Sharma Ayushe A, Allendorfer Jane B, Correia Stephen, Gaston Tyler E, Goodman Adam, Grayson Leslie E, Philip Noah S, LaFrance W Curt, Szaflarski Jerzy P
Departments of Neurology University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
Departments of Neurology University of Alabama at Birmingham (UAB), Birmingham, AL, USA; Departments of Neurobiology University of Alabama at Birmingham (UAB), Birmingham, AL, USA; Departments of Psychiatry and Neurology, Rhode Island Hospital and Brown University, Providence, Rhode Island, USA.
Neuroimage Clin. 2025 Apr 16;46:103774. doi: 10.1016/j.nicl.2025.103774.
Given the high prevalence of functional neurological symptom disorder and its negative effects on the individual, family, and society, the development of interventions to treat it-including the subtype of functional seizures (FS)-is critical.Although we have limited understanding of the neurobiological effects of neurobehavioral therapy (NBT), studies indicate that NBT reduces seizures and improves psychological comorbidities in FS. In this study, healthy adults (N = 33) and patients with a history of TBI with (TBI-FS; N = 50) and without FS (TBI-only; N = 50) underwent magnetic resonance imaging (MRI) at 3 T approximately 12 weeks apart. TBI-FS participants underwent up to 12 sessions of NBT between scans. Structural MRI data were analyzed using voxel-based morphometry. A voxelwise repeated measures ANOVA tested changes in grey matter volume (GMV) between groups over time. Following treatment with NBT, TBI-FS participants showed a 1.23 % GMV increase in the left inferior and middle temporal gyri (p < 0.05) along with a 35.78 % reduction in seizure events and decrease in depressive (p < 0.001) and anxiety (p = 0.01) symptoms. Left temporal GMV increases were directly associated (p = 0.04, r = 0.26) with improvements in overall psychological, social, and occupational functioning (p < 0.001). We observed structural brain changes within the left inferior temporal gyrus following NBT that correspond to functional and psychological improvements in patients with TBI-FS. This work highlights the need for further research into the neurobiological effects of NBT, building on the relationship between NBT and brain plasticity and demonstrating putative targets for interventions.
鉴于功能性神经症状障碍的高患病率及其对个人、家庭和社会的负面影响，开发治疗该疾病（包括功能性癫痫发作（FS）亚型）的干预措施至关重要。尽管我们对神经行为疗法（NBT）的神经生物学效应了解有限，但研究表明，NBT可减少FS患者的癫痫发作并改善其心理共病情况。在本研究中，健康成年人（N = 33）以及有（TBI-FS；N = 50）和无FS（仅TBI；N = 50）的创伤性脑损伤（TBI）病史患者，相隔约12周接受了3T的磁共振成像（MRI）检查。TBI-FS参与者在两次扫描之间接受了多达12次的NBT治疗。使用基于体素的形态学分析结构MRI数据。采用体素重复测量方差分析来测试不同组之间灰质体积（GMV）随时间的变化。接受NBT治疗后，TBI-FS参与者左侧颞下回和颞中回的GMV增加了1.23%（p < 0.05），同时癫痫发作事件减少了35.78%，抑郁（p < 0.001）和焦虑（p = 0.01）症状减轻。左侧颞叶GMV的增加与整体心理、社会和职业功能的改善直接相关（p = 0.04，r = 0.26）（p < 0.001）。我们观察到NBT治疗后左侧颞下回的脑结构变化与TBI-FS患者的功能和心理改善相对应。这项工作强调了在NBT与脑可塑性之间关系的基础上，进一步研究NBT神经生物学效应的必要性，并展示了干预的假定靶点。
