Elsevier

Journal of Affective Disorders

Volume 283, 15 March 2021, Pages 229-235
Journal of Affective Disorders

Research article
Hippocampal volume recovery with real-time functional MRI amygdala neurofeedback emotional training for posttraumatic stress disorder

https://doi.org/10.1016/j.jad.2021.01.058Get rights and content
Under a Creative Commons license
open access

Highlights

  • The fMRI neurofeedback influences hippocampal volume in veterans with PTSD.

  • Left amygdala rtfMRI neurofeedback positive emotion training was applied.

  • Significant hippocampal volume increase was observed in the left CA1 head.

  • Control group showed a volume decrease with time in the same region.

  • Hippocampal atrophy in PTSD is modifiable with neurofeedback.

Abstract

Background

Small hippocampal volume is a prevalent neurostructural abnormality in posttraumatic stress disorder (PTSD). However, whether the hippocampal atrophy is the cause of disease symptoms or a pre-existing risk factor and whether it is a reversible alteration or a permanent trait are unclear. The trait- or state-dependent alteration could also differ among the hippocampal subfields.

Methods

The study examined the longitudinal hippocampal volume changes due to positive emotional training with left amygdala (LA) real-time fMRI neurofeedback (rtfMRI-nf) in combat veterans with PTSD. The participants were trained to increase the neurofeedback signal from LA (experimental group, N = 20) or brain region not involved in emotion processing (control group, N = 9) by recalling a positive autobiographical memory. The pre- and post-training structural MRI brain images were processed with FreeSurfer to evaluate the hippocampal subfield volumes. Hippocampal volumes for healthy controls (N = 43) were also examined to evaluate the baseline abnormality in PTSD.

Results

A significant group difference in volume change was found in the left CA1 head region. This region had the most significant volume reduction at the baseline in PTSD. The experimental group showed a significant volume increase, while the control group showed a significant volume decrease in this region. The volume change in the control group negatively correlated with interval days between the scans.

Limitations

A cognitive improvement due to the hippocampal volume increase could not be found with symptom scales.

Conclusions

RtfMRI-nf positive emotional training increased the hippocampus volume among people with PTSD, suggesting that hippocampal atrophy in PTSD is modifiable.

Keywords

Real-time fMRI neurofeedback
Amygdala
Hippocampus
CA1
PTSD
Positive emotional training

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