A tale of two targets: examining the differential effects of posterior cingulate cortex- and amygdala-targeted fMRI-neurofeedback in a PTSD pilot study.

amygdala default mode network fMRI neurofeedback post-traumatic stress disorder posterior cingulate cortex

Journal

Frontiers in neuroscience
ISSN: 1662-4548
Titre abrégé: Front Neurosci
Pays: Switzerland
ID NLM: 101478481

Informations de publication

Date de publication:
2023
Historique:
received: 26 05 2023
accepted: 24 10 2023
medline: 14 12 2023
pubmed: 14 12 2023
entrez: 14 12 2023
Statut: epublish

Résumé

Real-time fMRI-based neurofeedback (rt-fMRI-NFB) is a non-invasive technology that enables individuals to self-regulate brain activity linked to neuropsychiatric symptoms, including those associated with post-traumatic stress disorder (PTSD). Selecting the target brain region for neurofeedback-mediated regulation is primarily informed by the neurobiological characteristics of the participant population. There is a strong link between PTSD symptoms and multiple functional disruptions in the brain, including hyperactivity within both the amygdala and posterior cingulate cortex (PCC) during trauma-related processing. As such, previous rt-fMRI-NFB studies have focused on these two target regions when training individuals with PTSD to regulate neural activity. However, the differential effects of neurofeedback target selection on PTSD-related neural activity and clinical outcomes have not previously been investigated. Here, we compared whole-brain activation and changes in PTSD symptoms between PTSD participants ( For the PCC as compared to the amygdala group, we observed decreased neural activity in several regions implicated in PTSD psychopathology - namely, the bilateral cuneus/precuneus/primary visual cortex, the left superior parietal lobule, the left occipital pole, and the right superior temporal gyrus/temporoparietal junction (TPJ) - during target region downregulation using rt-fMRI-NFB. Conversely, for the amygdala as compared to the PCC group, there were no unique (i.e., over and above that of the PCC group) decreases in neural activity. Importantly, amygdala downregulation was not associated with significantly improved PTSD symptoms, whereas PCC downregulation was associated with reduced reliving and distress symptoms over the course of this single training session. In this pilot analysis, we did not detect significant between-group differences in state PTSD symptoms during neurofeedback. As a critical control, the PCC and amygdala groups did not differ in their ability to downregulate activity within their respective target brain regions. This indicates that subsequent whole-brain neural activation results can be attributed to the effects of the neurofeedback target region selection in terms of neurophysiological function, rather than as a result of group differences in regulatory success. In this study, neurofeedback-mediated downregulation of the PCC was differentially associated with reduced state PTSD symptoms and simultaneous decreases in PTSD-associated brain activity during a single training session. This novel analysis may guide researchers in choosing a neurofeedback target region in future rt-fMRI-NFB studies and help to establish the clinical efficacy of specific neurofeedback targets for PTSD. A future multi-session clinical trial of rt-fMRI-NFB that directly compares between PCC and amygdala target regions is warranted.

Identifiants

DOI: 10.3389/fnins.2023.1229729 PMID: 38094001 PMC: PMC10716260
pubmed: 38094001
doi: 10.3389/fnins.2023.1229729
pmc: PMC10716260
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1229729

Informations de copyright

Copyright © 2023 Lieberman, Rabellino, Densmore, Frewen, Steyrl, Scharnowski, Théberge, Hosseini-Kamkar, Neufeld, Jetly, Frey, Ros, Lanius and Nicholson.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Auteurs

Jonathan M Lieberman (JM)

Atlas Institute for Veterans and Families, Ottawa, ON, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Imaging, Lawson Health Research Institute, London, ON, Canada.

Daniela Rabellino (D)

Imaging, Lawson Health Research Institute, London, ON, Canada.
Department of Neuroscience, Western University, London, ON, Canada.

Maria Densmore (M)

Imaging, Lawson Health Research Institute, London, ON, Canada.
Department of Psychiatry, Western University, London, ON, Canada.

Paul A Frewen (PA)

Department of Neuroscience, Western University, London, ON, Canada.
Department of Psychology, Western University, London, ON, Canada.

David Steyrl (D)

Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.

Frank Scharnowski (F)

Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria.

Jean Théberge (J)

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Department of Psychiatry, Western University, London, ON, Canada.
Department of Medical Biophysics, Western University, London, ON, Canada.
Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada.

Niki Hosseini-Kamkar (N)

Atlas Institute for Veterans and Families, Ottawa, ON, Canada.
The University of Ottawa Institute of Mental Health Research, Royal Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Richard W J Neufeld (RWJ)

Department of Neuroscience, Western University, London, ON, Canada.
Department of Psychiatry, Western University, London, ON, Canada.
Department of Psychology, Western University, London, ON, Canada.
Department of Psychology, University of British Columbia, Kelowna, BC, Canada.

Rakesh Jetly (R)

The University of Ottawa Institute of Mental Health Research, Royal Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.

Benicio N Frey (BN)

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Mood Disorders Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Ontario, ON, Canada.

Tomas Ros (T)

Department of Neuroscience and Psychiatry, University of Geneva, Geneva, Switzerland.

Ruth A Lanius (RA)

Imaging, Lawson Health Research Institute, London, ON, Canada.
Department of Neuroscience, Western University, London, ON, Canada.
Department of Psychiatry, Western University, London, ON, Canada.

Andrew A Nicholson (AA)

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
Department of Medical Biophysics, Western University, London, ON, Canada.
The University of Ottawa Institute of Mental Health Research, Royal Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
School of Psychology, University of Ottawa, Ottawa, ON, Canada.

Classifications MeSH