Brain sciences · 2025
Can Amygdala-Derived-EEG-fMRI-Pattern (EFP) Neurofeedback Treat Sleep Disturbances in PTSD?
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Tendler Aron, Stern Yaki, Harmelech Tal
Аннотация
BACKGROUND: Sleep disturbances are a core feature of post-traumatic stress disorder (PTSD), affecting up to 90% of patients and often persisting after standard PTSD treatment. As all the current interventions have limitations, amygdala-targeted neuromodulation may offer a novel treatment pathway.
METHODS: Secondary analysis of a prospective, single-arm trial (n = 58) was carried out evaluating Prism™ amygdala-derived-EEG-fMRI-Pattern neurofeedback (Amyg-EFP-NF). Sleep outcomes were assessed using the Clinician-Administered PTSD Scale (CAPS-5) sleep item, PTSD Checklist (PCL-5) sleep item, and Patient Health Questionnaire (PHQ-9) sleep items at baseline, post-treatment, and 3-month follow-up. Treatment consisted of 15 sessions over 8 weeks.
RESULTS: At 3-months' follow-up, 63.79% of participants demonstrated clinically meaningful reduction in sleep disturbances (≥1 point reduction in CAPS-5 Item 20). Sleep improvement showed a moderate correlation with overall PTSD symptom reduction (r = 0.484, p < 0.001) and a balanced improvement pattern (-15.1% early, -9.1% late). Sleep responders sustained improvement across multiple measures and showed significant increases in cognitive reappraisal (mean change: +2.57 ± 1.0, p = 0.006), while non-responders showed initial but un-sustained improvement in trauma-related dreams.
CONCLUSIONS: Amyg-EFP-NF shows preliminary promise for treating PTSD-related sleep disturbances. Our exploratory analyses suggest distinct temporal patterns of sleep improvement and potential associations with enhanced cognitive reappraisal capacity that warrant rigorous investigation in future randomized controlled trials.
METHODS: Secondary analysis of a prospective, single-arm trial (n = 58) was carried out evaluating Prism™ amygdala-derived-EEG-fMRI-Pattern neurofeedback (Amyg-EFP-NF). Sleep outcomes were assessed using the Clinician-Administered PTSD Scale (CAPS-5) sleep item, PTSD Checklist (PCL-5) sleep item, and Patient Health Questionnaire (PHQ-9) sleep items at baseline, post-treatment, and 3-month follow-up. Treatment consisted of 15 sessions over 8 weeks.
RESULTS: At 3-months' follow-up, 63.79% of participants demonstrated clinically meaningful reduction in sleep disturbances (≥1 point reduction in CAPS-5 Item 20). Sleep improvement showed a moderate correlation with overall PTSD symptom reduction (r = 0.484, p < 0.001) and a balanced improvement pattern (-15.1% early, -9.1% late). Sleep responders sustained improvement across multiple measures and showed significant increases in cognitive reappraisal (mean change: +2.57 ± 1.0, p = 0.006), while non-responders showed initial but un-sustained improvement in trauma-related dreams.
CONCLUSIONS: Amyg-EFP-NF shows preliminary promise for treating PTSD-related sleep disturbances. Our exploratory analyses suggest distinct temporal patterns of sleep improvement and potential associations with enhanced cognitive reappraisal capacity that warrant rigorous investigation in future randomized controlled trials.