Application of fMRI Brain-Computer Interface to self-regulation of the BOLD signal and neural connectivity in Schizophrenia

精神分裂症是一种毁灭性的脑部疾病，尽管接受了治疗，但患者的预后仍然很差。目前的知识表明，精神分裂症的精神病理和认知缺陷源于有限的大脑异常，但也源于分布的大脑网络之间的异常连接。基于功能性磁共振成像（fMRI-BCI）的脑机接口使受试者能够实现对大脑解剖特异性区域的意志控制，从而导致与激活区域相关的行为改变。我们实验室获得的初步结果表明，fMRI-BCI也可以诱导大脑网络连通性的增强。我们已经开发了一种fMRI-BCI，它可以为受试者提供图像动画，实时的大脑特定区域的偶然反馈，以训练他们有意识地自我调节BOLD信号。此外，我们可以提供两个或多个脑区的有效连通性（EC）反馈，训练受试者直接调节这些网络的连通性。基于这项技术和我们的初步结果，我们建议首次在精神分裂症中实施fMRI-BCI。本研究的主要目的是：1)通过fMRI-BCI训练，训练精神分裂症患者自我调节限定脑区的活动和相关脑网络的EC； 2)证明自我调节所实现的活动和连通性的增强导致了精神分裂症核心稳定认知缺陷的行为反应的改变。

Schizophrenia is a devastating brain disorder where patients still suffer from a poor outcome in spite of treatments. Current knowledge states that psychopathology and cognitive deficits in schizophrenia arise from circumscribed brain abnormalities but also from an abnormal connectivity between distributed brain networks. Brain-Computer Interfaces based on functional Magnetic Resonance Imaging (fMRI-BCI) enable subjects to achieve volitional control of anatomically specific regions of the brain, leading to behavioral changes related to the activated areas. Preliminary results obtained in our laboratory demonstrated that fMRI-BCI can also induce an enhancement of connectivity of the brain networks. We have developed an fMRI-BCI that can provide subjects graphically animated, real-time contingent feedback of circumscribed regions of the brain to train them to volitionally self-regulate the BOLD signal. Furthermore, we can provide feedback of the effective connectivity (EC) of two or more brain regions, to train subjects to directly regulate the connectivity of these networks. Based in this technology and on our preliminary results, we propose to implement for the first time, fMRI-BCI in schizophrenia. The main aims of this study are: 1) to train schizophrenia patients to self-regulate, by fMRI-BCI training, the activity of circumscribed brain areas and the EC of relevant brain networks, and 2) to demonstrate that the enhanced activity and connectivity achieved by self-regulation leads to a modification of the behavioural response of core stable cognitive deficits of the disorder.