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Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety

Zhiying Zhao, Shuxia Yao, Keshuang Li, Cornelia Sindermann, Feng Zhou, Weihua Zhao, Jianfu Li, Michael Lührs, Rainer Goebel, Keith M. Kendrick, Benjamin Becker
doi: https://doi.org/10.1101/308924
Zhiying Zhao
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Shuxia Yao
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Keshuang Li
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Cornelia Sindermann
2Institute of Psychology and Education, Ulm University, Ulm, Germany
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Feng Zhou
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Weihua Zhao
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Jianfu Li
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Michael Lührs
3Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
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Rainer Goebel
3Department of Cognitive Neuroscience, Maastricht University, Maastricht, The Netherlands
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Keith M. Kendrick
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Benjamin Becker
1Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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  • For correspondence: ben_becker@gmx.de
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Abstract

Deficient emotion regulation and exaggerated anxiety represent a major transdiagnostic psychopathological marker. On the neural level these deficits have been closely linked to impaired, yet treatment-sensitive, prefrontal regulatory control over the amygdala. Gaining direct control over these pathways could therefore provide an innovative and promising strategy to regulate exaggerated anxiety. To this end the current proof-of-concept study evaluated the feasibility, functional relevance and maintenance of a novel connectivity-informed real-time fMRI neurofeedback training. In a randomized within-subject sham-controlled design high anxious subjects (n = 26) underwent real-time fMRI-guided training to enhance connectivity between the ventrolateral prefrontal cortex (vlPFC) and the amygdala (target pathway) during threat exposure. Maintenance of regulatory control was assessed after three days and in the absence of feedback. Training-induced changes in functional connectivity of the target pathway and anxiety ratings served as primary outcomes. Training of the target, yet not the sham-control, pathway significantly increased amygdala-vlPFC connectivity and decreased subjective anxiety levels. On the individual level stronger connectivity increases were significantly associated with anxiety reduction. At follow-up, volitional control over the target pathway and decreased anxiety level were maintained in the absence of feedback. The present results demonstrate for the first time that successful self-regulation of amygdala-prefrontal top-down regulatory circuits may represent a novel strategy to control anxiety. As such, the present findings underscore both the critical contribution of amygdala-prefrontal circuits to emotion regulation and the therapeutic potential of connectivity-informed real-time neurofeedback.

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The copyright holder for this preprint is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license.
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Posted April 28, 2018.
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Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety
Zhiying Zhao, Shuxia Yao, Keshuang Li, Cornelia Sindermann, Feng Zhou, Weihua Zhao, Jianfu Li, Michael Lührs, Rainer Goebel, Keith M. Kendrick, Benjamin Becker
bioRxiv 308924; doi: https://doi.org/10.1101/308924
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Real-time functional connectivity-based neurofeedback of amygdala-frontal pathways reduces anxiety
Zhiying Zhao, Shuxia Yao, Keshuang Li, Cornelia Sindermann, Feng Zhou, Weihua Zhao, Jianfu Li, Michael Lührs, Rainer Goebel, Keith M. Kendrick, Benjamin Becker
bioRxiv 308924; doi: https://doi.org/10.1101/308924

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