Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany.
Hum Brain Mapp. 2013 Jan;34(1):200-12. doi: 10.1002/hbm.21427. Epub 2011 Oct 22.
Real-time functional magnetic resonance imaging (rtfMRI) is a novel technique that has allowed subjects to achieve self-regulation of circumscribed brain regions. Despite its anticipated therapeutic benefits, there is no report on successful application of this technique in psychiatric populations. The objectives of the present study were to train schizophrenia patients to achieve volitional control of bilateral anterior insula cortex on multiple days, and to explore the effect of learned self-regulation on face emotion recognition (an extensively studied deficit in schizophrenia) and on brain network connectivity. Nine patients with schizophrenia were trained to regulate the hemodynamic response in bilateral anterior insula with contingent rtfMRI neurofeedback, through a 2-weeks training. At the end of the training stage, patients performed a face emotion recognition task to explore behavioral effects of learned self-regulation. A learning effect in self-regulation was found for bilateral anterior insula, which persisted through the training. Following successful self-regulation, patients recognized disgust faces more accurately and happy faces less accurately. Improvements in disgust recognition were correlated with levels of self-activation of right insula. RtfMRI training led to an increase in the number of the incoming and outgoing effective connections of the anterior insula. This study shows for the first time that patients with schizophrenia can learn volitional brain regulation by rtfMRI feedback training leading to changes in the perception of emotions and modulations of the brain network connectivity. These findings open the door for further studies of rtfMRI in severely ill psychiatric populations, and possible therapeutic applications.
实时功能磁共振成像（rtfMRI）是一种新的技术，它允许被试实现对特定脑区的自我调节。尽管该技术有预期的治疗益处，但目前还没有关于该技术在精神科人群中成功应用的报道。本研究的目的是训练精神分裂症患者在多天内实现双侧前岛叶皮层的自主控制，并探索习得的自我调节对面孔情绪识别（精神分裂症中广泛研究的缺陷）和脑网络连接的影响。9 名精神分裂症患者接受了通过 contingent rtfMRI 神经反馈来调节双侧前岛叶血流动力学反应的训练，为期 2 周。在训练阶段结束时，患者进行了面孔情绪识别任务，以探索习得的自我调节的行为效应。在双侧前岛叶发现了自我调节的学习效应，这种效应在训练过程中持续存在。在成功自我调节后，患者对面部表情的识别更加准确，对快乐的面部表情识别准确性降低。对厌恶表情的识别的改善与右侧岛叶的自我激活水平相关。rtfMRI 训练导致前岛叶传入和传出有效连接的数量增加。这项研究首次表明，精神分裂症患者可以通过 rtfMRI 反馈训练学习自主的大脑调节，从而改变对情绪的感知和大脑网络连接的调节。这些发现为进一步研究严重精神疾病人群中的 rtfMRI 以及可能的治疗应用打开了大门。
