Down-regulation of amygdala activation with real-time fMRI neurofeedback in a healthy female sample.

Christian Paret,Christian Schmahl,Steffen Hoesterey,Matthias Ruf,Rosemarie Kluetsch,Traute Demirakca,Gabriele Ende

doi:10.3389/fnbeh.2014.00299

Abstract

Psychiatric conditions of emotion dysregulation are often characterized by difficulties in regulating the activity of limbic regions such as the amygdala. Real-time functional magnetic resonance imaging (rt-fMRI) allows to feedback brain activation and opens the possibility to establish a neurofeedback (NF) training of amygdala activation, e.g., for subjects suffering from emotion dysregulation. As a first step, we investigated whether feedback of the amygdala response to aversive scenes can improve down-regulation of amygdala activation. One group of healthy female participants received amygdala feedback (N = 16) and a control group was presented with feedback from a control region located in the basal ganglia [N(sum) = 32]. Subjects completed a one-session rt-fMRI-NF training where they viewed aversive pictures and received continuous visual feedback on brain activation (REGULATE condition). In a control condition, subjects were advised to respond naturally to aversive pictures (VIEW), and a neutral condition served as the non-affective control (NEUTRAL). In an adjacent run, subjects were presented with aversive pictures without feedback to test for transfer effects of learning. In a region of interest (ROI) analysis, the VIEW and the REGULATE conditions were contrasted to estimate brain regulation success. The ROI analysis was complemented by an exploratory analysis of activations at the whole-brain level. Both groups showed down-regulation of the amygdala response during training. Feedback from the amygdala but not from the control region was associated with down-regulation of the right amygdala in the transfer test. The whole-brain analysis did not detect significant group interactions. Results of the group whole-brain analyses are discussed. We present a proof-of-concept study using rt-fMRI-NF for amygdala down-regulation in the presence of aversive scenes. Results are in line with a potential benefit of NF training for amygdala regulation.

Highlights

The amygdala constitutes a core structure of emotion processing (Phan et al, 2002; Kober et al, 2008)
There is evidence for normalization of the amygdala response with psychotherapy (Sheline et al, 2001; Goossens et al, 2007; Godlewska et al, 2012; Lipka et al, 2013). This is in line with a recent meta-analysis by Buhle et al (2013), who identified the amygdala as a robust target of cognitive emotion regulation
We looked for group differences in subjective arousal and valence elicited by picture viewing and conducted Group × Condition (VIEW, REGULATE) analysis of variance (ANOVA) for pictures presented during training and transfer

Summary

Introduction

The amygdala constitutes a core structure of emotion processing (Phan et al, 2002; Kober et al, 2008). There is evidence for normalization of the amygdala response with psychotherapy (Sheline et al, 2001; Goossens et al, 2007; Godlewska et al, 2012; Lipka et al, 2013). This is in line with a recent meta-analysis by Buhle et al (2013), who identified the amygdala as a robust target of cognitive emotion regulation. In addition to amygdala hyperactivity, individuals with the aforementioned disorders have previously shown dysfunctional amygdala-prefrontal coupling (Johnstone et al, 2007; Fonzo et al, 2010; Schulze et al, 2011; Simmons et al, 2011; Lang et al, 2012)

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