Role In Emotional Processing Research Articles

Valproic acid inhibits excess dopamine release in response to a fear-conditioned stimulus in the basolateral complex of the amygdala of methamphetamine-sensitized rats

Valproic acid, an established antiepileptic and antimanic drug, has recently emerged as a promising emotion-stabilizing agent for patients with psychosis. Although dopamine transmission in the amygdala plays a key role in emotional processing, there has been no direct evidence about how valproic acid acts on the dopaminergic system in the brain during emotional processing. In the present study, we tested the effect of valproic acid on a trait marker of vulnerability to emotional stress in psychosis, which is excess dopamine release in response to a fear-conditioned stimulus (CS) in the basolateral complex of the amygdala of methamphetamine-sensitized rats. Extracellular dopamine was collected from the amygdala of freely moving methamphetamine-sensitized rats by in vivo microdialysis and was measured using high-performance liquid chromatography. During microdialysis, valproic acid was intraperitoneally injected followed by CS exposure. Valproic acid treatment decreased baseline levels of dopamine and also attenuated the excess dopamine release in response to the CS in the amygdala of methamphetamine-sensitized rats. The results prove that valproic acid inhibits spontaneous dopamine release and also attenuates excess dopaminergic signaling in response to emotional stress in the amygdala. These findings suggest that the mechanisms of the emotion-stabilizing effect of valproic acid in psychosis involve modulation of dopaminergic transmission in emotional processing.

Alterations of attention and emotional processing following childhood-onset damage to the prefrontal cortex.

The prefrontal cortex (PFC), especially the medial sector, plays a crucial role in emotional processing. Damage to this region results in impaired processing of emotional information, perhaps attributable to an inability to initiate and maintain attention toward emotional materials, a process that is normally automatic. Childhood onset damage to the PFC impairs emotional processing more than adult-onset PFC damage. The aim of this work was to study the involvement of the PFC in attention to emotional stimuli, and to explore how age at lesion onset affects this involvement. To address these issues, we studied both the emotional and attentional modulation of the startle reflex. Our sample was composed of 4 patients with childhood-onset PFC damage, 6 patients with adult-onset PFC damage, and 10 healthy comparison participants. Subjects viewed 54 affective pictures; acoustic startle probes were presented at 300 ms after picture onset in 18 pictures (as an index of attentional modulation) and at 3,800 ms after picture onset in 18 pictures (as an index of emotional modulation). Childhood-onset PFC patients did not show attentional or emotional modulation of the response, in contrast to adult-onset PFC damage and comparison participants. Early onset damage to the PFC results, therefore, in more severe dysfunction in the processing of affective stimuli than adult-onset PFC damage, perhaps reflecting limited plasticity in the neural systems that support these processes.

EPA-0866 – Using an individualized neuroimaging approach to investigate effects of psychotherapy in depression. First results of the zurich depression study

Research on neurobiologic underpinnings of psychotherapy in depression is still sparse, particularly in psychodynamic oriented research. At present, there is insufficient data on neurobiologic parameters that could allow a targeted use of therapeutic interventions. One reason for this is the methodological difficulty of investigating complex and individual phenomena relevant to the psychotherapeutic process with functional neuroimaging techniques. The Zurich Depression Study takes up this strong research need developing a pioneer study design. An individualized neuroimaging paradigm was developed based on the MIPQS (Maladaptive Interpersonal Q-Sort (Zimmermann et al., accepted), a self report instrument derived from the OPD-2 axis interpersonal relations (Operationalized Psychodynamic Diagnosis 2, Arbeitskreis OPD, 2006). Visual stimuli were developed and tested that systematically illustrate interpersonal behaviour patterns (Interpersonal Relations Picture Set (IRPS)). They are employed in an individualized fMRI experiment. The experiment was validated with ten healthy study participants Preliminary results suggest that the experimental paradigm is an accurate method to be employed in psychotherapy research with depressed patients. Specific hemodynamic activation patterns observed during the individualized fMRI task involve brain regions commonly identified as playing a role in emotion processing and autobiographic memory. A final overview of these first results will be given at the EPA 2014 congress.

EPA-1418 – Therapeutic letters using for emotional processing

Although CBT stresses the importance of cognitions in activating or maintaining negative affects, there has been increasing emphasis on considering the role of emotional processing. Many patients believe that one should be rational and logical all the time, never have conflicting feelings, and should ruminate in order to figure things out. Meaningful cognitive and simultaneously experiential technique for working with deep emotional schemas, formatted in childhood, is writing therapeutic letters. Inclusions of emotion regulation skills in the treatment especially for patients with personality disorder enhance the efficacy of CBT. We used therapeutic letters to help the patient identify difficult feelings and process firstly outside of therapy session and working with them repeatedly with the therapist. Typical therapeutic letters are address to important close persons from the patient life, like parents, siblings, a partner and friends, children. The patient uses the letter to impress his/her feeling and needs, inclusive defenses of his rights in past and present. Patient writes a letter at home, and he brings it then into the session and reads it to the therapist. These letters are not intended to be sent to that important person, but to process strong emotions inside the patient. In fact the patient writes a letter to his inner representation of an important person, who was connected with the development of the maladaptive schemas. The letter-writing process is inherently collaborative and enables the patient to work at his or her own pace while also facilitating patient empowerment.

10.5937/mckg48-5899 = Functional and anatomical aspects of the habenular complex of epithalamus

The habenular nuclear complex presents bilateral part of epithalamus, consisting of medial (nc. habenularis medialis - MHb) and lateral (nc. habenularis lateralis - LHb) habenular nucleus. According to its anatomical position and neuronal connections it is a 'crossroads' of pathways of the limbic system and basal ganglia. The human habenular complex is involved in control of brain reward system and it is considered to play a very important role in emotional processes. It is involved in the regulation of the activity of dopaminergic, serotonergic, noradrenergic and cholinergic neurons of the brainstem and their transmission in structures involved in cognitive processes. It participates in determination of behavior and motor responses, acting through motivational processes. The dysfunction of the complex may be important for the development of a variety of neurological and mental disorders. Lesions of habenular complex lead to cognitive and motor dysfunction, behavioral changes, changes in response to pain, stress, sleep disorders, mood and attention disorders and inadequate value-based decision-making. In recent years, there is a growing interest of scientists in this brain structure, as it represents the target area of new therapeutic methods of treatment of psychiatric and neurological disorders.

Abnormal autonomic and associated brain activities during rest in autism spectrum disorder

Autism spectrum disorders are associated with social and emotional deficits, the aetiology of which are not well understood. A growing consensus is that the autonomic nervous system serves a key role in emotional processes, by providing physiological signals essential to subjective states. We hypothesized that altered autonomic processing is related to the socio-emotional deficits in autism spectrum disorders. Here, we investigated the relationship between non-specific skin conductance response, an objective index of sympathetic neural activity, and brain fluctuations during rest in high-functioning adults with autism spectrum disorder relative to neurotypical controls. Compared with control participants, individuals with autism spectrum disorder showed less skin conductance responses overall. They also showed weaker correlations between skin conductance responses and frontal brain regions, including the anterior cingulate and anterior insular cortices. Additionally, skin conductance responses were found to have less contribution to default mode network connectivity in individuals with autism spectrum disorders relative to controls. These results suggest that autonomic processing is altered in autism spectrum disorders, which may be related to the abnormal socio-emotional behaviours that characterize this condition.

Comparative analysis of the dendritic organization of principal neurons in the lateral and central nuclei of the rhesus macaque and rat amygdala

The amygdala plays a critical role in emotional processing and has been implicated in the etiology of numerous psychiatric disorders. It is an evolutionarily ancient structure that is enlarged in primates relative to rodents. Certain amygdala nuclei, such as the lateral nucleus, show relatively greater phylogenetic expansion than other nuclei. However, it is unknown whether there is also differential alteration in neuronal features. To address this question, we examined the dendritic arbors of principal neurons, visualized by using the Golgi method, in the lateral and central nuclei of young adult rhesus macaques and rats. Total dendritic length is greater in the macaque than in the rat. Dendritic trees are increased by 250% in length in the lateral nucleus of the monkey compared with the rat (6,009 μm vs. 2,473 μm); dendritic tree length in the central nucleus is increased by 50% (1,786 μm vs. 1,232 μm). Somal volume is increased 62% between species in the lateral nucleus and 48% in the central nucleus. Spine density is lower on macaque lateral nucleus dendrites compared with rat (-22%) but equivalent in the central nucleus. Spines are equally long in the lateral nucleus of rat and macaque, but spines are longer by about 20% in the central nucleus of the macaque. The alterations in dendritic structure that we observed between the two species suggest differences in the number and spacing of inputs into these nuclei that undoubtedly influence amygdala function.

Effects of MIR137 on fronto-amygdala functional connectivity

BackgroundMIR137 is implicated in brain development and encodes a microRNA that regulates neuronal maturation and adult neurogenesis. Recently, a common genetic variant within MIR137 showed genome wide evidence of association with schizophrenia, and with altered amygdala activation in those at genetic risk for schizophrenia. Following this evidence, we investigated the effects of MIR137 genotype on neuronal activity during face processing. MethodsBy grouping 81 healthy participants as carrier or non-carriers of the MIR137 rs1625579 risk allele associated with schizophrenia, we investigated MIR137's effects on altered cortical response during an fMRI face processing task and altered functional connectivity using the amygdala as a seed region. ResultsHomozygous carriers of the risk allele were observed to show relatively increased functional connectivity between the right amygdala and frontal regions that play a key role in emotion processing and regulation (e.g. the cingulate and prefrontal cortex). ConclusionsOur findings provide the first evidence that the rs1625579 variant affects fronto-amygdala functional connectivity, providing further evidence that MIR137 may contribute to forms of psychosis in which affective symptoms are more prominent.

Prefrontal activation in response to emotional words in patients with bipolar disorder and major depressive disorder

Abnormal emotional processing is involved in the pathophysiology of bipolar disorder (BD) and major depressive disorder (MDD). However, whether the neural mechanism underlying this deficit is a trait characteristic of BD and MDD is unclear. The aim of this study was to elucidate the similarities and differences in processing of emotional stimuli between patients with BD and MDD in remission, using functional near-infrared spectroscopy (fNIRS). Thirty-two patients (16 with BD and 16 with MDD) and 20 healthy control subjects matched for age, sex, handedness, and years of education were included. An emotional Stroop task, including happy, sad, and threat words, was used. The relative oxygenated and deoxygenated hemoglobin concentration ([oxy-Hb] and [deoxy-Hb]) changes in the frontal region were measured using 52-channels of NIRS. During the threat task, compared to healthy control subjects, patients with BD showed significantly increased [oxy-Hb] in the left inferior frontal region whereas patients with MDD showed significantly increased [oxy-Hb] in the left middle frontal region. During the happy task, compared to healthy control subjects, patients with BD showed significantly decreased [oxy-Hb] in the middle frontal region in both hemispheres. Moreover, patients with BD exhibited decreased [oxy-Hb] and increased [deoxy-Hb] in the superior frontal and middle frontal regions compared to MDD in response to the happy stimulus. No significant differences in [oxy-Hb] or [deoxy-Hb] were seen between the groups during the sad task. These results suggest that abnormal neural responses to emotional stimuli in patients with mood disorders in remission may be a trait characteristic, that negative emotional stimuli are associated with similar prefrontal responses, and that positive emotional stimuli are associated with different prefrontal responses in patients with BD and MDD. These findings indicate that different neural circuits play a role in emotional processing in BD and MDD; this may aid the elucidation of the pathophysiology of these two disorders.

Ventral medial prefrontal functional connectivity and emotion regulation in chronic schizophrenia: A pilot study

People with schizophrenia exhibit impaired social cognitive functions, particularly emotion regulation. Abnormal activations of the ventral medial prefrontal cortex (vMPFC) during emotional tasks have been demonstrated in schizophrenia, suggesting its important role in emotion processing in patients. We used the resting-state functional connectivity approach, setting a functionally relevant region, the vMPFC, as a seed region to examine the intrinsic functional interactions and communication between the vMPFC and other brain regions in schizophrenic patients. We found hypo-connectivity between the vMPFC and the medial frontal cortex, right middle temporal lobe (MTL), right hippocampus, parahippocampal cortex (PHC) and amygdala. Further, there was a decreased strength of the negative connectivity (or anticorrelation) between the vMPFC and the bilateral dorsal lateral prefrontal cortex (DLPFC) and pre-supplementary motor areas. Among these connectivity alterations, reduced vMPFC-DLPFC connectivity was positively correlated with positive symptoms on the Positive and Negative Syndrome Scale, while vMPFC-right MTL/PHC/amygdala functional connectivity was positively correlated with the performance of emotional regulation in patients. These findings imply that communication and coordination throughout the brain networks are disrupted in schizophrenia. The emotional correlates of vMPFC connectivity suggest a role of the hypo-connectivity between these regions in the neuropathology of abnormal social cognition in chronic schizophrenia.

926 – Emotional processing in patients with affective, borderline and dissociative disorders

Many of patients suffering with affective, dissociative and dissociative disorders experienced significant stressful or traumatic events from childhood or later in their life. Many of them suffer as children with unsatisfactory fulfilled basic child's needs, such as security, acceptance or approbation. Without the systematic processing these traumatic experiences the treatment is unsuccessful and their problems persist. Although CBT stresses the importance of cognitions or thoughts in activating or maintaining negative affects, there has been increasing emphasis on considering the role of emotional processing. Many of our patients believe that one should be rational and logical all the time, never have conflicting feelings, and should ruminate in order to figure things out. Meaningful cognitive and simultaneously experiential technique for working with deep emotional schemas, formatted in childhood, is imaginal rescripting of the traumatic events, role playing and writing the therapeutic letters. Inclusions of emotion regulation skills in the treatment especially for patients with dissociative disorders enhance the efficacy of CBT. Several examples of emotional processing and trauma rescripting will be presented. Supported by the project IGA MZ CR NT 11047-4/2010

Endocannabinoids in Amygdala and Nucleus Accumbens Mediate Social Play Reward in Adolescent Rats

The brain endocannabinoid system plays a crucial role in emotional processes. We have previously identified an important role for endocannabinoids in social play behavior, a highly rewarding form of social interaction in adolescent rats. Here, we tested the hypothesis that endocannabinoid modulation of social play behavior occurs in brain regions implicated in emotion and motivation. Social play increased levels of the endocannabinoid anandamide in the amygdala and nucleus accumbens (NAc), but not in prefrontal cortex or hippocampus of 4- to 5-week-old male Wistar rats. Furthermore, social play increased phosphorylation of CB1 cannabinoid receptors in the amygdala. Systemic administration of the anandamide hydrolysis inhibitor URB597 increased social play behavior, and augmented the associated elevation in anandamide levels in the amygdala, but not the NAc. Infusion of URB597 into the basolateral amygdala (BLA) increased social play behavior, and blockade of BLA CB1 cannabinoid receptors with the antagonist/inverse agonist SR141716A prevented the play-enhancing effects of systemic administration of URB597. Infusion of URB597 into the NAc also increased social play, but blockade of NAc CB1 cannabinoid receptors did not antagonize the play-enhancing effects of systemic URB597 treatment. Last, SR141716A did not affect social play after infusion into the core and shell subregions of the NAc, while it reduced social play when infused into the BLA. These data show that increased anandamide signaling in the amygdala and NAc augments social play, and identify the BLA as a prominent site of action for endocannabinoids to modulate the rewarding properties of social interactions in adolescent rats.

A case of hyperthymesia: rethinking the role of the amygdala in autobiographical memory

Much controversy has been focused on the extent to which the amygdala belongs to the autobiographical memory (AM) core network. Early evidence suggested the amygdala played a vital role in emotional processing, likely helping to encode emotionally charged stimuli. However, recent work has highlighted the amygdala's role in social and self-referential processing, leading to speculation that the amygdala likely supports the encoding and retrieval of AM. Here, cognitive as well as structural and functional magnetic resonance imaging data was collected from an extremely rare individual with near-perfect AM, or hyperthymesia. Right amygdala hypertrophy (approximately 20%) and enhanced amygdala-to-hippocampus connectivity (>10 SDs) was observed in this volunteer relative to controls. Based on these findings and previous literature, we speculate that the amygdala likely charges AMs with emotional, social, and self-relevance. In heightened memory, this system may be hyperactive, allowing for many types of autobiographical information, including emotionally benign, to be more efficiently processed as self-relevant for encoding and storage.

Serotonergic innervation and serotonin receptor expression of NPY-producing neurons in the rat lateral and basolateral amygdaloid nuclei

Pharmacobehavioral studies in experimental animals, and imaging studies in humans, indicate that serotonergic transmission in the amygdala plays a key role in emotional processing, especially for anxiety-related stimuli. The lateral and basolateral amygdaloid nuclei receive a dense serotonergic innervation in all species studied to date. We investigated interrelations between serotonergic afferents and neuropeptide Y (NPY)-producing neurons, which are a subpopulation of inhibitory interneurons in the rat lateral and basolateral nuclei with particularly strong anxiolytic properties. Dual light microscopic immunolabeling showed numerous appositions of serotonergic afferents on NPY-immunoreactive somata. Using electron microscopy, direct membrane appositions and synaptic contacts between serotonin-containing axon terminals and NPY-immunoreactive cellular profiles were unequivocally established. Double in situ hybridization documented that more than 50 %, and about 30–40 % of NPY mRNA-producing neurons, co-expressed inhibitory 5-HT1A and excitatory 5-HT2C mRNA receptor subtype mRNA, respectively, in both nuclei with no gender differences. Triple in situ hybridization showed that individual NPY mRNA-producing interneurons co-express both 5-HT1A and 5-HT2C mRNAs. Co-expression of NPY and 5-HT3 mRNA was not observed. The results demonstrate that serotonergic afferents provide substantial innervation of NPY-producing neurons in the rat lateral and basolateral amygdaloid nuclei. Studies of serotonin receptor subtype co-expression indicate a differential impact of the serotonergic innervation on this small, but important, population of anxiolytic interneurons, and provide the basis for future studies of the circuitry underlying serotonergic modulation of emotional stimulus processing in the amygdala.

P-1165 - Therapeutic letters - changing the emotional schemas using writing letters to significant caregivers

emotional schemas, therapeutic letters, emotional processing, cognitive behavioral therapy, therapeutic strategy, dissociation; anxiety disorders; depression, personality disorders Abstract The letter writing has been used as a strategy in different psychotherapeutic approaches. Therapeutic letters are intended to extend the work of therapy beyond the consulting room door by continuing the meaning-making that occurred in a therapeutic conversa- tion. Although CBT stresses the importance of cognitions or thoughts in activating or maintaining negative affects, there has been increasing emphasis on considering the role of emotional processing. Many of our patients believe that one should be rational and logical all the time, never have conflicting feelings, and should ruminate in order to figure things out. Meaningful cognitive and simultaneously experiential technique for working with deep emotional schemas, formatted in childhood, is writing therapeutic letters. Inclusions of emotion regulation skills in the treatment especially for patients with personality dis- order enhance the efficacy of CBT. We used therapeutic letters to help the patient identify difficult feelings, process them in a way that maybe they could not in a therapy session, and finally get release and freedom from them. Typical therapeutic letters are address to important close persons from the patient life, like parents, siblings, a partner and friends, children. The patient uses the letter to impress his/her feeling and needs, inclusive defenses of his rights in past and present. Patient writes a letter at home, and he brings it then into the session and reads it to the therapist. These letters are not intended to be sent to that important person, but to process strong emotions inside the patient. In fact the patient writes a letter to his inner representation of an important person, who was connected with the development of the maladaptive schemas. The letter-writing process is inherently collaborative and enables the patient to work at his or her own pace while also facilitating patient empowerment.

Emotions, the great captains of our lives: Their role in the process of change in psychotherapy.

A view of human functioning is presented in which functioning is seen as integrating head and heart, emotion and reason, in a process by which people are constantly making sense of their lived emotional experience to form narratives of told experience. Because much of the processing involved in the generation of emotional experience occurs independently of and prior to conscious thought, therapeutic work on a purely cognitive level of processing is unlikely to produce enduring emotional change. The questions especially relevant to psychotherapy are how we can best facilitate change in emotions rather than only changes in cognition or behavior. A theory of emotional change is presented in which change in emotion is seen as requiring that first emotions be felt and then they both be exposed to new emotional experience and be reflected on to create new meaning. The process of emotional change thus involves both new experience and new understanding. At times, people also need to protect themselves from being overwhelmed by emotions. They need to be helped to tolerate and regulate them so that emotions inform their lives rather than control them. The importance of both emotion awareness and emotion regulation in therapeutic change is thus highlighted. The article ends by reviewing research on the role of emotional processing in therapeutic change and presents six empirically based principles of emotional processing that will help move the field toward psychotherapy integration in a manner that clearly recognizes emotion as a key component of functioning and change.

Emotional faces and the default mode network

The default-mode network (DMN) of the human brain has become a central topic of cognitive neuroscience research. Although alterations in its resting state activity and in its recruitment during tasks have been reported for several mental and neurodegenerative disorders, its role in emotion processing has received relatively little attention. We investigated brain responses to different categories of emotional faces with functional magnetic resonance imaging (fMRI) and found deactivation in ventromedial prefrontal cortex (VMPFC), posterior cingulate gyrus (PC) and cuneus. This deactivation was modulated by emotional category and was less prominent for happy than for sad faces. These deactivated areas along the midline conformed to areas of the DMN. We also observed emotion-dependent deactivation of the left middle frontal gyrus, which is not a classical component of the DMN. Conversely, several areas in a fronto-parietal network commonly linked with attention were differentially activated by emotion categories. Functional connectivity patterns, as obtained by correlation of activation levels, also varied between emotions. VMPFC, PC or cuneus served as hubs between the DMN-type areas and the fronto-parietal network. These data support recent suggestions that the DMN is not a unitary system but differentiates according to task and even type of stimulus. The emotion-specific differential pattern of DMN deactivation may be explored further in patients with mood disorder, where the quest for biological markers of emotional biases is still ongoing.

Decision-making capacities and affective reward anticipation in DWI recidivists compared to non-offenders: A preliminary study

ObjectivesImpaired decision making is seen in several problem behaviours including alcoholism and problem gambling. Decision-making style may contribute to driving while impaired with alcohol (DWI) in some offenders as well. The Somatic Marker Framework theorizes that decision making is the product of two interacting affective neural systems, an impulsive, rapid, amygdala-dependent process for emotionally signalling the immediate negative or positive consequences of an option, and a reflective, longer-lasting, ventral medial prefrontal cortex dependent system for emotionally signalling the future negative or positive prospects of an option. This study tested the hypothesis that offenders who showed disadvantageous decision-making would be at higher risk for recidivism than those who showed more advantageous decision-making. In addition, in line with the Somatic Marker Hypothesis, offenders who showed disadvantageous decision-making would exhibit a distinct pattern of somatic activation compared to offenders who showed more advantageous decision-making. MethodsA sample of 21 DWI offenders with from 2 to 7 past DWI convictions and a reference group consisting of 19 non-offender (N-O) drivers were recruited and administered the Iowa Gambling Task (IGT), as well as evaluated on sociodemographic, driving and alcohol use dimensions. In addition, anticipatory skin conductance response (aSCR) was measured in the 5s prior to each of a 100 card draws on the IGT. ResultsMedian split of the DWI offender sample based upon overall performance on the IGT yielded two subgroups (IGT-R Hi and IGT-R Lo). Hypothesis 1 was supported, as the IGT-R Lo group possessed significantly greater frequency of past DWI convictions and severity of past drinking. Descriptive analyses revealed that on the IGT, IGT-R Hi group performed similarly to the N-O reference group while the IGT-R Lo group performed significantly worse. Hypothesis 2 was not supported. ConclusionsDecision making is a plausible explanatory neurocognitive pathway to severer forms of DWI. The role of emotional processing in DWI risk is uncertain. Subtyping DWI offenders using neurocognitive criteria seems a promising avenue for improving clinically meaningful methods of DWI risk assessment and intervention.

Self-Regulation of Amygdala Activation Using Real-Time fMRI Neurofeedback

Real-time functional magnetic resonance imaging (rtfMRI) with neurofeedback allows investigation of human brain neuroplastic changes that arise as subjects learn to modulate neurophysiological function using real-time feedback regarding their own hemodynamic responses to stimuli. We investigated the feasibility of training healthy humans to self-regulate the hemodynamic activity of the amygdala, which plays major roles in emotional processing. Participants in the experimental group were provided with ongoing information about the blood oxygen level dependent (BOLD) activity in the left amygdala (LA) and were instructed to raise the BOLD rtfMRI signal by contemplating positive autobiographical memories. A control group was assigned the same task but was instead provided with sham feedback from the left horizontal segment of the intraparietal sulcus (HIPS) region. In the LA, we found a significant BOLD signal increase due to rtfMRI neurofeedback training in the experimental group versus the control group. This effect persisted during the Transfer run without neurofeedback. For the individual subjects in the experimental group the training effect on the LA BOLD activity correlated inversely with scores on the Difficulty Identifying Feelings subscale of the Toronto Alexithymia Scale. The whole brain data analysis revealed significant differences for Happy Memories versus Rest condition between the experimental and control groups. Functional connectivity analysis of the amygdala network revealed significant widespread correlations in a fronto-temporo-limbic network. Additionally, we identified six regions — right medial frontal polar cortex, bilateral dorsomedial prefrontal cortex, left anterior cingulate cortex, and bilateral superior frontal gyrus — where the functional connectivity with the LA increased significantly across the rtfMRI neurofeedback runs and the Transfer run. The findings demonstrate that healthy subjects can learn to regulate their amygdala activation using rtfMRI neurofeedback, suggesting possible applications of rtfMRI neurofeedback training in the treatment of patients with neuropsychiatric disorders.

Frontocingular Dysfunction in Bulimia Nervosa when Confronted with Disease‐specific Stimuli

Bulimia nervosa (BN) is characterized by dysregulation of impulse control, in other words, uncontrolled eating. Functional neuroimaging studies have been sparse and have used variable methodologies. Thirteen medication-free female BN patients and 13 female healthy controls were investigated by functional magnetic resonance imaging using a disease-specific food paradigm. Stimuli were rated after the scanning procedure. Bulimia nervosa patients showed increased fear ratings and a trend for increased disgust. Magnetic resonance imaging data of 10 BN patients could be analysed. Three BN patients had to be excluded from the analysis because of minimal blood oxygen level dependent signals. Compared with healthy controls, BN patients showed less activation of the anterior cingulate cortex, which extended into the lateral prefrontal cortex. Furthermore, the right temporal pole showed decreased reactivity. This study substantiates a key role of lateral prefrontal dysfunction in BN, a brain region involved in impulse control. Furthermore, the anterior cingulate cortex, which plays a key role in emotion processing, is dysfunctional. A major limitation of this study is the small sample size.