Amygdala electrical-finger-print (AmygEFP) NeuroFeedback guided by individually-tailored Trauma script for post-traumatic stress disorder: Proof-of-concept.

BACKGROUND: Amygdala activity dysregulation plays a central role in post-traumatic stress disorder (PTSD). Hence learning to self-regulate one's amygdala activity may facilitate recovery. PTSD is further characterized by abnormal contextual processing related to the traumatic memory. Therefore, provoking the personal traumatic narrative while training amygdala down-regulation could enhance clinical efficacy. We report the results of a randomized controlled trial (NCT02544971) of a novel self-neuromodulation procedure (i.e. NeuroFeedback) for PTSD, aimed at down-regulating limbic activity while receiving feedback from an auditory script of a personal traumatic narrative. To scale-up applicability, neural activity was probed by an fMRI-informed EEG model of amygdala activity, termed Amygdala Electrical Finger-Print (AmygEFP). METHODS: Fifty-nine adults meeting DSM-5 criteria for PTSD were randomized between three groups: Trauma-script feedback interface (Trauma-NF) or Neutral feedback interface (Neutral-NF), and a control group of No-NF (to control for spontaneous recovery). Before and immediately after 15 NF training sessions patients were blindly assessed for PTSD symptoms and underwent one session of amygdala fMRI-NF for transferability testing. Follow-up clinical assessment was performed at 3- and 6-months following NF treatment. RESULTS: Patients in both NF groups learned to volitionally down-regulate AmygEFP signal and demonstrated a greater reduction in PTSD symptoms and improved down-regulation of the amygdala during fMRI-NF, compared to the No-NF group. The Trauma-NF group presented the largest immediate clinical improvement. CONCLUSIONS: This proof-of-concept study indicates the feasibility of the AmygEFP-NF process-driven as a scalable intervention for PTSD and illustrates its clinical potential. Further investigation is warranted to elucidate the contribution of AmygEFP-NF beyond exposure and placebo effects.

Publisher Correction: Process-based framework for precise neuromodulation.

The original and corrected figures, and the Editorial Summary, are shown in the accompanying Publisher Correction.An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Publisher Correction: Process-based framework for precise neuromodulation.

The original and corrected text is shown in the accompanying Publisher Correction.

Process-based framework for precise neuromodulation.

Functional MRI neurofeedback (NF) allows humans to self-modulate neural patterns in specific brain areas. This technique is regarded as a promising tool to translate neuroscientific knowledge into brain-guided psychiatric interventions. However, its clinical implementation is restricted by unstandardized methodological practices, by clinical definitions that are poorly grounded in neurobiology, and by lack of a unifying framework that dictates experimental choices. Here we put forward a new framework, termed 'process-based NF', which endorses a process-oriented characterization of mental dysfunctions to form precise and effective psychiatric treatments. This framework relies on targeting specific dysfunctional mental processes by modifying their underlying neural mechanisms and on applying process-specific contextual feedback interfaces. Finally, process-based NF offers designs and a control condition that address the methodological shortcomings of current approaches, thus paving the way for a precise and personalized neuromodulation.

The interaction between emotion and executive control: Comparison between visual, auditory, and tactile modalities.

The reciprocal connections between emotion and attention are vital for adaptive behaviour. Previous results demonstrated that the behavioural effects of emotional stimuli on performance are attenuated when executive control is recruited. The current research studied whether this attenuation is modality dependent. In two experiments, negative and neutral pictures were presented shortly before a visual, tactile, or auditory target in a Simon task. All three modalities demonstrated a Simon effect, a conflict adaptation effect, and an emotional interference effect. However, the interaction between picture valence and Simon congruency was found only in the visual task. Specifically, when the Simon target was visual, emotional interference was reduced during incongruent compared to congruent trials. These findings suggest that although the control-related effects observed in the Simon tasks are not modality dependent, the link between emotion and executive control is modality dependent. Presumably, this link occurs only when the emotional stimulus and the target are presented in the same modality.

Does working memory load facilitate target detection?

Previous studies demonstrated that increasing working memory (WM) load delays performance of a concurrent task, by distracting attention and thus interfering with encoding and maintenance processes. The present study used a version of the change detection task with a target detection requirement during the retention interval. In contrast to the above prediction, target detection was faster following a larger set-size, specifically when presented shortly after the memory array (up to 400 ms). The effect of set-size on target detection was also evident when no memory retention was required. The set-size effect was also found using different modalities. Moreover, it was only observed when the memory array was presented simultaneously, but not sequentially. These results were explained by increased phasic alertness exerted by the larger visual display. The present study offers new evidence of ongoing attentional processes in the commonly-used change detection paradigm.