Posttraumatic stress disorder (PTSD) is widely associated with deficits in implicit emotion regulation. Recently, adaptive fMRI neurofeedback (A-NF) has been developed as a methodology that offers a unique probe of brain networks that mediate implicit emotion regulation and their impairment in PTSD. We designed an A-NF paradigm in which difficulty of an emotional conflict task (i.e., embedding trauma distractors onto a neutral target stimulus) was controlled by a whole-brain classifier trained to differentiate attention to the trauma distractor vs. target. We exploited this methodology to test whether PTSD was associated with: (1) an altered brain state that differentiates attention towards vs. away from trauma cues; and (2) an altered ability to use concurrent feedback about brain states during an implicit emotion regulation task. Adult women with a current diagnosis of PTSD (n = 10) and healthy control (n = 9) women participated in this task during 3T fMRI. During two initial non-feedback runs used to train a whole-brain classifier, we observed: (1) poorer attention performance in PTSD; and (2) a linear relationship between brain state discrimination and attention performance, which was significantly attenuated among the PTSD group when the task contained trauma cues. During the A-NF phase, the PTSD group demonstrated poorer ability to regulate brain states as per attention instructions, and this poorer ability was related to PTSD symptom severity. Further, PTSD was associated with the heightened encoding of feedback in the insula and hippocampus. These results suggest a novel understanding of whole-brain states and their regulation that underlie emotion regulation deficits in PTSD.

中文翻译：

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对 PTSD 女性内隐情绪调节神经机制的适应性神经反馈试点研究

创伤后应激障碍（PTSD）与内隐情绪调节缺陷广泛相关。最近，自适应 fMRI 神经反馈 (A-NF) 已被开发为一种方法，它提供了一种独特的大脑网络探测方法，可调节内隐情绪调节及其在 PTSD 中的损伤。我们设计了一个 A-NF 范式，其中情绪冲突任务（即，将创伤干扰因素嵌入中性目标刺激上）的难度由经过训练的全脑分类器控制，以区分对创伤干扰因素与目标的注意力。我们利用这种方法来测试 PTSD 是否与：(1) 一种改变的大脑状态，将注意力与创伤线索区分开来；(2) 在隐性情绪调节任务中使用关于大脑状态的并发反馈的能力改变。目前诊断为 PTSD 的成年女性 (n = 10) 和健康对照 (n = 9) 女性在 3T fMRI 期间参与了这项任务。在用于训练全脑分类器的两次初始非反馈运行中，我们观察到：（1）PTSD 中的注意力表现较差；(2) 大脑状态辨别力和注意力表现之间的线性关系，当任务包含创伤线索时，这种关系在 PTSD 组中显着减弱。在 A-NF 阶段，PTSD 组根据注意力指令调节大脑状态的能力较差，这种较差的能力与 PTSD 症状的严重程度有关。此外，创伤后应激障碍与脑岛和海马中反馈的增强编码有关。