Music as a real-time fMRI neurofeedback interface for modulating interhemispheric connectivity: effects on mood and recruitment of the putamen and insula

Music is a universal language that transcends cultures and is deeply rooted in human evolutionary history. Its creation and appreciation recruit the brain’s limbic and reward systems, leading to the evocation of emotions ranging from happiness and sadness to tenderness and grief. Here, we explore the potential of music as an interventional tool in a novel neurofeedback experiment. This study introduces and validates a musical interface for real-time fMRI neurofeedback that is adaptable to various experimental paradigms. Using a previously developed motor imagery connectivity-based framework, we evaluate its feasibility and efficacy by comparing the modulation of bilateral premotor cortex (PMC) 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 PMC functional localizer run, and four neurofeedback runs (two with active feedback and two with sham feedback). Pre- and post-session questionnaires assess mood (looking at the behavioral impact of the NF session), musical background (in search of predictors of NF 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 correlation between left and right PMC activity. 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 NF runs, possible due to the power of music to boost neuromodulation, but the network recruitment was stronger for active NF, including in the insula, putamen, and target ROIs. Behaviorally, we found a decrease in tension and an improvement in the overall mood of the participants after the session. When comparing our results to previous NF data with a visual interface, we found stronger brain activations, in particular in NF-relevant regions such as the insula and the putamen. This work highlights the potential of musical feedback as a more intuitive and engaging interface in neurofeedback protocols, paving the way for enhanced participant experience and training outcomes.