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The aim of this study was the analysis of the effect of a learned increase in the dissociation between the rostral anterior cingulate cortex (rACC) and the left posterior insula (pInsL) on pain intensity and unpleasantness and the contribution of each region to the effect, exploring the possibility to influence the perception of pain with neurofeedback methods. We trained ten healthy subjects to increase the difference in the blood oxygenation level-dependent response between the rACC and pInsL to painful electric stimuli. Subjects learned to increase the dissociation with either the rACC (state 1) or the pInsL (state 2) being higher. For feedback we subtracted the signal of one region from the other and provided feedback in four conditions with six trials each yielding two different states: (rACC – pInsL increase (state 1), rACC – pInsL decrease (state 2), pInsL – rACC increase (state 2), pInsL – rACC decrease (state 1)). Significant changes in the dissociation from trial one to six were seen in all conditions. There were significant changes from trial one to six in the pInsL in three of the four conditions, the rACC showed no significant change. Pain intensity or unpleasantness ratings were unrelated to the dissociation between the regions and the activation in each region. Learning success in the conditions did not significantly correlate and there was no significant correlation between the two respective conditions of one state, i.e. learning to achieve a specific state is not a stable ability. The pInsL seems to be the driving force behind changes in the learned dissociation between the regions. Despite successful differential modulation of activation in areas responsive to the painful stimulus, no corresponding changes in the perception of pain intensity or unpleasantness emerged. Learning to induce different states of dissociation between the areas is not a stable ability since success did not correlate overall or between two conditions of the the same state.

This pilot study aimed to explore whether criminal psychopaths can learn volitional regulation of the left anterior insula with real-time fMRI neurofeedback. Our previous studies with healthy volunteers showed that learned control of the blood oxygenation-level dependent (BOLD) signal was specific to the target region, and not a result of general arousal and global unspecific brain activation, and also that successful regulation modulates emotional responses, specifically to aversive picture stimuli but not neutral stimuli. In this pilot study, four criminal psychopaths were trained to regulate the anterior insula by employing negative emotional imageries taken from previous episodes in their lives, in conjunction with contingent feedback. Only one out of the four participants learned to increase the percent differential BOLD in the up-regulation condition across training runs. Subjects with higher Psychopathic Checklist-Revised (PCL:SV) scores were less able to increase the BOLD signal in the anterior insula than their lower PCL:SV counterparts. We investigated functional connectivity changes in the emotional network due to learned regulation of the successful participant, by employing multivariate Granger Causality Modeling. Learning to up-regulate the left anterior insula not only increased the number of connections (causal density) in the emotional network in the single successful participant but also increased the difference between the number of outgoing and incoming connections (causal flow) of the left insula. This pilot study shows modest potential for training psychopathic individuals to learn to control brain activity in the anterior insula.

Tailoring treatments to the specific needs and biology of individual patients – personalized medicine – requires delineation of reliable predictors of response. Unfortunately, these have been slow to emerge, especially in neuropsychiatric disorders. We have recently described a real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback protocol that can reduce contamination-related anxiety, a prominent symptom of many cases of obsessive-compulsive disorder (OCD). Individual response to this intervention is variable. Here we used patterns of brain functional connectivity, as measured by baseline resting-state fMRI (rs-fMRI), to predict improvements in contamination anxiety after neurofeedback training. Activity of a region of the orbitofrontal cortex (OFC) and anterior prefrontal cortex, Brodmann area (BA) 10, associated with contamination anxiety in each subject was measured in real time and presented as a neurofeedback signal, permitting subjects to learn to modulate this target brain region. We have previously reported both enhanced OFC/BA 10 control and improved anxiety in a group of subclinically anxious subjects after neurofeedback. Five individuals with contamination-related OCD who underwent the same protocol also showed improved clinical symptomatology. In both groups, these behavioral improvements were strongly correlated with baseline whole-brain connectivity in the OFC/BA 10, computed from rs-fMRI collected several days prior to neurofeedback training. These pilot data suggest that rs-fMRI can be used to identify individuals likely to benefit from rt-fMRI neurofeedback training to control contamination anxiety.

Perception is an active process that interprets and structures the stimulus input based on assumptions about its possible causes. We use real-time functional magnetic resonance imaging (rtfMRI) to investigate a particularly powerful demonstration of dynamic object integration in which the same physical stimulus intermittently elicits categorically different conscious object percepts. In this study, we simulated an outline object that is moving behind a narrow slit. With such displays, the physically identical stimulus can elicit categorically different percepts that either correspond closely to the physical stimulus (vertically moving line segments) or represent a hypothesis about the underlying cause of the physical stimulus (a horizontally moving object that is partly occluded). In the latter case, the brain must construct an object from the input sequence. Combining rtfMRI with machine learning techniques we show that it is possible to determine online the momentary state of a subject’s conscious percept from time resolved BOLD-activity. In addition, we found that feedback about the currently decoded percept increased the decoding rates compared to prior fMRI recordings of the same stimulus without feedback presentation. The analysis of the trained classifier revealed a brain network that discriminates contents of conscious perception with antagonistic interactions between early sensory areas that represent physical stimulus properties and higher-tier brain areas. During integrated object percepts, brain activity decreases in early sensory areas and increases in higher-tier areas. We conclude that it is possible to use BOLD responses to reliably track the contents of conscious visual perception with a relatively high temporal resolution. We suggest that our approach can also be used to investigate the neural basis of auditory object formation and discuss the results in the context of predictive coding theory.

Motor imagery training is an effective approach for motor skill learning and motor function rehabilitation. As a novel method of motor imagery training, real-time fMRI (rtfMRI) enables individuals to acquire self-control of localized brain activation, achieving desired changes in behavior. The regulation of target region activation by rtfMRI often alters the activation of related brain regions. However, the interaction between the target region and these related regions is unclear. The Granger causality model (GCM) is a data-driven method that can explore the causal interaction between brain regions. In this study, we employed rtfMRI to train subjects to regulate the activation of the ipsilateral dorsal premotor area (dPMA) during motor imagery training, and we calculated the causal interaction of the dPMA with other motor-related regions based on the GCM. The results demonstrated that as the activity of the dPMA changed during rtfMRI training, the interaction of the target region with other related regions became significantly altered, and behavioral performance was improved after training. The altered interaction primarily exhibited as an increased unidirectional interaction from the dPMA to the other regions. These findings support the dominant role of the dPMA in motor skill learning via rtfMRI training and may indicate how activation of the target region interacts with the activation of other related regions.

This study investigated the level of self-regulation of the somatomotor cortices (SMCs) attained by an extended functional magnetic resonance imaging (fMRI) neurofeedback training. Sixteen healthy subjects performed 12 real-time functional magnetic resonance imaging neurofeedback training sessions within 4 weeks, involving motor imagery of the dominant right as well as the non-dominant left hand. Target regions of interests in the SMC were individually localized prior to the training by overt finger movements. The feedback signal (FS) was defined as the difference between fMRI activation in the contra- and ipsilateral SMC and visually presented to the subjects. Training efficiency was determined by an off-line general linear model analysis determining the fMRI percent signal changes in the SMC target areas accomplished during the neurofeedback training. Transfer success was assessed by comparing the pre- and post-training transfer task, i.e., the neurofeedback paradigm without the presentation of the FS. Group results show a distinct increase in feedback performance (FP) in the transfer task for the trained group compared to a matched untrained control group, as well as an increase in the time course of the training, indicating an efficient training and a successful transfer. Individual analysis revealed that the training efficiency was not only highly correlated to the transfer success but also predictive. Trainings with at least 12 efficient training runs were associated with a successful transfer outcome. A group analysis of the hemispheric contributions to the FP showed that it is mainly driven by increased fMRI activation in the contralateral SMC, although some individuals relied on ipsilateral deactivation. Training and transfer results showed no difference between left- and right-hand imagery, with a slight indication of more ipsilateral deactivation in the early right-hand trainings. [ABSTRACT FROM AUTHOR]

Neurofeedback draws on multiple techniques that propel both healthy and patient populations to self-regulate neural activity. Since the 1970s, numerous accounts have promoted electroencephalography-neurofeedback as a viable treatment for a host of mental disorders. Today, while the number of health care providers referring patients to neurofeedback practitioners increases steadily, substantial methodological and conceptual caveats continue to pervade empirical reports. And yet, nascent imaging technologies (e.g., real-time functional magnetic resonance imaging) and increasingly rigorous protocols are paving the road towards more effective applications and a better scientific understanding of the underlying mechanisms. Here, we outline common neurofeedback methods, illuminate the tenuous state of the evidence, and sketch out future directions to further unravel the potential merits of this contentious therapeutic prospect. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Neurofeedback (NF) based on real-time functional magnetic resonance imaging (rt-fMRI) allows voluntary regulation of the activity in a selected brain region. For the training of this regulation, a well-designed feedback system is required. Social reward may serve as an effective incentive in NF paradigms, but its efficiency has not yet been tested. Therefore, we developed a social reward NF paradigm and assessed it in comparison with a typical visual NF paradigm (moving bar). We trained twenty-four healthy participants, on three consecutive days, to control activation in dorsal anterior cingulate cortex (ACC) with fMRI-based NF. In the social feedback group, an avatar gradually smiled when ACC activity increased, whereas in the standard feedback group, a moving bar indicated the activation level. In order to assess a transfer of the NF training both groups were asked to up-regulate their brain activity without receiving feedback immediately before and after the NF training (pre- and post-test). Finally, the effect of the acquired NF training on ACC function was evaluated in a cognitive interference task (Simon task) during the pre- and post-test. Social reward led to stronger activity in the ACC and reward-related areas during the NF training when compared to standard feedback. After the training, both groups were able to regulate ACC without receiving feedback, with a trend for stronger responses in the social feedback group. Moreover, despite a lack of behavioral differences, significant higher ACC activations emerged in the cognitive interference task, reflecting a stronger generalization of the NF training on cognitive interference processing after social feedback. Social reward can increase self-regulation in fMRI-based NF and strengthen its effects on neural processing in related tasks, such as cognitive interference. A particular advantage of social feedback is that a direct external reward is provided as in natural social interactions, opening perspectives for implicit learning paradigms. [ABSTRACT FROM AUTHOR]

Task performance depends on ongoing brain activity which can be influenced by attention, arousal, or motivation. However, such modulating factors of cognitive efficiency are unspecific, can be difficult to control, and are not suitable to facilitate neural processing in a regionally specific manner. Here, we non-pharmacologically manipulated regionally specific brain activity using technically sophisticated real-time fMRI neurofeedback. This was accomplished by training participants to simultaneously control ongoing brain activity in circumscribed motor and memory-related brain areas, namely the supplementary motor area and the parahippocampal cortex. We found that learned voluntary control over these functionally distinct brain areas caused functionally specific behavioral effects, i.e. shortening of motor reaction times and specific interference with memory encoding. The neurofeedback approach goes beyond improving cognitive efficiency by unspecific psychological factors such as attention, arousal, or motivation. It allows for directly manipulating sustained activity of task-relevant brain regions in order to yield specific behavioral or cognitive effects. [ABSTRACT FROM AUTHOR]

Working memory refers to the ability to temporarily store and manipulate information that is necessary for complex cognition activities. Previous studies have demonstrated that working memory capacity can be improved by behavioral training, and brain activities in the frontal and parietal cortices and the connections between these regions are also altered by training. Our recent neurofeedback training has proven that the regulation of the left dorsal lateral prefrontal cortex (DLPFC) activity using real-time functional magnetic resonance imaging (rtfMRI) can improve working memory performance. However, how working memory training promotes interaction between brain regions and whether this promotion correlates with performance improvement remain unclear. In this study, we employed structural equation modeling (SEM) to calculate the interactions between the regions within the working memory network during neurofeedback training. The results revealed that the direct effect of the frontoparietal connection in the left hemisphere was enhanced by the rtfMRI training. Specifically, the increase in the path from the left DLPFC to the left inferior parietal lobule (IPL) was positively correlated with improved performance in verbal working memory. These findings demonstrate the important role of the frontoparietal connection in working memory training and suggest that increases in frontoparietal connectivity might be a key factor associated with behavioral improvement. [ABSTRACT FROM AUTHOR]

Deficits in emotion regulation are a prominent feature of psychiatric conditions and a promising target for treatment. For instance, cognitive reappraisal is regarded as an effective strategy for emotion regulation. Neurophysiological models have established the lateral prefrontal cortex (LPFC) as a key structure in the regulation of emotion processing through modulations of emotion-eliciting structures such as the amygdala. Feedback of the LPFC activity by real-time functional magnetic resonance (fMRI) may thus enhance the efficacy of cognitive reappraisal. During cognitive reappraisal of aversive visual stimuli, LPFC activity was fed back to the experimental group, whereas control participants received no such information. As a result, during reappraisal, amygdala activity was lower in the experimental group than in the controls. Furthermore, an increase of inter-hemispheric functional connectivity emerged in the feedback group. The current study extends the neurofeedback literature by suggesting that fMRI feedback can modify brain activity during a given task. [ABSTRACT FROM AUTHOR]

Signal drift in functional magnetic resonance imaging (fMRI) is an unavoidable artifact that limits classification performance in multi-voxel pattern analysis of fMRI. As conventional methods to reduce signal drift, global demeaning or proportional scaling disregards regional variations of drift, whereas voxel-wise univariate detrending is too sensitive to noisy fluctuations. To overcome these drawbacks, we propose a multivariate real-time detrending method for multiclass classification that involves spatial demeaning at each scan and the recursive detrending of drifts in the classifier outputs driven by a multiclass linear support vector machine. Experiments using binary and multiclass data showed that the linear trend estimation of the classifier output drift for each class (a weighted sum of drifts in the class-specific voxels) was more robust against voxel-wise artifacts that lead to inconsistent spatial patterns and the effect of online processing than voxel-wise detrending. The classification performance of the proposed method was significantly better, especially for multiclass data, than that of voxel-wise linear detrending, global demeaning, and classifier output detrending without demeaning. We concluded that the multivariate approach using classifier output detrending of fMRI signals with spatial demeaning preserves spatial patterns, is less sensitive than conventional methods to sample size, and increases classification performance, which is a useful feature for real-time fMRI classification. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASDs) comprise a heterogeneous set of neurodevelopmental disorders characterized by dramatic impairments of interpersonal behavior, communication, and empathy. Recent neuroimaging studies suggested that ASD are disorders characterized by widespread abnormalities involving distributed brain network, though clear evidence of differences in large-scale brain network interactions underlying the cognitive and behavioral symptoms of ASD are still lacking. Consistent findings of anterior insula cortex hypoactivation and dysconnectivity during tasks related to emotional and social processing indicates its dysfunctional role in ASD. In parallel, increasing evidence showed that successful control of anterior insula activity can be attained using real-time fMRI paradigms. More importantly, successful regulation of this region was associated with changes in behavior and brain connectivity in both healthy individuals and psychiatric patients. Building on these results we here propose and discuss the use of real-time fMRI neurofeedback in ASD aiming at improving emotional and social behavior. [ABSTRACT FROM AUTHOR]

Recent advances in real-time functional magnetic resonance imaging (rt-fMRI) techniques enable online feedback about momentary brain activity from a localized region of interest. The anterior cingulate cortex (ACC) as a central hub for cognitive and emotional networks and its modulation has been suggested to elicit mood changes. In the presented real-time fMRI neurofeedback experiment at a 3 and a 7 T scanner we enabled participants to regulate ACC activity within one training session. The session consisted of three training runs of 8.5 min where subjects received online feedback about their current ACC activity. Before and after each run we presented emotional prosody. Subjects rated these stimuli according to their emotional valence and arousal, which served as an implicit mood measure. We found increases in ACC activation at 3 T (n = 15) and at 7 T (n = 9) with a higher activation success for the 3 T group. FMRI signal control of the rostral ACC depended on signal quality and predicted a valence bias in the rating of emotional prosody. Real-time fMRI neurofeedback of the ACC is feasible at different magnetic field strengths and can modulate localized ACC activity and emotion perception. It promises non-invasive therapeutic approaches for different psychiatric disorders characterized by impaired self-regulation. [ABSTRACT FROM AUTHOR]

Previous advances in magnetic resonance imaging allow the analysis of blood oxygen level-dependent signals in real time, thus opening the possibility of feeding an index of these signals back to scanned human participants. However, it is still not known to what extent different cortical networks may differ in their sensitivity to such internally generated neurofeedback (NF). Here, we compare NF efficacy across six cortical regions including: early and high-order visual areas and the posterior parietal lobe, a prominent node of the default mode network (DMN). Our results reveal a consistent difference in NF activation across these areas. Sham controls ruled out a role of attention/arousal in these effects. These differences are suggestive of a relationship to the relative reliance on intrinsic information, moving from early visual cortex (lowest) to the DMN (highest). Interestingly, the visual parahippocampal place area showed NF activation closer to the DMN node. The results are compatible with the notion of the DMN as an intrinsically oriented system. [ABSTRACT FROM AUTHOR]

Motor imagery (MI) has shown effectiveness in enhancing motor performance. This may be due to the common neural mechanisms underlying MI and motor execution (ME). The main region of the ME network, the primary motor cortex (M1), has been consistently linked to motor performance. However, the activation of M1 during motor imagery is controversial, which may account for inconsistent rehabilitation therapy outcomes using MI. Here, we examined the relationship between contralateral M1 (cM1) activation during MI and changes in sensorimotor performance. To aid cM1 activity modulation during MI, we used real-time fMRI neurofeedback-guided MI based on cM1 hand area blood oxygen level dependent (BOLD) signal in healthy subjects, performing kinesthetic MI of pinching. We used multiple regression analysis to examine the correlation between cM1 BOLD signal and changes in motor performance during an isometric pinching task of those subjects who were able to activate cM1 during motor imagery. Activities in premotor and parietal regions were used as covariates. We found that cM1 activity was positively correlated to improvements in accuracy as well as overall performance improvements, whereas other regions in the sensorimotor network were not. The association between cM1 activation during MI with performance changes indicates that subjects with stronger cM1 activation during MI may benefit more from MI training, with implications toward targeted neurotherapy. [ABSTRACT FROM AUTHOR]

In this methods article, we present a new implementation of a recently reported FSL-integrated neuro feed back tool, the standalone version of "Functional Real-time Interactive Endogenous Neuromodulation and Decoding" (FRIEND). We will refer to this new implementation as the FRIEND Engine Framework. The framework comprises a client-server cross-platform solution for real time fMRI and fMRI/EEG neuro feed back studies, enabling flexible customization or integration of graphical interfaces, devices, and data processing. This implementation allows a fast setup of novel plug-ins and frontends, which can be shared with the user community at large. The FRIEND Engine Framework is freely distributed for non-commercial, research purposes. [ABSTRACT FROM AUTHOR]

Self-regulation of brain activation using real-time functional magnetic resonance imaging has been used to train subjects to modulate activation in various brain areas and has been associated with behavioral changes such as altered pain perception. The aim of this study was to assess the comparability of upregulation versus downregulation of activation in the rostral anterior cingulate cortex (rACC) and left posterior insula (pInsL) and its effect on pain intensity and unpleasantness. In a first study, we trained 10 healthy subjects to separately upregulate and downregulate the blood oxygenation level-dependent response in the rACC or pInsL (six trials on 4 days) in response to painful electrical stimulation. The participants learned to significantly downregulate activation in pInsL and rACC and upregulate pInsL but not rACC. Success in the modulation of one region and direction of the modulation was not significantly correlated with success in another condition, indicating that the ability to control pain-related brain activation is site-specific. Less covariation between the areas in response to the nociceptive stimulus was positively correlated with learning success. Upregulation or downregulation of either region was unrelated to pain intensity or unpleasantness; however, our subjects did not learn rACC upregulation, which might be important for pain control. A significant increase in pain unpleasantness was found during upregulation of pInsL when covariation with the rACC was low. These initial results suggest that the state of the network involved in the processing of pain needs to be considered in the modulation of pain-evoked activation and its behavioral effects. Hum Brain Mapp 35:5784-5798, 2014. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Amygdala NeuroFeedback (NF) have the potential of being a valuable non-invasive intervention tool in many psychiatric disporders. However, the feasibility and best practices of this method have not been systematically examined. The current article presents a review of amygdala-NF studies, an analytic summary of study design parameters, and examination of brain mechanisms related to successful amygdala-NF performance. A meta-analysis of 33 publications showed that real amygdala-NF facilitates learned modulation compared to control conditions. In addition, while variability in study dsign parameters is high, these design choices are implicitly organized by the targeted valence domain (positive or negative). However, in most cases the neuro-behavioral effects of targeting such domains were not directly assessed. Lastly, re-analyzing six data sets of amygdala-fMRI-NF revealed that successful amygdala down-modulation is coupled with deactivation of the posterior insula and nodes in the Default-Mode-Network. Our findings suggest that amygdala self-modulation can be acquired using NF. Yet, additional controlled studies, relevant behavioral tasks before and after NF intervention, and neural 'target engagement' measures are critically needed to establish efficacy and specificity. In addition, the fMRI analysis presented here suggest that common accounts regarding the brain network involved in amygdala NF might reflect unsuccessful modulation attempts rather than successful modulation. • NF facilitates learned amygdala self-modulation more than placebo. • As for clinical outcomes, placebo-controlled evidence are yet scarce. • Variability in design choices could be explained by the targeted neurobehavioral domain. • Successful Amygdala down-modulation is coupled with deactivation of posterior insula and Default-Mode-Network nodes. • Studies should explicitly target neurobehavioral processes, and include 'target engagement' measures. [ABSTRACT FROM AUTHOR]

The capacity for subjects to learn to volitionally control localized brain activity using neurofeedback is actively being investigated. We aimed to investigate the ability of healthy volunteers to quickly learn to use visual feedback during real-time functional MRI (rtfMRI) to modulate brain activity within their anterior right insular cortex (RIC) localized during a blink suppression task, an approach of possible interest in the use of rtfMRI to reduce urges. The RIC region of interest (RIC-ROI) was functionally localized using a blink suppression task, and BOLD signal changes within RIC-ROI used to create a constantly updating display fed back to the subject in the scanner. Subjects were instructed to use emotional imagery to try and increase activity within RIC-ROI during four feedback training runs (FB1–FB4). A ‘control’ run (CNTRL) before training and a ‘transfer’ run (XSFR) after training were performed without feedback to assess for baseline abilities and learning effects. Fourteen participants completed all neurofeedback training runs. At the group level, increased BOLD activity was seen in the anterior RIC during all the FB runs, but a significant increase in the functionally defined RIC-ROI was only attained during FB2. In atlas-defined insular cortex ROIs, significant increases were seen bilaterally during the CNTRL, FB1, FB2, and FB4 runs. Increased activity within the insular cortices did not show lateralization. Training did, however, result in a significant increase in functional connectivity between the RIC-ROI and the medial frontal gyrus when comparing FB4 to FB1. Since neurofeedback training did not lead to an increase in BOLD signal across all feedback runs, we suggest that learning to control one’s brain activity in this fashion may require longer or repeated rtfMRI training sessions.

We recently demonstrated that ultra-high-speed real-time fMRI using multi-slab echo-volumar imaging (MEVI) significantly increases sensitivity for mapping task-related activation and resting state networks (RSNs) compared to echo-planar imaging (Posse et al. 2012). In the present study we characterize the sensitivity of MEVI for mapping RSN connectivity dynamics, comparing independent component analysis (ICA) and a novel seed-based connectivity analysis (SBCA) that combines sliding-window correlation analysis with meta-statistics. This SBCA approach is shown to minimize the effects of confounds, such as movement, and CSF and white matter signal changes, and enables real-time monitoring of RSN dynamics at time scales of tens of seconds. We demonstrate highly sensitive mapping of eloquent cortex in the vicinity of brain tumors and arteriovenous malformations, and detection of abnormal resting state connectivity in epilepsy. In patients with motor impairment, resting state fMRI provided focal localization of sensorimotor cortex compared with more diffuse activation in task-based fMRI. The fast acquisition speed of MEVI enabled segregation of cardiac-related signal pulsation using ICA, which revealed distinct regional differences in pulsation amplitude and waveform, elevated signal pulsation in patients with arteriovenous malformations and a trend towards reduced pulsatility in gray matter of patients compared with healthy controls. Mapping cardiac pulsation in cortical gray matter may carry important functional information that distinguishes healthy from diseased tissue vasculature. This novel fMRI methodology is particularly promising for mapping eloquent cortex in patients with neurological disease, having variable degree of cooperation in task-based fMRI. In conclusion, ultra-high-real-time speed fMRI enhances the sensitivity of mapping the dynamics of resting state connectivity and cerebrovascular pulsatility for clinical and neuroscience research applications.

This paper reviews evidence on the neural basis of how positive mood states can modulate cognition, particularly during creative problem-solving. Studies performed over the past few decades demonstrate that individuals in a positive mood engage in a broader scope of attention, enhancing their access to distant and unusual semantic associations, and increasing task-shifting and problem-solving capacities. In this review, we summarize these behavioral studies; we then present recent findings on the changes in brain activation patterns that are induced by a positive mood when participants engage in problem-solving tasks and show how these relate to task performance. Additionally, we integrate findings on the neuromodulatory influence of positive mood on cognition as mediated by dopaminergic signaling in the prefrontal cortex and we describe how this system can go awry during pathological states of elevated mood as in mania. Finally, we describe current and future research directions using psychotherapeutic and real-time fMRI neurofeedback approaches to up-regulate positive mood and facilitate optimal creative cognitive performance. We conclude with some speculations on the clinical implications of this emerging area of research.

Real-time brain functional MRI (rt-fMRI) allows in-vivo non-invasive monitoring of neural networks. The use of multivariate data-driven analysis methods such as independent component analysis (ICA) offers an attractive trade-off between data interpretability and information extraction, and can be used during both task-based and rest experiments. The purpose of this study was to assess the effectiveness of different ICA-based procedures to monitor in real-time a target IC defined from a functional localizer which also used ICA. Four novel methods were implemented to monitor ongoing brain activity in a sliding window approach. The methods differed in the ways in which a priori information, derived from ICA algorithms, was used to monitora target independent component (IC). We implemented four different algorithms, all based on ICA. One Back-projection method used ICA to derive static spatial information from the functional localizer, off line, which was then back-projected dynamically during the real-time acquisition. The other three methods used real-time ICA algorithms that dynamically exploited temporal, spatial, or spatial-temporal priors during the real-time acquisition. The methods were evaluated by simulating a rt-fMRI experiment that used real fMRI data. The performance of each method was characterized by the spatial and/or temporal correlation with the target IC component monitored, computation time and intrinsic stochastic variability of the algorithms. In this study the Back-projection method, which could monitor more than one IC of interest, outperformed the other methods. These results are consistent with a functional task that gives stable target ICs over time. The dynamic adaptation possibilities offered by the other ICA methods proposed may offer better performance than the Back-projection in conditions where the functional activation shows higher spatial and/or temporal variability.

Advances in neuroimaging have helped illuminate our understanding of how the brain works in the presence of chronic pain, which often persists with unknown etiology or after the painful stimulus has been removed and any wounds have healed. Neuroimaging has enabled us to make great progress in identifying many of the neural mechanisms that contribute to chronic pain, and to pinpoint the specific regions of the brain that are activated in the presence of chronic pain. It has provided us with a new perception of the nature of chronic pain in general, leading researchers to move toward a whole-brain approach to the study and treatment of chronic pain, and to develop novel technologies and analysis techniques, with real potential for developing new diagnostics and more effective therapies. We review the use of neuroimaging in the study of chronic pain, with particular emphasis on magnetic resonance imaging. [ABSTRACT FROM AUTHOR]

This pilot study aimed to explore whether criminal psychopaths can learn volitional regulation of the left anterior insula with real-time fMRI neurofeedback. Our previous studies with healthy volunteers showed that learned control of the blood oxygenationlevel dependent (BOLD) signal was specific to the target region, and not a result of general arousal and global unspecific brain activation, and also that successful regulation modulates emotional responses, specifically to aversive picture stimuli but not neutral stimuli. In this pilot study, four criminal psychopaths were trained to regulate the anterior insula by employing negative emotional imageries taken from previous episodes in their lives, in conjunction with contingent feedback. Only one out of the four participants learned to increase the percent differential BOLD in the up-regulation condition across training runs. Subjects with higher Psychopathic Checklist-Revised (PCL:SV) scores were less able to increase the BOLD signal in the anterior insula than their lower PCL:SV counterparts. We investigated functional connectivity changes in the emotional network due to learned regulation of the successful participant, by employing multivariate Granger Causality Modeling (GCM). Learning to up-regulate the left anterior insula not only increased the number of connections (causal density) in the emotional network in the single successful participant but also increased the difference between the number of outgoing and incoming connections (causal flow) of the left insula. This pilot study shows modest potential for training psychopathic individuals to learn to control brain activity in the anterior insula. [ABSTRACT FROM AUTHOR]

Although the neurofeedback of real-time fMRI can reportedly enable people to gain control of the activity in the premotor cortex (PMA) during motor imagery, it is unclear how the neurofeedback training of PMA affect the motor network engaged in the motor execution (ME) and imagery (MI) task. In this study, we investigated the changes in the motor network engaged in both ME and MI task induced by real-time neurofeedback training of the right PMA. The neurofeedback training induced changes in activity of the ME-related motor network as well as alterations in the functional connectivity of both the ME-related and MI-related motor networks. Especially, the percent signal change of the right PMA in the last training run was found to be significantly correlated with the connectivity between the right PMA and the left posterior parietal lobe (PPL) during the pre-training MI run, post-training MI run and the last training run. Moreover, the increase in the tapping frequency was significantly correlated with the increase of connectivity between the right cerebellum and the primary motor area/primary sensory area (M1/S1) of the ME-related motor network after neurofeedback training. These findings show the importance of the connectivity between the right PMA and left PPL of the MI network for the up-regulation of the right PMA as well as the critical role of connectivity between the right cerebellum and M1/S1 of the ME network in improving the behavioral performance. [ABSTRACT FROM AUTHOR]

Tailoring treatments to the specific needs and biology of individual patients-personalized medicine-requires delineation of reliable predictors of response. Unfortunately, these have been slow to emerge, especially in neuropsychiatric disorders. We have recently described a real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback protocol that can reduce contamination-related anxiety, a prominent symptom of many cases of obsessive-compulsive disorder (OCD). Individual response to this intervention is variable. Here we used patterns of brain functional connectivity, as measured by baseline resting-state fMRI (rs-fMRI), to predict improvements in contamination anxiety after neurofeedback training. Activity of a region of the orbitofrontal cortex (OFC) and anterior prefrontal cortex, Brodmann area (BA) 10, associated with contamination anxiety in each subject was measured in real time and presented as a neurofeedback signal, permitting subjects to learn to modulate this target brain region. We have previously reported both enhanced OFC/BA 10 control and improved anxiety in a group of subclinically anxious subjects after neurofeedback. Five individuals with contamination-related OCD who underwent the same protocol also showed improved clinical symptomatology. In both groups, these behavioral improvements were strongly correlated with baseline whole-brain connectivity in the OFC/BA 10, computed from rs-fMRI collected several days prior to neurofeedback training. These pilot data suggest that rs-fMRI can be used to identify individuals likely to benefit from rt-fMRI neurofeedback training to control contamination anxiety. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Real-time fMRI is especially vulnerable to task-correlated movement artifacts because statistical methods normally available in conventional analyses to remove such signals cannot be used in the context of real-time fMRI. Multi-voxel classifier-based methods, although advantageous in many respects, are particularly sensitive. Here we systematically studied various movements of the head and face to determine to what extent these can 'masquerade' as signal in multi-voxel classifiers. METHODS Ten subjects were instructed to move systematically (twelve instructed movements) throughout fMRI exams and data from a previously published real-time study was also analyzed to determine the extent to which non-neural signals contributed to the high reported accuracy in classifier output. RESULTS Of potential concern, whole-brain classifiers based solely on movements exhibited false positives in all cases ( P < .05). Artifacts were also observed in the spatial activation maps for two of the twelve movement tasks. In the retrospective analysis, it was determined that the relatively high reported classification accuracies were (fortunately) mostly explainable by neural activity, but that in some cases performance was likely dominated by movements. CONCLUSION Movement tasks of many types (including movements of the eyes, face, and body) can lead to false positives in classifier-based real-time fMRI paradigms. [ABSTRACT FROM AUTHOR]

Perception is an active process that interprets and structures the stimulus input based on assumptions about its possible causes. We use real-time functional magnetic resonance imaging (rtfMRI) to investigate a particularly powerful demonstration of dynamic object integration in which the same physical stimulus intermittently elicits categorically different conscious object percepts. In this study, we simulated an outline object that is moving behind a narrow slit. With such displays, the physically identical stimulus can elicit categorically different percepts that either correspond closely to the physical stimulus (vertically moving line segments) or represent a hypothesis about the underlying cause of the physical stimulus (a horizontally moving object that is partly occluded). In the latter case, the brain must construct an object from the input sequence. Combining rtfMRI with machine learning techniques we show that it is possible to determine online the momentary state of a subject's conscious percept from time resolved BOLD-activity. In addition, we found that feedback about the currently decoded percept increased the decoding rates compared to prior fMRI recordings of the same stimulus without feedback presentation. The analysis of the trained classifier revealed a brain network that discriminates contents of conscious perception with antagonistic interactions between early sensory areas that represent physical stimulus properties and higher-tier brain areas. During integrated object percepts, brain activity decreases in early sensory areas and increases in higher-tier areas. We conclude that it is possible to use BOLD responses to reliably track the contents of conscious visual perception with a relatively high temporal resolution. We suggest that our approach can also be used to investigate the neural basis of auditory object formation and discuss the results in the context of predictive coding theory. [ABSTRACT FROM AUTHOR]

Abstract: The anterior insula (AI) plays a key role in affective processing, and insular dysfunction has been noted in several clinical conditions. Real-time functional MRI neurofeedback (rtfMRI-NF) provides a means of helping people learn to self-regulate activation in this brain region. Using the Blood Oxygenated Level Dependant (BOLD) signal from the right AI (RAI) as neurofeedback, we trained participants to increase RAI activation. In contrast, another group of participants was shown ‘control’ feedback from another brain area. Pre- and post-training affective probes were shown, with subjective ratings and skin conductance response (SCR) measured. We also investigated a reward-related reinforcement learning model of rtfMRI-NF. In contrast to the controls, we hypothesised a positive linear increase in RAI activation in participants shown feedback from this region, alongside increases in valence ratings and SCR to affective probes. Hypothesis-driven analyses showed a significant interaction between the RAI/control neurofeedback groups and the effect of self-regulation. Whole-brain analyses revealed a significant linear increase in RAI activation across four training runs in the group who received feedback from RAI. Increased activation was also observed in the caudate body and thalamus, likely representing feedback-related learning. No positive linear trend was observed in the RAI in the group receiving control feedback, suggesting that these data are not a general effect of cognitive strategy or control feedback. The control group did, however, show diffuse activation across the putamen, caudate and posterior insula which may indicate the representation of false feedback. No significant training-related behavioural differences were observed for valence ratings, or SCR. In addition, correlational analyses based on a reinforcement learning model showed that the dorsal anterior cingulate cortex underpinned learning in both groups. In summary, these data demonstrate that it is possible to regulate the RAI using rtfMRI-NF within one scanning session, and that such reward-related learning is mediated by the dorsal anterior cingulate. [Copyright &y& Elsevier]

Abstract: Neurofeedback is a promising approach for non-invasive modulation of human brain activity with applications for treatment of mental disorders and enhancement of brain performance. Neurofeedback techniques are commonly based on either electroencephalography (EEG) or real-time functional magnetic resonance imaging (rtfMRI). Advances in simultaneous EEG–fMRI have made it possible to combine the two approaches. Here we report the first implementation of simultaneous multimodal rtfMRI and EEG neurofeedback (rtfMRI–EEG-nf). It is based on a novel system for real-time integration of simultaneous rtfMRI and EEG data streams. We applied the rtfMRI–EEG-nf to training of emotional self-regulation in healthy subjects performing a positive emotion induction task based on retrieval of happy autobiographical memories. The participants were able to simultaneously regulate their BOLD fMRI activation in the left amygdala and frontal EEG power asymmetry in the high-beta band using the rtfMRI−EEG-nf. Our proof-of-concept results demonstrate the feasibility of simultaneous self-regulation of both hemodynamic (rtfMRI) and electrophysiological (EEG) activities of the human brain. They suggest potential applications of rtfMRI–EEG-nf in the development of novel cognitive neuroscience research paradigms and enhanced cognitive therapeutic approaches for major neuropsychiatric disorders, particularly depression. [Copyright &y& Elsevier]

Visual attention is used to selectively filter relevant information depending on current task demands and goals. Visual attention is called object-based attention when it is directed to coherent forms or objects in the visual field. This study used real-time functional magnetic resonance imaging for moment-to-moment decoding of attention to spatially overlapped objects belonging to two different object categories. First, a whole-brain classifier was trained on pictures of faces and places. Subjects then saw transparently overlapped pictures of a face and a place, and attended to only one of them while ignoring the other. The category of the attended object, face or place, was decoded on a scan-by-scan basis using the previously trained decoder. The decoder performed at 77.6% accuracy indicating that despite competing bottom-up sensory input, object-based visual attention biased neural patterns towards that of the attended object. Furthermore, a comparison between different classification approaches indicated that the representation of faces and places is distributed rather than focal. This implies that real-time decoding of object-based attention requires a multivariate decoding approach that can detect these distributed patterns of cortical activity. [ABSTRACT FROM AUTHOR]

Research from the University of Florida Center for the Study of Emotion and Attention aims to develop neurobiological measures that objectively discriminate among symptom patterns in patients with anxiety disorders. From this perspective, anxiety and mood pathologies are considered to be brain disorders, resulting from dysfunction and maladaptive plasticity in the neural circuits that determine fearful/defensive and appetitive/reward behavior (Insel et al., 2010). We review recent studies indicating that an enhanced probe startle reflex during the processing of fear memory cues (mediated by cortico-limbic circuitry and thus indicative of plastic brain changes), varies systematically in strength over a spectrum-wide dimension of anxiety pathology-across and within diagnoses-extending from strong focal fear reactions to a consistently blunted reaction in patients with more generalized anxiety and comorbid mood disorders. Preliminary studies with functional magnetic resonance imaging (fMRI) encourage the hypothesis that fear/defense circuit dysfunction covaries with this same dimension of psychopathology. Plans are described for an extended study of the brain's motivation circuitry in anxiety spectrum patients, with the aim of defining the specifics of circuit dysfunction in severe disorders. A sub-project explores the use of real-time fMRI feedback in circuit analysis and as a modality to up-regulate circuit function in the context of blunted affect. [ABSTRACT FROM AUTHOR]

Highlights: [•] RtfMRI-BCI has been used for self-regulation of circumscribed brain regions. [•] Single-ROI regulation does not represent the control of the whole neural network. [•] New developments in rtfMRI-BCI enable the feedback of distributed brain networks. [ABSTRACT FROM AUTHOR]

The amygdala is a central target of emotion regulation. It is overactive and dysregulated in affective and anxiety disorders and amygdala activity normalizes with successful therapy of the symptoms. However, a considerable percentage of patients do not reach remission within acceptable duration of treatment. The amygdala could therefore represent a promising target for real-time functional magnetic resonance imaging (rtfMRI) neurofeedback. rtfMRI neurofeedback directly improves the voluntary regulation of localized brain activity. At present, most rtfMRI neurofeedback studies have trained participants to increase activity of a target, i.e. up-regulation. However, in the case of the amygdala, down-regulation is supposedly more clinically relevant. Therefore, we developed a task that trained participants to down-regulate activity of the right amygdala while being confronted with amygdala stimulation, i.e. negative emotional faces. The activity in the functionally-defined region was used as online visual feedback in six healthy subjects instructed to minimize this signal using reality checking as emotion regulation strategy. Over a period of four training sessions, participants significantly increased down-regulation of the right amygdala compared to a passive viewing condition to control for habilitation effects. This result supports the concept of using rtfMRI neurofeedback training to control brain activity during relevant stimulation, specifically in the case of emotion, and has implications towards clinical treatment of emotional disorders. [ABSTRACT FROM AUTHOR]

Abstract: The dopaminergic system is involved in reward encoding and reinforcement learning. Dopaminergic neurons from this system in the substantia nigra/ventral tegmental area complex (SN/VTA) fire in response to unexpected reinforcing cues. The goal of this study was to investigate whether individuals can gain voluntary control of SN/VTA activity, thereby potentially enhancing dopamine release to target brain regions. Neurofeedback and mental imagery were used to self-regulate the SN/VTA. Real-time functional magnetic resonance imaging (rtfMRI) provided abstract visual feedback of the SN/VTA activity while the subject imagined rewarding scenes. Skin conductance response (SCR) was recorded as a measure of emotional arousal. To examine the effect of neurofeedback, subjects were assigned to either receiving feedback directly proportional (n=15, veridical feedback) or inversely proportional (n=17, inverted feedback) to SN/VTA activity. Both groups of subjects were able to up-regulate SN/VTA activity initially without feedback. Veridical feedback improved the ability to up-regulate SN/VTA compared to baseline while inverted feedback did not. Additional dopaminergic regions were activated in both groups. The ability to self-regulate SN/VTA was differentially correlated with SCR depending on the group, suggesting an association between emotional arousal and neurofeedback performance. These findings indicate that SN/VTA can be voluntarily activated by imagery and voluntary activation is further enhanced by neurofeedback. The findings may lead the way towards a non-invasive strategy for endogenous control of dopamine. [Copyright &y& Elsevier]

We explored the potential of using real-time fMRI (rt-fMRI) neurofeedback training to bias interpretations of naturalistic narrative stimuli. Participants were randomly assigned to one of two possible conditions, each corresponding to a different interpretation of an ambiguous spoken story. While participants listened to the story in the scanner, neurofeedback was used to reward neural activity corresponding to the assigned interpretation. After scanning, final interpretations were assessed. While neurofeedback did not change story interpretations on average, participants with higher levels of decoding accuracy during the neurofeedback procedure were more likely to adopt the assigned interpretation; additional control conditions are needed to establish the role of individualized feedback in driving this result. While naturalistic stimuli introduce a unique set of challenges in providing effective and individualized neurofeedback, we believe that this technique holds promise for individualized cognitive therapy., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

We outline general theoretical and practical implications of what we promote as enactive cinema for the neuroscientific study of online socio-emotional interaction. In a real-time functional magnetic resonance imaging (rt-fMRI) setting, participants are immersed in cinematic experiences that simulate social situations. While viewing, their physiological reactions - including brain responses - are tracked, representing implicit and unconscious experiences of the on-going social situations. These reactions, in turn, are analysed in real-time and fed back to modify the cinematic sequences they are viewing while being scanned. Due to the engaging cinematic content, the proposed setting focuses on living-by in terms of shared psycho-physiological epiphenomena of experience rather than active coping in terms of goal-oriented motor actions. It constitutes a means to parametrically modify stimuli that depict social situations and their broader environmental contexts. As an alternative to studying the variation of brain responses as a function of a priori fixed stimuli, this method can be applied to survey the range of stimuli that evoke similar responses across participants at particular brain regions of interest.