Abstract
Purpose of review
Early life stress has been shown to have profound effects on the developmental trajectories of individuals. Findings have implicated most major areas of the brain as being affected, and existing treatments have been limited in ameliorating symptoms. The purpose of this review is to focus on the development of the autonomic nervous system in concert with the brain.
Recent findings
We suggest that the majority of psychopathology related to early life stress represents an allostatic equilibrium achieved by the autonomic nervous system organizing around threat states. Recent findings in the field of neurofeedback implicate alpha waves as a potential key to helping treat individuals who have been affected by early life stress.
Summary
We conclude that alpha neurofeedback may represent a novel treatment approach to engender changes within the autonomic nervous system in helping to achieve a homeostatic equilibrium. Alpha downtrain neurofeedback may represent a “nudge” for a stuck nervous system that acts as a precursor to increase the efficacy of other training protocols and more traditional talk therapy techniques.
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References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
** The highlighted references provide evidence that alpha rhythms appear to be associated with organization and functioning of the default mode network. This is important because emerging research has shown that alpha downtrain neurofeedback can significantly change not only the alpha rhythms but also connectivity of the default mode network. Our suggestion is that neurofeedback may provide a unique means of regulating connectivity and functioning of large-scale networks in the brain which have been impacted by early life stress.
Kaiser RH, et al. Childhood stress, grown-up brain networks: corticolimbic correlates of threat-related early life stress and adult stress response. Psychol Med. 2018;48(7):1157–66.
Teicher MH, et al. The effects of childhood maltreatment on brain structure, function and connectivity. Nat Rev Neurosci. 2016;17(10):652–66.
Teicher MH, Samson JA. Annual research review: enduring neurobiological effects of childhood abuse and neglect. J Child Psychol Psychiatry. 2016;57(3):241–66.
Hughes K, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. Lancet Public Health. 2017;2(8):e356–66.
Balbernie R. Circuits and circumstances: the neurobiological consequences of early relationship experiences and how they shape later behaviour. J Child Psychother. 2001;27(3):237–55.
Ohashi K, et al. Susceptibility or resilience to maltreatment can be explained by specific differences in brain network architecture. Biol Psychiatry. 2019;85(8):690–702.
Teicher MH, et al. Differential effects of childhood neglect and abuse during sensitive exposure periods on male and female hippocampus. Neuroimage. 2018;169:443–52.
Zhu J, et al. Association of prepubertal and postpubertal exposure to childhood maltreatment with adult amygdala function. JAMA Psychiatry. 2019;76(8):843–53.
Yerkes RM, Dodson JD. The relation of strength of stimulus to rapidity of habit-formation. Punishment: Issues and experiments. 1908:27–41.
Cardinali DP. Autonomic nervous system: basic and clinical aspects. Springer; 2017.
Ros T, et al. Neurofeedback tunes long-range temporal correlations in spontaneous brain activity. Cerebral Cortex. 2016.
Porges SW. The polyvagal theory: neurophysiological foundations of emotions, attachment, communication, and self-regulation (Norton Series on Interpersonal Neurobiology). WW Norton & Company; 2011
Kirschbaum C, et al. Sex-specific effects of social support on cortisol and subjective responses to acute psychological stress. Psychosom Med. 1995;57(1):23–31.
Uno D, Uchino BN, Smith TW. Relationship quality moderates the effect of social support given by close friends on cardiovascular reactivity in women. Int J Behav Med. 2002;9(3):243–62.
Hostinar CE, Sullivan RM, Gunnar MR. Psychobiological mechanisms underlying the social buffering of the hypothalamic–pituitary–adrenocortical axis: A review of animal models and human studies across development. Psychol Bull. 2014;140(1):256.
Roelofs K. Freeze for action: neurobiological mechanisms in animal and human freezing. Philosophical Transactions of the Royal Society B: Biological Sciences. 2017;372(1718):20160206.
Berger H. Über das elektroenkephalogramm des menschen. Archiv für psychiatrie und nervenkrankheiten. 1929;87(1):527–70.
Kreezer G. The electro-encephalogram and its use in psychology. Am J Psychol. 1938;51(4):737–59.
Sterman M, Macdonald L, Stone R. Biofeedback training of sensorimotor EEG rhythm in man-effects on epilepsy. in Electroencephalography and clinical neurophysiology. Elsevier SCI Ireland Ltd Customer Relations Manager, Bay 15, Shannon; 1975.
Sterman M, MacDonald L, Stone R. EEG asymmetry and seizure modification following unilateral sensorimotor EEG biofeedback training. in Electroencephalography and clinical neurophysiology. Elsevier Ireland Ltd Elsevier House, Brookvale Plaza, East Park Shannon, CO; 1973.
Sterman M, Macdonald L, Stone R. of the sensor/motor electroencephalogram rhythm in man: effects on epilepsy. Biofeedback and Self-control, 1971: p. 313.
Othmer SF, Othmer S. Interhemispheric EEG training; clinical experience and conceptual models. In: Evans JR, editor. Handbook of neurofeedback: dynamics and clinical applications. New York: Haworth Medical Press; 2007. p. 109–36.
Peniston EG, et al. EEG alpha-theta brainwave synchronization in Vietnam theater veterans with combat-related post-traumatic stress disorder and alcohol abuse. Advances in Medical Psychotherapy. 1993;6:37–50.
Peniston EG, Kulkosky PJ. Alpha-theta brainwave neurofeedback for Vietnam veterans with combat-related post-traumatic stress disorder. Medical Psychotherapy. 1991;4(1):47–60.
Peniston E, et al. EEG alpha-theta brainwave synchronization in Vietnam theater veterans with combat-related post-traumatic stress disorder and alcohol abuse. Advances in Medical Psychotherapy. 1993;6(7):37–50.
Graap K, Freides D. Regarding the database for the Peniston alpha-theta EEG biofeedback protocol. Appl Psychophysiol Biof. 1998;23(4):265–72.
Gapen M, et al. A pilot study of neurofeedback for chronic PTSD. Appl Psychophysiol Biof. 2016;41(3):251–61.
van der Kolk BA, et al. A randomized controlled study of neurofeedback for chronic PTSD. PLoS One. 2016;11(12):e0166752.
Rogel A, et al. The impact of neurofeedback training on children with developmental trauma: a randomized controlled study. Psychological Trauma: Theory, Research, Practice, and Policy. Preprint. 2020 This is a recent finding of the efficacy of neurofeedback for treating complex PTSD in children.
•• Nicholson AA, et al. A randomized, controlled trial of alpha-rhythm EEG neurofeedback in posttraumatic stress disorder: a preliminary investigation showing evidence of decreased PTSD symptoms and restored default mode and salience network connectivity using fMRI. NeuroImage: Clinical. 2020;28:102490 Alpha neurofeedback was associated with normalization of connectivity between the DMN and SN.
Clancy K, et al. Restless ‘rest’: intrinsic sensory hyperactivity and disinhibition in post-traumatic stress disorder. Brain. 2017;140(7):2041–50.
Laufs H, et al. EEG-correlated fMRI of human alpha activity. Neuroimage. 2003;19(4):1463–76.
Veltmeyer MD, et al. Integrative assessment of brain and cognitive function in post-traumatic stress disorder. J Integr Neurosci. 2005;4(01):145–59.
Peterson A, et al. Resting-state neuroimaging studies: a new way of identifying differences and similarities among the anxiety disorders? Can J Psychiatr. 2014;59(6):294–300.
Menon V. Large-scale brain networks and psychopathology: a unifying triple network model. Trends Cogn Sci. 2011;15:483–506.
Seeley WW, et al. Dissociable intrinsic connectivity networks for salience processing and executive control. J Neurosci. 2007;27(9):2349–56.
Patel R, et al. Neurocircuitry models of posttraumatic stress disorder and beyond: a meta-analysis of functional neuroimaging studies. Neurosci Biobehav Rev. 2012;36(9):2130–42.
Hayes JP, Hayes SM, Mikedis AM. Quantitative meta-analysis of neural activity in posttraumatic stress disorder. Biol Mood Anxiety Disord. 2012;2(1):9.
Lanius RA, et al. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions. Eur J Psychotraumatol. 2015;6(1):27313.
Greicius MD, et al. Functional connectivity in the resting brain: a network analysis of the default mode hypothesis. Proc Natl Acad Sci. 2003;100(1):253–8.
Spreng RN, Mar RA, Kim AS. The common neural basis of autobiographical memory, prospection, navigation, theory of mind, and the default mode: a quantitative meta-analysis. J Cogn Neurosci. 2009;21(3):489–510.
Tursich M, et al. Distinct intrinsic network connectivity patterns of post-traumatic stress disorder symptom clusters. Acta Psychiatr Scand. 2015;132(1):29–38.
Rabellino D, et al. Intrinsic connectivity networks in post-traumatic stress disorder during sub-and supraliminal processing of threat-related stimuli. Acta Psychiatr Scand. 2015;132(5):365–78.
•• Nicholson AA, et al. Intrinsic connectivity network dynamics in PTSD during amygdala downregulation using real-time fMRI neurofeedback: a preliminary analysis. Hum Brain Mapp. 2018;39(11):4258–75 This study provides preliminary evidence that neurofeedback can alter intrinsic connectivity dynamics in PTSD.
Bandler R, et al. Central circuits mediating patterned autonomic activity during active vs. passive emotional coping. Brain Res Bull. 2000;53(1):95–104.
Young CB, et al. Dynamic shifts in large-scale brain network balance as a function of arousal. J Neurosci. 2017;37(2):281–90.
Sridharan D, Levitin DJ, Menon V. A critical role for the right fronto-insular cortex in switching between central-executive and default-mode networks. Proc Natl Acad Sci. 2008;105(34):12569–74.
Chang C, et al. EEG correlates of time-varying BOLD functional connectivity. Neuroimage. 2013;72:227–36.
•• Bowman AD, et al. Relationship between alpha rhythm and the default mode network: an EEG-fMRI study. J Clin Neurophysiol. 2017;34(6):527–33 This article provides evidence that alpha oscillations appear to be a biomarker for functioning of the default mode network.
•• Shtark MB, et al. Neuroimaging study of alpha and beta EEG biofeedback effects on neural networks. Appl Psychophysiol Biof. 2018;43(2):169–78 This study showed that alpha neurofeedback affected brain network connectivity.
Kluetsch RC, et al. Plastic modulation of PTSD resting-state networks and subjective wellbeing by EEG neurofeedback. Acta Psychiatr Scand. 2014;130(2):123–36.
Nicholson AA, et al. Alpha oscillation neurofeedback modulates amygdala complex connectivity and arousal in posttraumatic stress disorder. NeuroImage: Clinical. 2016;12:506–16.
Bassett DS, Khambhati AN. A network engineering perspective on probing and perturbing cognition with neurofeedback. Ann N Y Acad Sci. 2017;1396(1):126.
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Gapen, M., Guy, T. Neurofeedback in the Treatment of Early Life Stress: a “Nudge” for the Nervous System?. Curr Treat Options Psych 8, 77–94 (2021). https://doi.org/10.1007/s40501-021-00243-1
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DOI: https://doi.org/10.1007/s40501-021-00243-1