A double-blind trial of decoded neurofeedback intervention for specific phobias.

IF 5 3区 医学 Q1 CLINICAL NEUROLOGY Psychiatry and Clinical Neurosciences Pub Date : 2024-09-02 DOI:10.1111/pcn.13726
Cody A Cushing, Hakwan Lau, Mitsuo Kawato, Michelle G Craske, Vincent Taschereau-Dumouchel
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Abstract

Aim: A new closed-loop functional magnetic resonance imaging method called multivoxel neuroreinforcement has the potential to alleviate the subjective aversiveness of exposure-based interventions by directly inducing phobic representations in the brain, outside of conscious awareness. The current study seeks to test this method as an intervention for specific phobia.

Methods: In a randomized, double-blind, controlled single-university trial, individuals diagnosed with at least two (one target, one control) animal subtype-specific phobias were randomly assigned (1:1:1) to receive one, three, or five sessions of multivoxel neuroreinforcement in which they were rewarded for implicit activation of a target animal representation. Amygdala response to phobic stimuli was assessed by study staff blind to target and control animal assignments. Pretreatment to posttreatment differences were analyzed with a two-way repeated-measures anova.

Results: A total of 23 participants (69.6% female) were randomized to receive one (n = 8), three (n = 7), or five (n = 7) sessions of multivoxel neuroreinforcement. Eighteen (n = 6 each group) participants were analyzed for our primary outcome. After neuroreinforcement, we observed an interaction indicating a significant decrease in amygdala response for the target phobia but not the control phobia. No adverse events or dropouts were reported as a result of the intervention.

Conclusion: Results suggest that multivoxel neuroreinforcement can specifically reduce threat signatures in specific phobia. Consequently, this intervention may complement conventional psychotherapy approaches with a nondistressing experience for patients seeking treatment. This trial sets the stage for a larger randomized clinical trial to replicate these results and examine the effects on real-life exposure.

Clinical trial registration: The now-closed trial was prospectively registered at ClinicalTrials.gov with ID NCT03655262.

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针对特定恐惧症的解码神经反馈干预双盲试验。
目的:一种名为多象素神经强化的新型闭环功能磁共振成像方法可以在意识之外直接诱导大脑中的恐惧症表征,从而减轻基于暴露的干预措施的主观厌恶性。目前的研究试图测试这种方法对特定恐惧症的干预效果:在一项随机、双盲、对照的单一大学试验中,被诊断出患有至少两种(一种目标,一种对照)动物亚型特异性恐惧症的人被随机分配(1:1:1)接受一次、三次或五次多体细胞神经强化训练,在这些训练中,他们会因目标动物表征的隐性激活而获得奖励。杏仁核对恐惧刺激的反应由研究人员进行评估,他们对目标动物和对照组动物的分配情况保密。采用双向重复测量anova法分析治疗前与治疗后的差异:共有 23 名参与者(69.6% 为女性)被随机分配接受一次(n = 8)、三次(n = 7)或五次(n = 7)多体神经强化训练。我们对 18 名参与者(每组 6 人)的主要结果进行了分析。在神经强化后,我们观察到一种交互作用,表明目标恐惧症的杏仁核反应显著下降,而对照恐惧症则没有。干预过程中未出现任何不良事件或辍学报告:结论:研究结果表明,多体素神经强化疗法可以有针对性地减少特定恐惧症的威胁特征。因此,这种干预方法可以补充传统的心理治疗方法,为寻求治疗的患者带来无压力的体验。这项试验为更大规模的随机临床试验奠定了基础,以复制这些结果并检查其对现实生活暴露的影响:这项现已结束的试验已在 ClinicalTrials.gov 进行了前瞻性注册,注册号为 NCT03655262。
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来源期刊
CiteScore
7.40
自引率
4.20%
发文量
181
审稿时长
6-12 weeks
期刊介绍: PCN (Psychiatry and Clinical Neurosciences) Publication Frequency: Published 12 online issues a year by JSPN Content Categories: Review Articles Regular Articles Letters to the Editor Peer Review Process: All manuscripts undergo peer review by anonymous reviewers, an Editorial Board Member, and the Editor Publication Criteria: Manuscripts are accepted based on quality, originality, and significance to the readership Authors must confirm that the manuscript has not been published or submitted elsewhere and has been approved by each author
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