Process-based framework for precise neuromodulation

Abstract

Functional MRI neurofeedback (NF) allows humans to self-modulate neural patterns in specific brain areas. This technique is regarded as a promising tool to translate neuroscientific knowledge into brain-guided psychiatric interventions. However, its clinical implementation is restricted by unstandardized methodological practices, by clinical definitions that are poorly grounded in neurobiology, and by lack of a unifying framework that dictates experimental choices. Here we put forward a new framework, termed 'process-based NF', which endorses a process-oriented characterization of mental dysfunctions to form precise and effective psychiatric treatments. This framework relies on targeting specific dysfunctional mental processes by modifying their underlying neural mechanisms and on applying process-specific contextual feedback interfaces. Finally, process-based NF offers designs and a control condition that address the methodological shortcomings of current approaches, thus paving the way for a precise and personalized neuromodulation. The use of functional MRI (fMRI) in neurofeedback (fMRI-NF) has brought new hope to the field of self-guided neuromodulation. fMRI-NF allows individuals to modulate spatially localized neural patterns in real-time, using contingent rewarding feedback. Accumulating evidence suggests that in many cases, attaining significant neural modulations in line with the task protocol (i.e., NF success) is followed by corresponding mental and behavioural changes1, thus contributing to bridging the gap between brain functionality and our mental experience. Despite this promising prospect, the utilization of fMRI-NF for basic science as well as for clinical purposes has been slower than expected. This may be due to various methodological constraints, such as the lack of proper control conditions and inadequate blinding and randomization, as well as the relatively small sample sizes that characterize the field. Furthermore, brain-guided interventions do not correspond with current psychiatric categorization, which traditionally relies on subjective reports rather than on

The potential of functional near-infrared spectroscopy-based neurofeedback – a systematic review and recommendations for best practice

“…In this way, specific effects related to the control targets and neurofeedback-unspecific processes that likely differ for different neurofeedback targets may average out across all subjects of this control group. For extensive discussions on different control conditions in neurofeedback research, see Lubianiker et al, (2019) and Sorger et al, (2019).…”

“…However, these protocols should be established with caution and only with proper control of extracranial artifacts (e.g., using partial correlation and/or short-distance channels), which may easily produce spurious correlations. Future studies could also be oriented to recent methodological developments in fMRI-neurofeedback, such as implicit/covert neurofeedback protocols (i.e., neurofeedback without participants' awareness; e.g., Ramot et al, 2017) or decoded neurofeedback (Shibata et al, 2019)) and process-based neurofeedback, where protocols are designed to target disorder-specific processes (Lubianiker et al, 2019). Also, fMRI-informed approaches could be explored, as already applied in EEG-neurofeedback (e.g., Meir-Hasson et al, 2016), where fNIRS channels would predict the fMRI signal of a target region.…”

Modulation of Intrinsic Brain Connectivity by Implicit Electroencephalographic Neurofeedback

“…Currently, there are ongoing debates around neurofeedback. Some researchers wonder whether the observed improvements are due to the neurophysiological intervention per se or are related to nonspecific effects, such as behavioral or suggestion therapy, and call for proper controlled studies (Thibault et al, 2018;Lubianiker et al, 2019;Sorger et al, 2019). Other authors point to several methodological barriers interfering with an evidence-based evaluation of neurofeedback (Ioannides, 2018;Pigott et al, 2018;Sorger et al, 2019).…”

Delineating implicit and explicit processes in neurofeedback learning

“…Neurofeedback protocols are commonly divided into the explicit or implicit category (Gaume et al, 2016;Lubianiker et al, 2019). According to this taxonomy, in explicit paradigms, the participant has conscious knowledge of the origin of the feedback and is instructed to actively regulate it.…”