Direct modulation of aberrant brain network connectivity through real-time NeuroFeedback

Ramot, Michal; Kimmich, Sara; Gonzalez‐Castillo, Javier; Roopchansingh, Vinai; Popal, Haroon; White, Emily; Gotts, Stephen J.; Martin, Alex

doi:10.7554/elife.28974

Cited by 112 publications

(71 citation statements)

References 61 publications

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“…Despite increasing interest in the application of rt- fMRI, only a few studies to date have directly evaluated effects of NFT on functional connectivity between brain regions [54, 56, 71, 76-79]. In line with the present findings, a previous study with a relatively small sample of healthy subjects revealed initial evidence for the feasibility of connectivity-informed NF which was associated with increased perception of positive valence stimuli.…”

Section: Discussionsupporting

confidence: 79%

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Zhao

Yao

et al. 2019

Psychother Psychosom

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Background: Deficient emotion regulation and exaggerated anxiety represent a major transdiagnostic psychopathological marker. On the neural level these deficits have been closely linked to impaired, yet treatment-sensitive, prefrontal regulatory control over the amygdala. Gaining direct control over these pathways could therefore provide an innovative and promising intervention to regulate exaggerated anxiety. To this end the current proof-of-concept study evaluated the feasibility, functional relevance and maintenance of a novel connectivity-informed real-time fMRI neurofeedback training. Methods: In a randomized crossover sham-controlled design, 26 healthy subjects with high anxiety underwent real-time fMRI-guided neurofeedback training to enhance connectivity between the ventrolateral prefrontal cortex (vlPFC) and the amygdala (target pathway) during threat exposure. Maintenance of regulatory control was assessed after 3 days and in the absence of feedback. Training-induced changes in functional connectivity of the target pathway and anxiety ratings served as primary outcomes. Results: Training of the target, yet not the sham control, pathway significantly increased amygdala-vlPFC connectivity and decreased levels of anxiety. Stronger connectivity increases were significantly associated with higher anxiety reduction on the group level. At the follow-up, volitional control over the target pathway was maintained in the absence of feedback. Conclusions: The present results demonstrate for the first time that successful self-regulation of amygdala-prefrontal top-down regulatory circuits may represent a novel intervention to control anxiety. As such, the present findings underscore both the critical contribution of amygdala-prefrontal circuits to emotion regulation and the therapeutic potential of connectivity-informed real-time neurofeedback.

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Section: Discussionsupporting

confidence: 79%

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Zhao

Yao

et al. 2019

Psychother Psychosom

View full text Add to dashboard Cite

show abstract

“…Despite increasing interest in the application of rt-fMRI only a few studies to date have directly evaluated effects of neurofeedback training on functional connectivity between brain regions (50,(63)(64)(65)(66)(67)(68). In line with the present findings, a previous study with a relatively small sample of healthy subjects revealed initial evidence for the feasibility of connectivityinformed NF which was associated with increased perception of positive valence stimuli.…”

Section: Discussionsupporting

confidence: 88%

Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety

Zhao

Yao

et al. 2018

Preprint

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Deficient emotion regulation and exaggerated anxiety represent a major transdiagnostic psychopathological marker. On the neural level these deficits have been closely linked to impaired, yet treatment-sensitive, prefrontal regulatory control over the amygdala. Gaining direct control over these pathways could therefore provide an innovative and promising strategy to regulate exaggerated anxiety. To this end the current proof-of-concept study evaluated the feasibility, functional relevance and maintenance of a novel connectivityinformed real-time fMRI neurofeedback training. In a randomized within-subject shamcontrolled design high anxious subjects (n = 26) underwent real-time fMRI-guided training to enhance connectivity between the ventrolateral prefrontal cortex (vlPFC) and the amygdala (target pathway) during threat exposure. Maintenance of regulatory control was assessed after three days and in the absence of feedback. Training-induced changes in functional connectivity of the target pathway and anxiety ratings served as primary outcomes. Training of the target, yet not the sham-control, pathway significantly increased amygdala-vlPFC connectivity and decreased subjective anxiety levels. On the individual level stronger connectivity increases were significantly associated with anxiety reduction. At follow-up, volitional control over the target pathway and decreased anxiety level were maintained in the absence of feedback. The present results demonstrate for the first time that successful self-regulation of amygdala-prefrontal top-down regulatory circuits may represent a novel strategy to control anxiety. As such, the present findings underscore both the critical contribution of amygdala-prefrontal circuits to emotion regulation and the therapeutic potential of connectivity-informed real-time neurofeedback.

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“…Conversely, what sort of target can people learn to attain? For instance, while some evidence suggests that people can learn to modulate brain connectivity (Koush et al, 2015;Ramot, Grossman, Friedman, & Malach, 2016;Ramot et al, 2017;Ruiz et al, 2014) or even particular transient spatially extended patterns (Diaz Hernandez et al, 2016), and real-time as well as temporally non-local properties of brain activity | 1463 PAPO there is as yet no clear indications as to the range of feasible NF targets, and questions such as whether or not the measure of brain activity needs to be unique ought to be addressed in earnest. One may conjecture that almost any target may be attainable, so long as it can be expressed in a convenient way, though ultimately the essential ingredient is that cognitive control be able to move brain dynamics to the desired functional regime.…”

Section: Concluding Remark Smentioning

confidence: 99%

Neurofeedback: Principles, appraisal, and outstanding issues

Papo

2019

Eur J of Neuroscience

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Neurofeedback is a form of brain training in which subjects are fed back information about some measure of their brain activity which they are instructed to modify in a way thought to be functionally advantageous. Over the last 20 years, neurofeedback has been used to treat various neurological and psychiatric conditions, and to improve cognitive function in various contexts. However, in spite of a growing popularity, neurofeedback protocols typically make (often covert) assumptions on what aspects of brain activity to target, where in the brain to act and how, which have far‐reaching implications for the assessment of its potential and efficacy. Here we critically examine some conceptual and methodological issues associated with the way neurofeedback's general objectives and neural targets are defined. The neural mechanisms through which neurofeedback may act at various spatial and temporal scales, and the way its efficacy is appraised are reviewed, and the extent to which neurofeedback may be used to control functional brain activity discussed. Finally, it is proposed that gauging neurofeedback's potential, as well as assessing and improving its efficacy will require better understanding of various fundamental aspects of brain dynamics and a more precise definition of functional brain activity and brain‐behaviour relationships.

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Direct modulation of aberrant brain network connectivity through real-time NeuroFeedback

Cited by 112 publications

References 61 publications

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Real-Time Functional Connectivity-Informed Neurofeedback of Amygdala-Frontal Pathways Reduces Anxiety

Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety

Neurofeedback: Principles, appraisal, and outstanding issues

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