Can neurofeedback-based modification of functional cerebral asymmetries and anterior cingulate activation improve the treatment of depressive disorders?

基于核磁共振成像的神经反馈使受试者能够控制自己的大脑活动。这项技术相对简单直接：当受试者躺在核磁共振扫描仪上时，她的大脑活动被实时测量和可视化。因此，受试者可以了解通过哪种心理操作，图像或感觉被监测的大脑活动增加或减少，并在一段时间后有意控制自己的大脑活动。这项技术可以提供广泛的应用。由于它可以促进认知过程和改善情绪控制，它可能不仅对研究和教学有用，而且可能对精神疾病的治疗也有用。在这个项目中，我们想要调查基于核磁共振的神经反馈在多大程度上可以帮助治疗抑郁症。抑郁症的终生发病率约为20%，是精神疾病的主要组成部分。尽管有高度发达的药物和心理疗法，但许多患者并不能完全通过目前可用的治疗方案得到治疗。抑郁症通常伴随着几个典型的神经元特征。除此之外，前额叶皮层的激活失衡，前额叶皮层是负责执行功能、工作记忆和决策的大脑结构。左前额叶皮层通常被激活得太弱，而右前额叶皮层通常被激活得太强。因此，在第一项研究中，我们试图减少这种不平衡，以了解在此过程中抑郁症状减轻了多少。此外，抑郁症患者经常表现出前额皮质内部的超连通性，前额皮质和杏仁核之间也可能表现出超连通性。由于先前的研究表明，基于mri的神经反馈不仅可以改变特定大脑区域的活动，还可以影响大脑结构之间的连接，因此我们也想观察这方面。抑郁症的另一个显著的神经元特征是前扣带皮层激活不足，这是一个负责情绪控制和执行功能的大脑区域。此外，没有从心理治疗或抗抑郁药物中获益的患者，其大脑这一结构的激活程度比对治疗有反应的患者要弱得多。因此，第二项研究将测试针对该区域的基于mri的神经反馈在多大程度上提高了治疗成功率，改善了抑郁症状，并改善了执行功能，这些功能通常会因抑郁症而减轻。在第三项研究中，我们想训练另外两种通常在抑郁症中受到影响的认知功能：工作记忆和注意力。此外，我们想要调查基于核磁共振的神经反馈的积极影响在多大程度上延伸到其他未经训练的认知任务，以及持续多久。

MRI-based neurofeedback enables subjects to gain control over their own brain activity. The technique is relatively simple and straightforward: while the subject lies in an MRI scanner, her brain acitivity is measured and visualized in realtime. Thereby, the subject can learn through which kind of mental operations, imagery or feelings the monitored brain activity increases or decreases, and after a while deliberately control her own brain activity. This technique may offer a wide range of applications. Since it allows to foster cognitive processing and to improve emotional control, it may not only be useful for research and teaching, but probably also for the treatment of mental diseases. In this project, we want to investigate to which extent MRI-based neurofeedback can help in the treatment of depressive disorders. With a lifetime incidence of about 20 percent, depressive disorders constitute a major part of mental diseases. And inspite of highly developed medications and psychotherapies, many patients cannot entirely be treated with the treatment options available so far.Depressive disorders typically go along with several characteristic neuronal features. Among other things, there is a dysbalance of the activations whithin the prefrontal cortex, a brain structure dedicated to executive functions, working memory and decision making. While the left prefronal cortex is usually too weakly activated, the right prefronal cortex is often too strongly activated. In a first study, we therefore attempt to reduce this dysbalance in order to see how much depressive symptoms abate in the process. In addition, depressive patients often show a hyperconnectivity within the prefrontal cortex and possibly also a hyperconnectivity between prefrontal cortex and amygdala. Since previous studies demonstrated that MRI-based neurofeedback cannot only alter the activity of particular brain regions, but also influence the connections between brain structures, we want to observe this aspect too. Another striking neuronal feature in depressive disorders is an underactivation of the anterior cingulate cortex, a brain region responsible for emotional control and executive functions. Moreover, patients who do not profit from psychotherapy or antidepressants show much weaker activations of this brain structure than patients who respond to the treatment. Accordingly, a second study shall test to which extent MRI-based neurofeedback targeting this region increases therapy success, ameliorates depressive symptoms and improves executive functions, which are often mitigated by depression. In a third study, we want to train two other cognitive functions that are usually affected in depressive disorders: working memory and attention. In addition, we want to investigate how much the positive effect of the MRI-based neurofeedback extends to other, nontrained cognitive tasks, and how long it lasts.