Real-time fMRI Neurofeedback for PTSD in Frontline Healthcare Workers

Nearly 1 in 4 frontline healthcare workers in Canada have developed symptoms of post-traumatic stress disorder (PTSD) due to COVID-19-related traumas. Concerningly, gold-standard therapies for PTSD are ineffective for many patients and thus may leave up to 40% of afflicted healthcare workers with persistent symptoms. This exponential increase in PTSD prevalence calls for novel, effective interventions. Neurofeedback is a non-invasive brain-computer interface that trains individuals to self-regulate disrupted functional brain networks linked to mental illness. Unlike other treatments, neurofeedback can normalize pathological brain networks underlying PTSD and is highly effective in reducing symptoms. However, almost all research has involved only PTSD patients who have experienced military or childhood-related traumas. No studies have examined whether neurofeedback would be an effective approach to reducing PTSD symptoms associated with the unique COVID-19-related trauma exposures experienced by healthcare workers. This research will assess the efficacy of fMRI neurofeedback in reducing PTSD symptoms among healthcare workers by regulating pathological brain networks. Specifically, neurofeedback will be used to increase suboptimal ventromedial prefrontal cortex (vmPFC) inhibition on emotion generation (amygdala) and hyperarousal (brainstem) areas. Of primary interest is: i) the association between neurofeedback-mediated changes in brain networks and PTSD symptoms, and ii) the identification of participant clinical profiles and demographic factors that predict neurofeedback success. This research is a timely response to the exponential rise in trauma-related illness among Canadian healthcare workers and may lead to a novel, adjunctive treatment for PTSD.