Functional magnetic resonance imaging is one of the most technologically advanced forms of brain imaging. It is capable of measuring very accurately throughout the brain changes in blood oxygenation, and therefore changes in brain activity and connectivity. This tool has become one of the leading edges of brain science. Unfortunately, it requires a huge and hugely expensive piece of equipment.

In basic research, fMRI is increasingly studied as a means to provide immediate feedback to allow people to learn to change brain activity levels. This is neurofeedback with fMRI, also called real time fMRI neurofeedback (rtfMRI).

This is very much like what we do everyday at the NeuroDevelopment Center with EEG biofeedback or neurofeedback. We provide feedback about the brain’s electrical activity. fMRI neurofeedback provides feedback about the brains metabolic activity.

I recently participated in a symposium of rtfMRI neurofeedback researchers at Harvard. Some of the very best rtfMRI neurofeedback researchers in the country joined together to share their work, compare notes, and learn from each other. I was fortunate enough to be invited to share some of what we have learned in research and clinical practice with EEG neurofeedback. While there was much to learn that was exciting and encouraging, the rtfMRI researchers were also struggling with the clinical limitations of the approach. Because fMRI machines are so hugely costly, no one thinks rtfMRI will ever become a widespread form of treatment in mental or behavioral health. Its just too expensive. Everything we know about brain plasticity suggests that massive repetition is necessary to result in lasting change of brain activity patterns. Both rtfMRI and EEG neurofeedback have shown that brain change can be shown after only one feedback session. But that change does not last. In order to make for lasting change, the neurofeedback training must be repeated. Although we do not yet know how many repetitions are needed for rtfMRI neurofeedback, it has been shown in several EEG neurofeedback studies that when the training is repeated somewhere between 20 and 40 times, symptom improvement has lasted over time frames from 3 months to three years. Here’s the rub: 20-40 rtfMRI sessions is prohibitively expensive…..

So the researchers (and their funding sources) are very eager to find ways to make use of the advanced imaging capabilities of rtfMRI without breaking the healthcare bank. So a number of our rtfMRI colleagues expressed an interest in combining the two approaches. It is possible now to simultaneously record fMRI and EEG. This would allow us to find the EEG “signature” of the brain areas identified through rtfMRI and then do the bulk of the repetitive training with EEG neurofeedback. One researcher in attendance included this solution as a part of his NIMH funded grant.

It is my hope this this new neurofeedback partnership will lend increased precision and efficacy to EEG neurofeedback and provide the needed practical clinical payoff for rtfMRI neurofeedback. I’m excited to see what has emerged when we meet again next year.