BMC psychiatry
Amygdala neurofeedback as an adjunct to residential dialectical behavior therapy for borderline personality disorder: a pilot randomized controlled trial
By Hofmanová M, Santangelo PS, Kleindienst N and 2 others.
Abstract
Background
Borderline personality disorder (BPD) is characterized by affective instability and amygdala hyperreactivity. Although dialectical behavior therapy (DBT) reduces symptoms and amygdala-related abnormalities, many patients show only partial remission. Real-time functional magnetic resonance imaging (fMRI) amygdala neurofeedback (amy-NF) directly targets hyperactive limbic responses and has shown promise in uncontrolled trials. We examined whether amy-NF adds benefit to inpatient DBT.
Methods
Thirty-six mid-therapy people with BPD and clinically significant residual symptoms (BSL-23 > 1.5) were randomized to DBT plus amy-NF (n = 23) or DBT alone, termed treatment as usual (TAU = 13). Post-treatment assessments were completed by 15/9 (amy-NF/TAU), with 15/8 and 12/7 completing the 3- and 6-month follow-ups. Ecological momentary assessment (EMA) of daily-life affective instability served as the primary outcome. Secondary outcomes included self-reports, amygdala responses during two fMRI tasks, and resting-state fMRI. Assessments occurred at pre-, post-, 3-, and 6-month follow-up.