By guest blogger Eleanor Morgan

Interventions like cognitive behavioural therapy help people better control their emotions by teaching them new ways of thinking. A recent study published in NeuroImage suggests this approach could be augmented by using “neurofeedback” to help regulate activity in a key brain structure – the amygdala.

At a neural level, healthy regulation of our emotions involves the prefrontal cortex “down-regulating” activity in other brain areas, including the amygdala. This small, almond-shaped cluster of neurons, located on each side of the brain, is involved in memory processing, decision-making and emotional responses. Problems like PTSD, generalised anxiety and panic disorder are associated with heightened amygdala activation, raising the possibility that targeting this heightened activation could be beneficial.

Scientists from Germany, Switzerland and the USA joined forces to investigate whether down-regulation of the amygdala could be increased through providing participants with feedback on their amygdala activity while they tried to regulate their emotions in a fMRI (functional magnetic resonance imaging) brain scanner.

Uwe Herwig and his team placed 15 participants with good mental health in a “Feedback” group and 11 in a “Control” group. All participants underwent four weekly real-time (rt)fMRI emotional training sessions that involved looking at a sequence of negative emotional images (to provoke amygdala activation) and trying to regulate their emotional reaction using a “reality check” reappraisal strategy. Only participants in the feedback group received visual feedback on their amygdala activity while they looked at the pictures and attempted to regulate their emotions.

The reality-checking strategy involved using phrases such as “these are only pictures”, “I am participating in an experiment” and “I am lying in the scanner” (a form of cognitive reappraisal). Alongside this strategy, participants in the feedback group were also provided with visual feedback in the form of changing coloured squares that corresponded with their amygdala activation. In the control group, these colour squares changed randomly and the control participants were told they were meaningless.

When they performed the “reality check” emotional regulation technique in the fourth week, the feedback group showed significantly decreased amygdala activation as compared to the first week. In contrast, no such down-regulation of amygdala activity was observed in the control group even though they used the same “reality check” exercise.

The feedback group also exhibited increased task-related communication between the amygdala and other brain areas involved in emotional control. However, on the downside, the feedback group did not show greater down-regulation of their amygdala activity in a later, different task in which they were not given feedback and which involved them looking at videos of faces with negative expressions (the researchers speculated that this may have been due to the participants being fatigued and less motivated by this time).

In short, although the sample sizes were small, the study suggests that amygdala regulation can be trained by neurofeedback, apparently augmenting the neural effects of a popular emotional regulation technique (though note the behavioral and emotional benefits of this remain unclear at present – the feedback and control groups did not differ in the emotions they said they felt during the experiment, nor in how successful they believed they had been at regulating their emotions).

This study supports existing research showing promise for the application of rt-fMRI neurofeedback in the treatment of problems like PTSD, addiction and depression that are associated with heightened amygdala activation. The clinical potential of this technique, bridging the worlds of neurobiology and psychotherapy, is clear. That said, fMRI scanning is an expensive business, so it may be a while before a new world of personalised mental health interventions reveals itself.

—Training emotion regulation through real-time fMRI neurofeedback of amygdala activity

Post written by Eleanor Morgan (@eleanormorgan) for BPS Research Digest. Eleanor is a writer and trainee psychologist. Her work has been published in the Guardian, the Times, Independent, GQ, Harper’s Bazaar, Vogue, The New York Times, and others. Her first book, Anxiety for Beginners: A Personal Investigation was published by Bluebird (PanMacmillan). Her second book, Hormonal: A Journey into How Our Bodies Affect Our Minds and Why it’s Difficult to Talk About It, will be published by Virago in July 2019.