Study reveals potential role for fMRI-brain computer interface techniques in schizophrenia

By Kate Kahn A small study found that schizophrenic patients may be able to learn voluntary control over the insular cortex using a functional magnetic resonance imaging-based brain-computer interface (fMRI-BCI), and this technique could have a therapeutic application in this disorder. Brain-computer interfaces (BCI) measure brain activity online and are being investigated for use in different applications such as neurofeedback and control based on brain activity. Although most BCIs...

By Kate Kahn

A small study found that schizophrenic patients may be able to learn voluntary control over the insular cortex using a functional magnetic resonance imaging-based brain-computer interface (fMRI-BCI), and this technique could have a therapeutic application in this disorder.

Brain-computer interfaces (BCI) measure brain activity online and are being investigated for use in different applications such as neurofeedback and control based on brain activity. Although most BCIs used in humans have involved the use of electroencephalography and invasive techniques, fMRI-BCI is noninvasive and allows for higher spatial and temporal resolutions (Weiskopf et al, 2007).

Lead investigator Dr. Sergio Ruiz and colleagues from the Institute of Medical Psychology and Behavioral Neurobiology at the University of Tubingen in Germany, selected 4 stable patients with a DSM-IV schizophrenia diagnosis. Patients learned BCI by undergoing 10-14 feedback sessions that taught them how to control the Blood Oxygen Level Dependent (BOLD) signal from the left and right anterior insula. Subjects learned to increase activity of the anterior insula using visual feedback of the BOLD signal from the insula. All schizophrenic subjects were successful in learning how to regulate the BOLD magnitude in the right anterior insula. When compared with early sessions, later sessions showed improvement in the subjects' ability to regulate BOLD (P<.05).

Investigators also observed modulations in functional connectivity, which is typically decreased in schizophrenia. While early sessions showed that the inferior frontal gyrus was the major causal source in subjects, in later sessions investigators observed an increase in the causal density of functional connections of the network involved in self-regulation of emotions, areas related to cognitive control, attention, visual perception, and mental imagery.

Although small, this study is the first of its kind in attempting to train schizophrenic patients using fMRI-BCI neurofeedback techniques, the authors noted. The success achieved by these patients in learning volitional control of the insular cortex and modulation of functional connectivity may "open the door to therapeutic applications of this technique in schizophrenia." (Program 54.17, Poster AA8)