背景:患有精神分裂症(SZ)和幻听(AH)的个体表现出扭曲的自我和自我-他者边界感。已提出在自我参考过程中中线皮质结构(例如前额叶皮质(mPFC)和前扣带回皮质(ACC))以及颞上回(STG)的活动改变作为SZ和AH的神经标记。
方法:在本随机分组中,参与者失明,假对照试验,22名患有SZ谱系障碍(SZ或分裂情感障碍)和频繁耐药AH的成年人(18名男性)从STG(n=11;实验组)或运动皮层(n=11;对照组)接受了一次实时fMRI神经反馈(NFB)。NFB期间,参与者被指示通过注意以自己的声音说出的预先录制的句子来上调他们的STG活动,并通过忽略不熟悉的声音来下调STG活动.NFB之前和之后,参与者完成了一项自我参考任务,在那里他们评估了特质形容词是否提到了自己(自我条件),亚伯拉罕·林肯(其他条件),或者形容词是否具有正价(语义条件)。NFB后组间变化测试的自我参考任务数据的FMRI激活分析(自我>语义,post>pre-NFB,实验>对照)。在自参考网络中对分析进行了预屏蔽。
结果:活化分析显示,实验中激活增加显著(p<0.001),与对照组相比,在自参考网络的前部区域内的NFB之后(mPFC,ACC,上额叶皮层)。
结论:STG-NFB与mPFC的活性增加有关,ACC,和上额叶皮层在自我参照。调节STG与其他激活变化有关,不直接针对,服务于SZ中与自我参照过程和AHs精神病理学相关的高级认知过程的区域。
结果:GOV:精神分裂症的Rt-fMRI神经反馈和AH;https://clinicaltrials.gov/study/NCT03504579。
BACKGROUND: Individuals with schizophrenia (SZ) and auditory hallucinations (AHs) display a distorted sense of self and self-other boundaries. Alterations of activity in midline cortical structures such as the prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) during self-reference as well as in the superior temporal gyrus (STG) have been proposed as neuromarkers of SZ and AHs.
METHODS: In this randomized, participant-blinded, sham-controlled trial, 22 adults (18 males) with SZ spectrum disorders (SZ or schizoaffective disorder) and frequent medication-resistant AHs received one session of real-time fMRI neurofeedback (NFB) either from the STG (n = 11; experimental group) or motor cortex (n = 11; control group). During NFB, participants were instructed to upregulate their STG activity by attending to pre-recorded sentences spoken in their own voice and downregulate it by ignoring unfamiliar voices. Before and after NFB, participants completed a self-reference task where they evaluated if trait adjectives referred to themselves (self condition), Abraham Lincoln (other condition), or whether adjectives had a positive valence (semantic condition). FMRI activation analyses of self-reference task data tested between-group changes after NFB (self>semantic, post>pre-NFB, experimental>control). Analyses were pre-masked within a self-reference network.
RESULTS: Activation analyses revealed significantly (p < 0.001) greater activation increase in the experimental, compared to the control group, after NFB within anterior regions of the self-reference network (mPFC, ACC, superior frontal cortex).
CONCLUSIONS: STG-NFB was associated with activity increase in the mPFC, ACC, and superior frontal cortex during self-reference. Modulating the STG is associated with activation changes in other, not-directly targeted, regions subserving higher-level cognitive processes associated with self-referential processes and AHs psychopathology in SZ.
RESULTS: GOV: Rt-fMRI Neurofeedback and AH in Schizophrenia; https://clinicaltrials.gov/study/NCT03504579.