2020: Regulating Posttraumatic Stress Disorder Symptoms With Neurofeedback: Regaining Control of the Mind (Keynote)

Presented by Dr. Ruth Lanius: The default-mode network (DMN) and salience network (SN) have been shown to be dysregulated in posttraumatic stress disorder (PTSD). Restoring aberrant connectivity within these networks with electroencephalogram neurofeedback (EEG-NFB) has been shown previously to be associated with decreased PTSD symptoms. Here, we conducted a double-blind, sham-controlled randomized clinical trial of alpha-rhythm EEG-NFB in participants with PTSD (n=36) over 20-weeks. Our aim was to provide mechanistic evidence underlying clinical improvements by examining changes in network connectivity via fMRI. Methods: We randomly assigned participants with a primary diagnosis of PTSD to either the experimental group (n=18) or sham-control group (n=18). We collected resting-state fMRI scans pre- and post-NFB intervention, for both the experimental and sham-control PTSD groups, where we additionally compared baseline connectivity measures pre-NFB to age-matched healthy control participants (n=36). Results: We found significantly decreased PTSD severity scores in the experimental NFB group only, when comparing post-NFB (d = 0.91) and 3-month follow-up scores (d = 1.05) to baseline measures. Interestingly, we found evidence to suggest a normalization of DMN and SN connectivity post-NFB in the experimental group only. Both decreases in PTSD severity and NFB performance were correlated to decreased insula connectivity with the SN in the experimental group. Critically, 61.1% of individuals in the experimental group no longer met criteria for PTSD after treatment, in comparison to 33.3% in the sham-control group. Conclusion: The current study shows mechanistic evidence for therapeutic changes in DMN and SN connectivity that are known to be associated with PTSD psychopathology. The current intervention appears well tolerated with no participant dropouts and may prove to be a highly beneficial adjunct treatment for PTSD.

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Presented by Dr. Ruth Lanius: The default-mode network (DMN) and salience network (SN) have been shown to be dysregulated in posttraumatic stress disorder (PTSD). Restoring aberrant connectivity within these networks with electroencephalogram neurofeedback (EEG-NFB) has been shown previously to be associated with decreased PTSD symptoms. Here, we conducted a double-blind, sham-controlled randomized clinical trial of alpha-rhythm EEG-NFB in participants with PTSD (n=36) over 20-weeks. Our aim was to provide mechanistic evidence underlying clinical improvements by examining changes in network connectivity via fMRI. Methods: We randomly assigned participants with a primary diagnosis of PTSD to either the experimental group (n=18) or sham-control group (n=18). We collected resting-state fMRI scans pre- and post-NFB intervention, for both the experimental and sham-control PTSD groups, where we additionally compared baseline connectivity measures pre-NFB to age-matched healthy control participants (n=36). Results: We found significantly decreased PTSD severity scores in the experimental NFB group only, when comparing post-NFB (d = 0.91) and 3-month follow-up scores (d = 1.05) to baseline measures. Interestingly, we found evidence to suggest a normalization of DMN and SN connectivity post-NFB in the experimental group only. Both decreases in PTSD severity and NFB performance were correlated to decreased insula connectivity with the SN in the experimental group. Critically, 61.1% of individuals in the experimental group no longer met criteria for PTSD after treatment, in comparison to 33.3% in the sham-control group. Conclusion: The current study shows mechanistic evidence for therapeutic changes in DMN and SN connectivity that are known to be associated with PTSD psychopathology. The current intervention appears well tolerated with no participant dropouts and may prove to be a highly beneficial adjunct treatment for PTSD.

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2020: Regulating Posttraumatic Stress Disorder Symptoms With Neurofeedback: Regaining Control of the Mind (Keynote)
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