Neural correlates of the attention training technique as used in metacognitive therapy - A randomized sham-controlled fMRI study in healthy volunteers

Niklas Jahn; Christopher Sinke; Özlem Kayali; Svenja Krug; Erik Leichter; Stephanie Peschel; Torben Müller; Alev Burak; Tillmann H C Krüger; Kai G Kahl; Ivo Heitland

doi:10.3389/fpsyg.2023.1084022

Neural correlates of the attention training technique as used in metacognitive therapy - A randomized sham-controlled fMRI study in healthy volunteers

Front Psychol. 2023 Mar 13:14:1084022. doi: 10.3389/fpsyg.2023.1084022. eCollection 2023.

Authors

Niklas Jahn¹, Christopher Sinke^{1

2}, Özlem Kayali¹, Svenja Krug¹, Erik Leichter¹, Stephanie Peschel¹, Torben Müller¹, Alev Burak¹, Tillmann H C Krüger^{1

2

3}, Kai G Kahl¹, Ivo Heitland¹

Affiliations

¹ Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany.
² Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hanover, Germany.
³ Center for Systems Neuroscience, Hanover, Germany.

Abstract

Introduction: The Attention Training Technique (ATT) developed as part of metacognitive therapy is a psychotherapeutic treatment method used to enhance top-down attentional flexibility and control. This study investigated potential neurocognitive changes due to ATT and its underlying neural mechanisms using pre-to-post functional magnetic resonance imaging (fMRI).

Materials and methods: Fifty-four healthy participants were subjected to a randomized, sham-controlled attention training and evaluated using a neurocognitive test battery that partly took place in an fMRI environment. Participants received two doses ATT or sham ATT daily for 1 week. On day eight, all subjects completed the neurocognitive test battery again.

Results: After the training, the ATT group showed a significant improvement in reaction times regarding attentional disengagement compared to the sham ATT group. fMRI data showed decreased levels of activation in the anterior cingulate cortex (ACC) when comparing the ATT group to the sham ATT group during attentional disengagement post intervention. No ATT > sham ATT effects were found regarding selective auditory attention, working memory performance and inhibitory control.

Discussion: These findings putatively indicate that ATT facilitates faster attention allocation and increased attentional flexibility in healthy subjects. The fMRI results suggest this ATT-dependent improvement is accompanied by reduced ACC activity, indicating a more flexible attentional state.

Keywords: anterior cingulate cortex; attention training technique; attentional control; fMRI; healthy participants; metacognitive therapy.