Amygdala EFP Neurofeedback Effects on PTSD Symptom Clusters and Emotional Regulation Processes
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
4.1. Robustness and Long-Term Effects of Treatment
4.2. Cross-Cluster Symptom Improvement
4.3. Neural Circuit Mechanisms
4.4. Emotion Regulation Mechanisms
4.5. Clinical Implications and Future Directions
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
Amyg-EFP-NF | Amygdala-derived-EEG-fMRI-Pattern |
PTSD | Post-Traumatic Stress Disorder |
ERQ | Emotional Regulation Questionnaire |
fMRI-NF | Functional Magnetic Resonance Imaging-based NF |
CR | Cognitive Reappraisal |
ES | Expressive Suppression |
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Characteristic | Study 1 (N = 25) | Study 2 (N = 37) | Study 3 (N = 66) |
---|---|---|---|
Demographics | |||
Age, mean ± SD, years | 39.2 ± 12.3 | 36.8 ± 9.4 | 39.0 ± 10.6 |
Female, n (%) | 12 (48.0%) | 37 (100%) | 35 (53.0%) |
Education years, mean ± SD | 14.1 ± 2.5 | 14.5 ± 4.4 | 14.3 ± 2.8 |
Marital Status | |||
Married, n (%) | 12 (48.0%) | 9 (24.3%) | 32 (48.5%) |
Single/Divorced/Separated, n (%) | 13 (52.0%) | 28 (75.7%) | 34 (51.5%) |
Trauma Type | |||
Combat/Military, n (%) | 9 (36.0%) | 0 (0%) | 31 (47.0%) |
Childhood sexual abuse, n (%) | 4 (16.0%) | 37 (100%) | 12 (18.2%) |
Interpersonal violence, n (%) | 6 (24.0%) | 0 (0%) | 10 (15.1%) |
Accidents/Other, n (%) | 6 (24.0%) | 0 (0%) | 13 (19.7%) |
Clinical Characteristics | |||
CAPS-5 total score, mean ± SD | 35.4 ± 7.8 | 40.2 ± 8.1 | 42.5 ± 11.4 |
Time from trauma, mean ± SD, years | 7.3 ± 5.2 | 13.5 ± 8.7 | 10.0 ± 5.7 |
Medication use, n (%) | 17 (68.0%) | 30 (81.1%) | 48 (72.7%) |
Concurrent psychotherapy, n (%) | 9 (36.0%) | 37 (100%) | 30 (45.5%) |
Prior trauma-focused therapy completed, n (%) | 8 (32.0%) | 13 (35.1%) | 23 (34.8%) |
Cluster | Timepoint | Mean [SD] | ||
---|---|---|---|---|
Study 1 (N = 25) | Study 2 (N = 37) | Study 3 (N = 66/63) | ||
Intrusion (B) | Baseline | 8.60 [3.61] | 9.43 [3.90] | 10.24 [3.54] |
Immediate-Post | 6.48 [3.92] | 7.05 [3.76] | 7.21 [3.49] | |
3 M Follow-up | 6.71 [3.79] | |||
Avoidance (C) | Baseline | 4.28 [1.46] | 4.73 [1.88] | 4.59 [1.93] |
Immediate-Post | 3.00 [1.61] | 3.65 [2.24] | 3.52 [2.03] | |
3 M Follow-up | 3.13 [2.21] | |||
Cognition and Mood (D) | Baseline | 11.88 [4.37] | 15.38 [4.88] | 15.71 [4.90] |
Immediate-Post | 8.16 [4.84] | 13.38 [5.88] | 10.67 [6.15] | |
3 M Follow-up | 11.06 [5.55] | |||
Arousal and reactivity (E) | Baseline | 10.68 [3.48] | 10.70 [3.88] | 11.92 [3.92] |
Immediate-Post | 8.32 [4.07] | 9.00 [4.25] | 9.26 [4.57] | |
3 M Follow-up | 8.10 [4.65] |
Timepoint | Mean [SD] | ||
---|---|---|---|
CAPS-5 Total | ERQ Cognitive Reappraisal | ERQ Expressive Suppression | |
Baseline | 42.52 [11.46] | 24.89 [8.34] | 15.38 [6.03] |
Immediate Post | 30.49 [13.47] | 25.71 [6.79] | 14.62 [6.31] |
3 M Follow-up | 29.00 [13.61] | 27.02 [6.78] | 14.68 [5.98] |
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Goldental, N.; Gross, R.; Amital, D.; Harel, E.V.; Hendler, T.; Tendler, A.; Levi, L.; Lavro, D.; Harmelech, T.; Grinapol, S.; et al. Amygdala EFP Neurofeedback Effects on PTSD Symptom Clusters and Emotional Regulation Processes. J. Clin. Med. 2025, 14, 2421. https://doi.org/10.3390/jcm14072421
Goldental N, Gross R, Amital D, Harel EV, Hendler T, Tendler A, Levi L, Lavro D, Harmelech T, Grinapol S, et al. Amygdala EFP Neurofeedback Effects on PTSD Symptom Clusters and Emotional Regulation Processes. Journal of Clinical Medicine. 2025; 14(7):2421. https://doi.org/10.3390/jcm14072421
Chicago/Turabian StyleGoldental, Nadav, Raz Gross, Daniela Amital, Eiran V. Harel, Talma Hendler, Aron Tendler, Liora Levi, Dmitri Lavro, Tal Harmelech, Shulamit Grinapol, and et al. 2025. "Amygdala EFP Neurofeedback Effects on PTSD Symptom Clusters and Emotional Regulation Processes" Journal of Clinical Medicine 14, no. 7: 2421. https://doi.org/10.3390/jcm14072421
APA StyleGoldental, N., Gross, R., Amital, D., Harel, E. V., Hendler, T., Tendler, A., Levi, L., Lavro, D., Harmelech, T., Grinapol, S., Nacasch, N., & Fruchter, E. (2025). Amygdala EFP Neurofeedback Effects on PTSD Symptom Clusters and Emotional Regulation Processes. Journal of Clinical Medicine, 14(7), 2421. https://doi.org/10.3390/jcm14072421