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Updated: Jan 3, 2026

A Protocol for the Administration of Real-Time fMRI Neurofeedback Training
Published on: August 24, 2017
Real-time monitoring and regulating auditory cortex alpha activity in patients with chronic tinnitus
Azim Malekshahi1,2,3, Rahim Malekshahi1,2, Manuel Czornik1
1Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany.
Objective:
Low levels of alpha activity (8-13Hz) mirror a state of enhanced responsiveness, whereas high levels of alpha are a state of reduced responsiveness. Tinnitus is accompanied by reduction of alpha activity in the perisylvian regions compared to normal hearing controls. This reduction might be a key mechanism in the chain of reactions leading to tinnitus. We devised a novel spatial filter as an on-line source monitoring method, which can be used to control alpha activity in the primary auditory cortex. In addition, we designed an innovative experimental procedure to enable suppression of visual and somatosensory alpha, facilitating auditory alpha control during alpha neurofeedback.
Approach:
An amplitude-modulated auditory stimulation with 40 Hz modulation frequency and 1000 Hz carrier frequency specifically activates the primary auditory cortex. The topography of 40 Hz oscillation depicts the activity of the auditory cortices. We used this map as a spatial filter, which passes the activity originating from the auditory cortex. To suppress superposition of auditory alpha by somatosensory and visual alpha, we used a continuous tactile jaw-stimulation and visual stimulation protocol to suppress somatosensory alpha of regions adjacent to the auditory cortex and visual alpha for local regulation of auditory alpha activity only.
Main Results:
This novel spatial filter for online detection of auditory alpha activity and the usage of multi-sensory stimulation facilitate the appearance of alpha activity from the auditory cortex at the sensor level.
Significance:
The proposed procedure can be used in an EEG-neurofeedback-treatment approach allowing online auditory alpha self-regulation training in patients with chronic tinnitus.

