Yuan Zhang, Benjamin Becker, Keith M Kendrick, Qiong Zhang, Shuxia Yao
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Self-navigating the "Island of Reil": a systematic review of real-time fMRI neurofeedback training of insula activity.
Real-time fMRI (rtfMRI) neurofeedback (NF) is a novel noninvasive technique that permits individuals to voluntarily control brain activity. The crucial role of the insula in emotional and salience processing makes it one of the most commonly targeted regions in previous rtfMRI studies. To provide an overview of progress in the field, the present review identified 25 rtfMRI insula studies and systematically reviewed key characteristics and findings in these studies. We found that rtfMRI-based NF training is efficient for modulating insula activity and its associated behavioral/symptom-related and neural changes. Furthermore, we also observed a maintenance effect of self-regulation ability and sustained symptom improvement, which is of importance for clinical application. However, training success of insula regulation was not consistently paralleled by behavioral/symptom-related changes, suggesting a need for optimizing the NF training protocol enabling more robust training effects. Principles including inclusion of a well-designed control group/condition, statistical analyses and reporting results following common criteria and a priori determination of sample and effect sizes as well as pre-registration are also highly recommended. In summary, we believe our review will inspire and inform both basic research and therapeutic translation of rtfMRI NF training as an intervention in mental disorders particularly those with insula dysfunction.
期刊介绍:
Psychiatry has suffered tremendously by the limited translational pipeline. Nobel laureate Julius Axelrod''s discovery in 1961 of monoamine reuptake by pre-synaptic neurons still forms the basis of contemporary antidepressant treatment. There is a grievous gap between the explosion of knowledge in neuroscience and conceptually novel treatments for our patients. Translational Psychiatry bridges this gap by fostering and highlighting the pathway from discovery to clinical applications, healthcare and global health. We view translation broadly as the full spectrum of work that marks the pathway from discovery to global health, inclusive. The steps of translation that are within the scope of Translational Psychiatry include (i) fundamental discovery, (ii) bench to bedside, (iii) bedside to clinical applications (clinical trials), (iv) translation to policy and health care guidelines, (v) assessment of health policy and usage, and (vi) global health. All areas of medical research, including — but not restricted to — molecular biology, genetics, pharmacology, imaging and epidemiology are welcome as they contribute to enhance the field of translational psychiatry.