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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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Network activation and deactivation during neurofeedback.a) Activation of the insular cortex (INS) bilaterally and the right ventral striatum (VS) supported the neurofeedback task, whereas the temporoparietal junctions (TPJ) of both hemispheres were deactivated. The TPJ is recognised as part of the brain’s “default mode network” that is deactivated during effortful tasks. For a full documentation of the activated and deactivated networks see Table 3. View from the front and above. The right side of the brain is on the observer’s left (Talairach coordinates of virtual cuts: y = 25, z = −2). b) Successive training sessions produced further increases of activation during upregulation periods in the VS bilaterally (coronal view at y = 7, the right side of the brain is on the observer’s left).
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pone-0038115-g005: Network activation and deactivation during neurofeedback.a) Activation of the insular cortex (INS) bilaterally and the right ventral striatum (VS) supported the neurofeedback task, whereas the temporoparietal junctions (TPJ) of both hemispheres were deactivated. The TPJ is recognised as part of the brain’s “default mode network” that is deactivated during effortful tasks. For a full documentation of the activated and deactivated networks see Table 3. View from the front and above. The right side of the brain is on the observer’s left (Talairach coordinates of virtual cuts: y = 25, z = −2). b) Successive training sessions produced further increases of activation during upregulation periods in the VS bilaterally (coronal view at y = 7, the right side of the brain is on the observer’s left).

Mentions: Activation increases during upregulation periods of the neurofeedback scans included but were not confined to the individual target regions. Rather, the group map for the upregulation predictor showed activation of the bilateral anterior insula and hippocampal regions, bilateral medial premotor and prefrontal regions, the right ventral striatum, and the left cuneus (Fig. 5a, Table 3). Deactivation was prominent in the bilateral temporoparietal junction (TPJ), and it extended into the posterior insula, early and higher visual areas, and the right DLPFC (Fig. 5a, Table 3). Significantly higher activation in the upregulation periods of the late (Weeks 3 and 4) compared to early (Weeks 1 and 2) sessions was observed in the bilateral ventral striatum, and in left extrastriate visual cortex (p<001, cluster level corrected; see Fig. 5b and Table 3).


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)

Network activation and deactivation during neurofeedback.a) Activation of the insular cortex (INS) bilaterally and the right ventral striatum (VS) supported the neurofeedback task, whereas the temporoparietal junctions (TPJ) of both hemispheres were deactivated. The TPJ is recognised as part of the brain’s “default mode network” that is deactivated during effortful tasks. For a full documentation of the activated and deactivated networks see Table 3. View from the front and above. The right side of the brain is on the observer’s left (Talairach coordinates of virtual cuts: y = 25, z = −2). b) Successive training sessions produced further increases of activation during upregulation periods in the VS bilaterally (coronal view at y = 7, the right side of the brain is on the observer’s left).
© Copyright Policy
Related In: Results  -  Collection

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

pone-0038115-g005: Network activation and deactivation during neurofeedback.a) Activation of the insular cortex (INS) bilaterally and the right ventral striatum (VS) supported the neurofeedback task, whereas the temporoparietal junctions (TPJ) of both hemispheres were deactivated. The TPJ is recognised as part of the brain’s “default mode network” that is deactivated during effortful tasks. For a full documentation of the activated and deactivated networks see Table 3. View from the front and above. The right side of the brain is on the observer’s left (Talairach coordinates of virtual cuts: y = 25, z = −2). b) Successive training sessions produced further increases of activation during upregulation periods in the VS bilaterally (coronal view at y = 7, the right side of the brain is on the observer’s left).
Mentions: Activation increases during upregulation periods of the neurofeedback scans included but were not confined to the individual target regions. Rather, the group map for the upregulation predictor showed activation of the bilateral anterior insula and hippocampal regions, bilateral medial premotor and prefrontal regions, the right ventral striatum, and the left cuneus (Fig. 5a, Table 3). Deactivation was prominent in the bilateral temporoparietal junction (TPJ), and it extended into the posterior insula, early and higher visual areas, and the right DLPFC (Fig. 5a, Table 3). Significantly higher activation in the upregulation periods of the late (Weeks 3 and 4) compared to early (Weeks 1 and 2) sessions was observed in the bilateral ventral striatum, and in left extrastriate visual cortex (p<001, cluster level corrected; see Fig. 5b and Table 3).

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