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Neurofeedback mithilfe funktioneller Magnetresonanztomographie in Echtzeit

Anwendungspotenzial zur Emotionsregulation bei Patienten mit psychischen Erkrankungen

Neurofeedback using functional magnetic resonance imaging in real time

Potential applications for emotion regulation in patients with mental diseases

  • Schwerpunkt: Neurowissenschaftlich fundierte Psychotherapie – Übersichten
  • Published:
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Zusammenfassung

Ziel des Neurofeedbacks (NFB) ist es, die Aktivität im Gehirn willentlich im Sinne einer Selbstregulation zu beeinflussen. Neurofeedback mithilfe von funktioneller Magnetresonanztomographie in Echtzeit (rtfMRT, „real-time functional magnetic resonance imaging“) stellt einen innovativen Ansatz dar, mit dem Veränderungen in fokalen Kortexarealen und subkortikalen Bereichen des Gehirns erzielt werden können. Die Modulierung der Aktivität in Hirnregionen, die mit der Verarbeitung von Emotionen in Zusammenhang gebracht werden, kann die Basis für unterschiedliche klinische Anwendungen der Methode sein. Hier zeigen sich vielversprechende neurobiologische Veränderungen im Hinblick auf die Modulation sowohl der neuronalen Aktivität als auch der funktionellen Konnektivität zwischen verschiedenen Bereichen im Gehirn. Daneben liefern verschiedene Studien Hinweise für einen positiven Effekt auf die klinische Symptomatik, u. a. bei Patienten mit Depressionen, einer posttraumatischen Belastungsstörung oder einer Abhängigkeitserkrankung. Insbesondere vor dem Hintergrund der Diskussion über patientenorientierte, individualisierte Therapien könnte rtfMRT-NFB einen vielversprechenden Ansatz darstellen, weil die individuelle Anpassung des therapeutischen Vorgehens möglich ist.

Abstract

The aim of neurofeedback (NFB) is to deliberately influence brain activity in the sense of self-regulation. The NFB with real-time functional magnetic resonance imaging (rtfMRI) provides an innovative method offering the opportunity to achieve changes in focal cortical areas and subcortical regions of the brain. Clinical applications target the modulation of activity, e.g. in brain regions associated with the processing of emotions. Promising results on neurobiological parameters underlying the modulation of neuronal activity as well as functional connectivity between different brain regions were observed. In addition, various studies have provided evidence for a positive effect on clinical symptoms, e.g. in patients with depression, posttraumatic stress disorder (PTSD) and addictive diseases. In light of the importance of personalized therapeutic regimens, NFB with rtfMRI may represent a promising approach for an individualized therapeutic strategy.

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Danksagung

Wir danken M. Hartmann für die Unterstützung bei der Erstellung des Manuskripts.

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Authors and Affiliations

  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum, LMU München, Nußbaumstr. 7, 80336, München, Deutschland

    Susanne Karch, Hannah Jeanty, Arne Reckenfelderbäumer, Sarah Gschwendtner, Max Maywald, Boris-Stephan Rauchmann, Andrea Rabenstein, Agnieszka Chrobok, Marcus Gertzen, Oliver Pogarell, Tobias Rüther & Daniel Keeser

  2. Klinik und Poliklinik für Radiologie, Universitätsklinikum, LMU München, München, Deutschland

    Marco Paolini, Boris-Stephan Rauchmann, Birgit Ertl-Wagner & Daniel Keeser

  3. Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Kanada

    Birgit Ertl-Wagner

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  1. Susanne Karch
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  2. Marco Paolini
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  14. Daniel Keeser
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Corresponding author

Correspondence to Susanne Karch.

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Interessenkonflikt

S. Karch, M. Paolini, H. Jeanty, A. Reckenfelderbäumer, S. Gschwendtner, M. Maywald, B.-S. Rauchmann, A. Rabenstein, A. Chrobok, M. Gertzen, B. Ertl-Wagner, O. Pogarell, T. Rüther und D. Keeser geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen oder an menschlichem Gewebe wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Redaktion

Anja Hilbert, Leipzig

Ann-Christine Ehlis, Tübingen

Die vorgestellten klinischen Daten wurden im Rahmen der Promotionen von S. Gschwendtner, A. Reckenfelderbäumer und H. Jeanty erhoben.

Die Autoren S. Karch, M. Paolini, T. Rüther und D. Keeser trugen gleichermaßen zur vorliegenden Publikation bei.

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Karch, S., Paolini, M., Jeanty, H. et al. Neurofeedback mithilfe funktioneller Magnetresonanztomographie in Echtzeit. Psychotherapeut 64, 212–219 (2019). https://doi.org/10.1007/s00278-019-0352-2

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  • DOI: https://doi.org/10.1007/s00278-019-0352-2

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