Detection of Cerebral Reorganization Induced by Real-Time fMRI Feedback Training of Insula Activation

Background. Studies with real-time functional magnetic resonance imaging (fMRI) demonstrate that humans volitionally regulate hemodynamic signals from circumscribed regions of the brain, leading to area-specific behavioral consequences. Methods to better determine the nature of dynamic functional interactions between different brain regions and plasticity due to self-regulation training are still in development. Objective. The authors investigated changes in brain states while training 6 healthy participants to self-regulate insular cortex by real-time fMRI feedback. Methods. The authors used multivariate pattern analysis to observe spatial pattern changes and a multivariate Granger causality model to show changes in temporal interactions in multiple brain areas over the course of 5 repeated scans per subject during positive and negative emotional imagery with feedback about the level of insular activation. Results. Feedback training leads to more spatially focused recruitment of areas relevant for learning and emotion. Effective connectivity analysis reveals that initial training is associated with an increase in network density; further training “prunes” presumably redundant connections and “strengthens” relevant connections. Conclusions. The authors demonstrate the application of multivariate methods for assessing cerebral reorganization during the learning of volitional control of local brain activity. The findings provide insight into mechanisms of training-induced learning techniques for rehabilitation. The authors anticipate that future studies, specifically designed with this hypothesis in mind, may be able to construct a universal index of cerebral reorganization during skill learning based on multiple similar criteria across various skilled tasks. These techniques may be able to discern recovery from compensation, dose–response curves related to training, and ways to determine whether rehabilitation training is actively engaging necessary networks.