A novel music-based real-time fMRI neurofeedback interface modulates interhemispheric connectivity and enhances mood

Introduction: Music is a universal language that transcends cultures and is deeply rooted in human evolutionary history. Its creation and appreciation recruit the limbic and reward systems, leading to the evocation of emotions ranging from happiness and sadness to tenderness and grief. Here, we investigate the potential of music as an interventional tool in a novel neurofeedback connectivity-based experiment. Methods: This study proposes a musical interface for real-time functional magnetic resonance imaging neurofeedback that is adaptable to diverse experimental paradigms, namely the ones aiming at improving mood and other affective dimensions. Using a previously developed motor imagery connectivity-based approach, we evaluate its feasibility and efficacy by comparing the modulation of bilateral premotor cortex activity during functional runs with real versus sham (random) feedback in 22 healthy adults. We also assess its performance against a visual feedback interface. The experiment involves a 50-minute MRI session, including anatomical scans, a premotor cortex functional localizer run, and four neurofeedback runs (two with active feedback and two with sham feedback). Pre- and post-session questionnaires assess the neurobehavioral impact on mood, musical background (as a potential predictor of neurofeedback success), and subjective feedback experiences. During neurofeedback, participants perform motor imagery of finger-tapping, with feedback delivered as a dynamic, pre-validated chord progression that evolves or regresses based on the functional connectivity between left and right premotor cortex. Results: We found that our implementation of music-based feedback was successful, with participants managing to modulate their own connectivity using the proposed interface. The modulation performance was similar for active and sham runs, possibly due to the power of music to boost neuromodulation, but the network recruitment was stronger for active neurofeedback, including in the insula, putamen, and target regions of interest. Behaviorally, we found a decrease in tension and an improvement in the overall mood of the participants after the session. Discussion: When comparing our results to previous neurofeedback data with a visual interface, we found stronger brain activations, in particular in neurofeedback-relevant regions such as the insula and the putamen. This work shows that it is possible to directly modulate interhemispheric connectivity using a real-time functional magnetic resonance imaging musical interface with potential effects on mood and recruitment of saliency and learning networks.