Real-time fMRI feedback impacts brain activation, results in auditory hallucinations reduction: Part 1: Superior temporal gyrus -Preliminary evidence

Kana Okano; Clemens C C Bauer; Satrajit S Ghosh; Yoon Ji Lee; Helena Melero; Carlo de Los Angeles; Paul G Nestor; Elisabetta C Del Re; Georg Northoff; Susan Whitfield-Gabrieli; Margaret A Niznikiewicz

doi:10.1016/j.psychres.2020.112862

Real-time fMRI feedback impacts brain activation, results in auditory hallucinations reduction: Part 1: Superior temporal gyrus -Preliminary evidence

Psychiatry Res. 2020 Feb 10:286:112862. doi: 10.1016/j.psychres.2020.112862. Online ahead of print.

Authors

Affiliations

¹ Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. Electronic address: [email protected].
² Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
³ Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, MA 02115, USA.
⁴ Northeastern University, Boston, MA 02139, USA.
⁵ Northeastern University, Boston, MA 02139, USA; Medical Image Analysis Laboratory (LAIMBIO), Rey Juan Carlos University, Madrid, Spain.
⁶ University of Massachusetts, Boston, Boston MA 02215, USA; Harvard Medical School, Boston, MA 02115, USA; Boston VA Healthcare System, Boston, MA 02130, USA.
⁷ Harvard Medical School, Boston, MA 02115, USA; Boston VA Healthcare System, Boston, MA 02130, USA; Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.
⁸ Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada.
⁹ Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Northeastern University, Boston, MA 02139, USA.
¹⁰ Harvard Medical School, Boston, MA 02115, USA; Boston VA Healthcare System, Boston, MA 02130, USA; Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.

Abstract

Auditory hallucinations (AH) are one of the core symptoms of schizophrenia (SZ) and constitute a significant source of suffering and disability. One third of SZ patients experience pharmacology-resistant AH, so an alternative/complementary treatment strategy is needed to alleviate this debilitating condition. In this study, real-time functional Magnetic Resonance Imaging neurofeedback (rt-fMRI NFB), a non-invasive technique, was used to teach 10 SZ patients with pharmacology-resistant AH to modulate their brain activity in the superior temporal gyrus (STG), a key area in the neurophysiology of AH. A functional task was designed in order to provide patients with a specific strategy to help them modify their brain activity in the desired direction. Specifically, they received neurofeedback from their own STG and were trained to upregulate it while listening to their own voice recording and downregulate it while ignoring a stranger's voice recording. This guided performance neurofeedback training resulted in a) a significant reduction in STG activation while ignoring a stranger's voice, and b) reductions in AH scores after the neurofeedback session. A single, 21-minute session of rt-fMRI NFB was enough to produce these effects, suggesting that this approach may be an efficient and clinically viable alternative for the treatment of pharmacology-resistant AH.

Abstract

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