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Neurofeedback in Clinical Practice
Published in Hanno W. Kirk, Restoring the Brain, 2020
Localization theory versus network theory: The most useful training sites developed empirically over the years upon observation of the clinical training effects, as well as on available knowledge of functional neuroanatomy, such as the functional differentiation of Brodman areas. However, we should not go back to the localization theory. Rather, we should keep in mind that billions of neurons are working together in complex networks. This interconnectedness of the brain on the structural level is vividly illustrated with images that can be seen online at www.humanconnectome.org. On a functional level, it is interesting that the key electrode montages that were empirically found in the development of ILF training target nodes in the Default Mode Network and the Salience Network.2 It has been proposed that a number of psychiatric disorders are characterized by significant deviations in the functional connectivity of these control networks, in interaction with the Central Executive Network.3,4 The list includes Autism, ADHD, and PTSD. Interestingly, these are conditions we are treating very well with ILF training.
Social dysfunction is transdiagnostically associated with default mode network dysconnectivity in schizophrenia and Alzheimer’s disease
Published in The World Journal of Biological Psychiatry, 2022
Ilja M. J. Saris, Moji Aghajani, Lianne M. Reus, Pieter-Jelle Visser, Yolande Pijnenburg, Nic J. A. van der Wee, Amy C. Bilderbeck, Andreea Raslescu, Asad Malik, Maarten Mennes, Sanne Koops, Celso Arrango, Jose Luis Ayuso-Mateos, Gerard R. Dawson, Hugh Marston, Martien J. Kas, Brenda W. J. H. Penninx
Post hoc analyses assessed whether brain-social behaviour relationships documented here are specific to the DMN. We therefore reran our dimensional brain-social dysfunction analyses, though now focussing on two other canonical brain networks often implicated in neuropsychiatric disorders: The Salience Network (SN; serves saliency mapping) and the Central Executive Network (CEN; governs executive functions & behavioural control). The influential triple network model of psychopathology posits that functional disorganisation within the DMN and these two networks collectively spur susceptibility for maladaptive social behaviour and mental disorders, including SZ and AD (Menon 2011). The SN and CEN were part of our 20 network MELODIC-ICA solution (see Methods), which automatically split up the CEN into a right- and left-lateralized network assembly. GLM modelling and analytical sequence proceeded exactly as described for the DMN-social dysfunction analyses, though statistical inferences were additionally Bonferroni corrected for N networks to control for multiple testing (TFCE & FWE; P 0.05/3=0.017). No significant link between social dysfunction and SN or CEN connectivity emerged though (P’s>0.05), indicating that the brain-behaviour relationships reported here are specific to DMN.
Altered dynamic parahippocampus functional connectivity in patients with post-traumatic stress disorder
Published in The World Journal of Biological Psychiatry, 2021
Hui Juan Chen, Rongfeng Qi, Jun Ke, Jie Qiu, Qiang Xu, Zhiqiang Zhang, Yuan Zhong, Guang Ming Lu, Feng Chen
The recent development of neuroimaging techniques has offered a new avenue of research for depicting the early brain changes underlying PTSD. Structural MRI studies have revealed that grey matter volume and cortical thickness reduction may be found in the hippocampus, the parahippocampal gyrus, and the medial prefrontal cortex (mPFC) (Li et al. 2014; O'Doherty et al. 2015, 2017). Without the need for complex procedures or exposure to radiation, resting state functional MRI (rs-fMRI) has become an effective tool for further studying abnormalities in brain activity in participants with brain disorders. Aberrant functional alterations have been identified in brain regions, including the ventral anterior cingulate cortex and the parahippocampus/amygdala, insula, cerebellum and middle frontal gyrus in PTSD patients (Koch et al. 2016). A battery of studies have proven that the triple network model including the central executive network (CEN), salience network, and default mode network provides a reliable framework to detect altered cognitive and affective functions in a wide range of psychiatric and neurological conditions (Patel et al. 2012), including PTSD. Hub regions are nodes occupying a central position in the overall organisation of a network. They are important for the information flow in brain networks, a fact is that is reflected in the positive correlation between general intelligence and the level of hub centrality (van den Heuvel et al. 2009; Stam 2014). Since multiple regions are involved in PTSD development, exploring how hubs are affected in PTSD patients might be helpful in elucidating its pathology.
rTMS for the treatment of Alzheimer’s disease: where should we be stimulating?
Published in Expert Review of Neurotherapeutics, 2018
Alesha Heath, JL Taylor, M. Windy McNerney
Studies which targeted the DLPFC, a key node of the central-executive network, with rTMS have shown improvements in cognitive scores using both short- and long-term stimulation paradigms [7–11]. In patients with AD, disrupted DLPFC plasticity is linked to worsened working memory and language comprehension [12], so targeting the DLPFC could alleviate these deficits. Interestingly, rTMS targeting the DLPFC is also an FDA-approved treatment for patients suffering from Major Depressive Disorder. Depression has a high comorbidity with AD and impaired cognition is closely linked to depressive symptoms [13,14]. In an AD study where patients had depressive symptoms, stimulating the DLPFC improved cognitive performance whilst also reducing depression [11]. Currently, there exists a discrepancy between studies, with some excluding patients with depressive symptoms [7–10] and others not disclosing whether neuropsychological testing was considered [15,16]. This makes it difficult to dissect the effects of rTMS on improving cognition, as decreasing depressive symptoms could be contributing to the improvements [14].