Evidence map›Paper›PMID 36669352›Full record

Trial reportNeuroImage. Clinical2023

Increased top-down control of emotions during symptom provocation working memory tasks following a RCT of alpha-down neurofeedback in PTSD.

Saurabh Bhaskar Shaw, Andrew A Nicholson, Tomas Ros, Sherain Harricharan, Braeden Terpou, Maria Densmore, Jean Theberge, Paul Frewen, Ruth A Lanius

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in NeuroImage. Clinical, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 3 pooled it
5.8field-weighted citation impact, top 3% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.

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  12. Journal of military, veteran and family health · 2024
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  13. Reflecting onJournal of military, veteran and family health · 2024
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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

9 authors at 7 institutions in 2 countries.

Saurabh Bhaskar ShawDepartment of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Vector Institute, Toronto, Ontario, Canada; Homewood Research Institute (HRI), Guelph, Ontario, Canada. Electronic address: sshaw62@uwo.ca.
Andrew A NicholsonSchool of Psychology, University of Ottawa, Canada; Atlas Institute for Veterans and Families, Royal Ottawa Hospital, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada.
Tomas RosDepartments of Neuroscience and Psychiatry, University of Geneva, Geneva, Switzerland.
Sherain HarricharanHomewood Research Institute (HRI), Guelph, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada.
Braeden TerpouHomewood Research Institute (HRI), Guelph, Ontario, Canada; Department of Psychiatry and Behavioral Neuroscience, McMaster University, Hamilton, Ontario, Canada.
Maria DensmoreDepartment of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
Jean ThebergeDepartment of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Medical Biophysics, Western University, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, Ontario, Canada.
Paul FrewenDepartment of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Ruth A LaniusDepartment of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Homewood Research Institute (HRI), Guelph, Ontario, Canada; St. Joseph's Healthcare, Hamilton, Ontario, Canada. Electronic address: Ruth.Lanius@lhsc.on.ca.
Western University · CAHomewood Research Institute · CAMcMaster University · CASt Joseph's Health Care · CASt. Joseph’s Healthcare Hamilton · CAUniversity of Geneva · CHVector Institute · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPosttraumatic stress disorder (PTSD) has been found to be associated with emotion under-modulation from the prefrontal cortex and a breakdown of the top-down control of cognition and emotion. Novel adjunct therapies such as neurofeedback (NFB) have been shown to normalize aberrant neural circuits that underlie PTSD psychopathology at rest. However, little evidence exists for NFB-linked neural improvements under emotionally relevant cognitive load. The current study sought to address this gap by examining the effects of alpha-down NFB in the context of an emotional n-back task.

methodsWe conducted a 20-week double-blind randomized, sham-controlled trial of alpha-down NFB and collected neuroimaging data before and after the NFB protocol. Participants performed an emotional 1-back and 2-back working memory task, with interleaved trauma-neutral and trauma-relevant cues in the fMRI scanner. Data from 35 participants with a primary diagnosis of PTSD were analyzed in this study (n = 18 in the experimental group undergoing alpha-down NFB, n = 17 in the sham-control group).

resultsFirstly, within-group analyses showed clinically significant reductions in PTSD symptom severity scores at the post-intervention timepoint and 3-month follow-up for the experimental group, and not for the sham-control group. The neuroimaging analyses revealed that alpha-down NFB enhanced engagement of top-down cognitive and emotional control centers, such as the dorsolateral prefrontal cortex (dlPFC), and improved integration of the anterior and posterior parts of the default mode network (DMN). Finally, our results also indicate that increased alpha-down NFB performance correlated with increased activity in brain regions involved in top-down control and bodily consciousness/embodied processing of self (TPJ and posterior insula).

conclusionThis is the first study to provide mechanistic insights into how NFB may normalize dysfunctional brain activity and connectivity in PTSD under cognitive load with simultaneous symptom provocation, adding to a growing body of evidence supporting the therapeutic neuromodulatory effects of NFB. This preliminary study highlights the benefits of alpha-down NFB training as an adjunctive therapy for PTSD and warrants further investigation into its therapeutic effects on cognitive and emotion control in those with PTSD.

Indexed as

NeurofeedbackStress Disorders, Post-TraumaticBrainEmotionsHumansMagnetic Resonance ImagingMemory, Short-TermCognitionDLPFCEmotion regulationFunctional magnetic resonance imaging (fMRI)Neurofeedback (NFB)Post-traumatic stress disorder (PTSD)Top-down control

Identifiers

PMID36669352
PMCPMC9868881
OpenAlexW4313529532

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.