title: Voluntary control of anterior insula and its functional connections is feedback-independent and increases pain empathy.
abstract: Real-time functional magnetic resonance imaging (rtfMRI)-assisted neurofeedback (NF) training allows subjects to acquire volitional control over regional brain activity. Emerging evidence suggests its potential clinical utility as an effective non-invasive treatment approach in mental disorders. The therapeutic potential of rtfMRI-NF training depends critically upon whether: (1) acquired self-regulation produces functionally relevant changes at behavioral and brain network levels and (2) training effects can be maintained in the absence of feedback. To address these key questions, the present study combined rtfMRI-NF training for acquiring volitional anterior insula (AI) regulation with a sham-controlled between-subject design. The functional relevance of acquired AI control was assessed using both behavioral (pain empathy) and neural (activity, functional connectivity) indices. Maintenance of training effects in the absence of feedback was assessed two days later. During successful acquisition of volitional AI up-regulation subjects exhibited stronger empathic responses, increased AI-prefrontal coupling in circuits involved in learning and emotion regulation and increased resting state connectivity within AI-centered empathy networks. At follow-up both self-regulation and increased connectivity in empathy networks were fully maintained, although without further increases in empathy ratings. Overall these findings support the potential clinical application of rtfMRI-NF for inducing functionally relevant and lasting changes in emotional brain circuitry.
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
authors.forename: Shuxia
authors.initials: S
authors.lastname: Yao
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China; Department of Psychiatry, Division of Medical Psychology, University of Bonn, 53105 Bonn, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Becker
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
authors.forename: Yayuan
authors.initials: Y
authors.lastname: Geng
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Xu
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Ren
authors.affiliation: Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in BioMedicine, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China. Electronic address: k.kendrick.uestc@gmail.com.
authors.forename: Keith M
authors.initials: KM
authors.lastname: Kendrick
mesh_terms: D002540:Cerebral Cortex / Q000502:physiology*; D004645:Empathy / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D058765:Neurofeedback / Q000379:methods*; D010146:Pain / Q000523:psychology*; D055815:Young Adult
keywords: Empathy; Insula; Neurofeedback; Real-time fMRI; Resting state functional connectivity