Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity
Abstract 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 p...
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2025-05-01
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| Series: | Translational Psychiatry |
| Online Access: | https://doi.org/10.1038/s41398-025-03382-8 |
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| author | Yuan Zhang Benjamin Becker Keith M. Kendrick Qiong Zhang Shuxia Yao |
| author_facet | Yuan Zhang Benjamin Becker Keith M. Kendrick Qiong Zhang Shuxia Yao |
| author_sort | Yuan Zhang |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-1ee04f375a22428296f33e828ea310a4 |
| institution | DOAJ |
| issn | 2158-3188 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Nature Publishing Group |
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| series | Translational Psychiatry |
| spelling | doaj-art-1ee04f375a22428296f33e828ea310a42025-08-20T03:10:32ZengNature Publishing GroupTranslational Psychiatry2158-31882025-05-0115111610.1038/s41398-025-03382-8Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activityYuan Zhang0Benjamin Becker1Keith M. Kendrick2Qiong Zhang3Shuxia Yao4The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaThe State Key Laboratory of Brain and Cognitive Sciences, The University of Hong KongThe Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaThe Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaThe Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of ChinaAbstract 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.https://doi.org/10.1038/s41398-025-03382-8 |
| spellingShingle | Yuan Zhang Benjamin Becker Keith M. Kendrick Qiong Zhang Shuxia Yao Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity Translational Psychiatry |
| title | Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity |
| title_full | Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity |
| title_fullStr | Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity |
| title_full_unstemmed | Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity |
| title_short | Self-navigating the “Island of Reil”: a systematic review of real-time fMRI neurofeedback training of insula activity |
| title_sort | self navigating the island of reil a systematic review of real time fmri neurofeedback training of insula activity |
| url | https://doi.org/10.1038/s41398-025-03382-8 |
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