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Entwicklung eines Neurofeedback-Protokolls zur Reduktion verbal akustischer Halluzinationen

Development of a neurofeedback protocol for reduction of verbal acoustic hallucinations

  • Schwerpunkt: Neurowissenschaftlich fundierte Psychotherapie – Originalien
  • Published:
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Zusammenfassung

Hintergrund

Es besteht ein Bedarf an alternativen Behandlungsansätzen für Patienten mit einer schizophrenen Erkrankung und verbal akustischen Halluzinationen (AVH), die resistent gegenüber den herkömmlichen Therapiemöglichkeiten, wie antipsychotischer Medikation, sind.

Ziel der Arbeit

Das Vorgehen bei der Entwicklung eines Neurofeedback(NF)-Trainings als alternativen Behandlungsansatz soll am Beispiel einer Pilotstudie an Patienten mit einer schizophrenen Erkrankung und AVH zur Regulation des posterioren superioren temporalen Gyrus und eines anschließenden Heilversuchs erläutert werden. Es wurde untersucht, ob die Patienten erlernen konnten, die neuronale Aktivität herunterzuregulieren, und ob damit eine Symptomverbesserung einherging.

Material und Methoden

An der Pilotstudie nahmen 3 Patienten teil. Das Training umfasste 15 NF-Sitzungen mit der Methode der funktionellen Nahinfrarotspektroskopie (fNIRS), bei dem eine Herauf- und Herunterregulation der neuronalen Aktivität erlernt werden sollte. Das weiterentwickelte, adaptive Protokoll wurde anschließend im Rahmen eines Heilversuchs bei einer Patientin mit einer schizophrenen Erkrankung und AVH durchgeführt.

Ergebnisse

Die Patienten waren nur unzureichend in der Lage, ihre Gehirnaktivität zu regulieren; deswegen erfolgten eine Weiterentwicklung und adaptive Anpassung des Protokolls sowie die Durchführung als Heilversuch. Das adaptive Training führte nach der 27. Sitzung zu einer Symptomverbesserung.

Schlussfolgerung

Das fNIRS-NF könnte eine vielversprechende Interventionsmethode bei AVH darstellen. Jedoch sollten die NF-Protokolle so weiterentwickelt werden, dass sie sich adaptiv die AVH anpassen können. Darüber hinaus sind kontrollierte Studien mit großen Stichproben notwendig, um die Ergebnisse generalisieren zu können.

Abstract

Background

There is a need for alternative treatment approaches for patients with a schizophrenic disorder and verbal acoustic hallucinations (AVH), which are resistant to conventional treatment options, such as antipsychotic medication.

Objective

The approach in the development of a neurofeedback (NF) training as an alternative treatment option is outlined using the example of a pilot study on patients with a schizophrenic disorder and AVH targeting posterior superior temporal gyrus regulation and a subsequent curative attempt. It was investigated whether patients could learn to down-regulate neuronal activity and whether this was accompanied by symptom improvement.

Material and methods

In this pilot study three patients participated. The training comprised 15 NF sessions with the method of functional near-infrared spectroscopy (fNIRS) designed to train up-regulation and down-regulation of neuronal activity. The further developed adaptive protocol was then utilized as part of a curative attempt in a patient with a schizophrenic disorder and AVH.

Results

In the pilot study, patients were not sufficiently able to regulate their brain activity; therefore, the protocol was further developed and adapted and implemented as a curative attempt. The adaptive training led to symptom improvement after 27 sessions.

Conclusion

The use of fNIRS-NF could be a promising interventional method for AVH; however, the NF protocols should be further developed so that they can be individually adapted to the AVH. In addition, controlled studies with large samples are necessary to enable generalizability of the results.

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Notes

  1. Internationale statistische Klassifikation der Krankheiten und verwandter Gesundheitsprobleme, 10. Ausg.

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Funding

Förderung

A.-C. Ehlis wurde teilweise von dem IZKF Tübingen (Junior Research Group 2115-0-0) unterstützt.

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Authors and Affiliations

  1. Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland

    Helena Storchak, Justin Hudak, Andreas J. Fallgatter & Ann-Christine Ehlis

  2. LEAD Graduate School & Research Network, Eberhard-Karls-Universität, Gartenstr. 29, 72074, Tübingen, Deutschland

    Justin Hudak, Andreas J. Fallgatter & Ann-Christine Ehlis

  3. Werner Reichardt Centrum für Integrative Neurowissenschaften (CIN), Eberhard-Karls-Universität, Otfried-Mueller-Str. 25, 72076, Tübingen, Deutschland

    Andreas J. Fallgatter

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  1. Helena Storchak
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Correspondence to Helena Storchak.

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Interessenkonflikt

H. Storchak, J. Hudak, A.J. Fallgatter und A.-C. Ehlis geben an, dass kein Interessenkonflikt besteht.

Alle beschriebenen Untersuchungen am Menschen oder an menschlichem Gewebe wurden mit Zustimmung der zuständigen Ethikkommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Anja Hilbert, Leipzig

Ann-Christine Ehlis, Tübingen

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Storchak, H., Hudak, J., Fallgatter, A.J. et al. Entwicklung eines Neurofeedback-Protokolls zur Reduktion verbal akustischer Halluzinationen. Psychotherapeut 64, 202–211 (2019). https://doi.org/10.1007/s00278-019-0353-1

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