Plastic modulation of PTSD resting-state networks and subjective wellbeing by EEG neurofeedback

• Published in: Acta psychiatrica Scandinavica Vol. 130; no. 2; pp. 123 - 136
• Main Authors: Kluetsch, R. C., Ros, T., Théberge, J., Frewen, P. A., Calhoun, V. D., Schmahl, C., Jetly, R., Lanius, R. A.
• Format: Journal Article
• Language: English
• Published: Oxford Blackwell Publishing Ltd 01-08-2014; Blackwell
• Subjects: Adult; Adult and adolescent clinical studies; Alpha Rhythm - physiology; Anxiety - physiopathology; Anxiety disorders. Neuroses; Arousal - physiology; Biological and medical sciences; Cerebral Cortex - physiopathology; Connectome; electroencephalogram; Electroencephalography; Female; functional connectivity; functional MRI; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Nerve Net - physiopathology; neurofeedback; Neurofeedback - instrumentation; Neurofeedback - methods; Neurofeedback - physiology; Neuronal Plasticity - physiology; Neuropsychology; Post traumatic stress disorder; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Relaxation. Biofeedback. Hypnosis. Selfregulation. Meditation; Stress Disorders, Post-Traumatic - physiopathology; Stress Disorders, Post-Traumatic - therapy; Treatment Outcome; Treatments; Functional connectivity; post-traumatic stress disorder; Central nervous system; Anxiety disorder; Electrophysiology; Well being; Electroencephalography; Posttraumatic stress disorder; Nuclear magnetic resonance imaging; Stress; electroencephalogram; Encephalon; Electrodiagnosis; functional MRI; Rest; Functional magnetic resonance imaging; Medical imagery; Biofeedback; neurofeedback; functional connectivity
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.12229

Objective
Electroencephalographic (EEG) neurofeedback training has been shown to produce plastic modulations in salience network and default mode network functional connectivity in healthy individuals. In this study, we investigated whether a single session of neurofeedback training aimed at the voluntary reduction of alpha rhythm (8–12 Hz) amplitude would be related to differences in EEG network oscillations, functional MRI (fMRI) connectivity, and subjective measures of state anxiety and arousal in a group of individuals with post‐traumatic stress disorder (PTSD).
Method
Twenty‐one individuals with PTSD related to childhood abuse underwent 30 min of EEG neurofeedback training preceded and followed by a resting‐state fMRI scan.
Results
Alpha desynchronizing neurofeedback was associated with decreased alpha amplitude during training, followed by a significant increase (‘rebound’) in resting‐state alpha synchronization. This rebound was linked to increased calmness, greater salience network connectivity with the right insula, and enhanced default mode network connectivity with bilateral posterior cingulate, right middle frontal gyrus, and left medial prefrontal cortex.
Conclusion
Our study represents a first step in elucidating the potential neurobehavioural mechanisms mediating the effects of neurofeedback treatment on regulatory systems in PTSD. Moreover, it documents for the first time a spontaneous EEG ‘rebound’ after neurofeedback, pointing to homeostatic/compensatory mechanisms operating in the brain.