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New research published the Journal of Psychiatric Research sheds light on the neurophysiological processes related to gaze-contingent music reward therapy, a novel treatment that relies on eye-tracking technology and pleasing music to reduce attention to threatening stimuli.
The therapy has shown promise for patients with social anxiety disorder and the new study sought to better understand what neurophysiological mechanisms were associated with treatment response.
“I’m interested in this because, broadly speaking, it provides us insight into how we could utilize known neurophysiological indices to better predict which individuals respond to a certain treatment,” said study author Akina Umemoto, an associate research scientist at Columbia University in the Department of Psychiatry.
“More specifically, bridging the neurophysiological research with clinical treatment helps us better understand the function of the neural indices (what cognitive/affective processes they reflect?), and illuminate potential mechanisms underlying the treatment efficacy (for targeted treatment).”
In the study, 29 adults with social anxiety disorder and 20 healthy control participants completed a test of selective attention and executive control as the researchers monitored their electrical brain activity. The participants with social anxiety disorder then received up to 12 sessions of gaze-contingent music reward therapy
During the executive control test, the researchers observed that participants with social anxiety disorder tended to make fewer errors but exhibited increased error-related negativity, a pattern of electrical brain activity that is elicited when individuals unexpectedly make mistakes. Anxious participants with increased frontal midline theta — a neural marker of cognitive control — tended to see the greatest response to the treatment. The findings are in line with previous research indicating that anxiety is associated with hypervigilance to error.
“Gaze-contingent music reward therapy is a novel (and very cool) treatment, which uniquely targets a specific process found to be maladaptive in socially anxious individuals,” Umemoto told PsyPost. “That is, socially anxious people tend to narrowly focus their attention on perceived threat, such as threatening faces and performance evaluation. This treatment trains participants’ attention away from faces with threatening expression towards faces with neutral expression using participants’ favored music as the reinforcement.”
“By strengthening more adaptive attentional processes for 4-8 weeks, participants reported improvements in social anxiety symptoms, and this treatment response was most prominent for people who exhibited enhanced neural measures of performance monitoring and cognitive control regulation (which is related to one’s ability to overcome habitual responses and facilitate adaptive behavior).”
Umemoto noted, however, that the findings are preliminary
“Our sample size was small, so the results warrant replications,” he explained. “And the treatment approach is still experimental, its effectiveness needs to be confirmed in additional controlled trials. I’m also interested in further investigating what aspect of performance monitoring/cognitive control predicted treatment response. Did certain people benefit from the treatment simply because their symptoms were most severe and they had the most room to improve, or because they had a specific type of problem with excessive attention to threat that the attention regulation training corrected?”
The study, “Neurophysiological predictors of gaze-contingent music reward therapy among adults with social anxiety disorder“, was authored by Akina Umemoto, Sally L. Cole, Grace O. Allison, Sarah Dolan, Amit Lazarov, Randy P. Auerbach, and Franklin Schneier.
