PTSD is a chronic and disabling condition. Neurocircuitry-based models of PTSD emphasize dysregulation of the amygdala, which is involved in the regulation of PTSD-relevant emotions. We are utilizing real-time functional magnetic resonance imaging neurofeedback rtfMRI-nf training with concurrent electroencephalography EEG recordings to directly target and modulate the emotion regulation neurocircuit. By using multimodal data, we can determine which EEG signalsleads or their combination specifically predicts or correlates with clinical improvement associated with the rtfMRI-nf training. Difficult recruitment is the main reason behind the delayed study schedule currently 2nd year no cost extension. During year 4 of the project we have improved our recruitment, finished rtfMRI-nf and EEG data collection, and started EEG-only data collection. Data analysis indicates amygdala training with concurrent EEG recordings in a combat-related PTSD population is feasible, tolerated well and this procedure resulted in improvements in PTSD symptoms. We identified the variations in frontal upper alpha EEG asymmetry FEA during the rtfMRI-nf amygdala training as a promising measure of PTSD severity and treatment response. We are employing this measure together with our already developed stand-alone EEG-only neurofeedback training protocol to evaluate FEA EEG-nf training feasibility in combat-related PTSD.