What Happens During an fMRI Neurofeedback Session?

An fMRI neurofeedback session usually happens as part of a research study. After consent and a detailed MRI safety check, you lie in a scanner with ear protection and watch a simple display, often a thermometer, that reflects activity in one brain region. You practice mental strategies to raise or lower it, in short runs with rest in between. This walkthrough explains what to expect from fMRI neurofeedback, from booking to aftercare.

Before you book

fMRI neurofeedback needs an MRI scanner, real-time analysis software and a trained team, so it is offered mainly within research studies at universities and hospitals. Most people find it through a research center or a clinical trial registry. If you want neurofeedback you can book in a clinic, EEG neurofeedback is far easier to find, or you can explore related approaches.

Before you sign up, read the study information carefully. Ask what the study is testing, how many visits it involves, whether you could be assigned to a sham or comparison group, and whether you will be paid or reimbursed. Tell the team about any implants, pacemaker, metal fragments, past surgery, pregnancy, claustrophobia, seizures and your current medicines and mental health care.

When you arrive

Expect paperwork first. In a study, a researcher will go through the consent form with you and answer questions, and you can withdraw at any time. Then comes MRI safety screening: a detailed questionnaire about implants, devices, metal and surgery, checked by a trained staff member. This step matters, because the scanner's magnet is always on.

You will be asked to remove anything metal, such as jewelry, hairpins, watches, belts, hearing aids and phones, and you may be asked to change into scanner-safe clothing. Some studies start with short questionnaires or computer tasks to measure mood or attention before scanning. The team will explain the display you will see, the goal of each run and the strategies you might try, and show you how to call them during the scan.

During the session

Each study has its own protocol, and what follows is a typical shape rather than a script. You lie on your back on the scanner bed. Staff give you earplugs or headphones, place a coil around your head and use soft padding to help you keep still. You hold a call button or squeeze ball, and the team can talk to you through the intercom from the control room.

The bed slides into the scanner bore. A screen or mirror lets you see the display. The first scans usually take pictures of your brain's structure while you rest; the scanner makes loud knocking and buzzing sounds that change from scan to scan. Some protocols then run a localizer task to find the exact region to target, or a practice run without feedback, which a 2021 analysis linked to better performance.

Then the feedback runs begin. Each run usually alternates short rest blocks with regulation blocks. During regulation you try to move the display, for example raising the thermometer by recalling a happy memory or imagining a movement. Because the signal tracks blood flow, it changes a few seconds after your effort, so the feedback feels slightly delayed. Between runs the team may check in and you may try a different strategy.

Many protocols end with a transfer run, where you try to regulate without seeing feedback, to test whether the skill holds on its own. In sham-controlled studies, some participants see feedback from another region or another person, and neither you nor the researcher running the session may know which group you are in. Squeeze the call button at any point if you feel unwell, need to stop or feel panicky.

What you might notice

Many people find the scanner itself is the biggest adjustment: the noise, the narrow space and the need to keep your head still. Lying still for a long time can make your back or neck stiff. Some people feel drowsy during rest blocks, while the regulation blocks can feel mentally effortful, a bit like concentrating hard on a task with unclear rules.

It is common for the display not to respond the way you hope, especially at first. Research shows learning varies widely, and a considerable share of people do not learn to control the signal. That is not a personal failure. Emotional strategies can also bring up feelings. If you notice distress, dizziness or anything uncomfortable, tell the team. Any change you notice afterward is not a guaranteed result, and trials so far have shown mixed effects on symptoms.

Afterward

When the scan ends, the bed slides out and staff help you sit up slowly. Take a moment before standing, especially if you feel lightheaded. In a study, you may complete questionnaires about the strategies you used, how hard the task felt and your mood, and possibly repeat a computer task.

You can usually return to normal activities straight away, since nothing is injected and no medicine is involved unless a specific study says otherwise. Note how you feel over the next day or two and tell the team about anything unusual. If you are in medical or mental health care, let your clinician know you are taking part in a study.

Length, frequency and cost

A visit takes longer than the scan alone, because consent, safety screening and setup all take time. Ask the team how long each visit will be and how long you will be inside the scanner.

The number of sessions varies by study, and clinical trials usually involve several visits; a 2018 depression trial used five training sessions, for example. Research participants usually do not pay and are sometimes reimbursed for time or travel. If a private provider offers fMRI neurofeedback, cost varies widely, so ask for the full price, the number of sessions and what is included up front.

Questions to ask and when to check with your doctor first

Useful questions include: What is this study testing? Could I be in a sham group? How many visits are there, and how long will I be in the scanner? Who reviews my safety screening? What happens if I want to stop? Will I receive any results?

Check with your doctor first if you have a pacemaker, implant or metal in your body, are pregnant, have severe claustrophobia, epilepsy or an unstable mental health condition. Keep up your usual care; fMRI neurofeedback is still experimental and does not replace it.