OpenNFT: An open-source Python/Matlab framework for real-time fMRI neurofeedback training based on activity, connectivity and multivariate pattern analysis

Music in the loop: a systematic review of current neurofeedback methodologies using music

Music, a universal element in human societies, possesses a profound ability to evoke emotions and influence mood. This systematic review explores the utilization of music to allow self-control of brain activity and its implications in clinical neuroscience. Focusing on music-based neurofeedback studies, it explores methodological aspects and findings to propose future directions. Three key questions are addressed: the rationale behind using music as a stimulus, its integration into the feedback loop, and the outcomes of such interventions. While studies emphasize the emotional link between music and brain activity, mechanistic explanations are lacking. Additionally, there is no consensus on the imaging or behavioral measures of neurofeedback success. The review suggests considering whole-brain neural correlates of music stimuli and their interaction with target brain networks and reward mechanisms when designing music-neurofeedback studies. Ultimately, this review aims to serve as a valuable resource for researchers, facilitating a deeper understanding of music's role in neurofeedback and guiding future investigations.

Training individuals with schizophrenia to gain volitional control of the theory of mind network with real-time fMRI: A pilot study

Individuals diagnosed with schizophrenia spectrum disorders (SSDs) often demonstrate alterations in the Theory of Mind Network (ToM-N). Here, in this proof-of-concept, single-arm pilot study, we investigate whether participants with an SSD (N = 7) were able to learn to volitionally control regions of the ToM-N (dorso/middle/ventromedial prefrontal cortex [D/M/VMPFC], left temporoparietal junction [LTPJ], precuneus [PC], right superior temporal sulcus [RSTS], and right temporoparietal junction [RTPJ]) using real-time fMRI neurofeedback (rtfMRI-NF). Region-of-interest analyses demonstrate that after neurofeedback training, participants were able to gain volitional control in the following ToM-N brain regions during the transfer task, where no active feedback was given: right temporoparietal junction, precuneus, and dorso/ventromedial prefrontal cortex (neurofeedback effect Fs > 6.17, ps < .05). These findings suggest that trained volitional control over the ToM-N is tentatively feasible with rtfMRI neurofeedback in SSD, although findings need to be replicated with more robust designs that include a control group and larger samples.

Real-time fMRI neurofeedback modulates induced hallucinations and underlying brain mechanisms

Hallucinations can occur in the healthy population, are clinically relevant and frequent symptoms in many neuropsychiatric conditions, and have been shown to mark disease progression in patients with neurodegenerative disorders where antipsychotic treatment remains challenging. Here, we combine MR-robotics capable of inducing a clinically-relevant hallucination, with real-time fMRI neurofeedback (fMRI-NF) to train healthy individuals to up-regulate a fronto-parietal brain network associated with the robotically-induced hallucination. Over three days, participants learned to modulate occurrences of and transition probabilities to this network, leading to heightened sensitivity to induced hallucinations after training. Moreover, participants who became sensitive and succeeded in fMRI-NF training, showed sustained and specific neural changes after training, characterized by increased hallucination network occurrences during induction and decreased hallucination network occurrences during a matched control condition. These data demonstrate that fMRI-NF modulates specific hallucination network dynamics and highlights the potential of fMRI-NF as a novel antipsychotic treatment in neurodegenerative disorders and schizophrenia.

Enhanced attention-related alertness following right anterior insular cortex neurofeedback training

The anterior insular cortex, a central node of the salience network, plays a critical role in cognitive control and attention. Here, we investigated the feasibility of enhancing attention using real-time fMRI neurofeedback training that targets the right anterior insular cortex (rAIC). 56 healthy adults underwent two neurofeedback training sessions. The experimental group received feedback from neural responses in the rAIC, while control groups received sham feedback from the primary visual cortex or no feedback. Cognitive functioning was evaluated before, immediately after, and three months post-training. Our results showed that only the rAIC neurofeedback group successfully increased activity in the rAIC. Furthermore, this group showed enhanced attention-related alertness up to three months after the training. Our findings provide evidence for the potential of rAIC neurofeedback as a viable approach for enhancing attention-related alertness, which could pave the way for non-invasive therapeutic strategies to address conditions characterized by attention deficits.

Facing emotions: real-time fMRI-based neurofeedback using dynamic emotional faces to modulate amygdala activity

Introduction

Maladaptive functioning of the amygdala has been associated with impaired emotion regulation in affective disorders. Recent advances in real-time fMRI neurofeedback have successfully demonstrated the modulation of amygdala activity in healthy and psychiatric populations. In contrast to an abstract feedback representation applied in standard neurofeedback designs, we proposed a novel neurofeedback paradigm using naturalistic stimuli like human emotional faces as the feedback display where change in the facial expression intensity (from neutral to happy or from fearful to neutral) was coupled with the participant's ongoing bilateral amygdala activity.

Methods

The feasibility of this experimental approach was tested on 64 healthy participants who completed a single training session with four neurofeedback runs. Participants were assigned to one of the four experimental groups (n = 16 per group), i.e., happy-up, happy-down, fear-up, fear-down. Depending on the group assignment, they were either instructed to "try to make the face happier" by upregulating (happy-up) or downregulating (happy-down) the amygdala or to "try to make the face less fearful" by upregulating (fear-up) or downregulating (fear-down) the amygdala feedback signal.

Results

Linear mixed effect analyses revealed significant amygdala activity changes in the fear condition, specifically in the fear-down group with significant amygdala downregulation in the last two neurofeedback runs as compared to the first run. The happy-up and happy-down groups did not show significant amygdala activity changes over four runs. We did not observe significant improvement in the questionnaire scores and subsequent behavior. Furthermore, task-dependent effective connectivity changes between the amygdala, fusiform face area (FFA), and the medial orbitofrontal cortex (mOFC) were examined using dynamic causal modeling. The effective connectivity between FFA and the amygdala was significantly increased in the happy-up group (facilitatory effect) and decreased in the fear-down group. Notably, the amygdala was downregulated through an inhibitory mechanism mediated by mOFC during the first training run.

Discussion

In this feasibility study, we intended to address key neurofeedback processes like naturalistic facial stimuli, participant engagement in the task, bidirectional regulation, task congruence, and their influence on learning success. It demonstrated that such a versatile emotional face feedback paradigm can be tailored to target biased emotion processing in affective disorders.

Exploring protocol development: Implementing systematic contextual memory to enhance real-time fMRI neurofeedback

Objective

The goal of this study was to explore the development and implementation of a protocol for real-time fMRI neurofeedback (rtfMRI-nf) and to assess the potential for enhancing the selective brain activation using stimuli from Virtual Reality (VR). In this study we focused on two specific brain regions, supplementary motor area (SMA) and right inferior frontal gyrus (rIFG). Publications by other study groups have suggested impaired function in these specific brain regions in patients with the diagnoses Attention Deficit Hyperactivity Disorder (ADHD) and Tourette's Syndrome (TS). This study explored the development of a protocol to investigate if attention and contextual memory may be used to systematically strengthen the procedure of rtfMRI-nf.

Methods

We used open-science software and platforms for rtfMRI-nf and for developing a simulated repetition of the rtfMRI-nf brain training in VR. We conducted seven exploratory tests in which we updated the protocol at each step. During rtfMRI-nf, MRI images are analyzed live while a person is undergoing an MRI scan, and the results are simultaneously shown to the person in the MRI-scanner. By focusing the analysis on specific regions of the brain, this procedure can be used to help the person strengthen conscious control of these regions. The VR simulation of the same experience involved a walk through the hospital toward the MRI scanner where the training sessions were conducted, as well as a subsequent simulated repetition of the MRI training. The VR simulation was a 2D projection of the experience.The seven exploratory tests involved 19 volunteers. Through this exploration, methods for aiming within the brain (e.g. masks/algorithms for coordinate-system control) and calculations for the analyses (e.g. calculations based on connectivity versus activity) were updated by the project team throughout the project. The final procedure involved three initial rounds of rtfMRI-nf for learning brain strategies. Then, the volunteers were provided with VR headsets and given instructions for one week of use. Afterward, a new session with three rounds of rtfMRI-nf was conducted.

Results

Through our exploration of the indirect effect parameters - brain region activity (directed oxygenated blood flow), connectivity (degree of correlated activity in different regions), and neurofeedback score - the volunteers tended to increase activity in the reinforced brain regions through our seven tests. Updates of procedures and analyses were always conducted between pilots, and never within. The VR simulated repetition was tested in pilot 7, but the role of the VR contribution in this setting is unclear due to underpowered testing.

Conclusion

This proof-of-concept protocol implies how rtfMRI-nf may be used to selectively train two brain regions (SMA and rIFG). The method may likely be adapted to train any given region in the brain, but readers are advised to update and adapt the procedure to experimental needs.

Preliminary findings on long-term effects of fMRI neurofeedback training on functional networks involved in sustained attention

INTRODUCTION

Neurofeedback based on functional magnetic resonance imaging allows for learning voluntary control over one's own brain activity, aiming to enhance cognition and clinical symptoms. We previously reported improved sustained attention temporarily by training healthy participants to up-regulate the differential activity of the sustained attention network minus the default mode network (DMN). However, the long-term brain and behavioral effects of this training have not yet been studied. In general, despite their relevance, long-term learning effects of neurofeedback training remain under-explored.

METHODS

Here, we complement our previously reported results by evaluating the neurofeedback training effects on functional networks involved in sustained attention and by assessing behavioral and brain measures before, after, and 2 months after training. The behavioral measures include task as well as questionnaire scores, and the brain measures include activity and connectivity during self-regulation runs without feedback (i.e., transfer runs) and during resting-state runs from 15 healthy individuals.

RESULTS

Neurally, we found that participants maintained their ability to control the differential activity during follow-up sessions. Further, exploratory analyses showed that the training increased the functional connectivity between the DMN and the occipital gyrus, which was maintained during follow-up transfer runs but not during follow-up resting-state runs. Behaviorally, we found that enhanced sustained attention right after training returned to baseline level during follow-up.

CONCLUSION

The discrepancy between lasting regulation-related brain changes but transient behavioral and resting-state effects raises the question of how neural changes induced by neurofeedback training translate to potential behavioral improvements. Since neurofeedback directly targets brain measures to indirectly improve behavior in the long term, a better understanding of the brain-behavior associations during and after neurofeedback training is needed to develop its full potential as a promising scientific and clinical tool.

Real-Time Classification of Motor Imagery Using Dynamic Window-Level Granger Causality Analysis of fMRI Data

This article presents a method for extracting neural signal features to identify the imagination of left- and right-hand grasping movements. A functional magnetic resonance imaging (fMRI) experiment is employed to identify four brain regions with significant activations during motor imagery (MI) and the effective connections between these regions of interest (ROIs) were calculated using Dynamic Window-level Granger Causality (DWGC). Then, a real-time fMRI (rt-fMRI) classification system for left- and right-hand MI is developed using the Open-NFT platform. We conducted data acquisition and processing on three subjects, and all of whom were recruited from a local college. As a result, the maximum accuracy of using Support Vector Machine (SVM) classifier on real-time three-class classification (rest, left hand, and right hand) with effective connections is 69.3%. And it is 3% higher than that of traditional multivoxel pattern classification analysis on average. Moreover, it significantly improves classification accuracy during the initial stage of MI tasks while reducing the latency effects in real-time decoding. The study suggests that the effective connections obtained through the DWGC method serve as valuable features for real-time decoding of MI using fMRI. Moreover, they exhibit higher sensitivity to changes in brain states. This research offers theoretical support and technical guidance for extracting neural signal features in the context of fMRI-based studies.

Training volitional control of the theory of mind network with real-time fMRI neurofeedback

Is there a way improve our ability to understand the minds of others? Towards addressing this question, here, we conducted a single-arm, proof-of-concept study to evaluate whether real-time fMRI neurofeedback (rtfMRI-NF) from the temporo-parietal junction (TPJ) leads to volitional control of the neural network subserving theory of mind (ToM; the process by which we attribute and reason about the mental states of others). As additional aims, we evaluated the strategies used to self-regulate the network and whether volitional control of the ToM network was moderated by participant characteristics and associated with improved performance on behavioral measures. Sixteen participants underwent fMRI while completing a task designed to individually-localize the TPJ, and then three separate rtfMRI-NF scans during which they completed multiple runs of a training task while receiving intermittent, activation-based feedback from the TPJ, and one run of a transfer task in which no neurofeedback was provided. Region-of-interest analyses demonstrated volitional control in most regions during the training tasks and during the transfer task, although the effects were smaller in magnitude and not observed in one of the neurofeedback targets for the transfer task. Text analysis demonstrated that volitional control was most strongly associated with thinking about prior social experiences when up-regulating the neural signal. Analysis of behavioral performance and brain-behavior associations largely did not reveal behavior changes except for a positive association between volitional control in RTPJ and changes in performance on one ToM task. Exploratory analysis suggested neurofeedback-related learning occurred, although some degree of volitional control appeared to be conferred with the initial self-regulation strategy provided to participants (i.e., without the neurofeedback signal). Critical study limitations include the lack of a control group and pre-rtfMRI transfer scan, which prevents a more direct assessment of neurofeedback-induced volitional control, and a small sample size, which may have led to an overestimate and/or unreliable estimate of study effects. Nonetheless, together, this study demonstrates the feasibility of training volitional control of a social cognitive brain network, which may have important clinical applications. Given the study's limitations, findings from this study should be replicated with more robust experimental designs.

Effective Connectivity of the Bilateral Amygdala, Dorsomedial Prefrontal, and Subgenual Anterior Cingulate Cortices: Feasibility of Positive Social Emotion Regulation Models for Real-Time Functional Magnetic Resonance Imaging

Effective connectivity based on functional magnetic resonance imaging (fMRI) allows assessing directions of interaction between brain regions. For real-time fMRI, we compared models of positive social emotion regulation based on a network involving the bilateral amygdala, dorsomedial prefrontal, and subgenual anterior cingulate cortex. The top-down regulation model implied modulation of the dorsomedial prefrontal cortex exerted onto other regions, while the bottom-up model implied the inverse modulation. The validity of model calculations was tested using the data from three healthy volunteers who imagined positive interactions with people in presented photos (stimuli). We confirmed the dominance of the top-down model and evaluated the number and duration of iterations required for model estimations. The study shows the applicability of the four-node effective connectivity models for regulation of positive social emotions using real-time fMRI, e.g., for neurofeedback applications.

Self-regulation of visual word form area activation with real-time fMRI neurofeedback

The Visual Word Form Area (VWFA) is a key region of the brain's reading network and its activation has been shown to be strongly associated with reading skills. Here, for the first time, we investigated whether voluntary regulation of VWFA activation is feasible using real-time fMRI neurofeedback. 40 adults with typical reading skills were instructed to either upregulate (UP group, N = 20) or downregulate (DOWN group, N = 20) their own VWFA activation during six neurofeedback training runs. The VWFA target region was individually defined based on a functional localizer task. Before and after training, also regulation runs without feedback ("no-feedback runs") were performed. When comparing the two groups, we found stronger activation across the reading network for the UP than the DOWN group. Further, activation in the VWFA was significantly stronger in the UP group than the DOWN group. Crucially, we observed a significant interaction of group and time (pre, post) for the no-feedback runs: The two groups did not differ significantly in their VWFA activation before neurofeedback training, but the UP group showed significantly stronger activation than the DOWN group after neurofeedback training. Our results indicate that upregulation of VWFA activation is feasible and that, once learned, successful upregulation can even be performed in the absence of feedback. These results are a crucial first step toward the development of a potential therapeutic support to improve reading skills in individuals with reading impairments.

Targeted neurorehabilitation strategies in post-stroke aphasia

BACKGROUND

Aphasia is a debilitating language impairment, affecting millions of people worldwide. About 40% of stroke survivors develop chronic aphasia, resulting in life-long disability.

OBJECTIVE

This review examines extrinsic and intrinsic neuromodulation techniques, aimed at enhancing the effects of speech and language therapies in stroke survivors with aphasia.

METHODS

We discuss the available evidence supporting the use of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation, and functional MRI (fMRI) real-time neurofeedback in aphasia rehabilitation.

RESULTS

This review systematically evaluates studies focusing on efficacy and implementation of specialized methods for post-treatment outcome optimization and transfer to functional skills. It considers stimulation target determination and various targeting approaches. The translation of neuromodulation interventions to clinical practice is explored, emphasizing generalization and functional communication. The review also covers real-time fMRI neurofeedback, discussing current evidence for efficacy and essential implementation parameters. Finally, we address future directions for neuromodulation research in aphasia.

CONCLUSIONS

This comprehensive review aims to serve as a resource for a broad audience of researchers and clinicians interested in incorporating neuromodulation for advancing aphasia care.

Real-time and Recursive Estimators for Functional MRI Quality Assessment

Real-time quality assessment (rtQA) of functional magnetic resonance imaging (fMRI) based on blood oxygen level-dependent (BOLD) signal changes is critical for neuroimaging research and clinical applications. The losses of BOLD sensitivity because of different types of technical and physiological noise remain major sources of fMRI artifacts. Due to difficulty of subjective visual perception of image distortions during data acquisitions, a comprehensive automatic rtQA is needed. To facilitate rapid rtQA of fMRI data, we applied real-time and recursive quality assessment methods to whole-brain fMRI volumes, as well as time-series of target brain areas and resting-state networks. We estimated recursive temporal signal-to-noise ratio (rtSNR) and contrast-to-noise ratio (rtCNR), and real-time head motion parameters by a framewise rigid-body transformation (translations and rotations) using the conventional current to template volume registration. In addition, we derived real-time framewise (FD) and micro (MD) displacements based on head motion parameters and evaluated the temporal derivative of root mean squared variance over voxels (DVARS). For monitoring time-series of target regions and networks, we estimated the number of spikes and amount of filtered noise by means of a modified Kalman filter. Finally, we applied the incremental general linear modeling (GLM) to evaluate real-time contributions of nuisance regressors (linear trend and head motion). Proposed rtQA was demonstrated in real-time fMRI neurofeedback runs without and with excessive head motion and real-time simulations of neurofeedback and resting-state fMRI data. The rtQA was implemented as an extension of the open-source OpenNFT software written in Python, MATLAB and C++ for neurofeedback, task-based, and resting-state paradigms. We also developed a general Python library to unify real-time fMRI data processing and neurofeedback applications. Flexible estimation and visualization of rtQA facilitates efficient rtQA of fMRI data and helps the robustness of fMRI acquisitions by means of substantiating decisions about the necessity of the interruption and re-start of the experiment and increasing the confidence in neural estimates.

RT-Cloud: A cloud-based software framework to simplify and standardize real-time fMRI

Real-time fMRI (RT-fMRI) neurofeedback has been shown to be effective in treating neuropsychiatric disorders and holds tremendous promise for future breakthroughs, both with regard to basic science and clinical applications. However, the prevalence of its use has been hampered by computing hardware requirements, the complexity of setting up and running an experiment, and a lack of standards that would foster collaboration. To address these issues, we have developed RT-Cloud (https://github.com/brainiak/rt-cloud), a flexible, cloud-based, open-source Python software package for the execution of RT-fMRI experiments. RT-Cloud uses standardized data formats and adaptable processing streams to support and expand open science in RT-fMRI research and applications. Cloud computing is a key enabling technology for advancing RT-fMRI because it eliminates the need for on-premise technical expertise and high-performance computing; this allows installation, configuration, and maintenance to be automated and done remotely. Furthermore, the scalability of cloud computing makes it easier to deploy computationally-demanding multivariate analyses in real time. In this paper, we describe how RT-Cloud has been integrated with open standards, including the Brain Imaging Data Structure (BIDS) standard and the OpenNeuro database, how it has been applied thus far, and our plans for further development and deployment of RT-Cloud in the coming years.

A Library for fMRI Real-Time Processing Systems in Python (RTPSpy) With Comprehensive Online Noise Reduction, Fast and Accurate Anatomical Image Processing, and Online Processing Simulation

Real-time fMRI (rtfMRI) has enormous potential for both mechanistic brain imaging studies or treatment-oriented neuromodulation. However, the adaption of rtfMRI has been limited due to technical difficulties in implementing an efficient computational framework. Here, we introduce a python library for real-time fMRI (rtfMRI) data processing systems, Real-Time Processing System in python (RTPSpy), to provide building blocks for a custom rtfMRI application with extensive and advanced functionalities. RTPSpy is a library package including (1) a fast, comprehensive, and flexible online fMRI image processing modules comparable to offline denoising, (2) utilities for fast and accurate anatomical image processing to define an anatomical target region, (3) a simulation system of online fMRI processing to optimize a pipeline and target signal calculation, (4) simple interface to an external application for feedback presentation, and (5) a boilerplate graphical user interface (GUI) integrating operations with RTPSpy library. The fast and accurate anatomical image processing utility wraps external tools, including FastSurfer, ANTs, and AFNI, to make tissue segmentation and region of interest masks. We confirmed that the quality of the output masks was comparable with FreeSurfer, and the anatomical image processing could complete in a few minutes. The modular nature of RTPSpy provides the ability to use it for a simulation analysis to optimize a processing pipeline and target signal calculation. We present a sample script for building a real-time processing pipeline and running a simulation using RTPSpy. The library also offers a simple signal exchange mechanism with an external application using a TCP/IP socket. While the main components of the RTPSpy are the library modules, we also provide a GUI class for easy access to the RTPSpy functions. The boilerplate GUI application provided with the package allows users to develop a customized rtfMRI application with minimum scripting labor. The limitations of the package as it relates to environment-specific implementations are discussed. These library components can be customized and can be used in parts. Taken together, RTPSpy is an efficient and adaptable option for developing rtfMRI applications. Code available at: https://github.com/mamisaki/RTPSpy.

Real-Time fMRI Neurofeedback Training Changes Brain Degree Centrality and Improves Sleep in Chronic Insomnia Disorder: A Resting-State fMRI Study

Background

Chronic insomnia disorder (CID) is considered a major public health problem worldwide. Therefore, innovative and effective technical methods for studying the pathogenesis and clinical comprehensive treatment of CID are urgently needed.

Methods

Real-time fMRI neurofeedback (rtfMRI-NF), a new intervention, was used to train 28 patients with CID to regulate their amygdala activity for three sessions in 6 weeks. Resting-state fMRI data were collected before and after training. Then, voxel-based degree centrality (DC) method was used to explore the effect of rtfMRI-NF training. For regions with altered DC, we determined the specific connections to other regions that most strongly contributed to altered functional networks based on DC. Furthermore, the relationships between the DC value of the altered regions and changes in clinical variables were determined.

Results

Patients with CID showed increased DC in the right postcentral gyrus, Rolandic operculum, insula, and superior parietal gyrus and decreased DC in the right supramarginal gyrus, inferior parietal gyrus, angular gyrus, middle occipital gyrus, and middle temporal gyrus. Seed-based functional connectivity analyses based on the altered DC regions showed more details about the altered functional networks. Clinical scores in Pittsburgh sleep quality index, insomnia severity index (ISI), Beck depression inventory, and Hamilton anxiety scale decreased. Furthermore, a remarkable positive correlation was found between the changed ISI score and DC values of the right insula.

Conclusions

This study confirmed that amygdala-based rtfMRI-NF training altered the intrinsic functional hubs, which reshaped the abnormal functional connections caused by insomnia and improved the sleep of patients with CID. These findings contribute to our understanding of the neurobiological mechanism of rtfMRI-NF in insomnia treatment. However, additional double-blinded controlled clinical trials with larger sample sizes need to be conducted to confirm the effect of rtfMRI-NF from this initial study.

Real-Time Functional MRI in the Treatment of Mental Health Disorders

Multiple mental disorders have been associated with dysregulation of precise brain processes. However, few therapeutic approaches can correct such specific patterns of brain activity. Since the late 1960s and early 1970s, many researchers have hoped that this feat could be achieved by closed-loop brain imaging approaches, such as neurofeedback, that aim to modulate brain activity directly. However, neurofeedback never gained mainstream acceptance in mental health, in part due to methodological considerations. In this review, we argue that, when contemporary methodological guidelines are followed, neurofeedback is one of the few intervention methods in psychology that can be assessed in double-blind placebo-controlled trials. Furthermore, using new advances in machine learning and statistics, it is now possible to target very precise patterns of brain activity for therapeutic purposes. We review the recent literature in functional magnetic resonance imaging neurofeedback and discuss current and future applications to mental health.

Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Improved Regional Homogeneity in Chronic Insomnia Disorder After Amygdala-Based Real-Time fMRI Neurofeedback Training

BACKGROUND

Chronic insomnia disorder (CID) is a highly prevalent sleep disorder, which influences people's daily life and is even life threatening. However, whether the resting-state regional homogeneity (ReHo) of disrupted brain regions in CID can be reshaped to normal after treatment remains unclear.

METHODS

A novel intervention real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) was used to train 28 CID patients to regulate the activity of the left amygdala for three sessions in 6 weeks. The ReHo methodology was adopted to explore its role on resting-state fMRI data, which were collected before and after training. Moreover, the relationships between changes of clinical variables and ReHo value of altered regions were determined.

RESULTS

Results showed that the bilateral dorsal medial pre-frontal cortex, supplementary motor area (SMA), and left dorsal lateral pre-frontal cortex had decreased ReHo values, whereas the bilateral cerebellum anterior lobe (CAL) had increased ReHo values after training. Some clinical scores markedly decreased, including Pittsburgh Sleep Quality Index, Insomnia Severity Index, Beck Depression Inventory, and Hamilton Anxiety Scale (HAMA). Additionally, the ReHo values of the left CAL were positively correlated with the change in the Hamilton depression scale score, and a remarkable positive correlation was found between the ReHo values of the right SMA and the HAMA score.

CONCLUSION

Our study provided an objective evidence that amygdala-based rtfMRI-NF training could reshape abnormal ReHo and improve sleep in patients with CID. The improved ReHo in CID provides insights into the neurobiological mechanism for the effectiveness of this intervention. However, larger double-blinded sham-controlled trials are needed to confirm our results from this initial study.

Early Stopping in Experimentation With Real-Time Functional Magnetic Resonance Imaging Using a Modified Sequential Probability Ratio Test

Introduction: Functional magnetic resonance imaging (fMRI) often involves long scanning durations to ensure the associated brain activity can be detected. However, excessive experimentation can lead to many undesirable effects, such as from learning and/or fatigue effects, discomfort for the subject, excessive motion artifacts and loss of sustained attention on task. Overly long experimentation can thus have a detrimental effect on signal quality and accurate voxel activation detection. Here, we propose dynamic experimentation with real-time fMRI using a novel statistically driven approach that invokes early stopping when sufficient statistical evidence for assessing the task-related activation is observed. Methods: Voxel-level sequential probability ratio test (SPRT) statistics based on general linear models (GLMs) were implemented on fMRI scans of a mathematical 1-back task from 12 healthy teenage subjects and 11 teenage subjects born extremely preterm (EPT). This approach is based on likelihood ratios and allows for systematic early stopping based on target statistical error thresholds. We adopt a two-stage estimation approach that allows for accurate estimates of GLM parameters before stopping is considered. Early stopping performance is reported for different first stage lengths, and activation results are compared with full durations. Finally, group comparisons are conducted with both early stopped and full duration scan data. Numerical parallelization was employed to facilitate completion of computations involving a new scan within every repetition time (TR). Results: Use of SPRT demonstrates the feasibility and efficiency gains of automated early stopping, with comparable activation detection as with full protocols. Dynamic stopping of stimulus administration was achieved in around half of subjects, with typical time savings of up to 33% (4 min on a 12 min scan). A group analysis produced similar patterns of activity for control subjects between early stopping and full duration scans. The EPT group, individually, demonstrated more variability in location and extent of the activations compared to the normal term control group. This was apparent in the EPT group results, reflected by fewer and smaller clusters. Conclusion: A systematic statistical approach for early stopping with real-time fMRI experimentation has been implemented. This dynamic approach has promise for reducing subject burden and fatigue effects.

Conducting decoded neurofeedback studies

Closed-loop neurofeedback has sparked great interest since its inception in the late 1960s. However, the field has historically faced various methodological challenges. Decoded fMRI neurofeedback may provide solutions to some of these problems. Notably, thanks to the recent advancements of machine learning approaches, it is now possible to target unconscious occurrences of specific multivoxel representations. In this tools of the trade paper, we discuss how to implement these interventions in rigorous double-blind placebo-controlled experiments. We aim to provide a step-by-step guide to address some of the most common methodological and analytical considerations. We also discuss tools that can be used to facilitate the implementation of new experiments. We hope that this will encourage more researchers to try out this powerful new intervention method.

Application of fMRI and Simultaneous fMRI-EEG Neurofeedback in Post-Stroke Motor Rehabilitation

This article discusses the contribution of fMRI- and fMRI-EEG-neurofeedback into recovery of motor function in two subacute stroke patients during the early post-stroke period. Premotor and supplementary motor zones of the cortex were chosen as the targets of voluntary control. Patient 1 received 6 sessions of motor imagery-based fMRI neurofeedback of secondary motor areas activity and Patient 2 received a similar course with the addition of μ- and β-EEG activity suppression. Both reduced the motor deficit severity, improved on the quality of life, and increased the C3/C4 coherence to other central leads within EEG μ-band. Patient 1 reliably increased the fMRI signal in target areas and improved on the strength and speed of hand movements. Patient 2 (fMRI-EEG) mastered the EEG activity regulation to a greater degree. The authors conclude that pure fMRI neurofeedback and bi-modal fMRI-EEG neurofeedback produce different clinical effects in motor rehabilitation, which confirms the prospect of the closed-loop stroke treatment.

The impact of real-time fMRI denoising on online evaluation of brain activity and functional connectivity

Objective. Comprehensive denoising is imperative in functional magnetic resonance imaging (fMRI) analysis to reliably evaluate neural activity from the blood oxygenation level dependent signal. In real-time fMRI, however, only a minimal denoising process has been applied and the impact of insufficient denoising on online brain activity estimation has not been assessed comprehensively. This study evaluated the noise reduction performance of online fMRI processes in a real-time estimation of regional brain activity and functional connectivity.Approach.We performed a series of real-time processing simulations of online fMRI processing, including slice-timing correction, motion correction, spatial smoothing, signal scaling, and noise regression with high-pass filtering, motion parameters, motion derivatives, global signal, white matter/ventricle average signals, and physiological noise models with image-based retrospective correction of physiological motion effects (RETROICOR) and respiration volume per time (RVT).Main results.All the processing was completed in less than 400 ms for whole-brain voxels. Most processing had a benefit for noise reduction except for RVT that did not work due to the limitation of the online peak detection. The global signal regression, white matter/ventricle signal regression, and RETROICOR had a distinctive noise reduction effect, depending on the target signal, and could not substitute for each other. Global signal regression could eliminate the noise-associated bias in the mean dynamic functional connectivity across time.Significance.The results indicate that extensive real-time denoising is possible and highly recommended for real-time fMRI applications.

The effects of multi-echo fMRI combination and rapid T2*-mapping on offline and real-time BOLD sensitivity

A variety of strategies are used to combine multi-echo functional magnetic resonance imaging (fMRI) data, yet recent literature lacks a systematic comparison of the available options. Here we compare six different approaches derived from multi-echo data and evaluate their influences on BOLD sensitivity for offline and in particular real-time use cases: a single-echo time series (based on Echo 2), the real-time T₂*-mapped time series (T₂*FIT) and four combined time series (T₂*-weighted, tSNR-weighted, TE-weighted, and a new combination scheme termed T₂*FIT-weighted). We compare the influences of these six multi-echo derived time series on BOLD sensitivity using a healthy participant dataset (N = 28) with four task-based fMRI runs and two resting state runs. We show that the T₂*FIT-weighted combination yields the largest increase in temporal signal-to-noise ratio across task and resting state runs. We demonstrate additionally for all tasks that the T₂*FIT time series consistently yields the largest offline effect size measures and real-time region-of-interest based functional contrasts and temporal contrast-to-noise ratios. These improvements show the promising utility of multi-echo fMRI for studies employing real-time paradigms, while further work is advised to mitigate the decreased tSNR of the T₂*FIT time series. We recommend the use and continued exploration of T₂*FIT for offline task-based and real-time region-based fMRI analysis. Supporting information includes: a data repository (https://dataverse.nl/dataverse/rt-me-fmri), an interactive web-based application to explore the data (https://rt-me-fmri.herokuapp.com/), and further materials and code for reproducibility (https://github.com/jsheunis/rt-me-fMRI).

Targeting hippocampal hyperactivity with real-time fMRI neurofeedback: protocol of a single-blind randomized controlled trial in mild cognitive impairment

BACKGROUND

Several fMRI studies found hyperactivity in the hippocampus during pattern separation tasks in patients with Mild Cognitive Impairment (MCI; a prodromal stage of Alzheimer's disease). This was associated with memory deficits, subsequent cognitive decline, and faster clinical progression. A reduction of hippocampal hyperactivity with an antiepileptic drug improved memory performance. Pharmacological interventions, however, entail the risk of side effects. An alternative approach may be real-time fMRI neurofeedback, during which individuals learn to control region-specific brain activity. In the current project we aim to test the potential of neurofeedback to reduce hippocampal hyperactivity and thereby improve memory performance.

METHODS

In a single-blind parallel-group study, we will randomize n = 84 individuals (n = 42 patients with MCI, n = 42 healthy elderly volunteers) to one of two groups receiving feedback from either the hippocampus or a functionally independent region. Percent signal change of the hemodynamic response within the respective target region will be displayed to the participant with a thermometer icon. We hypothesize that only feedback from the hippocampus will decrease hippocampal hyperactivity during pattern separation and thereby improve memory performance.

DISCUSSION

Results of this study will reveal whether real-time fMRI neurofeedback is able to reduce hippocampal hyperactivity and thereby improve memory performance. In addition, the results of this study may identify predictors of successful neurofeedback as well as the most successful regulation strategies.

TRIAL REGISTRATION

The study has been registered with clinicaltrials.gov on the 16th of July 2019 (trial identifier: NCT04020744 ).

The efficacy of real-time functional magnetic resonance imaging neurofeedback for psychiatric illness: A meta-analysis of brain and behavioral outcomes

Real-time functional magnetic resonance imaging neurofeedback (rtfMRI-NF) has gained popularity as an experimental treatment for a variety of psychiatric illnesses. However, there has yet to be a quantitative review regarding its efficacy. Here, we present the first meta-analysis of rtfMRI-NF for psychiatric disorders, evaluating its impact on brain and behavioral outcomes. Our literature review identified 17 studies and 105 effect sizes across brain and behavioral outcomes. We find that rtfMRI-NF produces a medium-sized effect on neural activity during training (g = .59, 95 % CI [.44, .75], p < .0001), a large-sized effect after training when no neurofeedback is provided (g = .84, 95 % CI [.37, 1.31], p = .005), and small-sized effects for behavioral outcomes (symptoms g = .37, 95 % CI [.16, .58], p = .002; cognition g = .23, 95 % CI [-.33, .78], p = .288). Mixed-effects analyses revealed few moderators. Together, these data suggest a positive impact of rtfMRI-NF on brain and behavioral outcomes, although more research is needed to determine how rtfMRI-NF works, for whom, and under what circumstances.

Effects of neurofeedback on the activities of motor-related areas by using motor execution and imagery

Previous studies have reported that real-time functional magnetic resonance imaging (fMRI) neurofeedback using motor imagery can modulate the activity of several motor-related areas. However, the differences in these modulatory effects on distinct motor-related target regions using the same experimental protocol remain unelucidated. This study aimed to compare neurofeedback effects on the primary motor area (M1) and the ventral premotor cortex (PMv). Of the included participants, 15 received blood oxygenation level-dependent (BOLD) signals from their left M1, and the other 15 received signals from their left PMv. Both groups were instructed to try to increase the neurofeedback score (NF-Score), which reflected the averaged activation level of the target region, by executing or imagining a right-hand clenching movement. The result revealed that during imagery condition, the left M1 was deactivated in the PMv-group but not in the M1-group, whereas the left PMv was activated in the PMv-group but not in the M1-group. Our finding indicates that neurofeedback from distinct motor-related regions has different effects on brain activity regulation.

Pyneal: Open Source Real-Time fMRI Software

Increasingly, neuroimaging researchers are exploring the use of real-time functional magnetic resonance imaging (rt-fMRI) as a way to access a participant's ongoing brain function throughout a scan. This approach presents novel and exciting experimental applications ranging from monitoring data quality in real time, to delivering neurofeedback from a region of interest, to dynamically controlling experimental flow, or interfacing with remote devices. Yet, for those interested in adopting this method, the existing software options are few and limited in application. This presents a barrier for new users, as well as hinders existing users from refining techniques and methods. Here we introduce a free, open-source rt-fMRI package, the Pyneal toolkit, designed to address this limitation. The Pyneal toolkit is python-based software that offers a flexible and user friendly framework for rt-fMRI, is compatible with all three major scanner manufacturers (GE, Siemens, Phillips), and, critically, allows fully customized analysis pipelines. In this article, we provide a detailed overview of the architecture, describe how to set up and run the Pyneal toolkit during an experimental session, offer tutorials with scan data that demonstrate how data flows through the Pyneal toolkit with example analyses, and highlight the advantages that the Pyneal toolkit offers to the neuroimaging community.

Real-Time Resting-State Functional Magnetic Resonance Imaging Using Averaged Sliding Windows with Partial Correlations and Regression of Confounding Signals

Background/Introduction: There is considerable interest in using real-time functional magnetic resonance imaging (fMRI) for monitoring functional connectivity dynamics. To date, the majority of real-time resting-state fMRI studies have examined a limited number of brain regions. This is, in part, due to the computational demands of traditional seed- and independent component analysis-based methods, in particular when using increasingly available high-speed fMRI methods. Methods: This study describes a computationally efficient, real-time, seed-based, resting-state fMRI analysis pipeline using moving averaged sliding-windows (ASW) with partial correlations and regression of motion parameters and signals from white matter and cerebrospinal fluid. Results: Analytical and numerical analyses of ASW correlation and sliding-window regression as a function of window width show selectable bandpass filter characteristics and effective suppression of artifactual correlations resulting from signal drifts and transients. The analysis pipeline is compatible with multislab echo-volumar imaging and simultaneous multislice echo-planar imaging with repetition times as short as 136 msec. High-speed, resting-state fMRI data in healthy controls demonstrate the effectiveness of this approach for minimizing artifactual correlations in white and gray matter, which was comparable to conventional regression across the entire scan. Integrating sliding-window averaging (width: W₁) within a second-level sliding-window (width: W₂) enabled monitoring of intra- and internetwork correlation dynamics of up to 12 resting-state networks with bandpass filter characteristics determined by the first-level sliding-window and temporal resolution W₁ + W₂. Conclusions: The computational performance and confound tolerance make this seed-based, resting-state fMRI approach suitable for real-time monitoring of data quality and resting-state connectivity dynamics in neuroscience and clinical research studies. Impact statement Using averaged sliding-windows for seed-based correlation and regression of confounding signals provides a powerful model-free approach to increase tolerance to artifactual signal transients in resting-state analysis. The algorithmic efficiency of this sliding-window approach enables real-time, seed-based, resting-state functional magnetic resonance imaging (fMRI) of multiple networks with computation of connectivity matrices and online monitoring of data quality. Integration of a second-level sliding-window enables mapping of resting-state connectivity dynamics. Sensitivity and tolerance to confounding signals compare favorably with conventional correlation and confound regression across the entire scan. This methodological advance has the potential to enhance the clinical utility of resting-state fMRI and facilitate neuroscience applications.

Quality and denoising in real-time functional magnetic resonance imaging neurofeedback: A methods review

Neurofeedback training using real-time functional magnetic resonance imaging (rtfMRI-NF) allows subjects voluntary control of localised and distributed brain activity. It has sparked increased interest as a promising non-invasive treatment option in neuropsychiatric and neurocognitive disorders, although its efficacy and clinical significance are yet to be determined. In this work, we present the first extensive review of acquisition, processing and quality control methods available to improve the quality of the neurofeedback signal. Furthermore, we investigate the state of denoising and quality control practices in 128 recently published rtfMRI-NF studies. We found: (a) that less than a third of the studies reported implementing standard real-time fMRI denoising steps, (b) significant room for improvement with regards to methods reporting and (c) the need for methodological studies quantifying and comparing the contribution of denoising steps to the neurofeedback signal quality. Advances in rtfMRI-NF research depend on reproducibility of methods and results. Notably, a systematic effort is needed to build up evidence that disentangles the various mechanisms influencing neurofeedback effects. To this end, we recommend that future rtfMRI-NF studies: (a) report implementation of a set of standard real-time fMRI denoising steps according to a proposed COBIDAS-style checklist (https://osf.io/kjwhf/), (b) ensure the quality of the neurofeedback signal by calculating and reporting community-informed quality metrics and applying offline control checks and (c) strive to adopt transparent principles in the form of methods and data sharing and support of open-source rtfMRI-NF software. Code and data for reproducibility, as well as an interactive environment to explore the study data, can be accessed at https://github.com/jsheunis/quality-and-denoising-in-rtfmri-nf.

The role of the subgenual anterior cingulate cortex in dorsomedial prefrontal-amygdala neural circuitry during positive-social emotion regulation

Positive-social emotions mediate one's cognitive performance, mood, well-being, and social bonds, and represent a critical variable within therapeutic settings. It has been shown that the upregulation of positive emotions in social situations is associated with increased top-down signals that stem from the prefrontal cortices (PFC) which modulate bottom-up emotional responses in the amygdala. However, it remains unclear if positive-social emotion upregulation of the amygdala occurs directly through the dorsomedial PFC (dmPFC) or indirectly linking the bilateral amygdala with the dmPFC via the subgenual anterior cingulate cortex (sgACC), an area which typically serves as a gatekeeper between cognitive and emotion networks. We performed functional MRI (fMRI) experiments with and without effortful positive-social emotion upregulation to demonstrate the functional architecture of a network involving the amygdala, the dmPFC, and the sgACC. We found that effortful positive-social emotion upregulation was associated with an increase in top-down connectivity from the dmPFC on the amygdala via both direct and indirect connections with the sgACC. Conversely, we found that emotion processes without effortful regulation increased network modulation by the sgACC and amygdala. We also found that more anxious individuals with a greater tendency to suppress emotions and intrusive thoughts, were likely to display decreased amygdala, dmPFC, and sgACC activity and stronger connectivity strength from the sgACC onto the left amygdala during effortful emotion upregulation. Analyzed brain network suggests a more general role of the sgACC in cognitive control and sheds light on neurobiological informed treatment interventions.

A Guide to Literature Informed Decisions in the Design of Real Time fMRI Neurofeedback Studies: A Systematic Review

Background: Although biofeedback using electrophysiology has been explored extensively, the approach of using neurofeedback corresponding to hemodynamic response is a relatively young field. Real time functional magnetic resonance imaging-based neurofeedback (rt-fMRI-NF) uses sensory feedback to operantly reinforce patterns of neural response. It can be used, for example, to alter visual perception, increase brain connectivity, and reduce depression symptoms. Within recent years, interest in rt-fMRI-NF in both research and clinical contexts has expanded considerably. As such, building a consensus regarding best practices is of great value. Objective: This systematic review is designed to describe and evaluate the variations in methodology used in previous rt-fMRI-NF studies to provide recommendations for rt-fMRI-NF study designs that are mostly likely to elicit reproducible and consistent effects of neurofeedback. Methods: We conducted a database search for fMRI neurofeedback papers published prior to September 26th, 2019. Of 558 studies identified, 146 met criteria for inclusion. The following information was collected from each study: sample size and type, task used, neurofeedback calculation, regulation procedure, feedback, whether feedback was explicitly related to changing brain activity, feedback timing, control group for active neurofeedback, how many runs and sessions of neurofeedback, if a follow-up was conducted, and the results of neurofeedback training. Results: rt-fMRI-NF is typically upregulation practice based on hemodynamic response from a specific region of the brain presented using a continually updating thermometer display. Most rt-fMRI-NF studies are conducted in healthy samples and half evaluate its effect on immediate changes in behavior or affect. The most popular control group method is to provide sham signal from another region; however, many studies do not compare use a comparison group. Conclusions: We make several suggestions for designs of future rt-fMRI-NF studies. Researchers should use feedback calculation methods that consider neural response across regions (i.e., SVM or connectivity), which should be conveyed as intermittent, auditory feedback. Participants should be given explicit instructions and should be assessed on individual differences. Future rt-fMRI-NF studies should use clinical samples; effectiveness of rt-fMRI-NF should be evaluated on clinical/behavioral outcomes at follow-up time points in comparison to both a sham and no feedback control group.

Real-time fMRI for brain-computer interfacing

Brain-computer interfaces (BCIs) based on functional magnetic resonance imaging (fMRI) provide an important complement to other noninvasive BCIs. While fMRI has several disadvantages (being nonportable, methodologically challenging, costly, and noisy), it is the only method providing high spatial resolution whole-brain coverage of brain activation. These properties allow relating mental activities to specific brain regions and networks providing a transparent scheme for BCI users to encode information and for real-time fMRI BCI systems to decode the intents of the user. Various mental activities have been used successfully in fMRI BCIs so far that can be classified into the four categories: (a) higher-order cognitive tasks (e.g., mental calculation), (b) covert language-related tasks (e.g., mental speech and mental singing), (c) imagery tasks (motor, visual, auditory, tactile, and emotion imagery), and (d) selective attention tasks (visual, auditory, and tactile attention). While the ultimate spatial and temporal resolution of fMRI BCIs is limited by the physiologic properties of the hemodynamic response, technical and analytical advances will likely lead to substantially improved fMRI BCIs in the future using, for example, decoding of imagined letter shapes at 7T as the basis for more "natural" communication BCIs.

No time for drifting: Comparing performance and applicability of signal detrending algorithms for real-time fMRI

As a consequence of recent technological advances in the field of functional magnetic resonance imaging (fMRI), results can now be made available in real-time. This allows for novel applications such as online quality assurance of the acquisition, intra-operative fMRI, brain-computer-interfaces, and neurofeedback. To that aim, signal processing algorithms for real-time fMRI must reliably correct signal contaminations due to physiological noise, head motion, and scanner drift. The aim of this study was to compare performance of the commonly used online detrending algorithms exponential moving average (EMA), incremental general linear model (iGLM) and sliding window iGLM (iGLMwindow). For comparison, we also included offline detrending algorithms (i.e., MATLAB's and SPM8's native detrending functions). Additionally, we optimized the EMA control parameter, by assessing the algorithm's performance on a simulated data set with an exhaustive set of realistic experimental design parameters. First, we optimized the free parameters of the online and offline detrending algorithms. Next, using simulated data, we systematically compared the performance of the algorithms with respect to varying levels of Gaussian and colored noise, linear and non-linear drifts, spikes, and step function artifacts. Additionally, using in vivo data from an actual rt-fMRI experiment, we validated our results in a post hoc offline comparison of the different detrending algorithms. Quantitative measures show that all algorithms perform well, even though they are differently affected by the different artifact types. The iGLM approach outperforms the other online algorithms and achieves online detrending performance that is as good as that of offline procedures. These results may guide developers and users of real-time fMRI analyses tools to best account for the problem of signal drifts in real-time fMRI.

A framework for offline evaluation and optimization of real-time algorithms for use in neurofeedback, demonstrated on an instantaneous proxy for correlations

Interest in real-time fMRI neurofeedback has grown exponentially over the past few years, both for use as a basic science research tool, and as part of the search for novel clinical interventions for neurological and psychiatric illnesses. In order to expand the range of questions which can be addressed with this tool however, new neurofeedback methods must be developed, going beyond feedback of activations in a single region. These new methods, several of which have already been proposed, are by their nature complex, involving many possible parameters. Here we suggest a framework for evaluating and optimizing algorithms for use in a real-time setting, before beginning the neurofeedback experiment, by offline simulations of algorithm output using a previously collected dataset. We demonstrate the application of this framework on the instantaneous proxy for correlations which we developed for training connectivity between different network nodes, identify the optimal parameters for use with this algorithm, and compare it to more traditional correlation methods. We also examine the effects of advanced imaging techniques, such as multi-echo acquisition, and the integration of these into the real-time processing stream.

Treatment strategies for ADHD: an evidence-based guide to select optimal treatment

Attention-deficit/hyperactivity disorder (ADHD) is a common and impairing disorder affecting children, adolescents, and adults. Several treatment strategies are available that can successfully ameliorate symptoms, ranging from pharmacological to dietary interventions. Due to the increasing range of available options, an informed selection or prioritization of treatments is becoming harder for clinicians. This review aims to provide an evidence-based appraisal of the literature on ADHD treatment, supplemented by expert opinion on plausibility. We outline proposed mechanisms of action of established pharmacologic and non-pharmacologic treatments, and we review targets of novel treatments. The most relevant evidence supporting efficacy and safety of each treatment strategy is discussed. We review the individualized features of the patient that should guide the selection of treatments in a shared decision-making continuum. We provide guidance for optimizing initiation of treatment and follow-up of patients in clinical settings.

Neurofeedback learning for mental practice rather than repetitive practice improves neural pattern consistency and functional network efficiency in the subsequent mental motor execution

During brain modulation, repeated mental practice may not always result in efficient learning. Particularly, the effectiveness of mental motor practice depends on how well one induces neural activity in a desired state consistently across mental trials, which calls for feedbacks to adjust one's performance. We hypothesized that even a brief experience of neurofeedback learning enhances trial-by-trial neural pattern consistency during subsequent mental motor execution and that this experience would change recruitment of functional connectivity in the motor imagery and default mode networks. To test this hypothesis, we conducted an experiment with two sessions of mental motor practice before and after a neurofeedback training session, in which participants conducted four types of first-person mental motor execution tasks (walking forward, turning left, turning right, and touching a tree). During the neurofeedback training session, in which participants conducted a virtual navigation game, 10 experimental participants received real-time fMRI neuro-feedbacks, while 10 control participants simply repeated the same mental task according to given cues without feedbacks. The experimental group showed significantly higher effects of neuro-feedback training on trial-by-trial consistencies and classification accuracies of activated neural patterns than the control group. Task-performing global node strength and network efficiency were increased in the motor imagery network but decreased in the default mode network only in the experimental group. These results demonstrate that even a brief experience of feedback learning is more effective than simple practice repetitions without evaluation, which was reflected in increased neural pattern consistency and task-dependent functional connectivity during a mental motor execution task.

Neu3CA-RT: A framework for real-time fMRI analysis

Real-time functional magnetic resonance imaging (rtfMRI) allows visualisation of ongoing brain activity of the subject in the scanner. Denoising algorithms aim to rid acquired data of confounding effects, enhancing the blood oxygenation level-dependent (BOLD) signal. Further image processing and analysis methods, like general linear models (GLM) or multivariate analysis, then present application-specific information to the researcher. These processes are typically applied to regions of interest but, increasingly, rtfMRI techniques extract and classify whole brain functional networks and dynamics as correlates for brain states or behaviour, particularly in neuropsychiatric and neurocognitive disorders. We present Neu³CA-RT: a Matlab-based rtfMRI analysis framework aiming to advance scientific knowledge on real-time cognitive brain activity and to promote its translation into clinical practice. Design considerations are listed based on reviewing existing rtfMRI approaches. The toolbox integrates established SPM preprocessing routines, real-time GLM mapping of fMRI data to a basis set of spatial brain networks, correlation of activity with 50 behavioural profiles from the BrainMap database, and an intuitive user interface. The toolbox is demonstrated in a task-based experiment where a subject executes visual, auditory and motor tasks inside a scanner. In three out of four experiments, resulting behavioural profiles agreed with the expected brain state.

Brain networks for engaging oneself in positive-social emotion regulation

Positive emotions facilitate cognitive performance, and their absence is associated with burdening psychiatric disorders. However, the brain networks regulating positive emotions are not well understood, especially with regard to engaging oneself in positive-social situations. Here we report convergent evidence from a multimodal approach that includes functional magnetic resonance imaging (fMRI) brain activations, meta-analytic functional characterization, Bayesian model-driven analysis of effective brain connectivity, and personality questionnaires to identify the brain networks mediating the cognitive up-regulation of positive-social emotions. Our comprehensive approach revealed that engaging in positive-social emotion regulation with a self-referential first-person perspective is characterized by dynamic interactions between functionally specialized prefrontal cortex (PFC) areas, the temporoparietal junction (TPJ) and the amygdala. Increased top-down connectivity from the superior frontal gyrus (SFG) controls affective valuation in the ventromedial and dorsomedial PFC, self-referential processes in the TPJ, and modulate emotional responses in the amygdala via the ventromedial PFC. Understanding the brain networks engaged in the regulation of positive-social emotions that involve a first-person perspective is important as they are known to constitute an effective strategy in therapeutic settings.

Individual differences in rate of acquiring stable neural representations of tasks in fMRI

Task-related functional magnetic resonance imaging (fMRI) is a widely-used tool for studying the neural processing correlates of human behavior in both healthy and clinical populations. There is growing interest in mapping individual differences in fMRI task behavior and neural responses. By utilizing neuroadaptive task designs accounting for such individual differences, task durations can be personalized to potentially optimize neuroimaging study outcomes (e.g., classification of task-related brain states). To test this hypothesis, we first retrospectively tracked the volume-by-volume changes of beta weights generated from general linear models (GLM) for 67 adult subjects performing a stop-signal task (SST). We then modeled the convergence of the volume-by-volume changes of beta weights according to their exponential decay (ED) in units of half-life. Our results showed significant differences in beta weight convergence estimates of optimal stopping times (OSTs) between go following successful stop trials and failed stop trials for both cocaine dependent (CD) and control group (Con), and between go following successful stop trials and go following failed stop trials for Con group. Further, we implemented support vector machine (SVM) classification for 67 CD/Con labeled subjects and compared the classification accuracies of fMRI-based features derived from (1) the full fMRI task versus (2) the fMRI task truncated to multiples of the unit of half-life. Among the computed binary classification accuracies, two types of task durations based on 2 half-lives significantly outperformed the accuracies using fully acquired trials, supporting this length as the OST for the SST. In conclusion, we demonstrate the potential of a neuroadaptive task design that can be widely applied to personalizing other task-based fMRI experiments in either dynamic real-time fMRI applications or within fMRI preprocessing pipelines.

Real-time fMRI data for testing OpenNFT functionality

Here, we briefly describe the real-time fMRI data that is provided for testing the functionality of the open-source Python/Matlab framework for neurofeedback, termed Open NeuroFeedback Training (OpenNFT, Koush et al. [1]). The data set contains real-time fMRI runs from three anonymized participants (i.e., one neurofeedback run per participant), their structural scans and pre-selected ROIs/masks/weights. The data allows for simulating the neurofeedback experiment without an MR scanner, exploring the software functionality, and measuring data processing times on the local hardware. In accordance with the descriptions in our main article, we provide data of (1) periodically displayed (intermittent) activation-based feedback; (2) intermittent effective connectivity feedback, based on dynamic causal modeling (DCM) estimations; and (3) continuous classification-based feedback based on support-vector-machine (SVM) estimations. The data is available on our public GitHub repository:

https://github.com/OpenNFT/OpenNFT_Demo/releases.