Characteristics and Training of Neural Responding in BPD

点击翻译按钮获取中文摘要

The aim of this project is to develop an fMRI-based neurofeedback procedure that could be used by patients with BPD to reduce negative affect. In the previous funding period, we presented both BPD patients and healthy controls with aversive pictures and used fMRI to identify which brain regions were associated with negative affect processing, as measured by blood-oxygenlevel dependent (BOLD) contrast imaging. In both groups, looking at such pictures was found to produce a sustained BOLD response in the amygdala but not the anterior insula. Subsequently, we implemented a real-time procedure in which participants received continuous fMRI¿based feedback of their amygdala while viewing aversive pictures, and were asked to use that feedback to try to modulate their brain activation. The first part of that study was conducted in healthy subjects, who demonstrated a successful down-regulation of the amygdala response (Paret et al., 2014a). The same protocol was then implemented with BPD patients. The results of that part of the study are still being analyzed, but preliminary findings show a down-regulation of the amygdala response in this population as well. In the next funding period, our first goal is to enhance the effectivity of the neurofeedback training by an optimized feedback presentation and to explore a connectivity-based neurofeedback in a development study (study 1). The study will investigate whether feedback of connectivity is more effective than feedback of the BOLD response from a single brain region. Our second goal is to use the feedback method with the most robust regulation success to conduct a randomized controlled trial (RCT, study 2). Again, BPD patients will undergo fMRI scans while viewing aversive pictures. One group will be randomized to receive neurofeedback during the scans, while another group will receive the same number of scans but no neurofeedback, in order to control for the effects of being in a research environment. Performance on explicit and implicit emotion regulation tasks will be assessed before and after the intervention, and psychometric assessments will be conducted at each training session. In addition, we will extend our investigations to emotional stimuli that have a positive valence, as these appear to be of particular interest in light of findings from IP1. Activation patterns in brain regions of interest will be compared between BPD patients and healthy participants.