Okano Kana, Bauer Clemens C C, Ghosh Satrajit S, Lee Yoon Ji, Melero Helena, de Los Angeles Carlo, Nestor Paul G, Del Re Elisabetta C, Northoff Georg, Whitfield-Gabrieli Susan, Niznikiewicz Margaret A
Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Psychiatry Res. 2020 Feb 10;286:112862. doi: 10.1016/j.psychres.2020.112862.
Auditory hallucinations (AH) are one of the core symptoms of schizophrenia (SZ) and constitute a significant source of suffering and disability. One third of SZ patients experience pharmacology-resistant AH, so an alternative/complementary treatment strategy is needed to alleviate this debilitating condition. In this study, real-time functional Magnetic Resonance Imaging neurofeedback (rt-fMRI NFB), a non-invasive technique, was used to teach 10 SZ patients with pharmacology-resistant AH to modulate their brain activity in the superior temporal gyrus (STG), a key area in the neurophysiology of AH. A functional task was designed in order to provide patients with a specific strategy to help them modify their brain activity in the desired direction. Specifically, they received neurofeedback from their own STG and were trained to upregulate it while listening to their own voice recording and downregulate it while ignoring a stranger's voice recording. This guided performance neurofeedback training resulted in a) a significant reduction in STG activation while ignoring a stranger's voice, and b) reductions in AH scores after the neurofeedback session. A single, 21-minute session of rt-fMRI NFB was enough to produce these effects, suggesting that this approach may be an efficient and clinically viable alternative for the treatment of pharmacology-resistant AH.
幻听是精神分裂症的核心症状之一，也是痛苦和残疾的重要来源。三分之一的精神分裂症患者经历过药物抵抗性幻听，因此需要一种替代/补充治疗策略来缓解这种使人衰弱的状况。在本研究中，实时功能磁共振成像神经反馈（rt-fMRI NFB）这一非侵入性技术被用于教导10名患有药物抵抗性幻听的精神分裂症患者调节其颞上回（STG）的大脑活动，STG是幻听神经生理学中的一个关键区域。设计了一项功能性任务，以便为患者提供一种特定策略，帮助他们将大脑活动朝着期望的方向改变。具体而言，他们从自己的STG获得神经反馈，并接受训练，在听自己的语音录音时上调该区域活动，在忽略陌生人的语音录音时下调该区域活动。这种引导性表现神经反馈训练产生了以下结果：a）在忽略陌生人声音时，STG激活显著减少；b）神经反馈训练后幻听评分降低。一次21分钟的rt-fMRI NFB治疗就足以产生这些效果，这表明这种方法可能是治疗药物抵抗性幻听的一种有效且临床上可行的替代方法。
