A systematic review of hyperscanning in clinical encounters

Lena Adel ¹, Lisane Moses ², Elisabeth Irvine ³

⁰Integrated Program in Neuroscience, McGill University, Montréal, Canada; Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Canada; Division of Social and Transcultural Psychiatry, McGill University, Montréal, Canada; CHU Sainte Justine Azrieli Research Center, Department of Psychiatry, University of Montréal, Montréal, Québec, Canada.

Neuroscience and Biobehavioral Reviews +

|

June 8, 2025

View abstract on PubMed

Summary

Interpersonal neural synchrony (INS) shows promise for understanding therapeutic relationships. While observed in all studies, its direct link to therapeutic alliance and clinical outcomes requires further investigation.

Area Of Science

Neuroscience
Psychology
Clinical Research

Background

Therapeutic alliance is crucial for positive clinical outcomes.
The physiological underpinnings of therapeutic alliance remain largely unexplored.
Interpersonal neural synchrony (INS) offers a novel, objective method to study dyadic interactions using neuroimaging.

Purpose Of The Study

To systematically review existing research on interpersonal neural synchrony (INS) within clinical encounters.
To explore the relationship between INS, therapeutic alliance, and clinical outcomes.

Main Methods

A comprehensive literature search was conducted across four databases.
Studies were screened, with 11 articles meeting the inclusion criteria for full-text review.
Data from 160 dyads across studies published since 2018 were analyzed.

Main Results

Interpersonal neural synchrony (INS) was consistently observed in all included studies, regardless of methodology.
INS showed potential associations with therapeutic outcomes in several studies.
The relationship between INS and therapeutic alliance yielded mixed results.

Conclusions

Interpersonal neural synchrony (INS) is a promising area for understanding the neurophysiological basis of therapeutic relationships.
Further research is needed to clarify the precise links between INS, therapeutic alliance, and patient outcomes.
Future studies should focus on methodological standardization, temporal dynamics, and larger sample sizes.

Keywords:

Hyperscanning Inter-brain synchrony Interpersonal neural synchrony Neuroimaging Therapeutic alliance Therapy Treatment outcomes

Related Concept Videos

Computed Tomography

Tomography refers to imaging by sections. Computed tomography (CT) is a non-invasive imaging technique that uses computers to analyze several cross-sectional X-rays to reveal minute details about structures in the body.
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...