Amygdala-derived-EEG-fMRI-pattern neurofeedback for the treatment of chronic post-traumatic stress disorder. A prospective, multicenter, multinational study evaluating clinical efficacy

Psychiatry Research, Journal Year: 2024, Volume and Issue: 333, P. 115711 - 115711

Published: Jan. 8, 2024

We conducted a prospective, single arm, multisite, multinational, open label trial assessing the safety and efficacy of novel amygdala derived neurofeedback treatment, designated Amygdala-Derived-EFP, for chronic PTSD. Participants, including veterans civilians, underwent screening, training, 15 sessions over 8 weeks and; baseline, termination (8 weeks) 3 month post treatment assessments with validated measures. The primary endpoint was more than 50% participants demonstrating Minimally Clinically Important Difference (MCID) defined as 6-point reduction, on Clinician Administered PTSD Scale (CAPS-5) total score at months. Secondary measures included PCL-5, ERQ, PHQ-9, CGI. Statistical analyses were performed using SAS®V9.4. met, CAPS-5 MCID response rate 66.7%. average reduction in scores follow up 13.5 points, twice MCID. Changes from baseline CAPS-5, PHQ-9 follow-up demonstrated statistically significant improvements effect sizes ranging 0.46 to 1.07. Adverse events mild resolved after treatment. This study builds prior research similar outcomes amygdala-derived neurofeedback. Positive attributes this therapy include monitoring by non-physician personnel, affordability, accessibility, tolerability.

Language: Английский

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A brief real-time fNIRS-informed neurofeedback training of the prefrontal cortex changes brain activity and connectivity during subsequent working memory challenge

Progress in Neuro-Psychopharmacology and Biological Psychiatry, Journal Year: 2024, Volume and Issue: 132, P. 110968 - 110968

Published: Feb. 13, 2024

Language: Английский

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Neurorights in the Constitution: from neurotechnology to ethics and politics

Philosophical Transactions of the Royal Society B Biological Sciences, Journal Year: 2024, Volume and Issue: 379(1915)

Published: Oct. 21, 2024

Neuroimaging technologies such as brain–computer interfaces and neurofeedback have evolved rapidly new tools for cognitive neuroscience potential clinical interventions. However, along with these developments, concern has grown based on the fear of misuse neurotechnology. In October 2021, Chile became first country to include neurorights in its Constitution. The present article is divided into two parts. section, we describe path followed by that led inclusion Chilean Constitution, neurotechnologies usually involved discussions. second part, discuss problems neurorights. We begin pointing out some epistemological concerns regarding neurorights, mainly referring ambiguity concepts used neurolegislations, difficult relationship between politics weak reasons urgency legislating. then dangers overprotective laws medical research, detrimental effect recent legislation risk posed benefits development. This aims engage scientific community interested neurotechnology an interdisciplinary reflection consequences part theme issue ‘Neurofeedback: territories neurocognitive mechanisms endogenous neuromodulation’.

Language: Английский

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Amygdala self-neuromodulation capacity as a window for process-related network recruitment

Philosophical Transactions of the Royal Society B Biological Sciences, Journal Year: 2024, Volume and Issue: 379(1915)

Published: Oct. 21, 2024

Neurofeedback (NF) has emerged as a promising avenue for demonstrating process-related neuroplasticity, enabling self-regulation of brain function. NF targeting the amygdala drawn attention to therapeutic potential in psychiatry, by potentially harnessing emotion-regulation processes. However, not all individuals respond equally training, possibly owing varying abilities. This underscores importance understanding mechanisms behind successful neuromodulation (i.e. capacity). study aimed investigate establishment and neural correlates capacity using data from repeated sessions electrical fingerprint (Amyg-EFP)-NF post-training functional magnetic resonance imaging (fMRI)-NF sessions. Results 97 participants (healthy controls post-traumatic stress disorder fibromyalgia patients) revealed increased Amyg-EFP over associated with amygdala-fMRI modulation improvements alexithymia. Individual differenaces this were pre-training reactivity initial success. Additionally, downregulation during fMRI-NF co-modulated other regions such posterior insula parahippocampal gyrus. combined better explained EFP-modulation improvement alexithymia than alone, suggesting relevance broader network gained capacity. These findings support network-based approach highlight need consider individual differences function optimize interventions. article is part theme issue ‘Neurofeedback: new territories neurocognitive endogenous neuromodulation’.

Language: Английский

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Systematic review and meta-analysis of neurofeedback and its effect on posttraumatic stress disorder

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: March 21, 2024

Background To date, only one systematic review and meta-analysis of randomized controlled trials (RCTs) has evaluated the effect neurofeedback in PTSD, which included four studies found an uncertainty EEG-NF on PTSD symptoms. This is update considering that numerous have since been published. Additionally, more recent fMRI-NF as well fMRI-guided or -inspired EEG NF Methods Systematic literature searches for RCTs were conducted three online databases. Additional hand each study identified reviews meta-analyses published also undertaken. Outcomes vs. a control (active, sham, waiting list) their effects reducing symptoms using various health instruments. Meta-analytical methods used inverse variance random-effects models measuring both mean standardized differences. Quality certainty evidence assessed GRADE. Adverse events evaluated. Results A total 17 evaluating 628 patients. There 10 meta-analysis. from all favored neurofeedback’s including BDI pretest–posttest [mean difference (MD): 8.30 (95% CI: 3.09 to 13.52; P = 0.002; I 2 0%)]; pretest–follow-up (MD: 8.75 3.53 13.97; < 0.00001; 0%); CAPS-5 [MD: 7.01 1.36 12.66; 0.02; 86%)]; 1.29 21.29; 0.006; 77%); PCL-5 7.14 3.08 11.2; 0.0006; 14.95 7.95 21.96; 0.0001; 0%). Other reported improvements other GRADE assessments CAPS, PCL, demonstrated moderate/high level quality positive clinical effect. Conclusion Based newer outcomes measured, clinically meaningful size, with increased size at follow-up. appears be driven by deeper brain derivates it.

Language: Английский

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Nociplastic Pain: A Critical Paradigm for Multidisciplinary Recognition and Management

Journal of Clinical Medicine, Journal Year: 2024, Volume and Issue: 13(19), P. 5741 - 5741

Published: Sept. 26, 2024

Our understanding of chronic pain has evolved significantly, shifting from a focus on peripheral damage to recognizing the central mechanisms underlying perception. This perspective article explores concept nociplastic pain, term introduced by International Association for Study Pain (IASP) in 2017, which describes arising altered modulation within nervous system, without clear evidence tissue or inflammation. The historical progression fibrositis fibromyalgia, and now underscores complexity syndromes need multidisciplinary approach management. Nociplastic is characterized sensitization, leading heightened sensitivity often accompanied comorbidities such as fatigue, sleep disturbances, cognitive difficulties. Advances neuroimaging have revealed connectivity key brain networks, default mode salience patients with providing insights into neural underpinnings this condition. also addresses controversies surrounding role small fiber neuropathy autonomic dysfunction highlighting ongoing debates field. practical importance across various medical disciplines—including primary care, orthopedics, neurology, psychiatry, rheumatology—is emphasized, recommendations integrating knowledge clinical practice. Emerging therapies, neurofeedback, hyperbaric oxygen therapy, neuromodulation, offer new avenues treatment, particularly who do not respond conventional approaches. calls continued research development reliable diagnostic tools, exploration novel therapeutic strategies improve patient outcomes. recognition management are crucial advancing care necessitating interdisciplinary collaboration patient-centered approach.

Language: Английский

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Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity

Translational Psychiatry, Journal Year: 2025, Volume and Issue: 15(1)

Published: May 16, 2025

Language: Английский

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Amygdala‐related electroencephalogram neurofeedback as add‐on therapy for treatment‐resistant childhood sexual abuse posttraumatic stress disorder: feasibility study

Psychiatry and Clinical Neurosciences, Journal Year: 2023, Volume and Issue: 78(1), P. 19 - 28

Published: Aug. 24, 2023

Childhood sexual abuse (CSA) among women is an alarmingly prevalent traumatic experience that often leads to debilitating and treatment-refractory posttraumatic stress disorder (PTSD), raising the need for novel adjunctive therapies. Neuroimaging investigations systematically report amygdala hyperactivity most consistent reliable neural abnormality in PTSD following childhood abuse, potential of implementing volitional modulation using neurofeedback (NF) aimed at down-regulating activity. This study reliably probe limbic activity but overcome limited applicability functional magnetic resonance imaging (fMRI) NF by a scalable electroencephalogram amygdala-related activity, termed electrical-finger-print (amyg-EFP) randomized controlled trial.

Language: Английский

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Translation of monosynaptic circuits underlying amygdala fMRI neurofeedback training

Neuropsychopharmacology, Journal Year: 2024, Volume and Issue: 49(12), P. 1839 - 1850

Published: Aug. 5, 2024

fMRI neurofeedback using autobiographical memory recall to upregulate the amygdala is associated with resting-state functional connectivity (rsFC) changes between and salience default mode networks (SN DMN, respectively). We hypothesize existence of anatomical circuits underlying these rsFC changes. Using a cross-species brain parcellation, we identified in non-human primates locations homologous regions interest (ROIs) from studies showing pre-to-post-neurofeedback left amygdala. injected bidirectional tracers basolateral, lateral, central nuclei adult macaques used bright- dark-field microscopy identify cells axon terminals each ROI (SN: anterior cingulate, ventrolateral, insular cortices; DMN: temporal pole, middle frontal gyrus, angular precuneus, posterior cingulate cortex, parahippocampal hippocampus, thalamus). also performed additional injections specific ROIs validate results following delineate potential disynaptic pathways. Finally, high-resolution diffusion MRI data four post-mortem macaque brains one vivo human translate our findings neuroimaging domain. Different had significant monosynaptic connections all SN DMN ipsilateral ROIs. Amygdala contralateral are through hippocampus gyrus. Diffusion both species benefitted ground-truth tracer its findings, as false-negative false-positive results. This study provides foundation for future causal investigations modulation anatomic connections.

Language: Английский

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Whole-brain mechanism of neurofeedback therapy: predictive modeling of neurofeedback outcomes on repetitive negative thinking in depression

Translational Psychiatry, Journal Year: 2024, Volume and Issue: 14(1)

Published: Sept. 4, 2024

Language: Английский

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