Recent findings on neurofeedback training for auditory hallucinations in schizophrenia

Abstract

Purpose of review To provide recent evidence on real-time neurofeedback (NFB) training for auditory verbal hallucinations (AVH) in schizophrenia patients. Recent findings NFB is a promising technique that allows patients to gain control over their AVH by modulating their own speech-related/language-related networks including superior temporal gyrus (STG) and anterior cingulate cortex (ACC) using fMRI, fNIRS and EEG/MEG. A recent limited number of studies showed that while an EEG-based NFB study failed to regulate auditory-evoked potentials and reduce AVH, downregulation of STG hyperactivity and upregulation of ACC activity with fMRI-based NFB appear to alleviate treatment-resistant AVH in schizophrenia patients. A deeper understanding of AVH and development of more effective methodologies are still needed. Summary Despite recent innovations in antipsychotics, many schizophrenia patients continue to suffer from treatment-resistant AVH and social dysfunctions. Recent studies suggested that real-time NFB shows promise in enabling patients to gain control over AVH by regulating their own speech-related/language-related networks. Although fMRI-NFB is suitable for regulating localized activity, EEG/MEG-NFB are ideal for regulating the ever-changing AVH. Although there are still many challenges including logistic complexity and burden on patients, we hope that such innovative real-time NFB trainings will help patients to alleviate severe symptoms and improve social functioning.

Measuring Voluntary Control Over Hallucinations: The Yale Control Over Perceptual Experiences (COPE) Scales

“…The ability of voice-hearers to function is predicted by many factors, including psychiatric comorbidities, beliefs about voices, and the content of what is heard. As we 8,15 and others 19,[49][50][51] have argued, control over voice-hearing experiences is another, potentially modifiable determinant of functioning. Here, we demonstrate that the impact of control over voice-hearing experiences extends beyond these other factors.…”

“…Recent work in neurofeedback methods for auditory hallucinations highlights these methods' potential for improving functioning in voice-hearers by altering activity in the auditory cortex 51,55,56 . One potential outcome of these approaches may be enhanced control over hallucinations 49 , speaking to the potential involvement of auditory cortices in the exertion of control over voice-hearing experiences. The work presented here may be a means by which control itself may be systematically interrogated and enhanced, first by identifying circuits underlying control over voice-hearing experiences, and then using noninvasive techniques like neurofeedback to specifically alter activity in these networks in individuals without control abilities.…”

Toward recovery in schizophrenia: Current concepts, findings, and future research directions

“…111 Given these results and the heterogeneity of the designs among existing studies, further sophisticated studies are needed to validate the efficacy of rTMS for patients with TRS. Further technological breakthroughs, such as theta-burst TMS 108,112 with a combination of neurofeedback techniques 113,114 may contribute in this respect.…”

Editorial: Current MEG Research in Psychiatry

“…Despite the relatively small number of systems worldwide and high maintenance costs (12), MEG has the potential to significantly contribute toward the development of biomarkers for early detection and diagnosis for major syndromes [e.g., (13)]. Groundbreaking innovations, such as the new opticallypumped magnetometer (OPM) or wearable OPMs (21), will lead to a deeper understanding of the neural basis of psychiatric disorders as well as facilitate the development of novel treatment targets including neurofeedback treatments (22). Accordingly, we believe that the continued development of MEG hardware and analyses approaches will open up new perspectives for establishing neurophysiological biomarkers for psychiatric disorders.…”