A systematic review of the psychological factors that influence neurofeedback learning outcomes

Real-time functional magnetic resonance imaging (fMRI)-based neurofeedback represents the latest applied behavioural neuroscience methodology developed to train participants in the self-regulation of brain regions or networks. However, as with previous biofeedback approaches which rely on electroencephalography (EEG) or related approaches such as brain-machine interface technology (BCI), individual success rates vary significantly, and some participants never learn to control their brain responses at all. Given that these approaches are often being developed for eventual use in a clinical setting (albeit there is also significant interest in using NF for neuro-enhancement in typical populations), this represents a significant hurdle which requires more research. Here we present the findings of a systematic review which focused on how psychological variables contribute to learning outcomes in fMRI-based neurofeedback. However, as this is a relatively new methodology, we also considered findings from EEG-based neurofeedback and BCI. 271 papers were found and screened through PsycINFO, psycARTICLES, Psychological and Behavioural Sciences Collection, ISI Web of Science and Medline and 21 were found to contribute towards the aim of this survey. Several main categories emerged: Attentional variables appear to be of importance to both performance and learning, motivational factors and mood have been implicated as moderate predictors of success, while personality factors have mixed findings. We conclude that future research will need to systematically manipulate psychological variables such as motivation or mood, and to define clear thresholds for a successful neurofeedback effect. Non-responders need to be targeted for interventions and tested with different neurofeedback setups to understand whether their non-response is specific or general. Also, there is a need for qualitative evidence to understand how psychological variables influence participants throughout their training. This will help us to understand the subtleties of psychological effects over time. This research will allow interventions to be developed for non-responders and better selection procedures in future to improve the efficacy of neurofeedback.