Real-Time fMRI Neurofeedback from the Superior Temporal Gyrus Modulates Self-Referential Processes in Schizophrenia

Francesca Morfini, MA

VA Boston Healthcare System and Northeastern University
Real-Time fMRI Neurofeedback from the Superior Temporal Gyrus Modulates Self-Referential Processes in Schizophrenia

Scientific Abstract

 

Background: Disturbances of self-referential processes may contribute to the symptomatology of schizophrenic patients (SZp). The medial prefrontal cortex (mPFC) and superior temporal gyrus (STG) are key areas of the self-reference network and show aberrant activation in SZp. In particular, Holt 2011 showed mPFC hypoactivity at self-referential tasks in SZp. We propose that modulating STG activity would impact the mPFC and will increase its activation at a self- reference task. We trained SZp to increase their STG activation by focusing on sentences spoken in their own voice and to decrease it by ignoring sentences spoken in a stranger’s voice. Real-time neurofeedback (NF) based on the STG activation was visually presented to SZp in the scanner while they tried to modulate the STG

Methods: SZp underwent a self-reference task before (pre-NF) and after (post-NF) neurofeedback directed at the STG. Similarly to Holt (2011), SZp listened to unique adjectives recorded with a stranger’s voice and judged if they referred to themselves (self) or had a positive valence (semantic). We performed fMRI task analysis (self > semantic and post-NF > pre-NF) masked with a mPFC-ROI defined a priori based on the results from Holt (2011). The NF was based on the activation extracted from the patient-specific STG identified with a localizer task where SZp passively listened to sentences recorded in one’s own vs. a stranger’s voice

Results: Fourteen SZp underwent NF and completed the self-reference tasks (78% male, 71% Caucasian, mean age 35). Activation analysis in the mPFC showed significant activation increase after NF (pre-NF < post-NF) in three regions: the frontal medial cortex, para/cingulate gyrus, and frontal pole. All results were cluster uncorrected with a voxel threshold of P<0.001

Conclusions: Our results suggest that real-time fMRI NF directed at modulating the STG leads to activation increase in the mPFC selective for self-reflection in SZ. These results support our hypothesis that modulating one brain region belonging to the self-referential network – the STG – brings about changes in other regions of the network such as the mPFC, even if not directly targeted with NF

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research Areas

Authors

Francesca Morfini, MA, Clemens C. Bauer, MD, PhD, Jiahe Zhang, PhD, Yoon Lee, BS, Jovicarole Raya, BS, Angelina I. Awad, Lena M. Stone, BS, Ann K. Shinn, MD, MPH, Susan Whitfield-Gabrieli, PhD, Margaret A. Niznikiewicz, PhD

Principal Investigator

Susan Whitfield-Gabrieli, PhD, Margaret A. Niznikiewicz, PhD