title: Real-Time fMRI Neurofeedback with War Veterans with Chronic PTSD: A Feasibility Study.
abstract: Many patients with post-traumatic stress disorder (PTSD), especially war veterans, do not respond to available treatments. Here, we describe a novel neurofeedback (NF) intervention using real-time functional magnetic resonance imaging for treating and studying PTSD. The intervention involves training participants to control amygdala activity after exposure to personalized trauma scripts. Three combat veterans with chronic PTSD participated in this feasibility study. All three participants tolerated well the NF training. Moreover, two participants, despite the chronicity of their symptoms, showed clinically meaningful improvements, while one participant showed a smaller symptom reduction. Examination of changes in resting-state functional connectivity patterns revealed a normalization of brain connectivity consistent with clinical improvement. These preliminary results support feasibility of this novel intervention for PTSD and indicate that larger, well-controlled studies of efficacy are warranted.
authors.affiliation: Yale Child Study Center, Yale School of Medicine, New Haven, CT, USA; Division of Psychology and Language Sciences, University College London (UCL), London, UK; Anna Freud Centre, London, UK; Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Mattia I
authors.initials: MI
authors.lastname: Gerin
authors.affiliation: Department of Veteran Affairs, National Center for PTSD, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Bennington College, Bennington, VT, USA.
authors.forename: Harlan
authors.initials: H
authors.lastname: Fichtenholtz
authors.affiliation: Department of Veteran Affairs, National Center for PTSD, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Roy
authors.affiliation: Department of Radiology and Biomedical Imaging, Yale School of Medicine , New Haven, CT , USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Walsh
authors.affiliation: Department of Veteran Affairs, National Center for PTSD, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Krystal
authors.affiliation: Department of Veteran Affairs, National Center for PTSD, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Southwick
authors.affiliation: Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hampson
keywords: PTSD; functional connectivity; neurofeedback; real-time fMRI; resting-state; war veterans