title: Volitional control of the anterior insula in criminal psychopaths using real-time fMRI neurofeedback: a pilot study.
abstract: This pilot study aimed to explore whether criminal psychopaths can learn volitional regulation of the left anterior insula with real-time fMRI neurofeedback. Our previous studies with healthy volunteers showed that learned control of the blood oxygenation-level dependent (BOLD) signal was specific to the target region, and not a result of general arousal and global unspecific brain activation, and also that successful regulation modulates emotional responses, specifically to aversive picture stimuli but not neutral stimuli. In this pilot study, four criminal psychopaths were trained to regulate the anterior insula by employing negative emotional imageries taken from previous episodes in their lives, in conjunction with contingent feedback. Only one out of the four participants learned to increase the percent differential BOLD in the up-regulation condition across training runs. Subjects with higher Psychopathic Checklist-Revised (PCL:SV) scores were less able to increase the BOLD signal in the anterior insula than their lower PCL:SV counterparts. We investigated functional connectivity changes in the emotional network due to learned regulation of the successful participant, by employing multivariate Granger Causality Modeling (GCM). Learning to up-regulate the left anterior insula not only increased the number of connections (causal density) in the emotional network in the single successful participant but also increased the difference between the number of outgoing and incoming connections (causal flow) of the left insula. This pilot study shows modest potential for training psychopathic individuals to learn to control brain activity in the anterior insula.
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany ; Department of Biomedical Engineering, University of Florida Gainesville, FL, USA ; Sri Chitra Tirunal Institute of Medical Sciences and Technology Thiruvananthapuram, Kerala, India.
authors.forename: Ranganatha
authors.initials: R
authors.lastname: Sitaram
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Caria
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Veit
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Gaber
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany ; Departamento de Psiquiatría, Escuela de Medicina, Centro Interdisciplinario de Neurociencias, Pontificia Universidad Católica de Chile Santiago, Chile.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ruiz
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen Tübingen, Germany ; Ospedale San Camillo, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Venezia, Italy.
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
keywords: anterior insula; antisocial behavior; brain-computer interface; criminal psychopathy; neurofeedback; real-time fMRI