杏仁核实时 fMRI 神经反馈对耐药性抑郁症的上调作用：概念验证和剂量确定

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2024-03-15 DOI:10.1016/j.brat.2024.104523

Laurie Compère , Greg J. Siegle , Sair Lazzaro , Emily Riley , Marlene Strege , Gia Canovali , Scott Barb , Theodore Huppert , Kymberly Young

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引用次数: 0

摘要

先前的研究表明，患有重度抑郁症（MDD）的成年人可以通过实时神经反馈（rt-fMRI-nf）训练在回忆积极记忆时提高杏仁核的反应性，这与抑郁症状的减轻有关。本研究调查了这种干预措施是否也适用于对标准心理和药物干预措施无反应的 MDD 患者，即对治疗有抵抗力的患者（TR-MDD）。结果测量指标为急性干预后12周内的BDI评分评估的抑郁症状，以及神经反馈疗程中杏仁核活动从初始基线到最终转移运行的变化（神经反馈成功率）。访问对 BDI 评分的主效应表明，抑郁症状明显减轻。杏仁核信号变化百分比仅在第一次治疗中呈现出学习曲线。按疗程计算的神经反馈成功率仅在第二次疗程中呈现显著正值。这项概念验证研究表明，只需进行两次神经反馈治疗，就能使患者的杏仁核活动得到上调，因此有必要在未来进行一项临床试验。在rtfMRI-nf干预过程中，参与者还报告了抑郁症状的减轻：临床试验注册号：NCT03428828。

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Amygdala real-time fMRI neurofeedback upregulation in treatment resistant depression: Proof of concept and dose determination

Previous work has shown that adults suffering from major depressive disorder (MDD) can increase their amygdala reactivity while recalling positive memories via real-time neurofeedback (rt-fMRI-nf) training, which is associated with reduction in depressive symptoms. This study investigated if this intervention could also be considered for patients suffering from MDD who do not respond to standard psychological and pharmacological interventions, i.e., treatment resistant (TR-MDD).

15 participants received 5 neurofeedback sessions. Outcome measures were depressive symptoms assessed by BDI scores up to 12 weeks following acute intervention, and amygdala activity changes from initial baseline to final transfer run during neurofeedback sessions (neurofeedback success).

Participants succeeded in increasing their amygdala activity. A main effect of visit on BDI scores indicated a significant reduction in depressive symptomatology. Percent signal change in the amygdala showed a learning curve during the first session only. Neurofeedback success computed by session was significantly positive only during the second session. When examining the baseline amygdala response, baseline activity stabilized/asymptoted by session 3.

This proof-of-concept study suggests that only two neurofeedback sessions are necessary to enable those patients to upregulate their amygdala activity, warranting a future RCT. Over the course of the rtfMRI-nf intervention, participants also reported reduced depressive symptomatology.

Clinical trial registration number: NCT03428828 on ClinicalTrials.gov.

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.