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The purpose of this study is to compare the neural and behavioral effects of real-time functional magnetic resonance imaging (fMRI) neurofeedback training using two different interoceptive strategies: a unidimensional heartbeat detection strategy and a multidimensional interoception strategy. Specifically, the study compares the efficacy of these two regulation strategies in regulating activity of the anterior insula, a key brain region involved in interoceptive and emotional processing.
This study uses a randomized between-subject design to compare the efficacy of two interoceptive strategies in regulating anterior insula activity during real-time fMRI neurofeedback training. A total of 60 healthy participants are recruited and are randomly assigned to one of two groups. The heartbeat detection group (HDG; n = 30) uses a heartbeat detection strategy to upregulate anterior insula activity during neurofeedback training. The multidimensional interoception group (MIG; n = 30) uses a multidimensional interoception strategy which involves shifting attention among respiratory sensations, cardiac signals, gastric sensations, and bladder distension, to increase anterior insula activity during neurofeedback training. The neurofeedback protocol includes 4 training sessions with real-time neurofeedback and 1 transfer session without neurofeedback. Each session comprises 6 regulation (upregulate anterior insula activity with interoception strategies) blocks and 6 baseline (rest) blocks. Interoceptive accuracy is assessed using a heartbeat detection task performed before and after neurofeedback training. During MRI scanning, a heartbeat counting task will be employed prior to neurofeedback training to localize the anterior insula. The behavioral effects of neurofeedback training are evaluated using a pain empathy rating task and an interoception/relaxation rating task following the regulation or baseline block. Individual differences in personality traits and interoceptive characteristics are assessed using validated Chinese questionnaires, including State-Trait Anxiety Inventory (STAI), Beck Depression Inventory-Ⅱ (BDI-Ⅱ), Toronto Alexithymia Scale (TAS), Autism Spectrum Quotient (ASQ), Bermond-Vorst Alexithymia Questionnaire (BVAQ), Multidimensional Assessment of Interoceptive Awareness (MAIA), Interoceptive Confusion Questionnaire (ICQ), Interpersonal Reactivity Index (IRI), and Cognitive Flexibility Inventory (CFI). Affective moods are assessed using the Positive and Negative Affect Schedule (PANAS).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Multidimensional interoception strategy with real-time fMRI neurofeedback | Experimental | Subjects in the multidimensional interoception group are instructed to regulate anterior insula activity based on visual neurofeedback using a multidimensional interoception strategy that engages four distinct, interrelated interoceptive signals: respiratory signals, heartbeat, gastric sensations, and bladder distension. |
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| Heartbeat detection strategy with real-time fMRI neurofeedback | Active Comparator | Subjects in the heartbeat detection group are instructed to regulate anterior insula activity based on visual neurofeedback by using a heartbeat detection strategy. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| real-time fMRI neurofeedback training | Device | Real-time neurofeedback information is computed using the Turbo Brain voyager (TBV) 4.0 software (Brain Innovation, Maastricht, The Netherlands). Functional images are collected and processed in real time based on contrasts of regulation vs. rest conditions. The blood oxygen level dependent (BOLD) signal of the target region is then transformed into visual bars and displayed to participants via the projector screen. Both groups will undergo the same paradigm, but with different interoception strategies. |
| Measure | Description | Time Frame |
|---|---|---|
| Neural activity of the anterior insula based on blood oxygen level-dependent (BOLD) signal | The anterior insula activity induced during the regulation block compared to the baseline block. | 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Pain empathy ratings scores | Subjects are required to rate their empathic feeling towards painful pictures on a Likert Scale ranging from 1-9 (1 = not at all and 9 = very painful) after each regulation/baseline block. | 1 hour |
| Confidence rating scores of interoceptive sensitivity |
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Inclusion Criteria:
Exclusion Criteria:
Individuals whose self-identified gender is consistent with their biological sex.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Electronic Science and Technology of China | Chengdu | Sichuan | 611731 | China |
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Subjects are asked to rate to what extent they can feel their heartbeat based on a Likert Scale ranging from 1-9 (1 = very low and 9 = very high) |
| 10 minutes |
| Interoceptive accuracy | 1/N Σ(1-(|actual heartbeats--reported heartbeats|) / actual heartbeats). N indicates the number of recording blocks. | 10 minutes |