Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept

NeuroImage: Clinical

Shiri Mermelstein¹  Iman Jaljuli²  Talma Hendler³  Efrat Routledge⁴  Jackob N. Keynan⁴  Michael Krasnoshtein⁵  Tom Fruchtman-Steinbok⁶  Rebecca Playle⁶  Avihay Cohen⁶  Gadi Drori⁶  David E.J. Linden⁶ 

[1] Behavioral Science, Stanford University School of Medicine, Stanford, CA, USA;;Department of Psychiatry &Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel;School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel;Department of Statistics and Operations Research, School of Mathematical Sciences, Tel-Aviv University, Tel-Aviv, Israel;Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel;

关键词: Self-regulation;    Limbic activity;    Neuromodulation;    fMRI;    EEG;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Amygdala activity dysregulation plays a central role in post-traumatic stress disorder (PTSD). Hence learning to self-regulate one's amygdala activity may facilitate recovery. PTSD is further characterized by abnormal contextual processing related to the traumatic memory. Therefore, provoking the personal traumatic narrative while training amygdala down-regulation could enhance clinical efficacy. We report the results of a randomized controlled trial (NCT02544971) of a novel self-neuromodulation procedure (i.e. NeuroFeedback) for PTSD, aimed at down-regulating limbic activity while receiving feedback from an auditory script of a personal traumatic narrative. To scale-up applicability, neural activity was probed by an fMRI-informed EEG model of amygdala activity, termed Amygdala Electrical Finger-Print (AmygEFP). Methods: Fifty-nine adults meeting DSM-5 criteria for PTSD were randomized between three groups: Trauma-script feedback interface (Trauma-NF) or Neutral feedback interface (Neutral-NF), and a control group of No-NF (to control for spontaneous recovery). Before and immediately after 15 NF training sessions patients were blindly assessed for PTSD symptoms and underwent one session of amygdala fMRI-NF for transferability testing. Follow-up clinical assessment was performed at 3- and 6-months following NF treatment. Results: Patients in both NF groups learned to volitionally down-regulate AmygEFP signal and demonstrated a greater reduction in PTSD symptoms and improved down-regulation of the amygdala during fMRI-NF, compared to the No-NF group. The Trauma-NF group presented the largest immediate clinical improvement. Conclusions: This proof-of-concept study indicates the feasibility of the AmygEFP-NF process-driven as a scalable intervention for PTSD and illustrates its clinical potential. Further investigation is warranted to elucidate the contribution of AmygEFP-NF beyond exposure and placebo effects.

【 授权许可】

Unknown