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Updated: Nov 23, 2025
Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
Published on: March 14, 2025
Rt-fMRI neurofeedback-guided cognitive reappraisal training modulates amygdala responsivity in posttraumatic stress
Jana Zweerings1, Pegah Sarkheil1, Micha Keller1
1Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Aachen, Germany; Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Jülich, Germany.
This study shows that real-time fMRI neurofeedback can help reduce PTSD symptoms by decreasing amygdala activity. The training also improved emotional regulation and strategy use in daily life for individuals with PTSD.
Area of Science:
- Neuroscience
- Psychiatry
- Medical Imaging
Background:
- Traumatic experiences disrupt emotion regulation circuits, leading to exaggerated amygdala responses and reduced prefrontal control.
- Individuals with posttraumatic stress disorder (PTSD) struggle to apply learned emotion regulation strategies in daily life.
- Real-time fMRI (rtfMRI) neurofeedback may enhance self-control and skill transfer for PTSD patients.
Purpose of the Study:
- To investigate the clinical potential of rtfMRI-guided neurofeedback for enhancing emotion regulation in PTSD.
- To assess neurofeedback-induced changes in brain activity, symptom severity, and daily life application of learned skills.
- To evaluate the efficacy, acceptance, and transferability of the neurofeedback training protocol.
Main Methods:
- A cross-over design study involving 20 individuals with PTSD and 21 healthy controls.
- Participants underwent cognitive reappraisal training with and without rtfMRI neurofeedback (NF) targeting the left lateral prefrontal cortex (lPFC).
- Success markers included changes in lPFC and amygdala activity, symptom severity, affect ratings, and perceived clinical utility at four-week follow-up.
Main Results:
- Neurofeedback led to decreased lPFC engagement and attenuated amygdala responses compared to reappraisal alone.
- Reduced amygdala activity correlated with symptom improvement and decreased negative affect at follow-up.
- The PTSD symptom reduction exceeded minimal clinically important differences, with 75% of PTSD participants applying strategies in daily life.
Conclusions:
- rtfMRI neurofeedback training shows potential benefits for PTSD treatment, indicated by reduced amygdala activity and improved emotional state.
- The training demonstrated good tolerability and potential for clinical application, with participants reporting perceived control and strategy use in daily life.
- Unexpectedly, reduced prefrontal involvement was observed, warranting further investigation.
