Neural mechanisms of emotion-focused interventions: A meta-analytic review of fMRI studies

Emotion-focused interventions are emerging as promising tools to improve emotional functioning across clinical and nonclinical populations, yet their underlying neural mechanisms remain unclear. We conducted a coordinate-based meta-analysis (CBMA) using Seed-based d Mapping (SDM) of 20 task-based fMRI studies (N = 620) to quantify bidirectional activation changes associated with emotion-focused interventions. Results showed small-to-moderate improvements in emotional task performance (Hedges' g = 0.29) and self-reported affective outcomes (g = 0.54). Meta-analytic neuroimaging revealed increased activation in the right caudate and decreased activation in the right insula and left inferior frontal gyrus. Moderator analyses identified intervention type, emotional content, and delivery format as key modulators of these neural effects. Notably, reduced insula activity predicted better emotional outcomes, while right caudate activation increased with age. These findings are consistent with a dual-pathway model of neural plasticity-one marked by frontostriatal engagement (right caudate) and another by dampened salience and semantic-control responses (right insula, left inferior frontal gyrus). The results offer mechanistic insights into how emotion-focused training recalibrates regulatory networks and inform the development of targeted interventions.