Taming the voices-real time neuro-feedback in schizophrenia

Neurocognitive models and previous neuroimaging work posit that auditory verbal hallucinations (AVH) arise due to increased activity in speech-sensitive regions of the left posterior superior temporal gyrus (STG). This novel approach discussed here examined if patients with schizophrenia (SCZ) and AVH could be trained to down-regulate STG activity using real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF).

Here are two prior findings that implicate the STG in AVH.

Orlov et al. Translational Psychiatry (2018) 8:46

We showed in this pioneering study that patients with SCZ and AVH could learn to down-regulate activity in speech-sensitive regions of their left STG with an average of 14 runs of 9 min NF training. Left STG downregulation was seen between scanner visits suggesting that this effect could not easily be attributed to within visit STG habituation over rtfMRI-training runs. Furthermore, rtfMRI-NF training resulted in increased functional connectivity between frontal and temporal language regions that was associated with changes in AVH symptom severity. During the transfer scan, patients were able to reduce activity without visually presented feedback, suggesting that they had learned strategies to reduce activity in the voice-sensitive region of the left STG.

This works connects with the concept of the predictive (Bayesian) brain.

To learn more watch our video "Taming the Voices"