niki Pandria
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Alkinoos Athanasiou
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Charis Styliadis
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Nikos Terzopoulos
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Konstantinos Mitsopoulos
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Evangelos Paraskevopoulos
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece,Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Maria Karagianni
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece
| | - Athanasia Pataka
- Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Kali Makedou
- Laboratory of Biochemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Iliadis
- Laboratory of Biochemistry, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evgenia Lymperaki
- Department of Biomedical Sciences, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- Third Department of Psychiatry, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Panagiotis D. Bamidis
- Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece,*Correspondence: Panagiotis D. Bamidis
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15
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Lor CS, Haugg A, Zhang M, Schneider L, Herdener M, Quednow BB, Golestani N, Scharnowski F. Thalamic volume and functional connectivity are associated with nicotine dependence severity and craving. Addict Biol 2023; 28:e13261. [PMID: 36577730 PMCID: PMC10078543 DOI: 10.1111/adb.13261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 12/02/2022]
Abstract
Tobacco smoking is associated with deleterious health outcomes. Most smokers want to quit smoking, yet relapse rates are high. Understanding neural differences associated with tobacco use may help generate novel treatment options. Several animal studies have recently highlighted the central role of the thalamus in substance use disorders, but this research focus has been understudied in human smokers. Here, we investigated associations between structural and functional magnetic resonance imaging measures of the thalamus and its subnuclei to distinct smoking characteristics. We acquired anatomical scans of 32 smokers as well as functional resting-state scans before and after a cue-reactivity task. Thalamic functional connectivity was associated with craving and dependence severity, whereas the volume of the thalamus was associated with dependence severity only. Craving, which fluctuates rapidly, was best characterized by differences in brain function, whereas the rather persistent syndrome of dependence severity was associated with both brain structural differences and function. Our study supports the notion that functional versus structural measures tend to be associated with behavioural measures that evolve at faster versus slower temporal scales, respectively. It confirms the importance of the thalamus to understand mechanisms of addiction and highlights it as a potential target for brain-based interventions to support smoking cessation, such as brain stimulation and neurofeedback.
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Affiliation(s)
- Cindy Sumaly Lor
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics
- Psychiatric University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Amelie Haugg
- Department of Child and Adolescent Psychiatry and Psychotherapy
- Psychiatric University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Mengfan Zhang
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics
- Psychiatric University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Letitia Schneider
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics
- Psychiatric University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Boris B Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics
- Psychiatric University Hospital Zurich, University of Zurich, Zürich, Switzerland
| | - Narly Golestani
- Brain and Language Lab
- Cognitive Science Hub, University of Vienna, Vienna, Austria.,Department of Behavioral and Cognitive Biology, University of Vienna, Vienna, Austria.,Department of Psychology
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Frank Scharnowski
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.,Department of Psychiatry, Psychotherapy and Psychosomatics
- Psychiatric University Hospital Zurich, University of Zurich, Zürich, Switzerland
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16
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Pindi P, Houenou J, Piguet C, Favre P. Real-time fMRI neurofeedback as a new treatment for psychiatric disorders: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110605. [PMID: 35843369 DOI: 10.1016/j.pnpbp.2022.110605] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/12/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
Neurofeedback using real-time functional MRI (RT-fMRI-NF) is an innovative technique that allows to voluntarily modulate a targeted brain response and its associated behavior. Despite promising results in the current literature, its effectiveness on symptoms management in psychiatric disorders is not yet clearly demonstrated. Here, we provide 1) a state-of-art qualitative review of RT-fMRI-NF studies aiming at alleviating clinical symptoms in a psychiatric population; 2) a quantitative evaluation (meta-analysis) of RT-fMRI-NF effectiveness on various psychiatric disorders and 3) methodological suggestions for future studies. Thirty-one clinical trials focusing on psychiatric disorders were included and categorized according to standard diagnostic categories. Among the 31 identified studies, 22 consisted of controlled trials, of which only eight showed significant clinical improvement in the experimental vs. control group after the training. Nine studies found an effect at follow-up on ADHD symptoms, emotion dysregulation, facial emotion processing, depressive symptoms, hallucinations, psychotic symptoms, and specific phobia. Within-group meta-analysis revealed large effects of the NF training on depressive symptoms right after the training (g = 0.81, p < 0.01) and at follow-up (g = 1.19, p < 0.01), as well as medium effects on anxiety (g = 0.44, p = 0.01) and emotion regulation (g = 0.48, p < 0.01). Between-group meta-analysis showed a medium effect on depressive symptoms (g = 0.49, p < 0.01) and a large effect on anxiety (g = 0.77, p = 0.01). However, the between-studies heterogeneity is very high. The use of RT-fMRI-NF as a treatment for psychiatric symptoms is promising, however, further double-blind, multicentric, randomized-controlled trials are warranted.
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Affiliation(s)
- Pamela Pindi
- Paris Est Créteil University (UPEC), INSERM U955, IMRB, Translational Neuro-psychiatry Team, AP-HP, DMU IMPACT, Mondor University Hospitals, FondaMental Foundation, F-94010 Créteil, France; Paris-Saclay University, Neurospin, CEA, UNIACT Lab, PsyBrain Team, F-91191 Gif-sur-Yvette, France
| | - Josselin Houenou
- Paris Est Créteil University (UPEC), INSERM U955, IMRB, Translational Neuro-psychiatry Team, AP-HP, DMU IMPACT, Mondor University Hospitals, FondaMental Foundation, F-94010 Créteil, France; Paris-Saclay University, Neurospin, CEA, UNIACT Lab, PsyBrain Team, F-91191 Gif-sur-Yvette, France.
| | - Camille Piguet
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Pauline Favre
- Paris Est Créteil University (UPEC), INSERM U955, IMRB, Translational Neuro-psychiatry Team, AP-HP, DMU IMPACT, Mondor University Hospitals, FondaMental Foundation, F-94010 Créteil, France; Paris-Saclay University, Neurospin, CEA, UNIACT Lab, PsyBrain Team, F-91191 Gif-sur-Yvette, France
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17
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Yip SW, Lichenstein SD, Garrison K, Averill CL, Viswanath H, Salas R, Abdallah CG. Effects of Smoking Status and State on Intrinsic Connectivity. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:895-904. [PMID: 33618016 PMCID: PMC8373998 DOI: 10.1016/j.bpsc.2021.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/18/2021] [Accepted: 02/02/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Smoking behavior during the first 24 hours of a quit attempt is a significant predictor of longer-term abstinence, yet little is known about the neurobiology of early tobacco abstinence. Specifically, the effects of acute tobacco deprivation and reinstatement on brain function-particularly at the level of large-scale network dynamics and assessed across the entire brain-remain incompletely understood. To address this gap, this study used a mixed within- and between-subjects design to assess the effects of smoking status (yes/no smoker) and state (deprived vs. satiated) on whole-brain patterns of intrinsic connectivity. METHODS Participants included 42 tobacco smokers who underwent resting-state functional magnetic resonance imaging following overnight abstinence (deprived state) and following smoking reinstatement (satiated state, randomized order across participants). Sixty healthy control nonsmokers underwent a single resting-state scan using the same acquisition parameters. Functional connectivity data were analyzed using both a canonical network-of-interest approach and a whole-brain, data-driven approach, i.e., intrinsic connectivity distribution. RESULTS Network-of-interest-based analyses indicated decreased functional connectivity within frontoparietal and salience networks among smokers relative to nonsmokers as well as effects of smoking state on default mode connectivity. In addition, intrinsic connectivity distribution analyses identified novel between-group differences in subcortical-cerebellar and corticocerebellar networks that were largely smoking state dependent. CONCLUSIONS These data demonstrate the importance of considering smoking state and the utility of using both theory- and data-driven analysis approaches. These data provide much-needed insight into the functional neurobiology of early abstinence, which may be used in the development of novel treatments.
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Affiliation(s)
- Sarah W Yip
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.
| | - Sarah D Lichenstein
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Kathleen Garrison
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher L Averill
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Clinical Neurosciences Division, Veterans Administration National Center for PTSD, West Haven, Connecticut; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Humsini Viswanath
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas
| | - Ramiro Salas
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut; Clinical Neurosciences Division, Veterans Administration National Center for PTSD, West Haven, Connecticut; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas; Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas
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18
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Orth L, Meeh J, Gur RC, Neuner I, Sarkheil P. Frontostriatal circuitry as a target for fMRI-based neurofeedback interventions: A systematic review. Front Hum Neurosci 2022; 16:933718. [PMID: 36092647 PMCID: PMC9449529 DOI: 10.3389/fnhum.2022.933718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
Dysregulated frontostriatal circuitries are viewed as a common target for the treatment of aberrant behaviors in various psychiatric and neurological disorders. Accordingly, experimental neurofeedback paradigms have been applied to modify the frontostriatal circuitry. The human frontostriatal circuitry is topographically and functionally organized into the "limbic," the "associative," and the "motor" subsystems underlying a variety of affective, cognitive, and motor functions. We conducted a systematic review of the literature regarding functional magnetic resonance imaging-based neurofeedback studies that targeted brain activations within the frontostriatal circuitry. Seventy-nine published studies were included in our survey. We assessed the efficacy of these studies in terms of imaging findings of neurofeedback intervention as well as behavioral and clinical outcomes. Furthermore, we evaluated whether the neurofeedback targets of the studies could be assigned to the identifiable frontostriatal subsystems. The majority of studies that targeted frontostriatal circuitry functions focused on the anterior cingulate cortex, the dorsolateral prefrontal cortex, and the supplementary motor area. Only a few studies (n = 14) targeted the connectivity of the frontostriatal regions. However, post-hoc analyses of connectivity changes were reported in more cases (n = 32). Neurofeedback has been frequently used to modify brain activations within the frontostriatal circuitry. Given the regulatory mechanisms within the closed loop of the frontostriatal circuitry, the connectivity-based neurofeedback paradigms should be primarily considered for modifications of this system. The anatomical and functional organization of the frontostriatal system needs to be considered in decisions pertaining to the neurofeedback targets.
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Affiliation(s)
- Linda Orth
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
| | - Johanna Meeh
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Irene Neuner
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine 4, Forschungszentrum Jülich, Jülich, Germany
| | - Pegah Sarkheil
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
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19
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Liu T, Wang Y, Xu Z, Wu T, Zang X, Li M, Li J. 3D Cube FLAIR plus HyperSense compressed sensing is superior to 2D T2WI FLAIR scanning regarding image quality, spatial resolution, detection rate for cortical microinfarcts. Medicine (Baltimore) 2022; 101:e28659. [PMID: 35984121 PMCID: PMC9387951 DOI: 10.1097/md.0000000000028659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
3-dimention (3D) Cube isotropic volumetric magnetic resonance imaging (MRI) facilitates comprehensive recognition of microinfarcts while it takes long scanning time. HyperSense compressed sensing is an emerging technique for accelerating MRI acquisition to reduce scanning time, while its application along with 3D Cube MRI for microinfarcts is seldom reported. Therefore, this study aimed to investigate the efficiency of 3D Cube FLAIR plus HyperSense compressed sensing technique versus conventional 2-dimention (2D) FLAIR scanning in the detection of cortical microinfarcts (CMIs). Totally 59 patients with cerebrovascular disease were enrolled then scanned by 3D Cube FLAIR plus HyperSense compressed sensing and 2D T2WI FLAIR sequences. The image quality scores, signal-to-noise ratio (SNR) for gray matter (GM), SNR for white matter (WM), their contrast-to-noise ratio (WM-to-GM CNR), detected number of CMIs were evaluated. 3D Cube FLAIR plus HyperSense showed a dramatically increased scores of uniformity, artifact, degree of lesion displacement, and overall image quality compared to 2D T2WI FLAIR. Meanwhile, it exhibited similar SNRwm and SNRgm, but a higher WM-to-GM contrast-to-noise ratio compared with 2D T2WI FLAIR. Furthermore, the scanning time of 3D Cube FLAIR plus HyperSense and 2D T2WI FLAIR were both set as 2.5 minutes. Encouragingly, 244 CMIs were detected by 3D Cube FLAIR plus HyperSense, which was higher compared to 2D T2WI FLAIR (106 detected CMIs). 3D Cube FLAIR plus HyperSense compressed sensing is superior to 2D T2WI FLAIR scanning regarding image quality, spatial resolution, detection rate for CMIs; meanwhile, it does not increase the scanning time. These findings may contribute to early detection and treatment of stroke.
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Affiliation(s)
- Tiefang Liu
- Department of Radiology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Yonghao Wang
- Department of Ultrasound, The Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Zhengyang Xu
- Department of Radiology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Tao Wu
- GE Healthcare MR Enhanced Application Team, Beijing, China
| | - Xiao Zang
- Department of Radiology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Meng Li
- Department of Radiology, The First Medical Center of PLA General Hospital, Beijing, China
| | - Jinfeng Li
- Department of Radiology, The First Medical Center of PLA General Hospital, Beijing, China
- *Correspondence: Jinfeng Li, Department of Radiology, The First Medical Center of PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100048, China (e-mail: )
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20
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Paolini M, Keeser D, Rauchmann BS, Gschwendtner S, Jeanty H, Reckenfelderbäumer A, Yaseen O, Reidler P, Rabenstein A, Engelbregt HJ, Maywald M, Blautzik J, Ertl-Wagner B, Pogarell O, Rüther T, Karch S. Correlations Between the DMN and the Smoking Cessation Outcome of a Real-Time fMRI Neurofeedback Supported Exploratory Therapy Approach: Descriptive Statistics on Tobacco-Dependent Patients. Clin EEG Neurosci 2022; 53:287-296. [PMID: 34878329 PMCID: PMC9174614 DOI: 10.1177/15500594211062703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/28/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to explore the potential of default mode network (DMN) functional connectivity for predicting the success of smoking cessation in patients with tobacco dependence in the context of a real-time function al MRI (RT-fMRI) neurofeedback (NF) supported therapy.Fifty-four tobacco-dependent patients underwent three RT-fMRI-NF sessions including resting-state functional connectivity (RSFC) runs over a period of 4 weeks during professionally assisted smoking cessation. Patients were randomized into two groups that performed either active NF of an addiction-related brain region or sham NF. After preprocessing, the RSFC baseline data were statistically evaluated using seed-based ROI (SBA) approaches taking into account the smoking status of patients after 3 months (abstinence/relapse).The results of the real study group showed a widespread functional connectivity in the relapse subgroup (n = 10) exceeding the DMN template and mainly low correlations and anticorrelations in the within-seed analysis. In contrast, the connectivity pattern of the abstinence subgroup (n = 8) primarily contained the core DMN in the seed-to-whole-brain analysis and a left lateralized correlation pattern in the within-seed analysis. Calculated Multi-Subject Dictionary Learning (MSDL) matrices showed anticorrelations between DMN regions and salience regions in the abstinence group. Concerning the sham group, results of the relapse subgroup (n = 4) and the abstinence subgroup (n = 6) showed similar trends only in the within-seed analysis.In the setting of a RT-fMRI-NF-assisted therapy, a widespread intrinsic DMN connectivity and a low negative coupling between the DMN and the salience network (SN) in patients with tobacco dependency during early withdrawal may be useful as an early indicator of later therapy nonresponse.
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Affiliation(s)
- Marco Paolini
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Daniel Keeser
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sarah Gschwendtner
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hannah Jeanty
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Arne Reckenfelderbäumer
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Omar Yaseen
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Paul Reidler
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Hessel Jan Engelbregt
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Hersencentrum Mental Health Institute, Amsterdam, the
Netherlands
| | - Maximilian Maywald
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Janusch Blautzik
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Institute for Radiology and Nuclear
Medicine St. Anna, Luzern, Switzerland
| | - Birgit Ertl-Wagner
- Department of Radiology, University
Hospital, LMU Munich, Munich, Germany
- Division of Neuro-Radiology, The Hospital for Sick Children,
University of Toronto, Toronto, Canada
| | - Oliver Pogarell
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Susanne Karch
- Department of Psychiatry and
Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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21
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Taschereau-Dumouchel V, Cushing C, Lau H. Real-Time Functional MRI in the Treatment of Mental Health Disorders. Annu Rev Clin Psychol 2022; 18:125-154. [DOI: 10.1146/annurev-clinpsy-072220-014550] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multiple mental disorders have been associated with dysregulation of precise brain processes. However, few therapeutic approaches can correct such specific patterns of brain activity. Since the late 1960s and early 1970s, many researchers have hoped that this feat could be achieved by closed-loop brain imaging approaches, such as neurofeedback, that aim to modulate brain activity directly. However, neurofeedback never gained mainstream acceptance in mental health, in part due to methodological considerations. In this review, we argue that, when contemporary methodological guidelines are followed, neurofeedback is one of the few intervention methods in psychology that can be assessed in double-blind placebo-controlled trials. Furthermore, using new advances in machine learning and statistics, it is now possible to target very precise patterns of brain activity for therapeutic purposes. We review the recent literature in functional magnetic resonance imaging neurofeedback and discuss current and future applications to mental health. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Vincent Taschereau-Dumouchel
- Department of Psychiatry and Addictology, Université de Montréal, Montréal, Québec, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada
| | - Cody Cushing
- Department of Psychology, University of California, Los Angeles, California, USA
| | - Hakwan Lau
- RIKEN Center for Brain Science, Wakoshi, Saitama, Japan
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22
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Haugg A, Manoliu A, Sladky R, Hulka LM, Kirschner M, Brühl AB, Seifritz E, Quednow BB, Herdener M, Scharnowski F. Disentangling craving- and valence-related brain responses to smoking cues in individuals with nicotine use disorder. Addict Biol 2022; 27:e13083. [PMID: 34363643 PMCID: PMC9285426 DOI: 10.1111/adb.13083] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/17/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022]
Abstract
Tobacco smoking is one of the leading causes of preventable death and disease worldwide. Most smokers want to quit, but relapse rates are high. To improve current smoking cessation treatments, a better understanding of the underlying mechanisms of nicotine dependence and related craving behaviour is needed. Studies on cue‐driven cigarette craving have been a particularly useful tool for investigating the neural mechanisms of drug craving. Here, functional neuroimaging studies in humans have identified a core network of craving‐related brain responses to smoking cues that comprises of amygdala, anterior cingulate cortex, orbitofrontal cortex, posterior cingulate cortex and ventral striatum. However, most functional Magnetic Resonance Imaging (fMRI) cue‐reactivity studies do not adjust their stimuli for emotional valence, a factor assumed to confound craving‐related brain responses to smoking cues. Here, we investigated the influence of emotional valence on key addiction brain areas by disentangling craving‐ and valence‐related brain responses with parametric modulators in 32 smokers. For one of the suggested key regions for addiction, the amygdala, we observed significantly stronger brain responses to the valence aspect of the presented images than to the craving aspect. Our results emphasize the need for carefully selecting stimulus material for cue‐reactivity paradigms, in particular with respect to emotional valence. Further, they can help designing future research on teasing apart the diverse psychological dimensions that comprise nicotine dependence and, therefore, can lead to a more precise mapping of craving‐associated brain areas, an important step towards more tailored smoking cessation treatments.
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Affiliation(s)
- Amelie Haugg
- Psychiatric University Hospital Zurich Zurich Switzerland
- Faculty of Psychology University of Vienna Vienna Austria
| | - Andrei Manoliu
- Psychiatric University Hospital Zurich Zurich Switzerland
- McLean Hospital Belmont Massachusetts USA
- Harvard Medical School Harvard University Boston Massachusetts USA
| | - Ronald Sladky
- Faculty of Psychology University of Vienna Vienna Austria
| | - Lea M. Hulka
- Psychiatric University Hospital Zurich Zurich Switzerland
| | - Matthias Kirschner
- Psychiatric University Hospital Zurich Zurich Switzerland
- Montreal Neurological Institute McGill University Montreal Canada
| | | | - Erich Seifritz
- Psychiatric University Hospital Zurich Zurich Switzerland
| | | | | | - Frank Scharnowski
- Psychiatric University Hospital Zurich Zurich Switzerland
- Faculty of Psychology University of Vienna Vienna Austria
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23
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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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24
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Haugg A, Renz FM, Nicholson AA, Lor C, Götzendorfer SJ, Sladky R, Skouras S, McDonald A, Craddock C, Hellrung L, Kirschner M, Herdener M, Koush Y, Papoutsi M, Keynan J, Hendler T, Cohen Kadosh K, Zich C, Kohl SH, Hallschmid M, MacInnes J, Adcock RA, Dickerson KC, Chen NK, Young K, Bodurka J, Marxen M, Yao S, Becker B, Auer T, Schweizer R, Pamplona G, Lanius RA, Emmert K, Haller S, Van De Ville D, Kim DY, Lee JH, Marins T, Megumi F, Sorger B, Kamp T, Liew SL, Veit R, Spetter M, Weiskopf N, Scharnowski F, Steyrl D. Predictors of real-time fMRI neurofeedback performance and improvement - A machine learning mega-analysis. Neuroimage 2021; 237:118207. [PMID: 34048901 DOI: 10.1016/j.neuroimage.2021.118207] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 12/12/2022] Open
Abstract
Real-time fMRI neurofeedback is an increasingly popular neuroimaging technique that allows an individual to gain control over his/her own brain signals, which can lead to improvements in behavior in healthy participants as well as to improvements of clinical symptoms in patient populations. However, a considerably large ratio of participants undergoing neurofeedback training do not learn to control their own brain signals and, consequently, do not benefit from neurofeedback interventions, which limits clinical efficacy of neurofeedback interventions. As neurofeedback success varies between studies and participants, it is important to identify factors that might influence neurofeedback success. Here, for the first time, we employed a big data machine learning approach to investigate the influence of 20 different design-specific (e.g. activity vs. connectivity feedback), region of interest-specific (e.g. cortical vs. subcortical) and subject-specific factors (e.g. age) on neurofeedback performance and improvement in 608 participants from 28 independent experiments. With a classification accuracy of 60% (considerably different from chance level), we identified two factors that significantly influenced neurofeedback performance: Both the inclusion of a pre-training no-feedback run before neurofeedback training and neurofeedback training of patients as compared to healthy participants were associated with better neurofeedback performance. The positive effect of pre-training no-feedback runs on neurofeedback performance might be due to the familiarization of participants with the neurofeedback setup and the mental imagery task before neurofeedback training runs. Better performance of patients as compared to healthy participants might be driven by higher motivation of patients, higher ranges for the regulation of dysfunctional brain signals, or a more extensive piloting of clinical experimental paradigms. Due to the large heterogeneity of our dataset, these findings likely generalize across neurofeedback studies, thus providing guidance for designing more efficient neurofeedback studies specifically for improving clinical neurofeedback-based interventions. To facilitate the development of data-driven recommendations for specific design details and subpopulations the field would benefit from stronger engagement in open science research practices and data sharing.
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Affiliation(s)
- Amelie Haugg
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland; Faculty of Psychology, University of Vienna, Austria.
| | - Fabian M Renz
- Faculty of Psychology, University of Vienna, Austria
| | | | - Cindy Lor
- Faculty of Psychology, University of Vienna, Austria
| | | | - Ronald Sladky
- Faculty of Psychology, University of Vienna, Austria
| | - Stavros Skouras
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Amalia McDonald
- Department of Psychology, University of Virginia, United States
| | - Cameron Craddock
- Department of Diagnostic Medicine, The University of Texas at Austin Dell Medical School, United States
| | - Lydia Hellrung
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Switzerland
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland; McConnell Brain Imaging Centre, Montréal Neurological Institute, McGill University, Canada
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland
| | - Yury Koush
- Department of Radiology and Biomedical Imaging, Yale University, United States
| | - Marina Papoutsi
- UCL Huntington's Disease Centre, Institute of Neurology, University College London, United Kingdom; IXICO plc, United Kingdom
| | - Jackob Keynan
- Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Israel
| | - Talma Hendler
- Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Israel
| | | | - Catharina Zich
- Nuffiled Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Simon H Kohl
- JARA-Institute Molecular Neuroscience and Neuroimaging (INM-11), Jülich Research Centre, Germany
| | - Manfred Hallschmid
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Germany
| | - Jeff MacInnes
- Institute for Learning and Brain Sciences, University of Washington, United States
| | - R Alison Adcock
- Duke Institute for Brain Sciences, Duke University, United States; Department of Psychiatry and Behavioral Sciences, Duke University, United States
| | - Kathryn C Dickerson
- Department of Psychiatry and Behavioral Sciences, Duke University, United States
| | - Nan-Kuei Chen
- Department of Biomedical Engineering, University of Arizona, United States
| | - Kymberly Young
- Department of Psychiatry, School of Medicine, University of Pittsburgh, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, United States
| | - Michael Marxen
- Department of Psychiatry, Technische Universität Dresden, Germany
| | - Shuxia Yao
- Clinical Hospital of the Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, China
| | - Benjamin Becker
- Clinical Hospital of the Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, China
| | - Tibor Auer
- School of Psychology, University of Surrey, United Kingdom
| | | | - Gustavo Pamplona
- Department of Ophthalmology, University of Lausanne and Fondation Asile des Aveugles, Switzerland
| | - Ruth A Lanius
- Department of Psychiatry, University of Western Ontario, Canada
| | - Kirsten Emmert
- Department of Neurology, University Medical Center Schleswig-Holstein, Kiel University, Germany
| | - Sven Haller
- Department of Surgical Sciences, Radiology, Uppsala University, Sweden
| | - Dimitri Van De Ville
- Center for Neuroprosthetics, Ecole polytechnique féderale de Lausanne, Switzerland; Faculty of Medicine, University of Geneva, Switzerland
| | - Dong-Youl Kim
- Department of Brain and Cognitive Engineering, Korea University, Korea
| | - Jong-Hwan Lee
- Department of Brain and Cognitive Engineering, Korea University, Korea
| | - Theo Marins
- D'Or Institute for Research and Education, Brazil
| | | | - Bettina Sorger
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Tabea Kamp
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | | | - Ralf Veit
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Germany; German Center for Diabetes Research (DZD), Germany; High-Field Magnetic Resonance Center, Max Planck Institute for Biological Cybernetics, Germany
| | - Maartje Spetter
- School of Psychology, University of Birmingham, United Kingdom
| | - Nikolaus Weiskopf
- Max Planck Institute for Human Cognitive and Brain Sciences, Germany; Felix Bloch Institute for Solid State Physics, Faculty of Physics and Earth Sciences, Leipzig University, Germany
| | - Frank Scharnowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland; Faculty of Psychology, University of Vienna, Austria
| | - David Steyrl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Switzerland; Faculty of Psychology, University of Vienna, Austria
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25
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Dudek E, Dodell-Feder D. The efficacy of real-time functional magnetic resonance imaging neurofeedback for psychiatric illness: A meta-analysis of brain and behavioral outcomes. Neurosci Biobehav Rev 2021; 121:291-306. [PMID: 33370575 PMCID: PMC7856210 DOI: 10.1016/j.neubiorev.2020.12.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/01/2020] [Accepted: 12/18/2020] [Indexed: 12/13/2022]
Abstract
Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) has gained popularity as an experimental treatment for a variety of psychiatric illnesses. However, there has yet to be a quantitative review regarding its efficacy. Here, we present the first meta-analysis of rtfMRI-NF for psychiatric disorders, evaluating its impact on brain and behavioral outcomes. Our literature review identified 17 studies and 105 effect sizes across brain and behavioral outcomes. We find that rtfMRI-NF produces a medium-sized effect on neural activity during training (g = .59, 95 % CI [.44, .75], p < .0001), a large-sized effect after training when no neurofeedback is provided (g = .84, 95 % CI [.37, 1.31], p = .005), and small-sized effects for behavioral outcomes (symptoms g = .37, 95 % CI [.16, .58], p = .002; cognition g = .23, 95 % CI [-.33, .78], p = .288). Mixed-effects analyses revealed few moderators. Together, these data suggest a positive impact of rtfMRI-NF on brain and behavioral outcomes, although more research is needed to determine how rtfMRI-NF works, for whom, and under what circumstances.
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Affiliation(s)
- Emily Dudek
- Department of Psychology, University of Rochester, United States
| | - David Dodell-Feder
- Department of Psychology, University of Rochester, United States; Department of Neuroscience, University of Rochester Medical Center, United States.
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Kilmarx J, Oblak E, Sulzer J, Lewis-Peacock J. Towards a common template for neural reinforcement of finger individuation. Sci Rep 2021; 11:1065. [PMID: 33441742 PMCID: PMC7806844 DOI: 10.1038/s41598-020-80166-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/14/2020] [Indexed: 12/04/2022] Open
Abstract
The inability to individuate finger movements is a common impairment following stroke. Conventional physical therapy ignores underlying neural changes with recovery, leaving it unclear why sensorimotor function often remains impaired. Functional MRI neurofeedback can monitor neural activity and reinforce it towards a healthy template to restore function. However, identifying an individualized training template may not be possible depending on the severity of impairment. In this study, we investigated the use of functional alignment of brain data across healthy participants to create an idealized neural template to be used as a training target for new participants. We employed multi-voxel pattern analyses to assess the prediction accuracy and robustness to missing data of pre-trained functional templates corresponding to individual finger presses. We found a significant improvement in classification accuracy (p < 0.001) of individual finger presses when group data was aligned based on function (88%) rather than anatomy (46%). Importantly, we found no significant drop in performance when aligning a new participant to a pre-established template as compared to including this new participant in the creation of a new template. These results indicate that functionally aligned templates could provide an effective surrogate training target for patients following neurological injury.
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Affiliation(s)
- Justin Kilmarx
- Department of Mechanical Engineering, The University of Texas at Austin, 2501 Wichita St, Austin, TX, 78712, USA.
| | - Ethan Oblak
- Department of Mechanical Engineering, The University of Texas at Austin, 2501 Wichita St, Austin, TX, 78712, USA
| | - James Sulzer
- Department of Mechanical Engineering, The University of Texas at Austin, 2501 Wichita St, Austin, TX, 78712, USA
| | - Jarrod Lewis-Peacock
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA
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27
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Zhao Z, Yao S, Zweerings J, Zhou X, Zhou F, Kendrick KM, Chen H, Mathiak K, Becker B. Putamen volume predicts real-time fMRI neurofeedback learning success across paradigms and neurofeedback target regions. Hum Brain Mapp 2021; 42:1879-1887. [PMID: 33400306 PMCID: PMC7978128 DOI: 10.1002/hbm.25336] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/17/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022] Open
Abstract
Real-time fMRI guided neurofeedback training has gained increasing interest as a noninvasive brain regulation technique with the potential to modulate functional brain alterations in therapeutic contexts. Individual variations in learning success and treatment response have been observed, yet the neural substrates underlying the learning of self-regulation remain unclear. Against this background, we explored potential brain structural predictors for learning success with pooled data from three real-time fMRI data sets. Our analysis revealed that gray matter volume of the right putamen could predict neurofeedback learning success across the three data sets (n = 66 in total). Importantly, the original studies employed different neurofeedback paradigms during which different brain regions were trained pointing to a general association with learning success independent of specific aspects of the experimental design. Given the role of the putamen in associative learning this finding may reflect an important role of instrumental learning processes and brain structural variations in associated brain regions for successful acquisition of fMRI neurofeedback-guided self-regulation.
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Affiliation(s)
- Zhiying Zhao
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuxia Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Jana Zweerings
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
| | - Xinqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University, Aachen, Germany
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
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28
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Manoliu A, Haugg A, Sladky R, Hulka L, Kirschner M, Brühl AB, Seifritz E, Quednow B, Herdener M, Scharnowski F. SmoCuDa: A Validated Smoking Cue Database to Reliably Induce Craving in Tobacco Use Disorder. Eur Addict Res 2021; 27:107-114. [PMID: 32854096 DOI: 10.1159/000509758] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 05/04/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cue-reactivity paradigms provide valuable insights into the underlying mechanisms of nicotine craving in nicotine-dependent subjects. In order to study cue-driven nicotine craving, robust and validated stimulus datasets are essential. OBJECTIVES The aim of this study was to generate and validate a large set of individually rated smoking-related cues that allow for assessment of different stimulus intensities along the dimensions craving, valence, and arousal. METHODS The image database consisted of 330 visual cues. Two hundred fifty smoking-associated pictures (Creative Commons license) were chosen from online databases and showed a widespread variety of smoking-associated content. Eighty pictures from previously published databases were included for cross-validation. Forty volunteers with tobacco use disorder rated "urge-to-smoke," "valence," and "arousal" for all images on a 100-point visual analogue scale. Pictures were also labelled according to 18 categories such as lit/unlit cigarettes in mouth, cigarette end, and cigarette in ashtray. RESULTS Ratings (mean ± SD) were as follows: urge to smoke, 44.9 ± 13.2; valence, 51.2 ± 7.6; and arousal, 54.6 ± 7.1. All ratings, particularly "urge to smoke," were widely distributed along the whole scale spectrum. CONCLUSIONS We present a novel image library of well-described smoking-related cues, which were rated on a continuous scale along the dimensions craving, valence, and arousal that accounts for inter-individual differences. The rating software, image database, and their ratings are publicly available at https://smocuda.github.io.
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Affiliation(s)
- Andrei Manoliu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland, .,Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom, .,Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom,
| | - Amelie Haugg
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Ronald Sladky
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria.,Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Lea Hulka
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Matthias Kirschner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Montreal Neurological Institute, McGill University, Montreal, Québec, Canada
| | - Annette B Brühl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Behavioural and Clinical Neuroscience Institute and Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Boris Quednow
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marcus Herdener
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Frank Scharnowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland.,Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Vienna, Austria.,Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland
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29
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Frank DW, Cinciripini PM, Deweese MM, Karam-Hage M, Kypriotakis G, Lerman C, Robinson JD, Tyndale RF, Vidrine DJ, Versace F. Toward Precision Medicine for Smoking Cessation: Developing a Neuroimaging-Based Classification Algorithm to Identify Smokers at Higher Risk for Relapse. Nicotine Tob Res 2020; 22:1277-1284. [PMID: 31724052 DOI: 10.1093/ntr/ntz211] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/11/2019] [Indexed: 01/04/2023]
Abstract
INTRODUCTION By improving our understanding of the neurobiological mechanisms underlying addiction, neuroimaging research is helping to identify new targets for personalized treatment interventions. When trying to quit, smokers with larger electrophysiological responses to cigarette-related, compared with pleasant, stimuli ("C > P") are more likely to relapse than smokers with the opposite brain reactivity profile ("P > C"). AIM AND METHOD The goal was to (1) build a classification algorithm to identify smokers characterized by P > C or C > P neuroaffective profiles and (2) validate the algorithm's classification outcomes in an independent data set where we assessed both smokers' electrophysiological responses at baseline and smoking abstinence during a quit attempt. We built the classification algorithm applying discriminant function analysis on the event-related potentials evoked by emotional images in 180 smokers. RESULTS The predictive validity of the classifier showed promise in an independent data set that included new data from 177 smokers interested in quitting; the algorithm classified 111 smokers as P > C and 66 as C > P. The overall abstinence rate was low; 15 individuals (8.5% of the sample) achieved CO-verified 12-month abstinence. Although individuals classified as P > C were nearly 2.5 times more likely to be abstinent than smokers classified as C > P (12 vs. 3, or 11% vs. 4.5%), this result was nonsignificant, preliminary, and in need of confirmation in larger trials. CONCLUSION These results suggest that psychophysiological techniques have the potential to advance our knowledge of the neurobiological underpinnings of nicotine addiction and improve clinical applications. However, larger sample sizes are necessary to reliably assess the predictive ability of our algorithm. IMPLICATIONS We assessed the clinical relevance of a neuroimaging-based classification algorithm on an independent sample of smokers enrolled in a smoking cessation trial and found those with the tendency to attribute more relevance to rewards than cues were nearly 2.5 times more likely to be abstinent than smokers with the opposite brain reactivity profile (11% vs. 4.5%). Although this result was not statistically significant, it suggests our neuroimaging-based classification algorithm can potentially contribute to the development of new precision medicine interventions aimed at treating substance use disorders. Regardless, these findings are still preliminary and in need of confirmation in larger trials.
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Affiliation(s)
- David W Frank
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Paul M Cinciripini
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Menton M Deweese
- Department of Teaching and Learning, Peabody College at Vanderbilt University, Nashville, TN
| | - Maher Karam-Hage
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - George Kypriotakis
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Caryn Lerman
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA
| | - Jason D Robinson
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Departments of Psychiatry, Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Damon J Vidrine
- Stephenson Cancer Center, Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Francesco Versace
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
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30
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Tursic A, Eck J, Lührs M, Linden DEJ, Goebel R. A systematic review of fMRI neurofeedback reporting and effects in clinical populations. Neuroimage Clin 2020; 28:102496. [PMID: 33395987 PMCID: PMC7724376 DOI: 10.1016/j.nicl.2020.102496] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 12/22/2022]
Abstract
Real-time fMRI-based neurofeedback is a relatively young field with a potential to impact the currently available treatments of various disorders. In order to evaluate the evidence of clinical benefits and investigate how consistently studies report their methods and results, an exhaustive search of fMRI neurofeedback studies in clinical populations was performed. Reporting was evaluated using a limited number of Consensus on the reporting and experimental design of clinical and cognitive-behavioral neurofeedback studies (CRED-NF checklist) items, which was, together with a statistical power and sensitivity calculation, used to also evaluate the existing evidence of the neurofeedback benefits on clinical measures. The 62 found studies investigated regulation abilities and/or clinical benefits in a wide range of disorders, but with small sample sizes and were therefore unable to detect small effects. Most points from the CRED-NF checklist were adequately reported by the majority of the studies, but some improvements are suggested for the reporting of group comparisons and relations between regulation success and clinical benefits. To establish fMRI neurofeedback as a clinical tool, more emphasis should be placed in the future on using larger sample sizes determined through a priori power calculations and standardization of procedures and reporting.
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Affiliation(s)
- Anita Tursic
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands; Brain Innovation B.V, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands.
| | - Judith Eck
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands; Brain Innovation B.V, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands.
| | - Michael Lührs
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands; Brain Innovation B.V, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands.
| | - David E J Linden
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands.
| | - Rainer Goebel
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands; Brain Innovation B.V, Oxfordlaan 55, 6229 EV Maastricht, The Netherlands; Department of Neuroimaging and Neuromodeling, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, the Netherlands.
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31
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Haugg A, Sladky R, Skouras S, McDonald A, Craddock C, Kirschner M, Herdener M, Koush Y, Papoutsi M, Keynan JN, Hendler T, Cohen Kadosh K, Zich C, MacInnes J, Adcock RA, Dickerson K, Chen N, Young K, Bodurka J, Yao S, Becker B, Auer T, Schweizer R, Pamplona G, Emmert K, Haller S, Van De Ville D, Blefari M, Kim D, Lee J, Marins T, Fukuda M, Sorger B, Kamp T, Liew S, Veit R, Spetter M, Weiskopf N, Scharnowski F. Can we predict real-time fMRI neurofeedback learning success from pretraining brain activity? Hum Brain Mapp 2020; 41:3839-3854. [PMID: 32729652 PMCID: PMC7469782 DOI: 10.1002/hbm.25089] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 12/31/2022] Open
Abstract
Neurofeedback training has been shown to influence behavior in healthy participants as well as to alleviate clinical symptoms in neurological, psychosomatic, and psychiatric patient populations. However, many real-time fMRI neurofeedback studies report large inter-individual differences in learning success. The factors that cause this vast variability between participants remain unknown and their identification could enhance treatment success. Thus, here we employed a meta-analytic approach including data from 24 different neurofeedback studies with a total of 401 participants, including 140 patients, to determine whether levels of activity in target brain regions during pretraining functional localizer or no-feedback runs (i.e., self-regulation in the absence of neurofeedback) could predict neurofeedback learning success. We observed a slightly positive correlation between pretraining activity levels during a functional localizer run and neurofeedback learning success, but we were not able to identify common brain-based success predictors across our diverse cohort of studies. Therefore, advances need to be made in finding robust models and measures of general neurofeedback learning, and in increasing the current study database to allow for investigating further factors that might influence neurofeedback learning.
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Affiliation(s)
- Amelie Haugg
- Psychiatric University Hospital ZurichUniversity of ZurichZürichSwitzerland
- Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Ronald Sladky
- Faculty of PsychologyUniversity of ViennaViennaAustria
| | - Stavros Skouras
- Department of Biological and Medical PsychologyUniversity of BergenBergenNorway
| | - Amalia McDonald
- Department of PsychologyUniversity of VirginiaCharlottesvilleVirginia
| | - Cameron Craddock
- Department of Diagnostic MedicineThe University of Texas at Austin Dell Medical SchoolAustinTexas
| | - Matthias Kirschner
- Psychiatric University Hospital ZurichUniversity of ZurichZürichSwitzerland
- McConnell Brain Imaging CentreMontréal Neurological Institute, McGill UniversityMontrealCanada
| | - Marcus Herdener
- Psychiatric University Hospital ZurichUniversity of ZurichZürichSwitzerland
| | - Yury Koush
- Magnetic Resonance Research Center, Department of Radiology & Biomedical ImagingYale UniversityNew HavenConnecticut
| | - Marina Papoutsi
- UCL Huntington's Disease CentreInstitute of Neurology, University College LondonLondonEngland
| | - Jackob N. Keynan
- Functional Brain CenterWohl Institute for Advanced Imaging, Tel‐Aviv Sourasky Medical Center, Tel‐Aviv UniversityTel AvivIsrael
| | - Talma Hendler
- Functional Brain CenterWohl Institute for Advanced Imaging, Tel‐Aviv Sourasky Medical Center, Tel‐Aviv UniversityTel AvivIsrael
| | | | - Catharina Zich
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordEngland
| | - Jeff MacInnes
- Institute for Learning and Brain SciencesUniversity of WashingtonSeattleWashington
| | - R. Alison Adcock
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth Carolina
| | - Kathryn Dickerson
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth Carolina
| | - Nan‐Kuei Chen
- Department of Biomedical EngineeringUniversity of ArizonaTucsonArizona
| | - Kymberly Young
- Department of Psychiatry, School of MedicineUniversity of PittsburghPittsburghPennsylvania
| | | | - Shuxia Yao
- Clinical Hospital of Chengdu the Brain Science Institute, MOE Key Laboratory for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Benjamin Becker
- Clinical Hospital of Chengdu the Brain Science Institute, MOE Key Laboratory for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Tibor Auer
- School of PsychologyUniversity of SurreyGuildfordEngland
| | - Renate Schweizer
- Functional Imaging LaboratoryGerman Primate CenterGöttingenGermany
| | - Gustavo Pamplona
- Hôpital and Ophtalmique Jules GoninUniversity of LausanneLausanneSwitzerland
| | - Kirsten Emmert
- Department of NeurologyUniversity Medical Center Schleswig‐Holstein, Kiel UniversityKielGermany
| | - Sven Haller
- Radiology‐Department of Surgical SciencesUppsala UniversityUppsalaSweden
| | - Dimitri Van De Ville
- Center for NeuroprostheticsEcole Polytechnique Féderale de LausanneLausanneSwitzerland
- Department of Radiology and Medical Informatics, Faculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Maria‐Laura Blefari
- Center for NeuroprostheticsEcole Polytechnique Féderale de LausanneLausanneSwitzerland
| | - Dong‐Youl Kim
- Department of Brain and Cognitive EngineeringKorea UniversitySeoulKorea
| | - Jong‐Hwan Lee
- Department of Brain and Cognitive EngineeringKorea UniversitySeoulKorea
| | - Theo Marins
- D'Or Institute for Research and Education (IDOR)Rio de JaneiroBrazil
| | - Megumi Fukuda
- School of Fundamental Science and EngineeringWaseda UniversityTokyoJapan
| | - Bettina Sorger
- Department Cognitive Neuroscience, Faculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Tabea Kamp
- Department Cognitive Neuroscience, Faculty of Psychology and NeuroscienceMaastricht UniversityMaastrichtThe Netherlands
| | - Sook‐Lei Liew
- Division of Occupational Science and Occupational TherapyUniversity of Southern CaliforniaLos AngelesCalifornia
| | - Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center MunichUniversity of TübingenTübingenGermany
| | - Maartje Spetter
- School of PsychologyUniversity of BirminghamBirminghamEngland
| | - Nikolaus Weiskopf
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Frank Scharnowski
- Psychiatric University Hospital ZurichUniversity of ZurichZürichSwitzerland
- Faculty of PsychologyUniversity of ViennaViennaAustria
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Dieterich R, Nickel S, Endrass T. Toward a valid electrocortical correlate of regulation of craving using single-trial regression. Int J Psychophysiol 2020; 155:152-161. [DOI: 10.1016/j.ijpsycho.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 12/17/2022]
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33
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Pandria N, Athanasiou A, Konstantara L, Karagianni M, Bamidis PD. Advances in biofeedback and neurofeedback studies on smoking. Neuroimage Clin 2020; 28:102397. [PMID: 32947225 PMCID: PMC7502375 DOI: 10.1016/j.nicl.2020.102397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/02/2020] [Accepted: 08/19/2020] [Indexed: 11/19/2022]
Abstract
Smoking is a leading cause of morbidity and premature death constituting a global health challenge. Although, pharmacological and behavioral approaches comprise the mainstay of smoking cessation interventions, the efficacy and safety of pharmacotherapy is not demonstrated for some populations. Non-pharmacological approaches, such as biofeedback (BF) and neurofeedback (NF) could facilitate self-regulation of predisposing factors of relapse such as craving and stress. The current review aims to aggregate the existing evidence regarding the effects of BF and NF training on smokers. Relevant studies were identified through searching in Scopus, PubMed and Cochrane Library, and through hand-searching the references of screened articles. Peer-reviewed controlled and uncontrolled studies, where BF and/or NF training was administered, were included and evaluated according to PICOS framework. Narrative qualitative synthesis of ten eligible studies was performed, aggregated into three categories according to training provided. BF outcomes seem to be affected by smoking behavior prior to training; individualized EEG NF training holds promise for modulating craving-related response while minimizing the required number of sessions. Real-time fMRI NF studies concluded that nicotine-dependent individuals could modulate craving-related brain responses, while mixed results were revealed regarding smokers' ability to modulate brain responses related to resistance towards the urge to smoke. BF and NF training seem to facilitate modulation of autonomous and/or central nervous system activity while also transferring this learned self-regulation to behavioral outcomes. BF and NF training should a) address remaining issues on specificity and scientific validity, b) target diverse demographics, and c) produce robust reproducible methodologies and clinical guidelines for relevant health care providers, in order to be considered as viable complementary tools to standard smoking cessation care.
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Affiliation(s)
- N Pandria
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece; Northern Greece Neurofeedback Center, Thessaloniki, Greece.
| | - A Athanasiou
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - L Konstantara
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - M Karagianni
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
| | - P D Bamidis
- Lab of Medical Physics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
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34
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Martz ME, Hart T, Heitzeg MM, Peltier SJ. Neuromodulation of brain activation associated with addiction: A review of real-time fMRI neurofeedback studies. Neuroimage Clin 2020; 27:102350. [PMID: 32736324 PMCID: PMC7394772 DOI: 10.1016/j.nicl.2020.102350] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023]
Abstract
Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) has emerged in recent years as an imaging modality used to examine volitional control over targeted brain activity. rtfMRI-nf has also been applied clinically as a way to train individuals to self-regulate areas of the brain, or circuitry, involved in various disorders. One such application of rtfMRI-nf has been in the domain of addictive behaviors, including substance use. Given the pervasiveness of substance use and the challenges of existing treatments to sustain abstinence, rtfMRI-nf has been identified as a promising treatment tool. rtfMRI-nf has also been used in basic science research in order to test the ability to modulate brain function involved in addiction. This review focuses first on providing an overview of recent rtfMRI-nf studies in substance-using populations, specifically nicotine, alcohol, and cocaine users, aimed at reducing craving-related brain activation. Next, rtfMRI-nf studies targeting reward responsivity and emotion regulation in healthy samples are reviewed in order to examine the extent to which areas of the brain involved in addiction can be self-regulated using neurofeedback. We propose that future rtfMRI-nf studies could be strengthened by improvements to study design, sample selection, and more robust strategies in the development and assessment of rtfMRI-nf as a clinical treatment. Recommendations for ways to accomplish these improvements are provided. rtfMRI-nf holds much promise as an imaging modality that can directly target key brain regions involved in addiction, however additional studies are needed in order to establish rtfMRI-nf as an effective, and practical, treatment for addiction.
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Affiliation(s)
- Meghan E Martz
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA.
| | - Tabatha Hart
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Mary M Heitzeg
- Addiction Center, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Scott J Peltier
- Functional MRI Laboratory, USA; Department of Biomedical Engineering, Bonisteel Interdisciplinary Research Building, 2360 Bonisteel Blvd, Ann Arbor, MI 48109, USA
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35
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Weiss F, Aslan A, Zhang J, Gerchen MF, Kiefer F, Kirsch P. Using mind control to modify cue-reactivity in AUD: the impact of mindfulness-based relapse prevention on real-time fMRI neurofeedback to modify cue-reactivity in alcohol use disorder: a randomized controlled trial. BMC Psychiatry 2020; 20:309. [PMID: 32546139 PMCID: PMC7298966 DOI: 10.1186/s12888-020-02717-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Alcohol Use Disorder is a severe mental disorder affecting the individuals concerned, their family and friends and society as a whole. Despite its high prevalence, novel treatment options remain rather limited. Two innovative interventions used for treating severe disorders are the use of real-time functional magnetic resonance imaging neurofeedback that targets brain regions related to the disorder, and mindfulness-based treatments. In the context of the TRR SFB 265 C04 "Mindfulness-based relapse prevention as an addition to rtfMRI NFB intervention for patients with Alcohol Use Disorder (MiND)" study, both interventions will be combined to a state-of-the art intervention that will use mindfulness-based relapse prevention to improve the efficacy of a real-time neurofeedback intervention targeting the ventral striatum, which is a brain region centrally involved in cue-reactivity to alcohol-related stimuli. METHODS/DESIGN After inclusion, N = 88 patients will be randomly assigned to one of four groups. Two of those groups will receive mindfulness-based relapse prevention. All groups will receive two fMRI sessions and three real-time neurofeedback sessions in a double-blind manner and will regulate either the ventral striatum or the auditory cortex as a control region. Two groups will additionally receive five sessions of mindfulness-based relapse prevention prior to the neurofeedback intervention. After the last fMRI session, the participants will be followed-up monthly for a period of 3 months for an assessment of the relapse rate and clinical effects of the intervention. DISCUSSION The results of this study will give further insights into the efficacy of real-time functional magnetic resonance imaging neurofeedback interventions for the treatment of Alcohol Use Disorder. Additionally, the study will provide further insight on neurobiological changes in the brain caused by the neurofeedback intervention as well as by the mindfulness-based relapse prevention. The outcome might be useful to develop new treatment approaches targeting mechanisms of Alcohol Use Disorder with the goal to reduce relapse rates after discharge from the hospital. TRIAL REGISTRATION This trial is pre-registered at clinicaltrials.gov (trial identifier: NCT04366505; WHO Universal Trial Number (UTN): U1111-1250-2964). Registered 30 March 2020, published 29 April 2020.
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Affiliation(s)
- Franziska Weiss
- Department of Clinical Psychology, Central Institute of Mental Health (ZI), Heidelberg University/Medical Faculty Mannheim, 68159, Mannheim, Germany.
| | - Acelya Aslan
- grid.7700.00000 0001 2190 4373Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Jingying Zhang
- grid.7700.00000 0001 2190 4373Department of Clinical Psychology, Central Institute of Mental Health (ZI), Heidelberg University/Medical Faculty Mannheim, 68159 Mannheim, Germany
| | - Martin Fungisai Gerchen
- grid.7700.00000 0001 2190 4373Department of Clinical Psychology, Central Institute of Mental Health (ZI), Heidelberg University/Medical Faculty Mannheim, 68159 Mannheim, Germany ,grid.7700.00000 0001 2190 4373Department of Psychology, Heidelberg University, Heidelberg, Germany ,grid.455092.fBernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
| | - Falk Kiefer
- grid.7700.00000 0001 2190 4373Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Heidelberg University/Medical Faculty Mannheim, Mannheim, Germany
| | - Peter Kirsch
- grid.7700.00000 0001 2190 4373Department of Clinical Psychology, Central Institute of Mental Health (ZI), Heidelberg University/Medical Faculty Mannheim, 68159 Mannheim, Germany ,grid.7700.00000 0001 2190 4373Department of Psychology, Heidelberg University, Heidelberg, Germany ,grid.455092.fBernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
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Dehghani A, Soltanian-Zadeh H, Hossein-Zadeh GA. Global Data-Driven Analysis of Brain Connectivity During Emotion Regulation by Electroencephalography Neurofeedback. Brain Connect 2020; 10:302-315. [PMID: 32458692 DOI: 10.1089/brain.2019.0734] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Emotion regulation by neurofeedback involves interactions among multiple brain regions, including prefrontal cortex and subcortical regions. Previous studies focused on connections of specific brain regions such as amygdala with other brain regions. New method: Electroencephalography (EEG) neurofeedback is used to upregulate positive emotion by retrieving positive autobiographical memories and functional magnetic resonance imaging (fMRI) data acquired simultaneously. A global data-driven approach, group independent component analysis, is applied to the fMRI data and functional network connectivity (FNC) estimated. Results: The proposed approach identified all functional networks engaged in positive autobiographical memories and evaluated effects of neurofeedback. The results revealed two pairs of networks with significantly different functional connectivity among emotion regulation blocks (relative to other blocks of the experiment) and between experimental and control groups (false discovery rate corrected for multiple comparisons, q = 0.05). FNC distribution showed significant connectivity differences between neurofeedback blocks and other blocks, revealing more synchronized brain networks during neurofeedback. Comparison with Existing Methods: Although the results are consistent with those of previous model-based studies, some of the connections found in this study were not found previously. These connections are between (a) occipital and other regions including limbic system/sublobar, prefrontal/frontal cortex, inferior parietal, and middle temporal gyrus and (b) posterior cingulate cortex and hippocampus. Conclusions: This study provided a global insight into brain connectivity for emotion regulation. The brain network interactions may be used to develop connectivity-based neurofeedback methods and alternative therapeutic approaches, which may be more effective than the traditional activity-based neurofeedback methods.
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Affiliation(s)
- Amin Dehghani
- Department of Biomedical Engineering, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Hamid Soltanian-Zadeh
- Department of Biomedical Engineering, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,Department of Neuroimaging, School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran.,Department of Radiology and Henry Ford Health System, Detroit, Michigan, USA.,Department of Research Administration, Henry Ford Health System, Detroit, Michigan, USA
| | - Gholam-Ali Hossein-Zadeh
- Department of Biomedical Engineering, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran.,Department of Neuroimaging, School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
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Bu J, Young KD, Hong W, Ma R, Song H, Wang Y, Zhang W, Hampson M, Hendler T, Zhang X. Effect of deactivation of activity patterns related to smoking cue reactivity on nicotine addiction. Brain 2020; 142:1827-1841. [PMID: 31135053 DOI: 10.1093/brain/awz114] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/24/2019] [Accepted: 02/24/2019] [Indexed: 02/04/2023] Open
Abstract
With approximately 75% of smokers resuming cigarette smoking after using the Gold Standard Programme for smoking cessation, investigation into novel therapeutic approaches is warranted. Typically, smoking cue reactivity is crucial for smoking behaviour. Here we developed a novel closed-loop, smoking cue reactivity patterns EEG-based neurofeedback protocol and evaluated its therapeutic efficacy on nicotine addiction. During an evoked smoking cue reactivity task participants' brain activity patterns corresponding to smoking cues were obtained with multivariate pattern analysis of all EEG channels data, then during neurofeedback the EEG activity patterns of smoking cue reactivity were continuously deactivated with adaptive closed-loop training. In a double-blind, placebo-controlled, randomized clinical trial, 60 nicotine-dependent participants were assigned to receive two neurofeedback training sessions (∼1 h/session) either from their own brain (n = 30, real-feedback group) or from the brain activity pattern of a matched participant (n = 30, yoked-feedback group). Cigarette craving and craving-related P300 were assessed at pre-neurofeedback and post-neurofeedback. The number of cigarettes smoked per day was assessed at baseline, 1 week, 1 month, and 4 months following the final neurofeedback visit. In the real-feedback group, participants successfully deactivated EEG activity patterns of smoking cue reactivity. The real-feedback group showed significant decrease in cigarette craving and craving-related P300 amplitudes compared with the yoked-feedback group. The rates of cigarettes smoked per day at 1 week, 1 month and 4 months follow-up decreased 30.6%, 38.2%, and 27.4% relative to baseline in the real-feedback group, compared to decreases of 14.0%, 13.7%, and 5.9% in the yoked-feedback group. The neurofeedback effects on craving change and smoking amount at the 4-month follow-up were further predicted by neural markers at pre-neurofeedback. This novel neurofeedback training approach produced significant short-term and long-term effects on cigarette craving and smoking behaviour, suggesting the neurofeedback protocol described herein is a promising brain-based tool for treating addiction.
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Affiliation(s)
- Junjie Bu
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Kymberly D Young
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Wei Hong
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Ru Ma
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Hongwen Song
- School of Humanities and Social Science, University of Science and Technology of China, Hefei, China
| | - Ying Wang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Wei Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China
| | - Michelle Hampson
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Talma Hendler
- Functional Brain Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Xiaochu Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, University of Science and Technology of China, Hefei, China.,School of Humanities and Social Science, University of Science and Technology of China, Hefei, China.,Hefei Medical Research Center on Alcohol Addiction, Anhui Mental Health Center, Hefei, China.,Academy of Psychology and Behaviour, Tianjin Normal University, Tianjin, China
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38
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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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39
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Salehi M, Karbasi A, Barron DS, Scheinost D, Constable RT. Individualized functional networks reconfigure with cognitive state. Neuroimage 2019; 206:116233. [PMID: 31574322 DOI: 10.1016/j.neuroimage.2019.116233] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/22/2019] [Accepted: 09/27/2019] [Indexed: 02/08/2023] Open
Abstract
There is extensive evidence that functional organization of the human brain varies dynamically as the brain switches between task demands, or cognitive states. This functional organization also varies across subjects, even when engaged in similar tasks. To date, the functional network organization of the brain has been considered static. In this work, we use fMRI data obtained across multiple cognitive states (task-evoked and rest conditions) and across multiple subjects, to measure state- and subject-specific functional network parcellation (the assignment of nodes to networks). Our parcellation approach provides a measure of how node-to-network assignment (NNA) changes across states and across subjects. We demonstrate that the brain's functional networks are not spatially fixed, but that many nodes change their network membership as a function of cognitive state. Such reconfigurations are highly robust and reliable to the extent that they can be used to predict cognitive state with up to 97% accuracy. Our findings suggest that if functional networks are to be defined via functional clustering of nodes, then it is essential to consider that such definitions may be fluid and cognitive-state dependent.
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Affiliation(s)
- Mehraveh Salehi
- Department of Electrical Engineering, Yale University, New Haven, CT, 06511, USA; Yale Institute for Network Science (YINS), Yale University, New Haven, CT, 06511, USA.
| | - Amin Karbasi
- Department of Electrical Engineering, Yale University, New Haven, CT, 06511, USA; Yale Institute for Network Science (YINS), Yale University, New Haven, CT, 06511, USA
| | - Daniel S Barron
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06520, USA
| | - Dustin Scheinost
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06520, USA
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06520, USA; Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, 06520, USA; Department of Neurosurgery, Yale School of Medicine, New Haven, CT, 06520, USA
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40
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Zhou L, Zhan B, He W, Luo W. Commentary: Deficient Inhibition in Alcohol-Dependence: Let's Consider the Role of the Motor System! Front Neurosci 2019; 13:876. [PMID: 31481870 PMCID: PMC6710439 DOI: 10.3389/fnins.2019.00876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/05/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lanjun Zhou
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Bin Zhan
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Weiqi He
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Wenbo Luo
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
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41
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Zhu Y, Gao H, Tong L, Li Z, Wang L, Zhang C, Yang Q, Yan B. Emotion Regulation of Hippocampus Using Real-Time fMRI Neurofeedback in Healthy Human. Front Hum Neurosci 2019; 13:242. [PMID: 31379539 PMCID: PMC6660260 DOI: 10.3389/fnhum.2019.00242] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/28/2019] [Indexed: 01/12/2023] Open
Abstract
Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) is a prospective tool to enhance the emotion regulation capability of participants and to alleviate their emotional disorders. The hippocampus is a key brain region in the emotional brain network and plays a significant role in social cognition and emotion processing in the brain. However, few studies have focused on the emotion NF of the hippocampus. This study investigated the feasibility of NF training of healthy participants to self-regulate the activation of the hippocampus and assessed the effect of rtfMRI-NF on the hippocampus before and after training. Twenty-six right-handed healthy volunteers were randomly assigned to the experimental group receiving hippocampal rtfMRI-NF (n = 13) and the control group (CG) receiving rtfMRI-NF from the intraparietal sulcus rtfMRI-NF (n = 13) and completed a total of four NF runs. The hippocampus and the intraparietal sulcus were defined based on the Montreal Neurological Institute (MNI) standard template, and NF signal was measured as a percent signal change relative to the baseline obtained by averaging the fMRI signal for the preceding 20 s long rest block. NF signal (percent signal change) was updated every 2 s and was displayed on the screen. The amplitude of low-frequency fluctuation and regional homogeneity values was calculated to evaluate the effects of NF on spontaneous neural activity in resting-state fMRI. A standard general linear model (GLM) analysis was separately conducted for each fMRI NF run. Results showed that the activation of hippocampus increased after four NF training runs. The hippocampal activity of the experiment group participants was higher than that of the CG. They also showed elevated hippocampal activity and the greater amygdala–hippocampus connectivity. The anterior temporal lobe, parahippocampal gyrus, hippocampus, and amygdala of brain regions associated with emotional processing were activated during training. We presented a proof-of-concept study using rtfMRI-NF for hippocampus up-regulation in the recall of positive autobiographical memories. The current study may provide a new method to regulate our emotions and can potentially be applied to the clinical treatment of emotional disorders.
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Affiliation(s)
- Yashuo Zhu
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
| | - Hui Gao
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
| | - Li Tong
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
| | - ZhongLin Li
- Department of Radiology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, China
| | - Linyuan Wang
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
| | - Chi Zhang
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
| | - Qiang Yang
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
| | - Bin Yan
- PLA Strategy Support Force Information Engineering University, Communication Engineering College, Zhengzhou, China
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42
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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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43
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Karch S, Paolini M, Gschwendtner S, Jeanty H, Reckenfelderbäumer A, Yaseen O, Maywald M, Fuchs C, Rauchmann BS, Chrobok A, Rabenstein A, Ertl-Wagner B, Pogarell O, Keeser D, Rüther T. Real-Time fMRI Neurofeedback in Patients With Tobacco Use Disorder During Smoking Cessation: Functional Differences and Implications of the First Training Session in Regard to Future Abstinence or Relapse. Front Hum Neurosci 2019; 13:65. [PMID: 30886575 PMCID: PMC6409331 DOI: 10.3389/fnhum.2019.00065] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/08/2019] [Indexed: 02/04/2023] Open
Abstract
One of the most prominent symptoms in addiction disorders is the strong desire to consume a particular substance or to show a certain behavior (craving). The strong association between craving and the probability of relapse emphasizes the importance of craving in the therapeutic process. Former studies have demonstrated that neuromodulation using real-time fMRI (rtfMRI) neurofeedback (NF) can be used as a treatment modality in patients with tobacco use disorder. The aim of the present project was to determine whether it is possible to predict the outcome of NF training plus group psychotherapy at the beginning of the treatment. For that purpose, neuronal responses during the first rtfMRI NF session of patients who remained abstinent for at least 3 months were compared to those of patients with relapse. All patients were included in a certified smoke-free course and took part in three NF sessions. During the rtfMRI NF sessions tobacco-associated and neutral pictures were presented. Subjects were instructed to reduce their neuronal responses during the presentation of smoking cues in an individualized region of interest for craving [anterior cingulate cortex (ACC), insula or dorsolateral prefrontal cortex]. Patients were stratified to different groups [abstinence (N = 10) vs. relapse (N = 12)] according to their individual smoking status 3 months after the rtfMRI NF training. A direct comparison of BOLD responses during the first NF-session of patients who had remained abstinent over 3 months after the NF training and patients who had relapsed after 3 months showed that patients of the relapse group demonstrated enhanced BOLD responses, especially in the ACC, the supplementary motor area as well as dorsolateral prefrontal areas, compared to abstinent patients. These results suggest that there is a probability of estimating a successful withdrawal in patients with tobacco use disorder by analyzing the first rtfMRI NF session: a pronounced reduction of frontal responses during NF training in patients might be the functional correlate of better therapeutic success. The results of the first NF sessions could be useful as predictor whether a patient will be able to achieve success after the behavioral group therapy and NF training in quitting smoking or not.
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Affiliation(s)
- Susanne Karch
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marco Paolini
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Sarah Gschwendtner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Hannah Jeanty
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Arne Reckenfelderbäumer
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Omar Yaseen
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Maximilian Maywald
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Christina Fuchs
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Agnieszka Chrobok
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Birgit Ertl-Wagner
- Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.,Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
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44
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Sorger B, Scharnowski F, Linden DEJ, Hampson M, Young KD. Control freaks: Towards optimal selection of control conditions for fMRI neurofeedback studies. Neuroimage 2019; 186:256-265. [PMID: 30423429 PMCID: PMC6338498 DOI: 10.1016/j.neuroimage.2018.11.004] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 12/31/2022] Open
Abstract
fMRI Neurofeedback research employs many different control conditions. Currently, there is no consensus as to which control condition is best, and the answer depends on what aspects of the neurofeedback-training design one is trying to control for. These aspects can range from determining whether participants can learn to control brain activity via neurofeedback to determining whether there are clinically significant effects of the neurofeedback intervention. Lack of consensus over criteria for control conditions has hampered the design and interpretation of studies employing neurofeedback protocols. This paper presents an overview of the most commonly employed control conditions currently used in neurofeedback studies and discusses their advantages and disadvantages. Control conditions covered include no control, treatment-as-usual, bidirectional-regulation control, feedback of an alternative brain signal, sham feedback, and mental-rehearsal control. We conclude that the selection of the control condition(s) should be determined by the specific research goal of the study and best procedures that effectively control for relevant confounding factors.
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Affiliation(s)
- Bettina Sorger
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Frank Scharnowski
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland; Neuroscience Center Zürich, University of Zürich and Swiss Federal Institute of Technology, Zürich, Switzerland; Zürich Center for Integrative Human Physiology (ZIHP), University of Zürich, Zürich, Switzerland
| | - David E J Linden
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom; School of Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Michelle Hampson
- Department of Radiology and Biomedical Imaging, Psychiatry and the Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Kymberly D Young
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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45
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Herwig U, Lutz J, Scherpiet S, Scheerer H, Kohlberg J, Opialla S, Preuss A, Steiger V, Sulzer J, Weidt S, Stämpfli P, Rufer M, Seifritz E, Jäncke L, Brühl A. Training emotion regulation through real-time fMRI neurofeedback of amygdala activity. Neuroimage 2019; 184:687-696. [DOI: 10.1016/j.neuroimage.2018.09.068] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 08/03/2018] [Accepted: 09/24/2018] [Indexed: 12/17/2022] Open
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46
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Verdejo-Garcia A, Lorenzetti V, Manning V, Piercy H, Bruno R, Hester R, Pennington D, Tolomeo S, Arunogiri S, Bates ME, Bowden-Jones H, Campanella S, Daughters SB, Kouimtsidis C, Lubman DI, Meyerhoff DJ, Ralph A, Rezapour T, Tavakoli H, Zare-Bidoky M, Zilverstand A, Steele D, Moeller SJ, Paulus M, Baldacchino A, Ekhtiari H. A Roadmap for Integrating Neuroscience Into Addiction Treatment: A Consensus of the Neuroscience Interest Group of the International Society of Addiction Medicine. Front Psychiatry 2019; 10:877. [PMID: 31920740 PMCID: PMC6935942 DOI: 10.3389/fpsyt.2019.00877] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 11/06/2019] [Indexed: 01/01/2023] Open
Abstract
Although there is general consensus that altered brain structure and function underpins addictive disorders, clinicians working in addiction treatment rarely incorporate neuroscience-informed approaches into their practice. We recently launched the Neuroscience Interest Group within the International Society of Addiction Medicine (ISAM-NIG) to promote initiatives to bridge this gap. This article summarizes the ISAM-NIG key priorities and strategies to achieve implementation of addiction neuroscience knowledge and tools for the assessment and treatment of substance use disorders. We cover two assessment areas: cognitive assessment and neuroimaging, and two interventional areas: cognitive training/remediation and neuromodulation, where we identify key challenges and proposed solutions. We reason that incorporating cognitive assessment into clinical settings requires the identification of constructs that predict meaningful clinical outcomes. Other requirements are the development of measures that are easily-administered, reliable, and ecologically-valid. Translation of neuroimaging techniques requires the development of diagnostic and prognostic biomarkers and testing the cost-effectiveness of these biomarkers in individualized prediction algorithms for relapse prevention and treatment selection. Integration of cognitive assessments with neuroimaging can provide multilevel targets including neural, cognitive, and behavioral outcomes for neuroscience-informed interventions. Application of neuroscience-informed interventions including cognitive training/remediation and neuromodulation requires clear pathways to design treatments based on multilevel targets, additional evidence from randomized trials and subsequent clinical implementation, including evaluation of cost-effectiveness. We propose to address these challenges by promoting international collaboration between researchers and clinicians, developing harmonized protocols and data management systems, and prioritizing multi-site research that focuses on improving clinical outcomes.
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Affiliation(s)
- Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Valentina Lorenzetti
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Canberra, ACT, Australia
| | - Victoria Manning
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Hugh Piercy
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Raimondo Bruno
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Rob Hester
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - David Pennington
- San Francisco Veterans Affairs Health Care System (SFVAHCS), San Francisco, CA, United States.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Serenella Tolomeo
- School of Medicine, University of St Andrews, Medical and Biological Science Building, North Haugh, St Andrews, United Kingdom.,Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Shalini Arunogiri
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia.,Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Marsha E Bates
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | | | - Salvatore Campanella
- Laboratoire de Psychologie Médicale et d'Addictologie, ULB Neuroscience Institute (UNI), CHU Brugmann-Université Libre de Bruxelles (U.L.B.), Brussels, Belgium
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Christos Kouimtsidis
- Department of Psychiatry, Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, United Kingdom
| | - Dan I Lubman
- Eastern Health Clinical School Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Dieter J Meyerhoff
- DVA Medical Center and Department of Radiology and Biomedical Imaging, University of California San Francisco, School of Medicine, San Francisco, CA, United States
| | - Annaketurah Ralph
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Tara Rezapour
- Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Hosna Tavakoli
- Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran.,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.,School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Anna Zilverstand
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, United States
| | - Douglas Steele
- Medical School, University of Dundee, Ninewells Hospital, Scotland, United Kingdom
| | - Scott J Moeller
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Martin Paulus
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States
| | - Alex Baldacchino
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States
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47
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Moningka H, Lichenstein S, Worhunsky PD, DeVito EE, Scheinost D, Yip SW. Can neuroimaging help combat the opioid epidemic? A systematic review of clinical and pharmacological challenge fMRI studies with recommendations for future research. Neuropsychopharmacology 2019; 44:259-273. [PMID: 30283002 PMCID: PMC6300537 DOI: 10.1038/s41386-018-0232-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/11/2018] [Accepted: 09/18/2018] [Indexed: 02/04/2023]
Abstract
The current opioid epidemic is an urgent public health problem, with enormous individual, societal, and healthcare costs. Despite effective, evidence-based treatments, there is significant individual variability in treatment responses and relapse rates are high. In addition, the neurobiology of opioid-use disorder (OUD) and its treatment is not well understood. This review synthesizes published fMRI literature relevant to OUD, with an emphasis on findings related to opioid medications and treatment, and proposes areas for further research. We conducted a systematic literature review of Medline and Psychinfo to identify (i) fMRI studies comparing OUD and control participants; (ii) studies related to medication, treatment, abstinence or withdrawal effects in OUD; and (iii) studies involving manipulation of the opioid system in healthy individuals. Following application of exclusionary criteria (e.g., insufficient sample size), 45 studies were retained comprising data from ~1400 individuals. We found convergent evidence that individuals with OUD display widespread heightened neural activation to heroin cues. This pattern is potentiated by heroin, attenuated by medication-assisted treatments for opioids, predicts treatment response, and is reduced following extended abstinence. Nonetheless, there is a paucity of literature examining neural characteristics of OUD and its treatment. We discuss limitations of extant research and identify critical areas for future neuroimaging studies, including the urgent need for studies examining prescription opioid users, assessing sex differences and utilizing a wider range of clinically relevant task-based fMRI paradigms across different stages of addiction.
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Affiliation(s)
- Hestia Moningka
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Sarah Lichenstein
- Yale School of Medicine, Radiology and Bioimaging Sciences, New Haven, CT, 06510, USA
| | - Patrick D Worhunsky
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Elise E DeVito
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Dustin Scheinost
- Yale School of Medicine, Radiology and Bioimaging Sciences, New Haven, CT, 06510, USA
| | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA.
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48
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Efficacy of Invasive and Non-Invasive Brain Modulation Interventions for Addiction. Neuropsychol Rev 2018; 29:116-138. [PMID: 30536145 PMCID: PMC6499746 DOI: 10.1007/s11065-018-9393-5] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 11/08/2018] [Indexed: 12/14/2022]
Abstract
It is important to find new treatments for addiction due to high relapse rates despite current interventions and due to expansion of the field with non-substance related addictive behaviors. Neuromodulation may provide a new type of treatment for addiction since it can directly target abnormalities in neurocircuits. We review literature on five neuromodulation techniques investigated for efficacy in substance related and behavioral addictions: transcranial direct current stimulation (tDCS), (repetitive) transcranial magnetic stimulation (rTMS), EEG, fMRI neurofeedback and deep brain stimulation (DBS) and additionally report on effects of these interventions on addiction-related cognitive processes. While rTMS and tDCS, mostly applied at the dorsolateral prefrontal cortex, show reductions in immediate craving for various addictive substances, placebo-responses are high and long-term outcomes are understudied. The lack in well-designed EEG-neurofeedback studies despite decades of investigation impedes conclusions about its efficacy. Studies investigating fMRI neurofeedback are new and show initial promising effects on craving, but future trials are needed to investigate long-term and behavioral effects. Case studies report prolonged abstinence of opioids or alcohol with ventral striatal DBS but difficulties with patient inclusion may hinder larger, controlled trials. DBS in neuropsychiatric patients modulates brain circuits involved in reward processing, extinction and negative-reinforcement that are also relevant for addiction. To establish the potential of neuromodulation for addiction, more randomized controlled trials are needed that also investigate treatment duration required for long-term abstinence and potential synergy with other addiction interventions. Finally, future advancement may be expected from tailoring neuromodulation techniques to specific patient (neurocognitive) profiles.
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Abstract
PURPOSE OF REVIEW Neurobiological studies of tobacco/nicotine use examining genetic, molecular, functional, and behavioral correlates have improved our understanding of nicotine/tobacco dependence and have informed treatment. Recent work extending previously established findings and reporting novel methodologies and discoveries in preclinical and human studies are reviewed. RECENT FINDINGS Recent work in preclinical models has focused on the differential roles of nicotinic receptor subtypes and nicotine's effects on neural systems beyond cortico-striatal dopaminergic pathways, and utilizing advanced methodologies such as pharmacogenetics, optogenetics and rodent fMRI to identify targets for treatment. Likewise, human neuroimaging studies have identified molecular and functional dynamic shifts associated with tobacco/nicotine use that further inform treatment. SUMMARY Nicotine/tobacco use is associated with widespread neural adaptations that are persistent and function to maintain addiction. The continued identification of genetic, molecular, neural, and behavioral endophenotypes related to nicotine/tobacco use, dependence, and addiction will facilitate the development and delivery of personalized treatment.
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Affiliation(s)
- Megha Chawla
- Department of Neuroscience, Yale School of Medicine, 310 Cedar Street, Brady Memorial Laboratory #407 New Haven, CT 06510
| | - Kathleen A Garrison
- Department of Psychiatry, Yale School of Medicine, 1 Church Street #703, New Haven, CT 06510
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50
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Dickerson KC. Upregulating brain activity using non-drug reward imagery and real-time fMRI neurofeedback-A new treatment approach for addiction? EBioMedicine 2018; 38:21-22. [PMID: 30448154 PMCID: PMC6306366 DOI: 10.1016/j.ebiom.2018.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/13/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Kathryn C Dickerson
- Department of Psychiatry and Behavioral Sciences, Center of Cognitive Neuroscience, Duke University, Box 90999, Durham, NC 27708, United States.
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