Limbic self‐neuromodulation as a novel treatment option for emotional dysregulation in premenstrual dysphoric disorder (PMDD); a proof‐of‐concept study

• Published in: Psychiatry and clinical neurosciences 2023-10, Vol.77 (10), p.550-558
• Main Authors: Tene, Oren, Bleich Cohen, Maya, Helpman, Liat, Fine, Naomi, Halevy, Anat, Goldway, Noam, Perry, Daniella, Bary, Plia, Aisenberg Romano, Gabi, Ben‐Zion, Ziv, Hendler, Talma, Bloch, Miki
• Format: Article
• Language: English
• Subjects: amygdala electrical fingerprint; EEG; emotional dysregulation; Emotional regulation; Emotions; Feedback; Functional magnetic resonance imaging; Magnetic resonance imaging; Menstrual cycle; neurofeedback; Neuromodulation; PMS; premenstrual dysphoric disorder; Premenstrual syndrome
• ISSN: 1323-1316; 1440-1819
• DOI: 10.1111/pcn.13574

Aim To assess the efficacy of a novel neurofeedback (NF) method, targeting limbic activity, to treat emotional dysregulation related to premenstrual dysphoric disorder (PMDD). Methods We applied a NF probe targeting limbic activity using a functional magnetic resonance imaging‐inspired electroencephalogram model (termed Amyg‐EFP‐NF) in a double‐blind randomized controlled trial. A frontal alpha asymmetry probe (AAS‐NF), served as active control. Twenty‐seven participants diagnosed with PMDD (mean age = 33.57 years, SD = 5.67) were randomly assigned to Amyg‐EFP‐NF or AAS‐NF interventions with a 2:1 ratio, respectively. The treatment protocol consisted of 11 NF sessions through three menstrual cycles, and a follow‐up assessment 3 months thereafter. The primary outcome measure was improvement in the Revised Observer Version of the Premenstrual Tension Syndrome Rating Scale (PMTS‐OR). Results A significant group by time effect was observed for the core symptom subscale of the PMTS‐OR, with significant improvement observed at follow‐up for the Amyg‐EFP group compared with the AAS group [F(1, 15)=4.968, P = 0.042]. This finding was specifically robust for reduction in anger [F(1, 15) = 22.254, P