Evidence map›Paper›PMID 40886445›Full record

Trial reportPsychiatry research. Neuroimaging2025

Real-time fMRI neurofeedback modulates auditory cortex activity and connectivity in schizophrenia patients with auditory hallucinations: A controlled study.

Clemens C C Bauer, Jiahe Zhang, Francesca Morfini, Oliver Hinds, Paul Wighton, Yoonji Lee, Lena Stone, Angelina Awad, Kana Okano, Melissa Hwang and 5 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Psychiatry research. Neuroimaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Clemens C C BauerDepartment of Psychology, Northeastern University, Boston, MA 02115, USA; Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA. Electronic address: c.bauer@northeastern.edu.
Jiahe ZhangDepartment of Psychology, Northeastern University, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
Francesca MorfiniDepartment of Psychology, Northeastern University, Boston, MA 02115, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
Oliver HindsOrchard Scientific, Yucca Valley, CA, USA.
Paul WightonAthinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
Yoonji LeeDepartment of Psychology, Northeastern University, Boston, MA 02115, USA.
Lena StonePsychotic Disorders Division, McLean Hospital, Belmont, MA 02478, USA.
Angelina AwadDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
Kana OkanoDepartment of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Melissa HwangPsychotic Disorders Division, McLean Hospital, Belmont, MA 02478, USA.
Jude HammoudDepartment of Psychology, Northeastern University, Boston, MA 02115, USA; Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
Paul NestorLaboratory of Neuroscience, Boston VA Healthcare System, Boston, MA, 02130, USA.
Susan Whitfield-GabrieliDepartment of Psychology, Northeastern University, Boston, MA 02115, USA; Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Center for Precision Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.
Ann K ShinnDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Psychotic Disorders Division, McLean Hospital, Belmont, MA 02478, USA.
Margaret A NiznikiewiczDepartment of Psychiatry, Harvard Medical School, Boston, MA 02115, USA; Boston VA Healthcare System, Boston, MA 02130.

Funding

Real-time fMRI Neurofeedback as a Tool to Mitigate Auditory Hallucinations in Patients with SchizophreniaR61MH113751 · NIMH · HARVARD MEDICAL SCHOOL · PI NIZNIKIEWICZ, MARGARET A, WHITFIELD-GABRIELI, SUSAN · 2018 to 2019
$1.4M
NIMH NIH HHS R61 MH113751
6 · The paper itself

Abstract

background and hypothesisAuditory hallucinations (AHs) affect 60-80 % of schizophrenia patients and often resist antipsychotic treatment. AHs involve superior temporal gyrus (STG) hyperactivity and disrupted auditory-cognitive control connectivity. Real-time fMRI neurofeedback (NFB) enables voluntary modulation of targeted brain regions. We previously showed STG-targeted NFB with mindfulness meditation reduced STG activation and AHs in one session. However, whether effects are specific to hallucination-related regions versus placebo, and whether NFB modulates broader networks, remained unclear. STUDY

designThis randomized, sham-controlled trial examined NFB specificity and network effects. Twenty-three adults with schizophrenia/schizoaffective disorder and medication-resistant hallucinations practiced mindfulness meditation while receiving neurofeedback from either STG (n = 10, Real-NFB) or motor cortex (n = 13, Sham-NFB control). Sham participants subsequently received Real-NFB, providing within-subject comparison. STUDY

resultsBoth groups showed reduced AHs post-NFB without group differences. However, compared to Sham-NFB, Real-NFB produced greater reductions in secondary auditory cortex activation and connectivity between auditory cortex and cognitive control regions (dorsolateral prefrontal cortex and anterior cingulate). These connectivity reductions persisted in the Real-after-Sham condition. Both groups showed reduced primary auditory cortex activation, suggesting mindfulness meditation independently regulates bottom-up hallucination processes.

conclusionsRegion-specific NFB targeting produces distinct neural changes beyond symptom reduction. STG-targeted NFB differentially modulates auditory-cognitive control networks, potentially restoring the disrupted balance between bottom-up sensory processing and top-down control in AHs. These findings highlight the importance of anatomically-informed NFB targets and provide mechanistic insights for developing precision interventions for treatment-resistant psychiatric symptoms.

Indexed as

Auditory CortexConnectomeHallucinationsNerve NetNeurofeedbackPsychotic DisordersSchizophreniaAdultFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedMindfulnessTemporal LobeDefault mode networkDorsolateral prefrontal cortexFunctional magnetic resonance imagingMindfulnessSuperior temporal gyrus

Identifiers

PMID40886445
PMCPMC13264959

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.