Real-time Functional MRI and Neurofeedback of Brain Networks Mediating Trauma Memory Recall in PTSD

Post-traumatic stress disorder (PTSD) is characterized by intense emotional distress upon
exposure to trauma reminders and avoidance of people and places that can trigger the trauma
memory. Neurocircuitry models of PTSD that seek to explain symptoms of heightened emotional
reactivity, hypervigilance for threat, and avoidance suggest abnormal activity of neural
regions involved in emotional reactivity (e.g., amygdala) and cognitive control of emotional
responding (e.g., ventral medial prefrontal cortex, anterior cingulate cortex). While
knowledge exists about neurobiological abnormalities associated with PTSD, these data are
cross-sectional in nature and ignore individual differences in both neural encoding and
subjective aspects of the trauma itself (e.g., whether it elicits fear vs guilt vs disgust).
Additionally, the manner by which existing psychological treatments alter these neural
mechanisms mediating core PTSD symptoms is unknown. This is problematic, given that
state-of-the-art treatment for PTSD is only effective ~60% of the time.

Here, the investigator proposes to utilize a novel computational modeling approach combined
with state-of-the-art functional magnetic resonance imaging (fMRI)-based neurofeedback to
directly identify and modulate the idiosyncratic neural network encoding the trauma memory.
Successful pursuit of these aims would 1) provide scientific support for the hypothesis that
a distributed network including the amygdala, hippocampus, medial prefrontal cortex (PFC),
lateral PFC, and anterior insula mediates emotional responding upon trauma memory recall, and
2) provide proof-of-concept evidence that neurofeedback modulation of this network can boost
existing therapy efficacy.

Inclusion Criteria:

- Female

- Aged 21-50

- Medically healthy

Exclusion Criteria:

- Claustrophobia, or the inability to lie still in a confined space

- Major medical disorders (e.g., HIV, cancer)

- Magnetic metallic implants (such as screws, pins, shrapnel remnants, aneurysm clips,
artificial heart valves, inner ear (cochlear) implants, artificial joints, and
vascular stents)

- Electronic or magnetic implants, such as pacemakers

- Permanent makeup or tattoos with metallic dyes

- Currently pregnant

- A self-reported history of loss of consciousness (greater than 10 minutes)

- Physical disabilities that prohibit task performance (such as blindness or deafness)

- Psychotic disorders (e.g., schizophrenia)

- Any other condition that the investigator believes might put the participant at risk