The Impact of Visual Feedback Design on Self-Regulation Performance and Learning in a Single-Session rt-fMRI...

Background: The efficacy of real-time fMRI neurofeedback (NFB) depends critically on how feedback is presented and perceived by the participant. Although various visual feedback designs are used in practice, there is limited evidence on the impact of modality on learning and performance. We conducted a feasibility study to compare the effectiveness of different feedback modalities, and to evaluate the technical performance of NFB across two scanner field strengths. Methods: In a single-session study, nine healthy adults (6 men, 3 women) voluntarily adapted the activation level of the primary sensorimotor cortex (SMC) to reach three predefined activation levels. We contrasted a continuous, signal-proportional feedback (cFB; a thermometer-style bar) with an affect-based, categorical feedback (aFB; a smiling face). A no-feedback transfer condition (noFB) was included to probe regulation based on internal representations alone. To assess technical feasibility, three participants were scanned at 7T and six at 3T. Results: Participants achieved successful regulation in 44.4% of trials overall (cFB 46.9%, aFB 43.8%, noFB 42.6%). Overall success rates did not differ significantly between modalities and field strengths when averaged across the session; given the small feasibility sample, this null result is inconclusive and does not establish equivalence. Learning effects were modality-specific. Only cFB showed a significant within-session improvement (+14.8 percentage points from RUN1 to RUN2; p = 0.031; d_z = 0.94), whereas aFB and noFB showed no evidence of learning. Exploratory whole-brain contrasts (uncorrected) suggested increased recruitment of ipsilateral motor regions during noFB. The real-time pipeline demonstrated robust technical performance: transfer/reconstruction latency averaged 497.8 ms and workstation processing averaged 296.8 ms (≈795 ms end-to-end), with rare stochastic outliers occurring predominantly during 7T sessions. Conclusions: In this single-session motor rt-fMRI NFB paradigm, continuous signal-proportional feedback supported rapid within-session learning, whereas affect-based categorical cues did not yield comparable learning benefits. Stable low-latency operation was achievable at both 3T and 7T. Larger, balanced studies are warranted to confirm modality-by-learning effects and to better characterize transfer to feedback-free self-regulation.