Real-time fMRI brain-computer interface: A tool for personalized psychiatry?

Neurofeedback is emerging as an attractive new tool for psycho-physiological interventions in psychiatry. Over the past decade, progress has been made, particularly in the development and evaluation of neurofeedback protocols that use the blood oxygenation-dependent (BOLD) signal measured with functional magnetic resonance imaging (fMRI) as a target measure of brain activation. This chapter reviews the principles of neurofeedback training, with a focus on fMRI-protocols and the state of development of clinical applications in psychiatry and neurorehabilitation. In the context of this book, it is argued that neurofeedback can be regarded as a paradigmatic personalized therapy because it uses personalized neural targets, personalized stimulus material, and personalized homework or other adjunct elements. One challenge for future research will be to develop integrated treatment approaches that combine neurofeedback with psychological and behavioral interventions, and to evaluate them in randomized controlled trials.