Amygdala-related electroencephalogram neurofeedback as add-on therapy for treatment-resistant childhood sexual abuse posttraumatic stress disorder: feasibility study.

IF 5 3区 医学 Q1 CLINICAL NEUROLOGY
Psychiatry and Clinical Neurosciences Pub Date : 2024-01-01 Epub Date: 2023-12-22 DOI:10.1111/pcn.13591
Naomi B Fine, Liat Helpman, Daphna Bardin Armon, Guy Gurevitch, Gal Sheppes, Zivya Seligman, Talma Hendler, Miki Bloch
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引用次数: 0

Abstract

Aim: Childhood sexual abuse (CSA) among women is an alarmingly prevalent traumatic experience that often leads to debilitating and treatment-refractory posttraumatic stress disorder (PTSD), raising the need for novel adjunctive therapies. Neuroimaging investigations systematically report that amygdala hyperactivity is the most consistent and reliable neural abnormality in PTSD and following childhood abuse, raising the potential of implementing volitional neural modulation using neurofeedback (NF) aimed at down-regulating amygdala activity. This study aimed to reliably probe limbic activity but overcome the limited applicability of functional magnetic resonance imaging (fMRI) NF by using a scalable electroencephalogram NF probe of amygdala-related activity, termed amygdala electrical-finger-print (amyg-EFP) in a randomized controlled trial.

Method: Fifty-five women with CSA-PTSD who were in ongoing intensive trauma-focused psychotherapy for a minimum of 1 year but still met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD criteria were randomized to either 10 add-on sessions of amyg-EFP-NF training (test group) or continuing psychotherapy (control group). Participants were blindly assessed for PTSD symptoms before and after the NF training period, followed by self-reported clinical follow-up at 1, 3, and 6 months, as well as one session of amygdala real-time fMRI-NF before and after NF training period.

Results: Participants in the test group compared with the control group demonstrated a marginally significant immediate reduction in PTSD symptoms, which progressively improved during the follow-up period. In addition, successful neuromodulation during NF training was demonstrated.

Conclusion: This feasibility study for patients with treatment-resistant CSA-PTSD indicates that amyg-EFP-NF is a viable and efficient intervention.

将杏仁核相关脑电图神经反馈疗法作为治疗儿童性虐待创伤后应激障碍的附加疗法:可行性研究。
目的:儿童性虐待(CSA)在女性中是一种令人震惊的普遍创伤经历,往往会导致衰弱和难治的创伤后应激障碍(PTSD),因此需要新型的辅助疗法。神经影像学调查系统性地报告称,杏仁核过度活跃是创伤后应激障碍和童年受虐后最一致、最可靠的神经异常现象,这提高了利用神经反馈(NF)实施自愿神经调节以降低杏仁核活动的可能性。本研究旨在可靠地探查边缘活动,同时克服功能磁共振成像(fMRI)神经反馈的有限适用性,方法是在随机对照试验中使用可扩展的脑电图神经反馈探查杏仁核相关活动,即杏仁核电指印(amyg-EFP):方法:55 名患有 CSA-PTSD 的女性患者接受了至少 1 年的以创伤为重点的强化心理治疗,但仍符合《精神疾病诊断与统计手册》第五版(DSM-5)PTSD 标准,她们被随机分配到 10 次附加的杏仁核电-指-迹(amyg-EFP-NF)训练(试验组)或继续接受心理治疗(对照组)。在NF训练前后对参与者的创伤后应激障碍症状进行盲法评估,然后在1、3和6个月时进行自我报告的临床随访,并在NF训练前后进行一次杏仁核实时fMRI-NF训练:结果:与对照组相比,测试组参与者的创伤后应激障碍症状立即得到了轻微缓解,并在随访期间逐步改善。此外,NF 训练期间的神经调节也取得了成功:这项针对 CSA-PTSD 抗药性患者的可行性研究表明,amyg-EFP-NF 是一种可行且有效的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.40
自引率
4.20%
发文量
181
审稿时长
6-12 weeks
期刊介绍: PCN (Psychiatry and Clinical Neurosciences) Publication Frequency: Published 12 online issues a year by JSPN Content Categories: Review Articles Regular Articles Letters to the Editor Peer Review Process: All manuscripts undergo peer review by anonymous reviewers, an Editorial Board Member, and the Editor Publication Criteria: Manuscripts are accepted based on quality, originality, and significance to the readership Authors must confirm that the manuscript has not been published or submitted elsewhere and has been approved by each author
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