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

Abstract

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.

Keywords: electroencephalogram; functional MRI; functional connectivity; neurofeedback; post-traumatic stress disorder.

© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Figures

Fig. 1

Left and middle: Bar graphs show group mean alpha (8–12 Hz) amplitudes (calculated offline using a weighted average Laplacian montage) averaged across all subjects for Baseline 1, neurofeedback (NFB), and Baseline 2, respectively, globally over all 19 electrodes (left) and at the Pz feedback site only (middle). Stars indicate the level of statistical significance, with * indicating a threshold of P < 0.05 and ** indicating a threshold of P < 0.005. Error bars represent I standard error of the mean (SEM). Right: Topographic plot of mean alpha amplitude change during neurofeedback relative to the first baseline. Colors indicate magnitude of reductions in amplitude (uV).

Fig. 2

Clusters showing increased functional connectivity after neurofeedback (P < 0.005, corrected) for the (a) salience network and the (b) default mode network.

Fig. 3

Top panel: Clusters exhibiting a significant relationship between changes in calmness (Thayer subscale) and salience network connectivity (P < 0.005, corrected). Middle and bottom panels: Clusters exhibiting a significant relationship between changes in calmness (Thayer subscale) and default mode network connectivity (P < 0.005, corrected).