Table 4.
Details of real-time fMRI neurofeedback studies with regulation target in mixed subsystems.
| References | ROI(s), regulation direction and definition | Study population | Control condition | Feedback | Regulation of target ROI(s)/online changes | Offline analysis (Whole brain) | (Post-hoc) connectivity changes | Behavioral/ clinical changes |
|---|---|---|---|---|---|---|---|---|
| Hartwell et al., 2016 | ACC or PFC ↓; # | 21 nicotine-dependent smokers (23 controls) | Control without feedback intervention (with fMRI) | Continuous (scale) | Yes, ACC or PFC↓ (EG) | - | - | Behavioral improvement |
| Karch et al., 2015 | ACC, DLPFC or insula (DLPFC for HV) ↓; # | 13 patients with AUD and 14 healthy volunteers (2 control patients and 5 control volunteers) | Placebo control and other (HV) | Continuous (scale) | Yes, targeted regions↓ (AUD, EG) | ACC, DLPFC, insula, ITG, medial FC, cuneus, parietal cortex↓ (AUD, EG) | l. ACC → thalamus, l. insula → MPFC, SFG, parietal ares, r. insula → OFC, medial FC, temporal ares, l. MFG → DLPFC, lentiform nucleus, thalamus, r. MFG → insula (AUD, EG) | Behavioral improvement (trend) |
| Karch et al., 2019 | ACC, DLPFC or insula ↓; # | 22 nicotine-dependent smokers (14 controls*1) | Placebo control | Continuous (scale) | Not reported | No NF-specific effect reported | - | No behavioral improvement |
| Karch et al., 2021 | ACC, DLPFC or insula ↓; # | 24 alcohol-dependent patients (24 controls) | Placebo control | Continuous (scale) | Yes, targeted regions↓ (EG) | ACC, medial FC, pre-/post-central gyrus, insula, caudate↓ (EG), cuneus, precuneus, inferior/medial occipital gyrus↑ (EG) | - | Clinical improvement (both groups) |
| Morgenroth et al., 2020 | Connectivity between ACC (bilateral) and DLPFC (left) ↑; # | 15 anxiety patients (15 controls) | Placebo control | Continuous (scale) | Yes, ACC → DLPFC↑ (EG) | - | DLPFC → SMA (EG); ACC, insula, inferior PFC, angular gyrus, SFG, PCC | Clinical improvement |
| Spetter et al., 2017 | Connectivity between DLPFC and VMPFC ↑; # | 8 obesity patients (no controls) | No control | Continuous (scale) | Yes, DLPFC → VMPFC↑ | Insula, IFG, DLPFC, striatum↑ | DLPFC → VMPFC | No behavioral improvement |
| Kim et al., 2015 | ROI1: ACC/MPFC/OFC; ROI2: PCC/precuneus ↑; % | 7 nicotine-dependent smokers (7 controls) | Other | Continuous (visual) | Yes, ROI1 → ROI2↑(FC-Group); ROI1↑ (Activity-Group) | - | ROI1 → precuneus, PCC, mOFC, ACC (FC Group); ROI2 → precuneus, PCC, mOFC, ACC, mOFC (FC Group) | No behavioral improvement |
| Zotev et al., 2018 | Thalamus (anterior nucleus and the mediodorsal nucleus) ↑; % | 15 healthy volunteers (14 controls) | Placebo control | Continuous (scale) | Yes, AN/MD ↑ (EG) | - | MD → precuneus, IFG, ACC, precentral gyrus, SN (EG). AN → caudate, lentiform nucleus (EG) | No observation |
The publications are sorted based on the region(s) of interest.
AUD, alcohol use disorder; CG, control group; EG, experimental group; fMRI, functional magnetic resonance imaging; HV, healthy volunteers; NF, neurofeedback; ROI, region of interest; ACC, anterior cingulate cortex; AN, anterior nucleus; DLPFC, dorsolateral prefrontal cortex; FC, frontal cortex; IFG, inferior frontal gyrus; ITG, inferior temporal gyrus; MD, mediodorsal nucleus; MFG, middle frontal gyrus; mOFC, medial orbitofrontal cortex; MPFC, medial prefrontal cortex; OFC, orbitofrontal cortex; PCC, posterior cingulate cortex; PFC, prefrontal cortex; SFG, superior frontal gyrus; SMA, supplementary motor area; SN, substantia nigra; VMPFC, ventromedial prefrontal cortex; d, dorsal; r, rostral; s, subgenual; v, ventral; l., left; r., right.
functional localizer; %, anatomical ROI; ↑, up-regulation; ↓, down-regulation; ↑↓, bidirectional regulation; (ROI1) → (ROI2), connectivity between two regions; -, no information; ~, mixed results.
1In this article data of control group was not evaluated. Data of experimental group was split into relapsed (n = 12) and non-relapsed group (n = 10).