Zhang Yuan, Becker Benjamin, Kendrick Keith M, Zhang Qiong, Yao Shuxia
The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
The MOE Key Laboratory for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
Transl Psychiatry. 2025 May 16;15(1):170. doi: 10.1038/s41398-025-03382-8.
Real-time fMRI (rtfMRI) neurofeedback (NF) is a novel noninvasive technique that permits individuals to voluntarily control brain activity. The crucial role of the insula in emotional and salience processing makes it one of the most commonly targeted regions in previous rtfMRI studies. To provide an overview of progress in the field, the present review identified 25 rtfMRI insula studies and systematically reviewed key characteristics and findings in these studies. We found that rtfMRI-based NF training is efficient for modulating insula activity and its associated behavioral/symptom-related and neural changes. Furthermore, we also observed a maintenance effect of self-regulation ability and sustained symptom improvement, which is of importance for clinical application. However, training success of insula regulation was not consistently paralleled by behavioral/symptom-related changes, suggesting a need for optimizing the NF training protocol enabling more robust training effects. Principles including inclusion of a well-designed control group/condition, statistical analyses and reporting results following common criteria and a priori determination of sample and effect sizes as well as pre-registration are also highly recommended. In summary, we believe our review will inspire and inform both basic research and therapeutic translation of rtfMRI NF training as an intervention in mental disorders particularly those with insula dysfunction.
实时功能磁共振成像（rtfMRI）神经反馈（NF）是一种新型的非侵入性技术，它使个体能够自主控制大脑活动。脑岛在情绪和显著性加工中的关键作用使其成为以往rtfMRI研究中最常被靶向的区域之一。为了概述该领域的进展，本综述检索了25项rtfMRI脑岛研究，并系统回顾了这些研究的关键特征和结果。我们发现基于rtfMRI的NF训练对于调节脑岛活动及其相关的行为/症状相关和神经变化是有效的。此外，我们还观察到自我调节能力的维持效应和症状的持续改善，这对临床应用具有重要意义。然而，脑岛调节的训练成功并不总是与行为/症状相关的变化平行，这表明需要优化NF训练方案以实现更稳健的训练效果。还强烈推荐一些原则，包括纳入精心设计的对照组/条件、按照通用标准进行统计分析和报告结果、预先确定样本量和效应量以及预先注册。总之，我们相信我们的综述将为rtfMRI NF训练作为一种针对精神障碍尤其是那些脑岛功能障碍患者的干预措施的基础研究和治疗转化提供启发和信息。
