RESUMO
BACKGROUND: Individuals with schizophrenia (SZ) and auditory hallucinations (AHs) display a distorted sense of self and self-other boundaries. Alterations of activity in midline cortical structures such as the prefrontal cortex (mPFC) and anterior cingulate cortex (ACC) during self-reference as well as in the superior temporal gyrus (STG) have been proposed as neuromarkers of SZ and AHs. METHODS: In this randomized, participant-blinded, sham-controlled trial, 22 adults (18 males) with SZ spectrum disorders (SZ or schizoaffective disorder) and frequent medication-resistant AHs received one session of real-time fMRI neurofeedback (NFB) either from the STG (n = 11; experimental group) or motor cortex (n = 11; control group). During NFB, participants were instructed to upregulate their STG activity by attending to pre-recorded sentences spoken in their own voice and downregulate it by ignoring unfamiliar voices. Before and after NFB, participants completed a self-reference task where they evaluated if trait adjectives referred to themselves (self condition), Abraham Lincoln (other condition), or whether adjectives had a positive valence (semantic condition). FMRI activation analyses of self-reference task data tested between-group changes after NFB (self>semantic, post>pre-NFB, experimental>control). Analyses were pre-masked within a self-reference network. RESULTS: Activation analyses revealed significantly (p < 0.001) greater activation increase in the experimental, compared to the control group, after NFB within anterior regions of the self-reference network (mPFC, ACC, superior frontal cortex). CONCLUSIONS: STG-NFB was associated with activity increase in the mPFC, ACC, and superior frontal cortex during self-reference. Modulating the STG is associated with activation changes in other, not-directly targeted, regions subserving higher-level cognitive processes associated with self-referential processes and AHs psychopathology in SZ. CLINICALTRIALS: GOV: Rt-fMRI Neurofeedback and AH in Schizophrenia; https://clinicaltrials.gov/study/NCT03504579.
Assuntos
Alucinações , Imageamento por Ressonância Magnética , Neurorretroalimentação , Esquizofrenia , Lobo Temporal , Humanos , Esquizofrenia/diagnóstico por imagem , Esquizofrenia/fisiopatologia , Esquizofrenia/terapia , Masculino , Feminino , Adulto , Projetos Piloto , Neurorretroalimentação/métodos , Alucinações/fisiopatologia , Alucinações/diagnóstico por imagem , Alucinações/terapia , Alucinações/etiologia , Lobo Temporal/fisiopatologia , Lobo Temporal/diagnóstico por imagem , Método Simples-Cego , Transtornos Psicóticos/fisiopatologia , Transtornos Psicóticos/diagnóstico por imagem , Transtornos Psicóticos/terapia , Pessoa de Meia-Idade , Autoimagem , Adulto JovemRESUMO
BACKGROUND: A single bout of aerobic exercise can provide acute benefits to cognition and emotion in children. Yet, little is known about how acute exercise may impact children's underlying brain networks' resting-state functional connectivity (rsFC). OBJECTIVE: Using a data-driven multivariate pattern analysis, we investigated the effects of a single dose of exercise on acute rsFC changes in 9-to-13-year-olds. METHODS: On separate days in a crossover design, participants (Nâ=â21) completed 20-mins of acute treadmill walking at 65-75% heart rate maximum (exercise condition) and seated reading (control condition), with pre- and post-fMRI scans. Multivariate pattern analysis was used to investigate rsFC change between conditions. RESULTS: Three clusters in the left lateral prefrontal cortex (lPFC) of the frontoparietal network (FPN) had significantly different rsFC after the exercise condition compared to the control condition. Post-hoc analyses revealed that from before to after acute exercise, activity of these FPN clusters became more correlated with bilateral lPFC and the left basal ganglia. Additionally, the left lPFC became more anti-correlated with the precuneus of the default mode network (DMN). An opposite pattern was observed from before to after seated reading. CONCLUSIONS: The findings suggest that a single dose of exercise increases connectivity within the FPN, FPN integration with subcortical regions involved in movement and cognition, and segregation of FPN and DMN. Such patterns, often associated with healthier cognitive and emotional control, may underlie the transient mental benefits observed following acute exercise in youth.