实时功能磁共振成像神经反馈训练杏仁核上调可增加抑郁症的情感灵活性。
Real-time functional magnetic resonance imaging neurofeedback training of amygdala upregulation increases affective flexibility in depression.
机构信息
From the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA (Compère, Siegle, Strege, Young); University of Pittsburgh Medical Center, Pittsburgh, PA (Lazzaro, Canovali, Barb); the Department of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA (Huppert).
From the Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA (Compère, Siegle, Strege, Young); University of Pittsburgh Medical Center, Pittsburgh, PA (Lazzaro, Canovali, Barb); the Department of Radiology and Bioengineering, University of Pittsburgh, Pittsburgh, PA (Huppert)
出版信息
J Psychiatry Neurosci. 2023 Jun 20;48(3):E232-E239. doi: 10.1503/jpn.220208. Print 2023 May-Jun.
BACKGROUND
Decreased affective flexibility is associated with depression symptoms, and it has been suggested that common interventions may target this mechanism. To explore this hypothesis, we evaluated whether real-time functional magnetic resonance imaging neurofeedback (rtfMRI-nf) training to increase the amygdala responses during positive memory recall resulted in both symptom improvements, as has been observed previously, and flexibility to decrease amygdala reactivity in response to a cognitive task among patients with major depressive disorder (MDD).
METHODS
In a double-blind, placebo-controlled, randomized clinical trial, adults with MDD received 2 sessions of rtfMRI-nf training to increase their amygdala (experimental group) or parietal (control group) responses during positive autobiographical memory recall. We evaluated signal changes in the amygdala during both the positive memory neurofeedback and a subsequent counting condition.
RESULTS
We included 38 adults with MDD, including 16 in the experimental group and 22 in the control group. In the experimental group, amygdala activity increased ( > 2.01, df < 27, < 0.05, > 0.5) and depressive symptoms decreased (-8.57, 95 % confidence interval [CI] -15.12 to -2.59; = -3.06, = 0.009, = 1). Amygdala activity during the count condition decreased after rtfMRI-nf (-0.16, 95 % CI -0.23 to -0.09; = 4.73, < 0.001, = 0.48) and was correlated with decreased depression scores ( = 0.46, = 0.01). We replicated previous results and extended them to show decreased amygdala reactivity to a cognitive task during which no neurofeedback was provided.
LIMITATIONS
The count condition was reported by participants as negative, but emotionality or accuracy during this condition was not assessed.
CONCLUSION
These results suggest that nominally targeting unidimensional change in neural mechanisms could have implications for bidirectional control, increasing the likely reach and explanatory framework for how common depression interventions work. ClinicalTrials.gov NCT02709161.
背景
情感灵活性的降低与抑郁症状有关，并且有人提出，常见的干预措施可能针对这一机制。为了探索这一假设，我们评估了实时功能磁共振成像神经反馈（rtfMRI-nf）训练是否可以增加积极记忆回忆过程中的杏仁核反应，从而不仅改善了先前观察到的症状，而且还改善了重度抑郁症（MDD）患者对认知任务的杏仁核反应灵活性。
方法
在一项双盲、安慰剂对照、随机临床试验中，患有 MDD 的成年人接受了 2 次 rtfMRI-nf 训练，以增加他们在积极自传体记忆回忆过程中杏仁核（实验组）或顶叶（对照组）的反应。我们评估了积极记忆神经反馈和随后的计数条件下杏仁核的信号变化。
结果
我们纳入了 38 名患有 MDD 的成年人，其中实验组 16 人，对照组 22 人。在实验组中，杏仁核活动增加（ > 2.01，df < 27， < 0.05， > 0.5），抑郁症状减轻（-8.57，95%置信区间[CI]-15.12 至-2.59； = -3.06， = 0.009， = 1）。在 rtfMRI-nf 后，计数条件下的杏仁核活动减少（-0.16，95%CI-0.23 至-0.09； = 4.73， < 0.001， = 0.48），与抑郁评分降低相关（ = 0.46， = 0.01）。我们复制了先前的结果，并将其扩展到表明在没有神经反馈的情况下，对认知任务的杏仁核反应降低。
局限性
虽然参与者报告说计数条件是负面的，但没有评估此条件下的情绪或准确性。
结论
这些结果表明，针对神经机制的单一维度变化进行有针对性的治疗可能会对双向控制产生影响，从而增加常见抑郁干预措施如何发挥作用的可能性和解释框架。ClinicalTrials.gov NCT02709161。
Zotero 插件