Real-time fMRI neurofeedback reduces auditory hallucinations and modulates resting state connectivity of involved brain regions: Part 2: Default mode network -preliminary evidence.

Author: Bauer CCC1, Okano K2, Gosh SS2, Lee YJ3, Melero H4, Angeles CL2, Nestor PG5, Del Re EC6, Northoff G7, Niznikiewicz MA8, Whitfield-Gabrieli S9
Affiliation:
1Department 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. Electronic address: cccbauer@mit.edu.
2Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology. Cambridge, MA 02139, USA.
3Northeastern University, Boston, MA 02139, USA.
4Northeastern University, Boston, MA 02139, USA; Medical Image Analysis Laboratory (LAIMBIO), Rey Juan Carlos University, Madrid, Spain.
5Harvard Medical School. Boston, MA 02115, USA; Boston VA Healthcare System. Boston, MA 02130, USA; University of Massachusetts, Boston, Boston MA 02215, USA.
6Harvard 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.
7Mind, Brain Imaging and Neuroethics Research Unit, The Royal's Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada.
8Harvard Medical School. Boston, MA 02115, USA; Boston VA Healthcare System. Boston, MA 02130, USA; Beth Israel Deaconess Medical Center. Boston, MA 02215, USA.
9Department 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.
Conference/Journal: Psychiatry Res.
Date published: 2020 Jan 14
Other: Volume ID: 284 , Pages: 112770 , Special Notes: doi: 10.1016/j.psychres.2020.112770. [Epub ahead of print] , Word Count: 222

Auditory hallucinations (AHs) are one of the most distressing symptoms of schizophrenia (SZ) and are often resistant to medication. Imaging studies of individuals with SZ show hyperactivation of the default mode network (DMN) and the superior temporal gyrus (STG). Studies in SZ show DMN hyperconnectivity and reduced anticorrelation between DMN and the central executive network (CEN). DMN hyperconnectivity has been associated with positive symptoms such as AHs while reduced DMN anticorrelations with cognitive impairment. Using real-time fMRI neurofeedback (rt-fMRI-NFB) we trained SZ patients to modulate DMN and CEN networks. Meditation is effective in reducing AHs in SZ and to modulate brain network integration and increase DMN anticorrelations. Consequently, patients were provided with meditation strategies to enhance their abilities to modulate DMN/CEN. Results show a reduction of DMN hyperconnectivity and increase in DMNCEN anticorrelation. Furthermore, the change in individual DMN connectivity significantly correlated with reductions in AHs. This is the first time that meditation enhanced through rt-fMRI-NFB is used to reduce AHs in SZ. Moreover, it provides the first empirical evidence for a direct causal relation between meditation enhanced rt-fMRI-NFB modulation of DMNCEN activity and post-intervention modulation of resting state networks ensuing in reductions in frequency and severity of AHs.

Copyright © 2020 Elsevier B.V. All rights reserved.

KEYWORDS: Auditory hallucinations; Default mode network; Mindfulness meditation; Real-time neurofeedback; Schizophrenia

PMID: 32004893 DOI: 10.1016/j.psychres.2020.112770

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