The prevalence of stress-related disorders such as major depression and anxiety disorders
has increased among children, adolescents and young adults internationally. Despite
increasing concerns about the tremendous personal and societal toll of this development,
efficacious interventions to reduce the detrimental impact of stress in young individuals
are lacking. Therefore, working towards developing innovative approaches for regulating
negative emotional experiences has substantial implications for addressing the prevailing
mental health challenges affecting communities on a local and global scale.
Neurofeedback is a promising non-invasive neuromodulation technique allowing individuals
to rapidly learn volitional control over brain activity via providing real-time feedback
on brain function. Initial studies suggest that neurofeedback for emotion regulation
produces increased experiences of positive emotion in patients with depression and
decreased anxious mood in patients with anxiety disorder. A limitation of existing
studies, however, is that neurofeedback training is often not directed with a concrete
strategy that can help participants better learn control over brain activity, and extend
learning outside of the experimental context.
Cognitive reappraisal, an emotion regulation strategy that focuses on reevaluating and
changing the interpretation of an aversive scene or stimulus to reduce its negative
impact on an individuals' emotions, has been implemented in several neurofeedback
studies. It is shown to be effective in reducing negative emotions in clinical
populations, such as in depression, anxiety, and trauma disorders when combined with fMRI
neurofeedback. Meta-analytic evidence points to the lateral prefrontal cortex (lPFC) as a
common region active during cognitive reappraisal. Thus, lPFC regions are a promising
target for emotion regulation that has otherwise not been a target in existing studies,
which traditionally focus on modulating emotional reactivity via subcortical regions.
Nevertheless, the implementation of neurofeedback-guided training on cortical level
regions is relatively scarce, and even more so for improving emotion regulation in
non-clinical populations. In our own previous studies, it has been previously
demonstrated that healthy subjects can learn to control the activity of brain regions
involved in emotional processing and that this can reduce anxiety. This suggests there is
a promising potential of fNIRS neurofeedback training in combination with cognitive
reappraisal strategies as a novel approach with broader implications for regulating
stress in both clinical and non-clinical populations.
The present study aims to employ real-time fNIRS neurofeedback training in combination
with cognitive reappraisal strategies for regulating negative emotions in healthy
individuals. Participants will undergo cognitive reappraisal training with either real
neurofeedback or sham feedback. Furthermore, emotion regulation ability will be assessed
prior to and after neurofeedback training, through pre- and post-test behavioral measures
and from comparing performance between real neurofeedback and sham feedback groups on a
post-training task inducing physiological stress.
Participants will be explicitly instructed to apply cognitive reappraisal to upregulate
brain activity. Prior to the neurofeedback runs, they will receive training illustrating
the concept of cognitive reappraisal and neural basis of emotion regulation.
The present study will apply double-blinding. Participants will complete the experiment
without knowing the presence of a control condition. The instructions administered to
both groups will be exactly the same, and the experimenter responsible for administering
instructions to the participant will not be aware of the participant's assigned group.