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Research Papers
Showing 6 of 7Medical education and distrust modulate the response of insular-cingulate network and ventral striatum in pain diagnosis
Healthcare providers often underestimate patients' pain, sometimes even when aware of their reports. This could be the effect of experience reducing sensitivity to others pain, or distrust toward patients' self-evaluations. Across multiple experiments (375 participants), we tested whether senior medical students differed from younger colleagues and lay controls in the way they assess people's pain and take into consideration their feedback. We found that medical training affected the sensitivity to pain faces, an effect shown by the lower ratings and highlighted by a decrease in neural response of the insula and cingulate cortex. Instead, distrust toward the expressions' authenticity affected the processing of feedbacks, by decreasing activity in the ventral striatum whenever patients' self-reports matched participants' evaluations, and by promoting strong reliance on the opinion of other doctors. Overall, our study underscores the multiple processes which might influence the evaluation of others' pain at the early stages of medical career.
View Full Paper →Subthalamic beta-targeted neurofeedback speeds up movement initiation but increases tremor in Parkinsonian patients
Previous studies have explored neurofeedback training for Parkinsonian patients to suppress beta oscillations in the subthalamic nucleus (STN). However, its impacts on movements and Parkinsonian tremor are unclear. We developed a neurofeedback paradigm targeting STN beta bursts and investigated whether neurofeedback training could improve motor initiation in Parkinson's disease compared to passive observation. Our task additionally allowed us to test which endogenous changes in oscillatory STN activities are associated with trial-to-trial motor performance. Neurofeedback training reduced beta synchrony and increased gamma activity within the STN, and reduced beta band coupling between the STN and motor cortex. These changes were accompanied by reduced reaction times in subsequently cued movements. However, in Parkinsonian patients with pre-existing symptoms of tremor, successful volitional beta suppression was associated with an amplification of tremor which correlated with theta band activity in STN local field potentials, suggesting an additional cross-frequency interaction between STN beta and theta activities.
View Full Paper →The efficacy of biofeedback approaches for obsessive-compulsive and related disorders: A systematic review and meta-analysis
Biofeedback is applied to target excessive and/or deficient physiological signals to help patients identifying and self-managing their symptoms. Biofeedback has been employed in psychiatric disorders, including obsessive-compulsive disorder (OCD), mainly by using neural signals - neurofeedback. Recently, OCD has been integrated into the obsessive-compulsive and related disorders (OCD&RD) category (body dysmorphic, hoarding, trichotillomania/hair-pulling, and excoriation/skin-picking disorders). The efficacy of biofeedback for OCD&RD is still unknown. Our work provides a complete overview of publications assessing the therapeutic efficacy of biofeedback in OCD&RD with a systematic review and meta-analysis. We found ten studies involving 102 OCD participants (three randomized controlled trials) mostly applying neurofeedback (one publication used thermal biofeedback). Five neurofeedback studies were selected for meta-analysis (89 patients; two randomized controlled trials). The overall effect size within the treatment group varied between medium to large, but high heterogeneity and inconsistency values were found. The methodological quality was low indicating a high risk of bias. In conclusion, a beneficial effect of neurofeedback for OCD patients was found but also critical limitations on methodology, high heterogeneity among studies, and a putative reporting bias. Future research following high-quality guidelines should be conducted to address the efficacy of biofeedback approaches for OCD&RD.
View Full Paper →Direct modulation of aberrant brain network connectivity through real-time NeuroFeedback
The existence of abnormal connectivity patterns between resting state networks in neuropsychiatric disorders, including Autism Spectrum Disorder (ASD), has been well established. Traditional treatment methods in ASD are limited, and do not address the aberrant network structure. Using real-time fMRI neurofeedback, we directly trained three brain nodes in participants with ASD, in which the aberrant connectivity has been shown to correlate with symptom severity. Desired network connectivity patterns were reinforced in real-time, without participants' awareness of the training taking place. This training regimen produced large, significant long-term changes in correlations at the network level, and whole brain analysis revealed that the greatest changes were focused on the areas being trained. These changes were not found in the control group. Moreover, changes in ASD resting state connectivity following the training were correlated to changes in behavior, suggesting that neurofeedback can be used to directly alter complex, clinically relevant network connectivity patterns.
View Full Paper →Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity
Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain-behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of these non-invasive neuromodulation strategies to study basic mechanisms underlying eating behavior and to treat its disorders. Both of these approaches will be compared in light of recent work in this field, while addressing technical and practical questions. The third part of this review will be dedicated to invasive neuromodulation strategies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). In combination with neuroimaging approaches, these techniques are promising experimental tools to unravel the intricate relationships between homeostatic and hedonic brain circuits. Their potential as additional therapeutic tools to combat pharmacorefractory morbid obesity or acute eating disorders will be discussed, in terms of technical challenges, applicability and ethics. In a general discussion, we will put the brain at the core of fundamental research, prevention and therapy in the context of obesity and eating disorders. First, we will discuss the possibility to identify new biological markers of brain functions. Second, we will highlight the potential of neuroimaging and neuromodulation in individualized medicine. Third, we will introduce the ethical questions that are concomitant to the emergence of new neuromodulation therapies.
View Full Paper →Rhythms of Healing: A Case Study
Imagine for a moment living with a brain that cannot remember a simple tune or even a few words to a song, a brain that does not recall that there is music to life.
View Full Paper →Ready to Optimize Your Brain?
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