Mackey and deCharms will also determine if the therapy could be used for other disorders, such as depression, by teaching patients to control parts of their brains that have been implicated in those disorders. “Many diseases are localized to particular brain regions. Depression is localized to the serotonin system, Parkinson’s to the dopamine area,” says deCharms. “Maybe this technology could be used to control brain processes, rather than using a drug.”
Other fMRI experts say it’s too soon to say how widely applicable the imaging therapy could be. According to James Brewer, a neurologist at the University of California, San Diego, some parts of the brain may be more amenable to conscious control than others. The current experiment targeted the anterior cingulate cortex, a brain area that has been implicated in attention. It may be easier to voluntarily control a brain area involved in attention, which humans consciously control as they shift between activities like conversing or watching TV, than areas involved in other functions.
While the field is still in its infancy, several scientists are excited about exploring its possibilities. “The field of neurofeedback is wide open, it’s something that makes a lot of sense to investigate,” says Tor Wager, a psychologist at Columbia University in New York. “We need more research that explores what people can do themselves.”
John Gabrieli, a neuroscientist at MIT who collaborated on the current paper, says he wants to assess if a similar technique can be used to help children with learning disorders. For example, kids with dyslexia have a deficit in a particular brain circuit involved in language. Remedial reading programs can activate this brain area. Gabrieli plans to determine if activating this region with fMRI feedback could enhance the effectiveness of traditional reading programs.
The technique could also be promising in cases of stroke. “When a person has a stroke in [one part of the brain], activity in another part of brain sometimes compensates,” says Brewer. If researchers could figure out where and why that happens, exercising that part of the brain through focused attention may enhance recovery, he says.
Such applications are still down the road, but the current findings are giving hope that the approach can in fact ease pain. “All people have built into their brain a powerful physiological system to control pain,” says deCharms. “We’re training people to gain control over this system themselves.”
This is the first part in an occasional series that explores how new approaches to brain imaging could improve treatment of neurological and psychiatric disorders. A second installment, running on Thursday, December 22, will examine how understanding the neurobiology of the human subconscious could modernize psychoanalysis.