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一项关于慢性创伤后应激障碍神经反馈的随机对照研究。

A Randomized Controlled Study of Neurofeedback for Chronic PTSD.

作者信息

van der Kolk Bessel A, Hodgdon Hilary, Gapen Mark, Musicaro Regina, Suvak Michael K, Hamlin Ed, Spinazzola Joseph

机构信息

Trauma Center at Justice Resource Institute (JRI), Brookline MA, United States of America.

Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States of America.

出版信息

PLoS One. 2016 Dec 16;11(12):e0166752. doi: 10.1371/journal.pone.0166752. eCollection 2016.

Abstract

INTRODUCTION

Brain/Computer Interaction (BCI) devices are designed to alter neural signals and, thereby, mental activity. This study was a randomized, waitlist (TAU) controlled trial of a BCI, EEG neurofeedback training (NF), in patients with chronic PTSD to explore the capacity of NF to reduce PTSD symptoms and increase affect regulation capacities.

STUDY DESIGN

52 individuals with chronic PTSD were randomized to either NF (n = 28) or waitlist (WL) (n = 24). They completed four evaluations, at baseline (T1), after week 6 (T2), at post-treatment (T3), and at one month follow up (T4). Assessment measures were:1. Traumatic Events Screening Inventory (T1); 2. the Clinician Administered PTSD Scale (CAPS; T1, T3, T4); 3. the Davidson Trauma Scale (DTS; T1-T4) and 4. the Inventory of Altered Self-Capacities (IASC; T1-T4). NF training occurred two times per week for 12 weeks and involved a sequential placement with T4 as the active site, P4 as the reference site.

RESULTS

Participants had experienced an average of 9.29 (SD = 2.90) different traumatic events. Post-treatment a significantly smaller proportion of NF (6/22, 27.3%) met criteria for PTSD than the WL condition (15/22, 68.2%), χ2 (n = 44, df = 1) = 7.38, p = .007. There was a significant treatment condition x time interaction (b = -10.45, t = -5.10, p< .001). Measures of tension reduction activities, affect dysregulation, and affect instability exhibited a significant Time x Condition interaction. The effect sizes of NF (d = -2.33 within, d = - 1.71 between groups) are comparable to those reported for the most effective evidence based treatments for PTSD.

DISCUSSION

Compared with the control group NF produced significant PTSD symptom improvement in individuals with chronic PTSD, as well as in affect regulation capacities. NF deserves further investigation for its potential to ameliorate PTSD and to improve affect regulation, and to clarify its mechanisms of action.

摘要

引言

脑机交互(BCI)设备旨在改变神经信号,进而改变心理活动。本研究是一项针对慢性创伤后应激障碍(PTSD)患者的脑机接口、脑电图神经反馈训练(NF)的随机、等待列表(常规治疗)对照试验,以探索NF减轻PTSD症状和提高情感调节能力的能力。

研究设计

52名慢性PTSD患者被随机分为NF组(n = 28)或等待列表组(WL,n = 24)。他们在基线(T1)、第6周后(T2)、治疗后(T3)和1个月随访(T4)时完成了四项评估。评估指标包括:1.创伤事件筛查量表(T1);2.临床医生管理的PTSD量表(CAPS;T1、T3、T4);3.戴维森创伤量表(DTS;T1 - T4);4.自我能力改变量表(IASC;T1 - T4)。NF训练每周进行两次,共12周,电极依次置于T4作为激活部位,P4作为参考部位。

结果

参与者平均经历了9.29次(标准差 = 2.90)不同的创伤事件。治疗后,达到PTSD标准的NF组患者比例(6/22,27.3%)显著低于WL组(15/22,68.2%),χ2(n = 44,自由度 = 1) = 7.38,p = 0.007。存在显著的治疗条件×时间交互作用(b = -10.45,t = -5.10,p < 0.001)。减压活动、情感失调和情感不稳定的测量显示出显著的时间×条件交互作用。NF的效应大小(组内d = -2.33,组间d = -1.71)与报道的PTSD最有效的循证治疗效果相当。

讨论

与对照组相比,NF在慢性PTSD患者的PTSD症状改善以及情感调节能力方面产生了显著效果。NF在改善PTSD和提高情感调节方面的潜力值得进一步研究,并阐明其作用机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/343a/5161315/963cf9aa6887/pone.0166752.g001.jpg

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