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Updated: Sep 16, 2025

A Protocol for the Administration of Real-Time fMRI Neurofeedback Training
Published on: August 24, 2017
Neural Mechanisms of Feedback Processing and Regulation Recalibration During Neurofeedback Training
Gustavo S P Pamplona1,2,3, Jana Zweerings4, Cindy S Lor5
1Department of Ophthalmology/University of Lausanne, SensoriMotorLab, Jules-Gonin Eye Hospital/Fondation Asile Des Aveugles, Lausanne, Switzerland.
Abstract:
The acquisition of new skills is facilitated by providing individuals with feedback that reflects their performance. This process creates a closed loop that involves feedback processing and regulation recalibration to promote effective training. Functional magnetic resonance imaging (fMRI)-based neurofeedback is unique in applying this principle by delivering direct feedback on the self-regulation of brain activity. Understanding how feedback-driven learning occurs requires examining how feedback is evaluated and how regulation adjusts in response to feedback signals. In this pre-registered mega-analysis, we re-analyzed data from eight intermittent fMRI neurofeedback studies (N = 153 individuals) to investigate brain regions where activity and connectivity are linked to feedback processing and regulation recalibration (i.e., regulation after feedback) during training. We harmonized feedback scores presented during training in these studies and computed their linear associations with brain activity and connectivity using parametric general linear model analyses. We observed that, during feedback processing, feedback scores were positively associated with (1) activity in the reward system, dorsal attention network, default mode network, and cerebellum; and with (2) reward system-related connectivity within the salience network. During regulation recalibration, no significant associations were observed between feedback scores and either activity or associative learning-related connectivity. Our results suggest that neurofeedback is processed in the reward system, supporting the theory that reinforcement learning shapes this form of brain training. In addition, the involvement of large-scale networks in feedback processing, continuously transitioning between evaluating external feedback and internally assessing the adopted cognitive state, suggests that higher-level processing is integral to neurofeedback learning, which usually occurs over a short time span. Our findings highlight the pivotal role of performance-related feedback as a driving force in learning, potentially extending beyond neurofeedback training to other feedback-based processes.
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