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Limbic Activity Modulation Guided by Functional Magnetic Resonance Imaging–Inspired Electroencephalography Improves Implicit Emotion Regulation

  • Author Footnotes
    1 JNK and YM-H contributed equally to this work.
    Jackob N. Keynan
    Footnotes
    1 JNK and YM-H contributed equally to this work.
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel

    The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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  • Author Footnotes
    1 JNK and YM-H contributed equally to this work.
    Yehudit Meir-Hasson
    Footnotes
    1 JNK and YM-H contributed equally to this work.
    Affiliations
    Blavatnik School of Computer Science, Tel-Aviv University, Tel-Aviv, Israel
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  • Gadi Gilam
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel

    The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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  • Avihay Cohen
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel
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  • Gilan Jackont
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel

    The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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  • Sivan Kinreich
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel

    The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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  • Limor Ikar
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel
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  • Ayelet Or-Borichev
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel

    The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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  • Amit Etkin
    Affiliations
    Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford

    Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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  • Anett Gyurak
    Affiliations
    Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford

    Sierra-Pacific Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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  • Ilana Klovatch
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel
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  • Nathan Intrator
    Affiliations
    Blavatnik School of Computer Science, Tel-Aviv University, Tel-Aviv, Israel

    Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
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  • Talma Hendler
    Correspondence
    Address correspondence to: Talma Hendler, M.D., Ph.D., Tel Aviv Sourasky Medical Center, Functional Brain Center, Wohl Institute for Advanced Imaging, 6 Weizman St, Tel Aviv, Israel.
    Affiliations
    Functional Brain Center, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv University, Tel-Aviv, Israel

    The School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel

    Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel

    Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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  • Author Footnotes
    1 JNK and YM-H contributed equally to this work.

      Abstract

      The amygdala has a pivotal role in processing traumatic stress; hence, gaining control over its activity could facilitate adaptive mechanism and recovery. To date, amygdala volitional regulation could be obtained only via real-time functional magnetic resonance imaging (fMRI), a highly inaccessible procedure. The current article presents high-impact neurobehavioral implications of a novel imaging approach that enables bedside monitoring of amygdala activity using fMRI-inspired electroencephalography (EEG), hereafter termed amygdala-electrical fingerprint (amyg-EFP). Simultaneous EEG/fMRI indicated that the amyg-EFP reliably predicts amygdala-blood oxygen level–dependent activity. Implementing the amyg-EFP in neurofeedback demonstrated that learned downregulation of the amyg-EFP facilitated volitional downregulation of amygdala-blood oxygen level–dependent activity via real-time fMRI and manifested as reduced amygdala reactivity to visual stimuli. Behavioral evidence further emphasized the therapeutic potential of this approach by showing improved implicit emotion regulation following amyg-EFP neurofeedback. Additional EFP models denoting different brain regions could provide a library of localized activity for low-cost and highly accessible brain-based diagnosis and treatment.

      Keywords

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      Linked Article

      • Is Functional Magnetic Resonance Imaging-Inspired Electroencephalogram Feedback the Next New Treatment in Psychiatry?
        Biological PsychiatryVol. 80Issue 6
        • Preview
          Ever since Hans Berger recorded the first electroencephalogram (EEG) in 1924, scientists have struggled to understand which exact regions of the brain are causing the signal on the scalp. This inverse problem has proved quite difficult to crack, despite decades of research. Some researchers have used electrodes within the brain (electrocorticograms) simultaneously with surface electrodes to try to understand the source. Others have recorded functional magnetic resonance imaging (fMRI) blood oxygen level–dependent (BOLD) signals with concurrent surface EEG.
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