Goldental Nadav, Gross Raz, Amital Daniela, Harel Eiran V, Hendler Talma, Tendler Aron, Levi Liora, Lavro Dmitri, Harmelech Tal, Grinapol Shulamit, Nacasch Nitsa, Fruchter Eyal
Division of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer 52621, Israel.
Department of Epidemiology, School of Public Health and Department of Psychiatry, School of Medicine, Tel Aviv University, Sheba Medical Center, Tel Aviv 6997801, Israel.
J Clin Med. 2025 Apr 2;14(7):2421. doi: 10.3390/jcm14072421.
Post-traumatic stress disorder (PTSD) manifests through distinct symptom clusters that can respond differently to treatments. Neurofeedback guided by the Amygdala-derived-EEG-fMRI-Pattern (Amyg-EFP-NF) has been utilized to train PTSD patients to regulate amygdala-related activity and decrease symptoms. We conducted a combined analysis of 128 PTSD patients from three clinical trials of Amyg-EFP-NF to evaluate effects across symptom clusters (as assessed by CAPS-5 subscales) and on emotion regulation processing (evaluated by the ERQ). Amyg-EFP-NF significantly reduced severity across all PTSD symptom clusters immediately post-treatment, with improvements maintained at three-month follow-up. The arousal and reactivity cluster showed continued significant improvement during follow-up. Combined effect sizes were large (η = 0.23-0.35) across all symptom clusters. Regression analysis revealed that emotion regulation processes significantly explained 17% of the variance in symptom improvement during the follow-up period. Reduction of PTSD symptoms following Amyg-EFP-NF occurs across all symptom clusters, with emotional regulation processes potentially serving as an underlying mechanism of action. These results support Amyg-EFP-NF as a comprehensive treatment approach for PTSD that continues to show benefits after treatment completion.
创伤后应激障碍（PTSD）通过不同的症状群表现出来，这些症状群对治疗的反应可能不同。由杏仁核衍生的脑电图-功能磁共振成像模式（Amyg-EFP-NF）引导的神经反馈已被用于训练PTSD患者调节与杏仁核相关的活动并减轻症状。我们对来自三项Amyg-EFP-NF临床试验的128名PTSD患者进行了综合分析，以评估跨症状群（通过CAPS-5分量表评估）和情绪调节加工（通过ERQ评估）的效果。Amyg-EFP-NF在治疗后立即显著降低了所有PTSD症状群的严重程度，在三个月的随访中改善情况得以维持。唤醒和反应性症状群在随访期间持续显著改善。所有症状群的综合效应量都很大（η = 0.23 - 0.35）。回归分析显示，情绪调节过程在随访期间显著解释了症状改善差异的17%。Amyg-EFP-NF治疗后PTSD症状的减轻在所有症状群中均有出现，情绪调节过程可能是其潜在的作用机制。这些结果支持Amyg-EFP-NF作为一种PTSD的综合治疗方法，在治疗完成后仍能持续显示出益处。
