Neural Mechanisms of Vibroacoustically Augmented Breath Focused Mindfulness for Dissociative Traumatized People

振动声学增强呼吸聚焦正念对于解离性创伤患者的神经机制

• 批准号: 10554379
• 负责人: NEGAR FANI
• 金额: $ 73.24万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10554379
• 关键词: Acoustic Stimulation; Acoustics; Address; Affective; Anterior; Anxiety; Attention; Awareness; Behavioral; Brain; Breathing; Cells; Clinical; Cognitive; Cues; Data; Development; Devices; Diagnostic; Disease; Dissociation; Emotional; Emotions; Expenditure; Feedback; Functional Magnetic Resonance Imaging; Goals; Impairment; Individual; Insula of Reil; Interoception; Intervention; Lead; Mechanoreceptors; Meditation; Mental Depression; Mind-Body Intervention; Neurobiology; Parietal Lobe; Participant; Performance; Persons; Pilot Projects; Population; Post-Traumatic Stress Disorders; Randomized; Recovery; Research; Resources; Respiration; Rest; Schizophrenia; Signal Transduction; Somatosensory Cortex; Sternum; Stimulus; Stress; Symptoms; Task Performances; Training; Trauma; Trauma patient; Trust; Visit; attentional control; barrier to care; cingulate cortex; clinically significant; design; experience; experimental study; improved; mindfulness; mindfulness meditation; neural; neural network; neuromechanism; new technology; post intervention; recruit; response; success; sustained attention; treatment response; vibration; wearable device

Dissociation is a multifaceted, transdiagnostic, and disabling phenomenon that involves detachment from the self or surroundings. It is prevalent in traumatized people with posttraumatic stress disorder (PTSD), occurs in other disorders including depression, anxiety, and schizophrenia, and is a barrier to recovery in first-line treatments. Dissociation is characterized by attentional impairments and disruptions in body awareness, or interoception. Mindfulness-based meditative practices, including breath-focused mindfulness meditation (BFM), are designed to enhance attentional control through focused awareness on interoceptive cues (breath). However, this is a nearly impossible task for dissociative people, who experience disruptions in body agency and are unable to access or trust body signals. Exteroceptive feedback enhances interoceptive awareness and body agency in experimental studies and may similarly enhance attentional control with minimal cognitive effort. As such, the goal of this study is to address deficits in interoception and attentional control in dissociative traumatized patients via BFM augmented with exteroceptive feedback. This is delivered by a unique device that vibrates in concert with respiration, yielding non-ignorable mechanoreceptor reactivity to breathing. Using a stimulus-driven mechanism, our device is expected to enhance body agency and efficiently engage attention and interoception networks. We will recruit 200 traumatized people with clinically significant dissociation symptoms, divided in four equal groups to yield a 2x2 (breath-focused meditation or rest x with or without vibroacoustic stimulation) design. All participants will attend 8 sessions of their assigned intervention. We will administer attentional control and interoception tasks during fMRI pre- and post-intervention to examine: Aim 1) whether BFM with exteroceptive feedback engages attentional control and interoceptive networks to a significantly greater degree than the other treatment conditions from pre- to post- intervention. We will also examine: Aim 2) whether changes in neural network response correspond with changes in dissociation (and secondarily, other trauma-related problems) to a greater degree in BFM with exteroceptive feedback as compared to the other treatment conditions. The immediate impact of this research is to overcome neurobiological barriers to treatment response in dissociation using novel technology. The long-term impact will be to inform the development of publicly-disseminable devices that can augment current interventi ons.

解离是一种多方面的，经诊断的和禁用的现象，涉及 脱离自我或周围环境。它在受创伤的人中很普遍 创伤后应激障碍（PTSD）发生在其他疾病中，包括抑郁，焦虑， 和精神分裂症，是一线治疗中恢复的障碍。解离是 以注意力障碍和身体意识的破坏或互认为的特征。 基于正念的冥想实践，包括以呼吸为中心的正念冥想 （BFM）旨在通过集中意识来增强注意力控制 提示（呼吸）。但是，对于分离的人来说，这几乎是不可能的任务 人体代理的中断，无法访问或信任身体信号。外部感受 反馈在实验研究中增强了感受性的意识和身体代理，可能 同样，通过最少的认知工作来增强注意力控制。因此，这项研究的目标 是解决解离性创伤患者的互动和注意力控制的缺陷 通过BFM增强具有外部感受反馈。这是由独特的设备传递的 与呼吸协同振动，产生不可偶然的机械感受器的反应性 呼吸。使用刺激驱动的机制，我们的设备有望增强身体代理 并有效地参与关注和互认为网络。我们将招募200个受创伤的人 患有临床显着解离症状的人，分为四个相等的组，以产生 2x2（以呼吸为中心的冥想或休息X，具有或没有振动声刺激）。全部 参与者将参加他们分配的干预措施的8个会议。我们将管理注意力 fMRI前后干预前后的控制和际观察任务检查：目标1） 带有外部感受反馈的BFM是否参与注意力控制和互感 与从前到之前的其他治疗条件相比，网络的程度要高得多 干涉。我们还将检查：目标2）神经网络反应的变化是否 与解离的变化（第二，其他与创伤有关的问题）相对应 与其他治疗 状况。这项研究的直接影响是克服神经生物学障碍 使用新技术解离时的治疗反应。长期影响将是 告知可以扩大当前的公共设备的开发 介入。