Evidence map›Paper›PMID 27647695›Full record

ArticleHuman brain mapping2017

The neurobiology of emotion regulation in posttraumatic stress disorder: Amygdala downregulation via real-time fMRI neurofeedback.

Andrew A Nicholson, Daniela Rabellino, Maria Densmore, Paul A Frewen, Christian Paret, Rosemarie Kluetsch, Christian Schmahl, Jean Théberge, Richard W J Neufeld, Margaret C McKinnon and 3 more

2 registry-linked trialsOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Human brain mapping, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 118 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
118citing papers in PubMed, 13 pooled it
32.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03964545 nacompletednot on this mapstarted 2018, after this paper: background citation

Proof-of-concept and Validity of Amygdala-neurofeedback in Adolescent Patients With Emotion Dysregulation

TypeinterventionalSponsorCentral Institute of Mental Health, MannheimRan2018 to 2021Enrolled28ConditionsEmotional DisturbancesArmsneurofeedback
NCT05456958 narecruitingnot on this mapstarted 2023, after this paper: background citation

Self-regulation of Post-traumatic Stress Disorder (PTSD) Neurocircuitry Using Multiple Sessions of Real-Time Functional Magnetic Resonance Imaging (RtfMRI)

TypeinterventionalSponsorAndrew NicholsonRan2023 to 2025Enrolled60ConditionsPost Traumatic Stress DisorderArmsMRI Biofeedback, Sham-MRI Biofeedback
3 · Its place in the literature

Who cites it

118 citing papers in PubMed, 13 syntheses or guidelines pooled it, 272 citations in OpenAlex.

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  14. Dose-related reductions in prefrontal recruitment during cognitive reappraisal following oral delta-9-tetrahydrocannabinol in posttraumatic stress disorder.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026
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  18. Rostral anterior cingulate network effective connectivity in depressed adolescents and associations with treatment response in a randomized controlled trial.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022
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58 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 8 institutions in 2 countries.

Andrew A NicholsonDepartment of Neuroscience, Western University, London, Ontario, Canada.
Daniela RabellinoDepartment of Psychiatry, Western University, London, Ontario, Canada.
Maria DensmoreDepartment of Imaging, Lawson Health Research Institute, London, Ontario, Canada.
Paul A FrewenDepartment of Neuroscience, Western University, London, Ontario, Canada.
Christian ParetDepartment of Neuroimaging, Central Institute of Mental Health Mannheim, Medical, Faculty Mannheim/Heidelberg University, Heidelberg, Germany.
Rosemarie KluetschDepartment of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany.
Christian SchmahlDepartment of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim/Heidelberg University, Heidelberg, Germany.
Jean ThébergeDepartment of Psychiatry, Western University, London, Ontario, Canada.
Richard W J NeufeldDepartment of Neuroscience, Western University, London, Ontario, Canada.
Margaret C McKinnonMood Disorders Program and Clinical Neuropsychology Service, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
Jim ReissDepartment of Psychiatry, Western University, London, Ontario, Canada.
Rakesh JetlyCanadian Forces, Health Services, Ottawa, Ontario, Canada.
Ruth A LaniusDepartment of Neuroscience, Western University, London, Ontario, Canada.
Western University · CALawson Health Research Institute · CACanadian Armed Forces · CACentral Institute of Mental Health · DEHeidelberg University · DEMcMaster University · CASt Joseph's Health Care · CAUniversity Hospital Heidelberg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Amygdala dysregulation has been shown to be central to the pathophysiology of posttraumatic stress disorder (PTSD) representing a critical treatment target. Here, amygdala downregulation was targeted using real-time fMRI neurofeedback (rt-fMRI-nf) in patients with PTSD, allowing us to examine further the regulation of emotional states during symptom provocation. Patients (n = 10) completed three sessions of rt-fMRI-nf with the instruction to downregulate activation in the amygdala, while viewing personalized trauma words. Amygdala downregulation was assessed by contrasting (a) regulate trials, with (b) viewing trauma words and not attempting to regulate. Training was followed by one transfer run not involving neurofeedback. Generalized psychophysiological interaction (gPPI) and dynamic causal modeling (DCM) analyses were also computed to explore task-based functional connectivity and causal structure, respectively. It was found that PTSD patients were able to successfully downregulate both right and left amygdala activation, showing sustained effects within the transfer run. Increased activation in the dorsolateral and ventrolateral prefrontal cortex (PFC), regions related to emotion regulation, was observed during regulate as compared with view conditions. Importantly, activation in the PFC, rostral anterior cingulate cortex, and the insula, were negatively correlated to PTSD dissociative symptoms in the transfer run. Increased functional connectivity between the amygdala- and both the dorsolateral and dorsomedial PFC was found during regulate, as compared with view conditions during neurofeedback training. Finally, our DCM analysis exploring directional structure suggested that amygdala downregulation involves both top-down and bottom-up information flow with regard to observed PFC-amygdala connectivity. This is the first demonstration of successful downregulation of the amygdala using rt-fMRI-nf in PTSD, which was critically sustained in a subsequent transfer run without neurofeedback, and corresponded to increased connectivity with prefrontal regions involved in emotion regulation during the intervention. Hum Brain Mapp 38:541-560, 2017. © 2016 Wiley Periodicals, Inc.

Indexed as

Magnetic Resonance ImagingAdultAmygdalaAnalysis of VarianceBrainEmotionsFeedback, SensoryFemaleHumansImage Processing, Computer-AssistedMaleMiddle AgedModels, NeurologicalOxygenStress Disorders, Post-TraumaticOxygenamygdalabrain connectivityemotionfMRI neurofeedbackposttraumatic stress disorder

Identifiers

PMID27647695
PMCPMC6866912
OpenAlexW2521839929

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.