核心语言网络节点的神经反馈调节与默认模式网络的连通性：一项关于听觉言语幻觉的双盲 fMRI 神经反馈研究。

Neurofeedback of core language network nodes modulates connectivity with the default-mode network: A double-blind fMRI neurofeedback study on auditory verbal hallucinations.

机构信息

Department of Psychiatry, Psychotherapy and Psychosomatics, School of Medicine, RWTH Aachen University, Aachen, Germany.

出版信息

Neuroimage. 2019 Apr 1;189:533-542. doi: 10.1016/j.neuroimage.2019.01.058. Epub 2019 Jan 28.

DOI:10.1016/j.neuroimage.2019.01.058

PMID:30703519

Abstract

BACKGROUND

The experience of auditory verbal hallucinations in schizophrenia is associated with changes in brain network function. In particular, studies indicate altered functional coupling between nodes of the language and default mode networks. Neurofeedback based on real-time functional magnetic resonance imaging (rtfMRI) can be used to modulate such aberrant network connectivity.

METHODS

We investigated resting-state connectivity changes after neurofeedback (NF) in 21 patients with schizophrenia and 35 healthy individuals. All participants underwent two days of neurofeedback training of important nodes of the left-hemispheric language network including the inferior frontal gyrus (IFG) and posterior superior temporal gyrus (pSTG). In a double-blind randomized cross-over design, participants learned to down- and up-regulate their brain activation in the designated target regions based on NF. Prior to and after each training day, a resting state measurement took place.

RESULTS

Coupling between nodes of the language and the default mode network (DMN) selectively increased after down-as compared to up-regulation NF. Network analyses revealed more pronounced increases in functional connectivity between nodes of the language network and the DMN in patients compared to healthy individuals. In particular, down-regulation NF led to increased coupling between nodes of the language network and bilateral inferior parietal lobe (IPL) as well as posterior cingulate cortex (PCC)/precuneus in patients. Up-regulation strengthened connectivity with the medial prefrontal cortex (mPFC). Improved well-being four weeks after the training predicted increased functional coupling between the left IFG and left IPL.

CONCLUSION

Modulatory effects emerged as increased internetwork communication, indicating that down-regulation NF selectively enhances coupling between language and DM network nodes in patients with AVH. RtfMRI NF may thus be used to modulate brain network function that is relevant to the phenomenology of AVH. Specific effects of self-regulation on symptom improvement have to be explored in therapeutic interventions.

摘要

背景

精神分裂症患者的听觉言语幻觉体验与大脑网络功能变化有关。特别是，研究表明语言和默认模式网络节点之间的功能耦合发生改变。基于实时功能磁共振成像（rtfMRI）的神经反馈可用于调节这种异常的网络连通性。

方法

我们研究了 21 名精神分裂症患者和 35 名健康个体在神经反馈（NF）后的静息状态连接变化。所有参与者都接受了两天的左半球语言网络重要节点的神经反馈训练，包括额下回（IFG）和后上颞叶（pSTG）。在双盲随机交叉设计中，参与者根据 NF 学习调节指定目标区域的大脑激活。在每个训练日之前和之后，都会进行静息状态测量。

结果

与上调 NF 相比，下调 NF 后语言网络和默认模式网络（DMN）之间的节点连接选择性增加。网络分析显示，与健康个体相比，患者的语言网络和 DMN 节点之间的功能连接增加更为明显。特别是，下调 NF 导致语言网络节点与双侧顶下小叶（IPL）以及后扣带回/楔前叶（PCC/precuneus）之间的耦合增加。上调 NF 增强了与内侧前额叶皮质（mPFC）的连接。训练四周后的幸福感改善预测了左 IFG 和左 IPL 之间功能连接的增加。