Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept
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,...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | NeuroImage: Clinical |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S221315822100303X |
| _version_ | 1818353423628632064 |
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| author | Tom Fruchtman-Steinbok Jackob N. Keynan Avihay Cohen Iman Jaljuli Shiri Mermelstein Gadi Drori Efrat Routledge Michael Krasnoshtein Rebecca Playle David E.J. Linden Talma Hendler |
| author_facet | Tom Fruchtman-Steinbok Jackob N. Keynan Avihay Cohen Iman Jaljuli Shiri Mermelstein Gadi Drori Efrat Routledge Michael Krasnoshtein Rebecca Playle David E.J. Linden Talma Hendler |
| author_sort | Tom Fruchtman-Steinbok |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T19:09:18Z |
| format | Article |
| id | doaj.art-b694d0a06da34bffaa5d75d8f4fe0f89 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-13T19:09:18Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-b694d0a06da34bffaa5d75d8f4fe0f892022-12-21T23:34:27ZengElsevierNeuroImage: Clinical2213-15822021-01-0132102859Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-conceptTom Fruchtman-Steinbok0Jackob N. Keynan1Avihay Cohen2Iman Jaljuli3Shiri Mermelstein4Gadi Drori5Efrat Routledge6Michael Krasnoshtein7Rebecca Playle8David E.J. Linden9Talma Hendler10Sagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, IsraelSagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; Department of Psychiatry & Behavioral Science, Stanford University School of Medicine, Stanford, CA, USASagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, IsraelDepartment of Statistics and Operations Research, School of Mathematical Sciences, Tel-Aviv University, Tel-Aviv, IsraelSagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, IsraelSagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, IsraelSagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, IsraelPsychiatric Department, Tel-Aviv Sourasky Medical Center, Tel-Aviv, IsraelCenter for Trials Research, College of Biomedical & Life Sciences, Cardiff University, Cardiff, UKDivision of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UKSagol Brain Institute, Tel-Aviv Medical Center, Tel-Aviv, Israel; School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Corresponding author at: School of Psychological Sciences, Gershon H. Gordon Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel.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.http://www.sciencedirect.com/science/article/pii/S221315822100303XSelf-regulationLimbic activityNeuromodulationfMRIEEG |
| spellingShingle | Tom Fruchtman-Steinbok Jackob N. Keynan Avihay Cohen Iman Jaljuli Shiri Mermelstein Gadi Drori Efrat Routledge Michael Krasnoshtein Rebecca Playle David E.J. Linden Talma Hendler Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept NeuroImage: Clinical Self-regulation Limbic activity Neuromodulation fMRI EEG |
| title | Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept |
| title_full | Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept |
| title_fullStr | Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept |
| title_full_unstemmed | Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept |
| title_short | Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept |
| title_sort | amygdala electrical finger print amygefp neurofeedback guided by individually tailored trauma script for post traumatic stress disorder proof of concept |
| topic | Self-regulation Limbic activity Neuromodulation fMRI EEG |
| url | http://www.sciencedirect.com/science/article/pii/S221315822100303X |
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