Real-time fMRI Neurofeedback as a Tool to Mitigate Auditory Hallucinations in Patients with Schizophrenia

实时功能磁共振成像神经反馈作为减轻精神分裂症患者幻听的工具

基本信息

项目摘要

This is a resubmission application, originally in response to RFA-MH-16-406 and consists of R61 and R33 phases. Auditory verbal hallucinations (AH) have long been a hallmark of schizophrenia (SZ) and are one of its major diagnostic features Andreasen and Flaum 1991; DSM-IV). They are difficult to manage with existing treatment options. Here, we propose that neurofeedback aimed to regulate the superior temporal gyrus (STG) activation will not only lead to activation changes in the STG, but also to changes in the default mode network (DMN) (R61), as well as to reductions in AH (R33), and that the brain and clinical changes will be correlated (R33). The theoretical framework for the current proposal is an AH model that assumes that AH result from abnormalities in a network of regions including STG, and medial prefrontal cortex (MPFC) and posterior cingulate cortex (PCC), the two latter regions are core medial hubs of DMN that are related to self-referential processing. This model is supported by theoretical papers Northoff and Qin 2010, Alderson-Day,2016, and experimental evidence Gur 1995, Liddle 1992, Dierks 1999 as well as our preliminary data (PD). In both R61 and R33 we will study SZ patients with medication resistant AH in the rt-fMRI intervention arm and in the sham-rt-fMRI arm. In both arms, the task and the rt-fMRI session structure will be identical. The SZ-intervention group will receive feedback from the STG while SZ-sham group will receive feedback from the motor cortex. In addition, 2 functional fMRI tasks will examine the effect of rt-fMRI neurofeedback and of sham-rt-fMRI on brain response. In the R61, we will randomly assign 48 SZ patients to either SZ-intervention (n=24) or SZ-sham-rtfMRI (n=24). The STG targeted neurofeedback is predicted to bring changes in brain regions involved in AH (STG and DMN) in SZ-intervention group only. The R61 GO criterion will be BOLD signal reduction in the STG, and resting state connectivity reduction between MPFC-PCC, post rt-fMRI-feedback in SZ-intervention group. In the R33, SZ-intervention group (random n=52) will receive 5 sessions of rt-fMRI feedback targeting STG, while SZ-sham group (random n=52) will receive 5 sham-rt-fMRI sessions. Based on our PD, we predict that rt-fMRI feedback aimed at STG will reduce AH which will be, in turn, associated with reductions in the STG activation and in the DMN connectivity (i.e., brain changes achieved in R61 and replicated in R33) in SZ- intervention group only. Five sessions of rt-fMRI feedback will address the question of dose response at brain and clinical levels. The impact of rt-fMRI neurofeedback and of sham-rt-fMRI on AH (primary outcome), and on delusions, negative symptoms and working memory (WM) (exploratory outcome) will be assessed with clinical and neuropsychological measures. In an exploratory aim, based on the existing literature Garrity 2007; Whitfield-Gabrieli 2009; Rotarska-Jagiela 2010, we predict the improvement in delusions, negative symptoms and in WM score, only post-rt-fMRI neurofeedback targeting the STG and not post-sham-rt-fMRI.
这是一份重新提交申请,最初是为了响应RFA-MH-16-406,由R61和

项目成果

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MARGARET A NIZNIKIEWICZ其他文献

MARGARET A NIZNIKIEWICZ的其他文献

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{{ truncateString('MARGARET A NIZNIKIEWICZ', 18)}}的其他基金

Real-time fMRI Neurofeedback as a Tool to Mitigate Auditory Hallucinations in Patients with Schizophrenia
实时功能磁共振成像神经反馈作为减轻精神分裂症患者幻听的工具
  • 批准号:
    10019700
  • 财政年份:
    2018
  • 资助金额:
    $ 102.95万
  • 项目类别:
Real-time fMRI Neurofeedback as a Tool to Mitigate Auditory Hallucinations in Patients with Schizophrenia
实时功能磁共振成像神经反馈作为减轻精神分裂症患者幻听的工具
  • 批准号:
    10704690
  • 财政年份:
    2018
  • 资助金额:
    $ 102.95万
  • 项目类别:
Real time fMRI feedback and auditory processing in schizophrenia
精神分裂症的实时功能磁共振成像反馈和听觉处理
  • 批准号:
    8509122
  • 财政年份:
    2013
  • 资助金额:
    $ 102.95万
  • 项目类别:
Real time fMRI feedback and auditory processing in schizophrenia
精神分裂症的实时功能磁共振成像反馈和听觉处理
  • 批准号:
    8676940
  • 财政年份:
    2013
  • 资助金额:
    $ 102.95万
  • 项目类别:
Neurophysiological and MRI Studies of Schizophrenia
精神分裂症的神经生理学和 MRI 研究
  • 批准号:
    9337244
  • 财政年份:
    2009
  • 资助金额:
    $ 102.95万
  • 项目类别:
Semantic knowledge and its underlying structures in schizophrenia-an fMRI study
精神分裂症的语义知识及其底层结构——一项功能磁共振成像研究
  • 批准号:
    7251770
  • 财政年份:
    2007
  • 资助金额:
    $ 102.95万
  • 项目类别:
Language Systems in Schizophrenia: Behavioral & ERP Data
精神分裂症的语言系统:行为
  • 批准号:
    6891683
  • 财政年份:
    2002
  • 资助金额:
    $ 102.95万
  • 项目类别:
Language Systems in Schizophrenia: Behavioral & ERP Data
精神分裂症的语言系统:行为
  • 批准号:
    7075440
  • 财政年份:
    2002
  • 资助金额:
    $ 102.95万
  • 项目类别:
Language Systems in Schizophrenia: Behavioral & ERP Data
精神分裂症的语言系统:行为
  • 批准号:
    6742536
  • 财政年份:
    2002
  • 资助金额:
    $ 102.95万
  • 项目类别:
Language Systems in Schizophrenia: Behavioral & ERP Data
精神分裂症的语言系统:行为
  • 批准号:
    6471942
  • 财政年份:
    2002
  • 资助金额:
    $ 102.95万
  • 项目类别:

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