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

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/ Fruchtman-Steinbok T, Keynan JN, Cohen A, Jaljuli I, Mermelstein S, Drori G, Routledge E, Krasnoshtein M, Playle R, Linden DEJ, Hendler T.
Neuroimage Clin. 2021;32:102859. 

 

Demonstrating the feasibility of amygdala-EFP neurofeedback for PTSD treatment, by reducing PTSD symptoms and improving amygdala self-regulation.

The amygdala brain region is involved in emotional processing, and its dysregulation is associated with PTSD. Therefore, if we could teach a person to self-regulate their activity of this brain region, it could alleviate their symptoms. Such ‘brain training’ is accomplished by neurofeedback, in which the amygdala activity is recorded, analyzed in real-time and presented as feedback to the trainee. A major limitation in the scalability of this procedure for clinical use is that measurement of deep brain activity in the amygdala requires fMRI scanning. To overcome this limitation, an amygdala model was developed for use in an EEG-only neurofeedback procedure, termed amigdala EEG finger-print (EFP). It uses simultaneous EEG-fMRI recordings, training a machine-learning model to predict amygdala fMRI signals based on the EEG signals. The resulting amygdala EFP is implemented in EEG-based neurofeedback, without the need for patient MRI scanning.
 

In this study, PTSD patients treated with an 8-week neurofeedback protocol, followed by assessments at 3 and 6 months after completion. In a randomized clinical trial, 59 patients were assigned either to amygdala-EFP neurofeedback conditions (with two alternative feedback interfaces) or to no-neurofeedback control condition. Patients who trained with amygdala-EFP neurofeedback demonstrated greater reduction in PTSD symptoms (CAPS-5 questionnaire score) and improved fMRI down-regulation of the amygdala, compared to the control patients. Clinical improvement was preserved at 3 and 6 months following completion of the training, as measured via self-reported symptom severity (PCL questionnaire score). This demonstrates the potential benefit of amygdala-EFP neurofeedback training for PTSD treatment.

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To read the full article on NeuroImage: Clinical - https://www.sciencedirect.com/science/article/pii/S221315822100303X