Multi-session fMRI-Neurofeedback in PTSD

Condition(s) studied

Investigational drug(s) / intervention(s)

MRI Biofeedback: We will use state-of-the-art fMRI and neurofeedback of brain signals in order to teach patients with PTSD to self-regulate pathological brain activity that is associated with their symptoms. Indeed, feedback information is crucial for learning, where rt-fMRI-based neurofeedback makes information about brain activity accessible to our consciousness (Ros et al., 2014; Sitaram et al., 2017). It thus provides a reinforcement signal to induce personalized learning mechanisms, allowing individuals to search for appropriate cognitive strategies to voluntarily control brain activity. The feedback signal will come from activity within either the amygdala or PCC.

Sham-MRI Biofeedback: In the sham-control arm (N=20), individuals will receive fake neurofeedback signal, i.e., from a successful participant in one of the experimental arms.

Study summary

Post-traumatic stress disorder (PTSD) is a debilitating and highly prevalent psychiatric disorder that develops in the aftermath of trauma exposure (APA, 2013). PTSD has been strongly associated with altered activation patterns within several large-scale brain networks and, as such, it has been suggested that normalizing pathological brain activation may be an effective treatment approach.

The objective of this proposed study is to investigate the ability of PTSD patients to self-regulate aberrant neural circuitry associated with PTSD psychopathology using real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback. Here, the investigators are building upon previous single-session pilot studies examining the regulation of the amygdala and the posterior cingulate cortex (PCC) in PTSD (Nicholson et al., 2021) (Nicholson et al., 2016) by: (1) Examining the effect of multiple sessions of rt-fMRI neurofeedback and, (2) Comparing PCC- and amygdala-targeted rt-fMRI neurofeedback to sham-control groups with regards to changes in PTSD symptoms and neural connectivity.

Eligibility

Primary outcome measure(s)

• Changes in PTSD symptoms over neurofeedback training sessions — Change in baseline (pre-neurofeedback) at 1-week intervals (i.e., post-neurofeedback session 1, 2, 3) and at a 1-month follow-up)
  The change in PTSD symptoms, as measured by PTSD Checklist 5 (PCL-5) scores, will be assessed over the course of 3 neurofeedback training sessions and at a 1-month follow-up. PCL-5 is a self-report measure used to gauge the DSM-5 symptoms of PTSD. PCL-5 scores range from 0 to 80 with higher scores indicating more severe PTSD symptoms.
• Region-of-interest (ROI) downregulation analysis over neurofeedback training sessions — Change in ROI activation between neurofeedback sessions 1, 2, and 3
  In order to evaluate ROI downregulation (i.e., neurofeedback success), we will extract the event-related BOLD signal from the ROI during the regulate and view conditions.

Trial sites (1)

Other trials for the same condition