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fMRI Neurofeedback for Obsessive Compulsive Disorder

Publication date: 10 May 2013

A recently published study used fMRI (a form of brain imaging) as the basis for neurofeedback training in neuropsychiatric patients. The aim was to teach subjects to control activity in the orbitofrontal cortex (OFC) - a brain region known to be dysregulated in OCD (Obsessive Compulsive Disorder) sufferers - in the hope of controlling contamination anxiety. The neurofeedback trainees indeed learned to reduce their anxiety, while control group subjects (who received sham feedback) did not. The researchers recorded corresponding changes in brain connectivity in only the experimental subjects - changes still present several days after neurofeedback training. I think this combination of changes in anxiety and brain connectivity adds up to impressive evidence for the efficacy of neurofeedback.

FMRI based neurofeedback is a powerful form of neurofeedback, albeit rather expensive, because it can target specific regions of the brain, anywhere in the brain. Cheaper forms of neurofeedback such as EEG and HEG generally measure activity only in the outer part of the brain (the cortex).

Hyperactivity in the OFC is known to correlated with contamination anxiety in OCD patients. fMRI neurofeedback is thus a potential therapy for this group - for whom existing therapy options in mainstream medicine are limited. The researchers claim this is the first time fMRI neurofeedback has been used to successfully treat anxiety.

It's no surprise that neurofeedback affects brain connectivity. Some modern EEG neurofeedback methods are based on connectivity measures and specifically target connectivity changes. But it's likely that even much simpler forms of neurofeedback affect connectivity without directly training (or measuring) it. The highly interconnected nature of the brain means that there are probably lots of changes happening as a result of neurofeedback training. This impressive study of HEG neurofeedback for Traumatic Brain Injury (TBI) is an example.

However, researcher Jeffrey Schwartz measured changes in brain structure in OCD patients, as a consequence of a much simpler method - mindfulness. (He describes this work in his book 'The Mind and the Brain'.) What hope for combining mindfulness and neurofeedback?

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