Alpha oscillation neurofeedback modulates amygdala complex connectivity and arousal in posttraumatic stress disorder.
OBJECTIVE
Electroencephalogram (EEG) neurofeedback aimed at reducing the amplitude of the alpha-rhythm has been shown to alter neural networks associated with posttraumatic stress disorder (PTSD), leading to symptom alleviation. Critically, the amygdala is thought to be one of the central brain regions mediating PTSD symptoms. In the current study, we compare directly patterns of amygdala complex connectivity using fMRI, before and after EEG neurofeedback, in order to observe subcortical mechanisms associated with behavioural and alpha oscillatory changes among patients.


METHODS
We examined basolateral (BLA), centromedial (CMA), and superficial (SFA) amygdala complex resting-state functional connectivity using a seed-based approach via SPM Anatomy Toolbox. Amygdala complex connectivity was measured in twenty-one individuals with PTSD, before and after a 30-minute session of EEG neurofeedback targeting alpha desynchronization.


RESULTS
EEG neurofeedback was associated with a shift in amygdala complex connectivity from areas implicated in defensive, emotional, and fear processing/memory retrieval (left BLA and left SFA to the periaqueductal gray, and left SFA to the left hippocampus) to prefrontal areas implicated in emotion regulation/modulation (right CMA to the medial prefrontal cortex). This shift in amygdala complex connectivity was associated with reduced arousal, greater resting alpha synchronization, and was negatively correlated to PTSD symptom severity.


CONCLUSIONS
These findings have significant implications for developing targeted non-invasive treatment interventions for PTSD patients that utilize alpha oscillatory neurofeedback, showing evidence of neuronal reconfiguration between areas highly implicated in the disorder, in addition to acute symptom alleviation.
Department of Neuroscience, Western University, London, ON, Canada.
Andrew A
AA
Nicholson
Laboratory of Neurology and Imaging of Cognition, Department of Neuroscience, University of Geneva, Geneva, Switzerland.
Tomas
T
Ros
Department of Neuroscience, Western University, London, ON, Canada; Department of Psychology, Western University, London, ON, Canada.
Paul A
PA
Frewen
Imaging, Lawson Health Research Institute, London, ON, Canada.
Maria
M
Densmore
Department of Psychiatry, Western University, London, ON, Canada; Department of Medical Imaging, Western University, London, ON, Canada; Department of Medial Biophysics, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada.
Jean
J
Théberge
Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim Heidelberg University, Mannheim, Germany.
Rosemarie C
RC
Kluetsch
Canadian Forces, Health Services, Ottawa, Ontario, Canada.
Rakesh
R
Jetly
Department of Neuroscience, Western University, London, ON, Canada; Department of Psychiatry, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada.
Ruth A
RA
Lanius
Amygdala; Electroencephalogram; Functional MRI; Functional connectivity; Neurofeedback; Posttraumatic stress disorder
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