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Real-time self-regulation of emotion networks in patients with depression.

Linden DE, Habes I, Johnston SJ, Linden S, Tatineni R, Subramanian L, Sorger B, Healy D, Goebel R - PLoS ONE (2012)

Bottom Line: In a proof-of-concept study, eight patients with depression learned to upregulate brain areas involved in the generation of positive emotions (such as the ventrolateral prefrontal cortex (VLPFC) and insula) during four neurofeedback sessions.Their clinical symptoms, as assessed with the 17-item Hamilton Rating Scale for Depression (HDRS), improved significantly.A control group that underwent a training procedure with the same cognitive strategies but without neurofeedback did not improve clinically.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom. LindenD@cardiff.ac.uk

ABSTRACT
Many patients show no or incomplete responses to current pharmacological or psychological therapies for depression. Here we explored the feasibility of a new brain self-regulation technique that integrates psychological and neurobiological approaches through neurofeedback with functional magnetic resonance imaging (fMRI). In a proof-of-concept study, eight patients with depression learned to upregulate brain areas involved in the generation of positive emotions (such as the ventrolateral prefrontal cortex (VLPFC) and insula) during four neurofeedback sessions. Their clinical symptoms, as assessed with the 17-item Hamilton Rating Scale for Depression (HDRS), improved significantly. A control group that underwent a training procedure with the same cognitive strategies but without neurofeedback did not improve clinically. Randomised blinded clinical trials are now needed to exclude possible placebo effects and to determine whether fMRI-based neurofeedback might become a useful adjunct to current therapies for depression.

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Neurofeedback protocol.During the neurofeedback runs (3 in each of the 4 sessions), participants alternated between 20 s periods of rest and 20 s periods where they had to upregulate activity in the target area. The level of activation was fed back in real time (updated for each TR of 2 s) through the thermometer display.
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pone-0038115-g001: Neurofeedback protocol.During the neurofeedback runs (3 in each of the 4 sessions), participants alternated between 20 s periods of rest and 20 s periods where they had to upregulate activity in the target area. The level of activation was fed back in real time (updated for each TR of 2 s) through the thermometer display.

Mentions: Patients in the NF group were trained to upregulate brain areas responsive to positive emotions using a procedure modeled on our previous work with healthy participants [10]. A target area was identified by the contrast between responses to positive and neutral images in a localizer scan to ensure that an area involved in positive emotion processing was selected. In the localizer scan, we assessed brain responses to positive, negative and neutral pictures by presenting four pictures of the same emotion category in blocks of 6 s (1.5 s per picture), alternating with a fixation baseline of 12 s. We presented 12 blocks per category in pseudorandom order. We used pictures from the IAPS [15] with negative (mean normative ratings for valence 2.8 [SD.42], arousal 5.63 [SD.55]), positive (valence 6.90 [.55], arousal 6.00 [.74]) and neutral valence (valence 5.45 [.56], arousal 3.44 [.47]). Pictures showed, for example, scenes of danger or disgust in the negative category, and scenes of romance including mild erotica or exciting sports in the positive category. After the localizer scan, patients were trained to upregulate the target area during three neurofeedback scans lasting ca. 7 minutes each per session (Fig. 1). Patients were informed about the general function of the target area but were not given any specific instructions about strategy. The task we set for them was to increase activity in the target area by as much and as consistently as possible.


Real-time self-regulation of emotion networks in patients with depression.

Linden DE, Habes I, Johnston SJ, Linden S, Tatineni R, Subramanian L, Sorger B, Healy D, Goebel R - PLoS ONE (2012)

Neurofeedback protocol.During the neurofeedback runs (3 in each of the 4 sessions), participants alternated between 20 s periods of rest and 20 s periods where they had to upregulate activity in the target area. The level of activation was fed back in real time (updated for each TR of 2 s) through the thermometer display.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3366978&req=5

pone-0038115-g001: Neurofeedback protocol.During the neurofeedback runs (3 in each of the 4 sessions), participants alternated between 20 s periods of rest and 20 s periods where they had to upregulate activity in the target area. The level of activation was fed back in real time (updated for each TR of 2 s) through the thermometer display.
Mentions: Patients in the NF group were trained to upregulate brain areas responsive to positive emotions using a procedure modeled on our previous work with healthy participants [10]. A target area was identified by the contrast between responses to positive and neutral images in a localizer scan to ensure that an area involved in positive emotion processing was selected. In the localizer scan, we assessed brain responses to positive, negative and neutral pictures by presenting four pictures of the same emotion category in blocks of 6 s (1.5 s per picture), alternating with a fixation baseline of 12 s. We presented 12 blocks per category in pseudorandom order. We used pictures from the IAPS [15] with negative (mean normative ratings for valence 2.8 [SD.42], arousal 5.63 [SD.55]), positive (valence 6.90 [.55], arousal 6.00 [.74]) and neutral valence (valence 5.45 [.56], arousal 3.44 [.47]). Pictures showed, for example, scenes of danger or disgust in the negative category, and scenes of romance including mild erotica or exciting sports in the positive category. After the localizer scan, patients were trained to upregulate the target area during three neurofeedback scans lasting ca. 7 minutes each per session (Fig. 1). Patients were informed about the general function of the target area but were not given any specific instructions about strategy. The task we set for them was to increase activity in the target area by as much and as consistently as possible.

Bottom Line: In a proof-of-concept study, eight patients with depression learned to upregulate brain areas involved in the generation of positive emotions (such as the ventrolateral prefrontal cortex (VLPFC) and insula) during four neurofeedback sessions.Their clinical symptoms, as assessed with the 17-item Hamilton Rating Scale for Depression (HDRS), improved significantly.A control group that underwent a training procedure with the same cognitive strategies but without neurofeedback did not improve clinically.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, United Kingdom. LindenD@cardiff.ac.uk

ABSTRACT
Many patients show no or incomplete responses to current pharmacological or psychological therapies for depression. Here we explored the feasibility of a new brain self-regulation technique that integrates psychological and neurobiological approaches through neurofeedback with functional magnetic resonance imaging (fMRI). In a proof-of-concept study, eight patients with depression learned to upregulate brain areas involved in the generation of positive emotions (such as the ventrolateral prefrontal cortex (VLPFC) and insula) during four neurofeedback sessions. Their clinical symptoms, as assessed with the 17-item Hamilton Rating Scale for Depression (HDRS), improved significantly. A control group that underwent a training procedure with the same cognitive strategies but without neurofeedback did not improve clinically. Randomised blinded clinical trials are now needed to exclude possible placebo effects and to determine whether fMRI-based neurofeedback might become a useful adjunct to current therapies for depression.

Show MeSH
Related in: MedlinePlus