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Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback

Background: Post-traumatic stress disorder (PTSD) is a neuropsychiatric affective disorder that can develop after traumatic life-events. Exposure-based therapy is currently one of the most effective treatments for PTSD. However, exposure to traumatic stimuli is so aversive that a significant number...

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Autores principales: Chiba, Toshinori, Kanazawa, Tetsufumi, Koizumi, Ai, Ide, Kentarou, Taschereau-Dumouchel, Vincent, Boku, Shuken, Hishimoto, Akitoyo, Shirakawa, Miyako, Sora, Ichiro, Lau, Hakwan, Yoneda, Hiroshi, Kawato, Mitsuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650780/
https://www.ncbi.nlm.nih.gov/pubmed/31379538
http://dx.doi.org/10.3389/fnhum.2019.00233
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author Chiba, Toshinori
Kanazawa, Tetsufumi
Koizumi, Ai
Ide, Kentarou
Taschereau-Dumouchel, Vincent
Boku, Shuken
Hishimoto, Akitoyo
Shirakawa, Miyako
Sora, Ichiro
Lau, Hakwan
Yoneda, Hiroshi
Kawato, Mitsuo
author_facet Chiba, Toshinori
Kanazawa, Tetsufumi
Koizumi, Ai
Ide, Kentarou
Taschereau-Dumouchel, Vincent
Boku, Shuken
Hishimoto, Akitoyo
Shirakawa, Miyako
Sora, Ichiro
Lau, Hakwan
Yoneda, Hiroshi
Kawato, Mitsuo
author_sort Chiba, Toshinori
collection PubMed
description Background: Post-traumatic stress disorder (PTSD) is a neuropsychiatric affective disorder that can develop after traumatic life-events. Exposure-based therapy is currently one of the most effective treatments for PTSD. However, exposure to traumatic stimuli is so aversive that a significant number of patients drop-out of therapy during the course of treatment. Among various attempts to develop novel therapies that bypass such aversiveness, neurofeedback appears promising. With neurofeedback, patients can unconsciously self-regulate brain activity via real-time monitoring and feedback of the EEG or fMRI signals. With conventional neurofeedback methods, however, it is difficult to induce neural representation related to specific trauma because the feedback is based on the neural signals averaged within specific brain areas. To overcome this difficulty, novel neurofeedback approaches such as Decoded Neurofeedback (DecNef) might prove helpful. Instead of the average BOLD signals, DecNef allows patients to implicitly regulate multivariate voxel patterns of the BOLD signals related with feared stimuli. As such, DecNef effects are postulated to derive either from exposure or counter-conditioning, or some combination of both. Although the exact mechanism is not yet fully understood. DecNef has been successfully applied to reduce fear responses induced either by fear-conditioned or phobic stimuli among non-clinical participants. Methods: Follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted to compare DecNef effect with those of conventional EEG/fMRI-based neurofeedback on PTSD amelioration. To elucidate the possible mechanisms of DecNef on fear reduction, we mathematically modeled the effects of exposure-based and counter conditioning separately and applied it to the data obtained from past DecNef studies. Finally, we conducted DecNef on four PTSD patients. Here, we review recent advances in application of neurofeedback to PTSD treatments, including the DecNef. This review is intended to be informative for neuroscientists in general as well as practitioners planning to use neurofeedback as a therapeutic strategy for PTSD. Results: Our mathematical model suggested that exposure is the key component for DecNef effects in the past studies. Following DecNef a significant reduction of PTSD severity was observed. This effect was comparable to those reported for conventional neurofeedback approach. Conclusions: Although a much larger number of participants will be needed in future, DecNef could be a promising therapy that bypasses the unpleasantness of conscious exposure associated with conventional therapies for fear related disorders, including PTSD.
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spelling pubmed-66507802019-08-02 Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback Chiba, Toshinori Kanazawa, Tetsufumi Koizumi, Ai Ide, Kentarou Taschereau-Dumouchel, Vincent Boku, Shuken Hishimoto, Akitoyo Shirakawa, Miyako Sora, Ichiro Lau, Hakwan Yoneda, Hiroshi Kawato, Mitsuo Front Hum Neurosci Neuroscience Background: Post-traumatic stress disorder (PTSD) is a neuropsychiatric affective disorder that can develop after traumatic life-events. Exposure-based therapy is currently one of the most effective treatments for PTSD. However, exposure to traumatic stimuli is so aversive that a significant number of patients drop-out of therapy during the course of treatment. Among various attempts to develop novel therapies that bypass such aversiveness, neurofeedback appears promising. With neurofeedback, patients can unconsciously self-regulate brain activity via real-time monitoring and feedback of the EEG or fMRI signals. With conventional neurofeedback methods, however, it is difficult to induce neural representation related to specific trauma because the feedback is based on the neural signals averaged within specific brain areas. To overcome this difficulty, novel neurofeedback approaches such as Decoded Neurofeedback (DecNef) might prove helpful. Instead of the average BOLD signals, DecNef allows patients to implicitly regulate multivariate voxel patterns of the BOLD signals related with feared stimuli. As such, DecNef effects are postulated to derive either from exposure or counter-conditioning, or some combination of both. Although the exact mechanism is not yet fully understood. DecNef has been successfully applied to reduce fear responses induced either by fear-conditioned or phobic stimuli among non-clinical participants. Methods: Follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted to compare DecNef effect with those of conventional EEG/fMRI-based neurofeedback on PTSD amelioration. To elucidate the possible mechanisms of DecNef on fear reduction, we mathematically modeled the effects of exposure-based and counter conditioning separately and applied it to the data obtained from past DecNef studies. Finally, we conducted DecNef on four PTSD patients. Here, we review recent advances in application of neurofeedback to PTSD treatments, including the DecNef. This review is intended to be informative for neuroscientists in general as well as practitioners planning to use neurofeedback as a therapeutic strategy for PTSD. Results: Our mathematical model suggested that exposure is the key component for DecNef effects in the past studies. Following DecNef a significant reduction of PTSD severity was observed. This effect was comparable to those reported for conventional neurofeedback approach. Conclusions: Although a much larger number of participants will be needed in future, DecNef could be a promising therapy that bypasses the unpleasantness of conscious exposure associated with conventional therapies for fear related disorders, including PTSD. Frontiers Media S.A. 2019-07-17 /pmc/articles/PMC6650780/ /pubmed/31379538 http://dx.doi.org/10.3389/fnhum.2019.00233 Text en Copyright © 2019 Chiba, Kanazawa, Koizumi, Ide, Taschereau-Dumouchel, Boku, Hishimoto, Shirakawa, Sora, Lau, Yoneda and Kawato. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Chiba, Toshinori
Kanazawa, Tetsufumi
Koizumi, Ai
Ide, Kentarou
Taschereau-Dumouchel, Vincent
Boku, Shuken
Hishimoto, Akitoyo
Shirakawa, Miyako
Sora, Ichiro
Lau, Hakwan
Yoneda, Hiroshi
Kawato, Mitsuo
Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback
title Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback
title_full Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback
title_fullStr Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback
title_full_unstemmed Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback
title_short Current Status of Neurofeedback for Post-traumatic Stress Disorder: A Systematic Review and the Possibility of Decoded Neurofeedback
title_sort current status of neurofeedback for post-traumatic stress disorder: a systematic review and the possibility of decoded neurofeedback
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650780/
https://www.ncbi.nlm.nih.gov/pubmed/31379538
http://dx.doi.org/10.3389/fnhum.2019.00233
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