Introducing Haptic Feedback in Real-Time fMRI Neurofeedback: A Novel Approach to Modulate Primary Motor Cortex Activity

ABSTRACT As fMRI-Neurofeedback (fMRI-NF) is still in its early stages, many questions remain regarding the optimal methodology, particularly in relation to feedback modalities. One of the core components of neurofeedback is the feedback itself, which the participant relies on to regulate, learn, and refine their mental strategies. However, most fMRI-NF protocols to date have primarily used visual feedback, which may not be ideal in all cases. Certain individuals or populations might benefit from alternative or additional feedback modalities, such as haptic feedback —a novel approach in this field— along with auditory, virtual reality/immersive environments, or a combination of these. In this study, we assess the performance of neurofeedback elicited by a motor imagery (MI) task using visuo-haptic feedback and compare it to unisensory visual and haptic feedback. Our results suggest that combining visual and haptic feedback in neurofeedback may be more engaging than conventional visual feedback alone, particularly in neurorehabilitation, by more effectively activating the primary motor cortex—a region considered a key target for promoting motor recovery.