title: Orbitofrontal cortex neurofeedback produces lasting changes in contamination anxiety and resting-state connectivity.
abstract: Anxiety is a core human emotion but can become pathologically dysregulated. We used functional magnetic resonance imaging (fMRI) neurofeedback (NF) to noninvasively alter patterns of brain connectivity, as measured by resting-state fMRI, and to reduce contamination anxiety. Activity of a region of the orbitofrontal cortex associated with contamination anxiety was measured in real time and provided to subjects with significant but subclinical anxiety as a NF signal, permitting them to learn to modulate the target brain region. NF altered network connectivity of brain regions involved in anxiety regulation: subjects exhibited reduced resting-state connectivity in limbic circuitry and increased connectivity in the dorsolateral prefrontal cortex. NF has been shown to alter brain connectivity in other contexts, but it has been unclear whether these changes persist; critically, we observed changes in connectivity several days after the completion of NF training, demonstrating that such training can lead to lasting modifications of brain functional architecture. Training also increased subjects' control over contamination anxiety several days after the completion of NF training. Changes in resting-state connectivity in the target orbitofrontal region correlated with these improvements in anxiety. Matched subjects undergoing a sham feedback control task showed neither a reorganization of resting-state functional connectivity nor an improvement in anxiety. These data suggest that NF can enable enhanced control over anxiety by persistently reorganizing relevant brain networks and thus support the potential of NF as a clinically useful therapy.
authors: Department of Biomedical Engineering, Yale University, New Haven, CT, USA.
authors: D
authors: D
authors: Scheinost
authors: T
authors: T
authors: Stoica
authors: J
authors: J
authors: Saksa
authors: X
authors: X
authors: Papademetris
authors: R T
authors: RT
authors: Constable
authors: C
authors: C
authors: Pittenger
authors: M
authors: M
authors: Hampson
mesh_terms: D001007:Anxiety / Q000503:physiopathology*; D025461:Feedback, Physiological / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000502:physiology* / Q000503:physiopathology; D059907:Functional Neuroimaging; D006801:Humans; D008032:Limbic System / Q000502:physiology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000502:physiology / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000502:physiology / Q000503:physiopathology
references: Neurosci Biobehav Rev. 2008;32(3):525-49
references: 18061263
references: PLoS One. 2012;7(9):e44067
references: 22984460
references: Neuropsychopharmacology. 2010 Jan;35(1):317-36
references: 19759530
references: Behav Res Ther. 1996 Feb;34(2):163-73
references: 8741724
references: Brain Connect. 2011;1(1):91-8
references: 22432958
references: Neuroimage. 2004 Jan;21(1):436-43
references: 14741680
references: J Neurosci. 2011 Nov 9;31(45):16309-17
references: 22072682
references: Proc Natl Acad Sci U S A. 2004 Feb 17;101(7):2140-4
references: 14766981
references: Biol Psychiatry. 2003 Mar 15;53(6):482-93
references: 12644353
references: Neuroimage. 2012 Jan 2;59(1):431-8
references: 21810475
references: Mol Psychiatry. 2010 Jan;15(1):53-63
references: 18725912
references: PLoS One. 2011;6(9):e24522
references: 21931738
references: Brain Lang. 2011 Jun;117(3):123-32
references: 20888628
references: Neuroinformatics. 2011 Mar;9(1):69-84
references: 21249532
references: Hum Brain Mapp. 2013 Jan;34(1):200-12
references: 22021045
references: Braz J Psychiatry. 2012 Jun;34(2):207-12
references: 22729418
references: Science. 2011 Dec 9;334(6061):1413-5
references: 22158821
references: Curr Dir Psychol Sci. 2008 Apr;17(2):153-158
references: 25425765
references: Neuroimage. 2007 Oct 1;37(4):1091-6; discussion 1097-9
references: 17368915
references: Neuroimage. 2010 Jan 1;49(1):823-34
references: 19631277
references: Hum Brain Mapp. 2011 Jan;32(1):22-31
references: 21157877
references: Hum Brain Mapp. 2009 May;30(5):1605-14
references: 18661503
references: J Vis Exp. 2012 Jan 20;(59):
references: 22297729
references: Neuroinformatics. 2013 Jul;11(3):291-300
references: 23319241
references: Neuroimage. 2010 Sep;52(3):1059-69
references: 19819337
references: Neuroreport. 2006 Aug 21;17(12):1273-8
references: 16951568
references: Addict Biol. 2013 Jul;18(4):739-48
references: 22458676
references: J Neurosci. 2012 Jun 27;32(26):8988-99
references: 22745498
references: Proc Natl Acad Sci U S A. 2005 Dec 20;102(51):18626-31
references: 16352728
references: Arch Gen Psychiatry. 2004 Jun;61(6):564-76
references: 15184236
references: Neuroreport. 2002 Aug 7;13(11):1377-81
references: 12167756
references: Biol Psychiatry. 2010 Sep 1;68(5):425-32
references: 20570245