Hallucinations, Verbal Auditory Clinical Trial
The aim of the study is the examination of brain plasticity on verbal auditory hallucinations (AVH) after neuromodulation with fMRI (functional magnetic resonance imaging) neurofeedback. During the training of fMRI neurofeedback subjects are trained to regulate consciously the connectivity of areas which are associated with hallucinations.The aim is to improve perceived hallucinations' intensity in everyday life of the patients as well as investigating the impact of neurofeedback on resting-state networks in the brain. As control groups, control subjects without AVH and participants with AVH, but no psychiatric diagnosis will be included.
This study investigates the brain plasticity after neuromodulation with fMRI neurofeedback on
verbal auditory hallucinations (AVH). The new technique of real-time fMRI enables subjects to
influence their brain activity in certain areas based on neurofeedback. Current brain
activity as measured by fMRI will be reported to the participants in real time via brain
computer interface (BCI). Due to the identification of contingency between feedback and
mental strategies subjects are able to control their own brain activity consciously. This
provides the opportunity to control symptoms such as AVH. Neurofeedback has been tested on
subjects with schizophrenia, leading to conscious control of circumscribed brain areas.
Recent studies show that, in addition to the modulation of single areas, neurofeedback can
also modulate connectivity between different areas. Thus, it is possible to regulate not only
single brain regions but also whole networks.
AVH are a key symptom of schizophrenia. They limit social functions significantly and are
resistant to the therapy with antipsychotics in 25 % of cases. AVH also occur in 6-15 % of
the healthy population, without meeting any diagnostic criteria for schizophrenia or other
psychiatric disorders. This study will perform a direct, not-invasive and selective
modulation of networks underlying AVH and assess their neural, cognitive and emotional
effects. The focus of this study is on the connectivity between auditory cortex and inferior
frontal cortex. Various studies demonstrated that the auditory cortex exhibits an abnormal
function in schizophrenia patients. It was shown that during AVH, auditory cortex (superior
temporal lobe) and inferior frontal cortex synchronize spontaneously. These regions play an
essential role in speech perception and processing. An increased synchronisation of these
areas could lead to the development of AVH. This study will try to reduce frontotemporal
connectivity to uncouple the regions. Increasing connectivity of both areas will serve as
control condition and furthermore intensify the perceived control of the own brain activity
and of the associated AVH. Thus, patients will learn which factors influence the appearance
of their hallucinations.
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