Babaskina Liudmila, Afanasyeva Natalia, Semyonkina Marta, Myasnyankina Olivia, Sushko Natalia
Sechenov First Moscow State Medical University, Moscow, Russia.
Pacific National University, Khabarovsk, Russia.
Iran J Psychiatry. 2023 Jul;18(3):352-361. doi: 10.18502/ijps.v18i3.13014.
Personality disorders are serious psychiatric conditions, and some studies have examined neurofeedback training as a potential alternative treatment to improve cognitive and clinical symptoms in patients with such disorders. Here, we aimed to provide a first systematic review of such trials and present existing evidence regarding this treatment for individuals with personality disorders. A systematic search of peer-reviewed English journal articles was conducted for this study to identify original studies on fMRI and EEG neurofeedback treatment protocols in patients with personality disorders up to January 2023. PubMed, Web of Science, ProQuest, Cochrane Library, and Google Scholar databases were queried through the keywords "neurofeedback," "biofeedback," and "personality disorder," as well as their related Mesh synonyms. Totally, five studies were included in our systematic review. Two studies utilized EEG neurofeedback protocols, while three articles used real-time fMRI neurofeedback protocols. The types of studies were non-randomized, not-blinded case reports, case series, and single-arm trials with a high risk of bias. EEG neurofeedback protocols applied more training sessions and reported improvements in patients' neuropsychological and behavioral functions after treatment. Furthermore, fMRI-based neurofeedback studies reported neurophysiological changes, such as a shift in vmPFC-amygdala connectivity, towards healthy states following treatment. Moreover, behavioral symptoms of patients were reported to be improved after fMRI neurofeedback. Neurofeedback studies investigating this therapeutic technique for personality disorders are still very preliminary, and no strict conclusions can be drawn at this time. Therefore, further basic and clinical investigations are required to address several open methodological and technical questions and establish consensus and standardization, which will eventually lead to translational works.
人格障碍是严重的精神疾病，一些研究已将神经反馈训练作为一种潜在的替代疗法，用于改善此类障碍患者的认知和临床症状。在此，我们旨在对这类试验进行首次系统综述，并呈现关于人格障碍患者这种治疗方法的现有证据。 本研究对同行评审的英文期刊文章进行了系统检索，以识别截至2023年1月有关人格障碍患者功能磁共振成像（fMRI）和脑电图（EEG）神经反馈治疗方案的原始研究。通过关键词“神经反馈”“生物反馈”“人格障碍”及其相关的医学主题词（Mesh）同义词，对PubMed、科学网、ProQuest、考科蓝图书馆和谷歌学术数据库进行了查询。 我们的系统综述共纳入五项研究。两项研究采用了EEG神经反馈方案，而三篇文章使用了实时fMRI神经反馈方案。研究类型为非随机、非盲法的病例报告、病例系列以及偏倚风险较高的单臂试验。EEG神经反馈方案应用的训练疗程更多，并报告了治疗后患者神经心理和行为功能的改善。此外，基于fMRI的神经反馈研究报告了神经生理变化，如治疗后腹内侧前额叶皮质-杏仁核连接向健康状态转变。此外，fMRI神经反馈后患者的行为症状也有改善。 针对人格障碍的这种治疗技术的神经反馈研究仍非常初步，目前无法得出严格结论。因此，需要进一步进行基础和临床研究，以解决若干尚未解决的方法学和技术问题，并建立共识和标准化，这最终将促成转化研究工作。
