Dudek Emily, Dodell-Feder David
Department of Psychology, University of Rochester, United States.
Department of Psychology, University of Rochester, United States; Department of Neuroscience, University of Rochester Medical Center, United States.
Neurosci Biobehav Rev. 2021 Feb;121:291-306. doi: 10.1016/j.neubiorev.2020.12.020. Epub 2020 Dec 25.
Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) has gained popularity as an experimental treatment for a variety of psychiatric illnesses. However, there has yet to be a quantitative review regarding its efficacy. Here, we present the first meta-analysis of rtfMRI-NF for psychiatric disorders, evaluating its impact on brain and behavioral outcomes. Our literature review identified 17 studies and 105 effect sizes across brain and behavioral outcomes. We find that rtfMRI-NF produces a medium-sized effect on neural activity during training (g = .59, 95 % CI [.44, .75], p < .0001), a large-sized effect after training when no neurofeedback is provided (g = .84, 95 % CI [.37, 1.31], p = .005), and small-sized effects for behavioral outcomes (symptoms g = .37, 95 % CI [.16, .58], p = .002; cognition g = .23, 95 % CI [-.33, .78], p = .288). Mixed-effects analyses revealed few moderators. Together, these data suggest a positive impact of rtfMRI-NF on brain and behavioral outcomes, although more research is needed to determine how rtfMRI-NF works, for whom, and under what circumstances.
实时功能磁共振成像神经反馈（rtfMRI-NF）作为一种针对多种精神疾病的实验性治疗方法已受到广泛关注。然而，关于其疗效尚未有定量综述。在此，我们首次对rtfMRI-NF治疗精神疾病进行荟萃分析，评估其对大脑和行为结果的影响。我们的文献综述确定了17项研究以及105个关于大脑和行为结果的效应量。我们发现，rtfMRI-NF在训练期间对神经活动产生中等大小的效应（g = 0.59，95%置信区间[0.44, 0.75]，p < 0.0001），在训练后不提供神经反馈时产生大的效应（g = 0.84，95%置信区间[0.37, 1.31]，p = 0.005），而对行为结果产生小的效应（症状g = 0.37，95%置信区间[0.16, 0.58]，p = 0.002；认知g = 0.23，95%置信区间[-0.33, 0.78]，p = 0.288）。混合效应分析显示几乎没有调节因素。总体而言，这些数据表明rtfMRI-NF对大脑和行为结果有积极影响，尽管还需要更多研究来确定rtfMRI-NF如何起作用、对谁起作用以及在何种情况下起作用。
