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Real-time fMRI-based brain computer interfacing for neurofeedback therapy and compensation of lost motor functions

Rainer Goebel, Anna Zilverstand and Bettina Sorger

Real-time functional MRI (rt-fMRI) allows for brain–computer interfaces based on hemodynamic brain signals and opens up various novel clinical applications. For example, rt-fMRI-based neurofeedback has been suggested as a novel tool for the treatment of neurological and psychopathological disorders. In contrast to conventional offline applications, neurofeedback requires the analysis of functional MRI signals online in order to provide participants with information about their brain activation during an ongoing MRI scan. Recent research supports the idea that an improvement of symptoms of diseases can be achieved if patients are trained with rt-fMRI-based neurofeedback to change their brain activation patterns. rt-fMRI also enables online ‘brain-reading‘ applications that can be exploited to develop alternative communication and control devices for patients with severe motor impairments (e.g., ‘locked-in’ patients). Although other methods, especially electroencephalography-based brain–computer interfacing, have been successfully used in this context, rt-fMRI-based methods may enable robust communication and control in cases where traditional approaches do not provide satisfactory results.