实时 fMRI 神经反馈可减少听觉幻觉,并调节相关脑区的静息状态连接:第 2 部分:默认模式网络——初步证据。

Real-time fMRI neurofeedback reduces auditory hallucinations and modulates resting state connectivity of involved brain regions: Part 2: Default mode network -preliminary evidence.

机构信息

Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA; Northeastern University, Boston, MA 02139, USA.

Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA.

出版信息

Psychiatry Res. 2020 Feb;284:112770. doi: 10.1016/j.psychres.2020.112770. Epub 2020 Jan 14.

Abstract

Auditory hallucinations (AHs) are one of the most distressing symptoms of schizophrenia (SZ) and are often resistant to medication. Imaging studies of individuals with SZ show hyperactivation of the default mode network (DMN) and the superior temporal gyrus (STG). Studies in SZ show DMN hyperconnectivity and reduced anticorrelation between DMN and the central executive network (CEN). DMN hyperconnectivity has been associated with positive symptoms such as AHs while reduced DMN anticorrelations with cognitive impairment. Using real-time fMRI neurofeedback (rt-fMRI-NFB) we trained SZ patients to modulate DMN and CEN networks. Meditation is effective in reducing AHs in SZ and to modulate brain network integration and increase DMN anticorrelations. Consequently, patients were provided with meditation strategies to enhance their abilities to modulate DMN/CEN. Results show a reduction of DMN hyperconnectivity and increase in DMNCEN anticorrelation. Furthermore, the change in individual DMN connectivity significantly correlated with reductions in AHs. This is the first time that meditation enhanced through rt-fMRI-NFB is used to reduce AHs in SZ. Moreover, it provides the first empirical evidence for a direct causal relation between meditation enhanced rt-fMRI-NFB modulation of DMNCEN activity and post-intervention modulation of resting state networks ensuing in reductions in frequency and severity of AHs.

摘要

听觉幻觉 (AHs) 是精神分裂症 (SZ) 最令人痛苦的症状之一,通常对药物治疗有抗性。对 SZ 患者的影像学研究显示默认模式网络 (DMN) 和颞上回 (STG) 的过度活跃。SZ 研究表明 DMN 过度连接,DMN 与中央执行网络 (CEN) 之间的相关性降低。DMN 过度连接与 AH 等阳性症状有关,而 DMN 相关性降低与认知障碍有关。我们使用实时 fMRI 神经反馈 (rt-fMRI-NFB) 来训练 SZ 患者调节 DMN 和 CEN 网络。冥想在减少 SZ 中的 AHs 以及调节大脑网络整合和增加 DMN 相关性方面非常有效。因此,为患者提供了冥想策略,以增强他们调节 DMN/CEN 的能力。结果显示 DMN 过度连接减少,DMN-CEN 相关性增加。此外,个体 DMN 连接的变化与 AHs 的减少显著相关。这是首次通过 rt-fMRI-NFB 增强冥想来减少 SZ 中的 AHs。此外,它为冥想增强的 rt-fMRI-NFB 对 DMN-CEN 活动的调节与干预后静息状态网络的调节之间的直接因果关系提供了第一个经验证据,从而导致 AHs 的频率和严重程度降低。

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