Trial Will Test Whether Real-Time Brain Feedback Can Change Brain Networks

This is a study plan, not a completed clinical trial. The researchers have registered a randomized controlled trial that will test real-time neurofeedback in people considered at clinical high risk of psychosis. That term describes a phase in which someone may have milder psychosis-related symptoms and thinking difficulties. It does not mean that every participant will develop psychosis.

Neurofeedback gives a person information about their brain activity while it is happening. In this trial, the information will come from functional MRI, or fMRI. This type of scan tracks changes in blood oxygen levels that are used as an indirect sign of activity in different brain areas. The aim is to see whether participants can influence a specific pattern of communication between brain networks when they receive feedback.

The study plans to enroll 40 participants ages 18 to 30 who are at clinical high risk. They will be randomly assigned to one of two groups, with 20 people in each group. Random assignment is meant to make the groups more comparable, so researchers can better judge whether any differences are linked to the type of feedback received.

One group will receive real neurofeedback based on activity involving the default mode network and the central executive network. The default mode network is active during inward-focused thought, while the central executive network is involved in focused attention and problem-solving. The researchers are interested in patterns that have been linked with schizophrenia, including unusually strong connection within the default mode network and weaker opposite-pattern coordination between the two networks.

The comparison group will receive sham neurofeedback based on a different brain system, called the somatomotor network. A sham comparison is designed to help separate the possible effect of targeted feedback from other parts of the experience, such as spending time in a scanner or believing that feedback may be helpful.

Before and after the intervention, the team plans to measure connectivity between brain networks. Their main hypotheses are that real neurofeedback will reduce unusually high default-mode connectivity and strengthen the relationship between the default mode and executive networks. They also plan to compare the post-intervention brain-connectivity patterns of the real-feedback group with those of 20 neurotypical participants.

A secondary goal is to explore two brain chemicals: GABA and glutamate. Both help brain cells communicate. The researchers will examine whether levels of these chemicals are related to network connectivity, and whether they change from before to after neurofeedback.

Importantly, the protocol does not provide outcomes. It does not yet show that neurofeedback changes brain connectivity, alters GABA or glutamate, reduces symptoms, improves thinking skills, or prevents psychosis. The planned study is also small, with 40 participants receiving the intervention or comparison feedback, so any eventual findings would need careful interpretation and confirmation in further research.

The news coverage describes neurofeedback and meditation more broadly, including work related to schizophrenia and depression. But the primary source here is narrower: it lays out a planned fMRI-neurofeedback trial in 18-to-30-year-olds at clinical high risk of psychosis. The next step is completion of the trial and publication of its results, including whether the targeted feedback changed the measures the researchers set out to test.