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Yury Koush

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YNIMG Journal 2021 Journal Article

Predictors of real-time fMRI neurofeedback performance and improvement – A machine learning mega-analysis

  • Amelie Haugg
  • Fabian M. Renz
  • Andrew A. Nicholson
  • Cindy Lor
  • Sebastian J. Götzendorfer
  • Ronald Sladky
  • Stavros Skouras
  • Amalia McDonald

Real-time fMRI neurofeedback is an increasingly popular neuroimaging technique that allows an individual to gain control over his/her own brain signals, which can lead to improvements in behavior in healthy participants as well as to improvements of clinical symptoms in patient populations. However, a considerably large ratio of participants undergoing neurofeedback training do not learn to control their own brain signals and, consequently, do not benefit from neurofeedback interventions, which limits clinical efficacy of neurofeedback interventions. As neurofeedback success varies between studies and participants, it is important to identify factors that might influence neurofeedback success. Here, for the first time, we employed a big data machine learning approach to investigate the influence of 20 different design-specific (e.g. activity vs. connectivity feedback), region of interest-specific (e.g. cortical vs. subcortical) and subject-specific factors (e.g. age) on neurofeedback performance and improvement in 608 participants from 28 independent experiments. With a classification accuracy of 60% (considerably different from chance level), we identified two factors that significantly influenced neurofeedback performance: Both the inclusion of a pre-training no-feedback run before neurofeedback training and neurofeedback training of patients as compared to healthy participants were associated with better neurofeedback performance. The positive effect of pre-training no-feedback runs on neurofeedback performance might be due to the familiarization of participants with the neurofeedback setup and the mental imagery task before neurofeedback training runs. Better performance of patients as compared to healthy participants might be driven by higher motivation of patients, higher ranges for the regulation of dysfunctional brain signals, or a more extensive piloting of clinical experimental paradigms. Due to the large heterogeneity of our dataset, these findings likely generalize across neurofeedback studies, thus providing guidance for designing more efficient neurofeedback studies specifically for improving clinical neurofeedback-based interventions. To facilitate the development of data-driven recommendations for specific design details and subpopulations the field would benefit from stronger engagement in open science research practices and data sharing.

YNIMG Journal 2020 Journal Article

Network-based fMRI-neurofeedback training of sustained attention

  • Gustavo S.P. Pamplona
  • Jennifer Heldner
  • Robert Langner
  • Yury Koush
  • Lars Michels
  • Silvio Ionta
  • Frank Scharnowski
  • Carlos E.G. Salmon

The brain regions supporting sustained attention (sustained attention network; SAN) and mind-wandering (default-mode network; DMN) have been extensively studied. Nevertheless, this knowledge has not yet been translated into advanced brain-based attention training protocols. Here, we used network-based real-time functional magnetic resonance imaging (fMRI) to provide healthy individuals with information about current activity levels in SAN and DMN. Specifically, 15 participants trained to control the difference between SAN and DMN hemodynamic activity and completed behavioral attention tests before and after neurofeedback training. Through training, participants improved controlling the differential SAN-DMN feedback signal, which was accomplished mainly through deactivating DMN. After training, participants were able to apply learned self-regulation of the differential feedback signal even when feedback was no longer available (i. e. , during transfer runs). The neurofeedback group improved in sustained attention after training, although this improvement was temporally limited and rarely exceeded mere practice effects that were controlled by a test-retest behavioral control group. The learned self-regulation and the behavioral outcomes suggest that neurofeedback training of differential SAN and DMN activity has the potential to become a non-invasive and non-pharmacological tool to enhance attention and mitigate specific attention deficits.

YNIMG Journal 2019 Journal Article

Brain networks for engaging oneself in positive-social emotion regulation

  • Yury Koush
  • Swann Pichon
  • Simon B. Eickhoff
  • Dimitri Van De Ville
  • Patrik Vuilleumier
  • Frank Scharnowski

Positive emotions facilitate cognitive performance, and their absence is associated with burdening psychiatric disorders. However, the brain networks regulating positive emotions are not well understood, especially with regard to engaging oneself in positive-social situations. Here we report convergent evidence from a multimodal approach that includes functional magnetic resonance imaging (fMRI) brain activations, meta-analytic functional characterization, Bayesian model-driven analysis of effective brain connectivity, and personality questionnaires to identify the brain networks mediating the cognitive up-regulation of positive-social emotions. Our comprehensive approach revealed that engaging in positive-social emotion regulation with a self-referential first-person perspective is characterized by dynamic interactions between functionally specialized prefrontal cortex (PFC) areas, the temporoparietal junction (TPJ) and the amygdala. Increased top-down connectivity from the superior frontal gyrus (SFG) controls affective valuation in the ventromedial and dorsomedial PFC, self-referential processes in the TPJ, and modulate emotional responses in the amygdala via the ventromedial PFC. Understanding the brain networks engaged in the regulation of positive-social emotions that involve a first-person perspective is important as they are known to constitute an effective strategy in therapeutic settings.

YNIMG Journal 2019 Journal Article

Data-driven tensor independent component analysis for model-based connectivity neurofeedback

  • Yury Koush
  • Nemanja Masala
  • Frank Scharnowski
  • Dimitri Van De Ville

Neurofeedback based on real-time functional MRI is an emerging technique to train voluntary control over brain activity in healthy and disease states. Recent developments even allow for training of brain networks using connectivity feedback based on dynamic causal modeling (DCM). DCM is an influential hypothesis-driven approach that requires prior knowledge about the target brain network dynamics and the modulatory influences. Data-driven approaches, such as tensor independent component analysis (ICA), can reveal spatiotemporal patterns of brain activity without prior assumptions. Tensor ICA allows flexible data decomposition and extraction of components consisting of spatial maps, time-series, and session/subject-specific weights, which can be used to characterize individual neurofeedback regulation per regulation trial, run, or session. In this study, we aimed to better understand the spatiotemporal brain patterns involved and affected by model-based feedback regulation using data-driven tensor ICA. We found that task-specific spatiotemporal brain patterns obtained using tensor ICA were highly consistent with model-based feedback estimates. However, we found that the DCM approach captured specific network interdependencies that went beyond what could be detected with either general linear model (GLM) or ICA approaches. We also found that neurofeedback-guided regulation resulted in activity changes that were characteristic of the mental strategies used to control the feedback signal, and that these activity changes were not limited to periods of active self-regulation, but were also evident in distinct gradual recovery processes during subsequent rest periods. Complementary data-driven and model-based approaches could aid in interpretation of the neurofeedback data when applied post-hoc, and in the definition of the target brain area/pattern/network/model prior to the neurofeedback training study when applied to the pilot data. Systematically investigating the triad of mental effort, spatiotemporal brain network changes, and activity and recovery processes might lead to a better understanding of how learning with neurofeedback is accomplished, and how such learning can cause plastic brain changes along with specific behavioral effects.

YNIMG Journal 2019 Journal Article

Functional MRS with J-edited lactate in human motor cortex at 4 T

  • Yury Koush
  • Robin A. de Graaf
  • Lihong Jiang
  • Douglas L. Rothman
  • Fahmeed Hyder

While functional MRI (fMRI) localizes regions of brain activation, functional MRS (fMRS) provides insights into metabolic underpinnings. Previous fMRS studies detected task-induced lactate increase using short echo-time non-edited 1H-MRS protocols, where lactate changes depended on accurate exclusion of overlapping lactate and lipid/macromolecule signals. Because long echo-time J-difference 1H-MRS detection of lactate is less susceptible to this shortcoming, we posited if J-edited fMRS protocol could reliably detect metabolic changes in the human motor cortex during a finger-tapping paradigm in relation to a reliable measure of basal lactate. Our J-edited fMRS protocol at 4T was guided by an fMRI pre-scan to determine the 1H-MRS voxel placement in the motor cortex. Because lactate and β-hydroxybutyrate (BHB) follow similar J-evolution profiles we observed both metabolites in all spectra, but only lactate showed reproducible task-induced modulation by 0. 07 mM from a basal value of 0. 82 mM. These J-edited fMRS results demonstrate good sensitivity and specificity for task-induced lactate modulation, suggesting that J-edited fMRS studies can be used to investigate the metabolic underpinning of human cognition by measuring lactate dynamics associated with activation and deactivation fMRI paradigms across brain regions at magnetic field lower than 7T.

YNIMG Journal 2019 Journal Article

Volitional modulation of higher-order visual cortex alters human perception

  • Jinendra Ekanayake
  • Gerard R. Ridgway
  • Joel S. Winston
  • Eva Feredoes
  • Adeel Razi
  • Yury Koush
  • Frank Scharnowski
  • Nikolaus Weiskopf

Can we change our perception by controlling our brain activation? Awareness during binocular rivalry is shaped by the alternating perception of different stimuli presented separately to each monocular view. We tested the possibility of causally influencing the likelihood of a stimulus entering awareness. To do this, participants were trained with neurofeedback, using realtime functional magnetic resonance imaging (rt-fMRI), to differentially modulate activation in stimulus-selective visual cortex representing each of the monocular images. Neurofeedback training led to altered bistable perception associated with activity changes in the trained regions. The degree to which training influenced perception predicted changes in grey and white matter volumes of these regions. Short-term intensive neurofeedback training therefore sculpted the dynamics of visual awareness, with associated plasticity in the human brain.

YNICL Journal 2017 Journal Article

Continuous vs. intermittent neurofeedback to regulate auditory cortex activity of tinnitus patients using real-time fMRI - A pilot study

  • Kirsten Emmert
  • Rotem Kopel
  • Yury Koush
  • Raphael Maire
  • Pascal Senn
  • Dimitri Van De Ville
  • Sven Haller

The emerging technique of real-time fMRI neurofeedback trains individuals to regulate their own brain activity via feedback from an fMRI measure of neural activity. Optimum feedback presentation has yet to be determined, particularly when working with clinical populations. To this end, we compared continuous against intermittent feedback in subjects with tinnitus. Fourteen participants with tinnitus completed the whole experiment consisting of nine runs (3 runs × 3 days). Prior to the neurofeedback, the target region was localized within the auditory cortex using auditory stimulation (1 kHz tone pulsating at 6 Hz) in an ON-OFF block design. During neurofeedback runs, participants received either continuous (n = 7, age 46.84 ± 12.01, Tinnitus Functional Index (TFI) 49.43 ± 15.70) or intermittent feedback (only after the regulation block) (n = 7, age 47.42 ± 12.39, TFI 49.82 ± 20.28). Participants were asked to decrease auditory cortex activity that was presented to them by a moving bar. In the first and the last session, participants also underwent arterial spin labeling (ASL) and resting-state fMRI imaging. We assessed tinnitus severity using the TFI questionnaire before all sessions, directly after all sessions and six weeks after all sessions. We then compared neuroimaging results from neurofeedback using a general linear model (GLM) and region-of-interest analysis as well as behavior measures employing a repeated-measures ANOVA. In addition, we looked at the seed-based connectivity of the auditory cortex using resting-state data and the cerebral blood flow using ASL data. GLM group analysis revealed that a considerable part of the target region within the auditory cortex was significantly deactivated during neurofeedback. When comparing continuous and intermittent feedback groups, the continuous group showed a stronger deactivation of parts of the target region, specifically the secondary auditory cortex. This result was confirmed in the region-of-interest analysis that showed a significant down-regulation effect for the continuous but not the intermittent group. Additionally, continuous feedback led to a slightly stronger effect over time while intermittent feedback showed best results in the first session. Behaviorally, there was no significant effect on the total TFI score, though on a descriptive level TFI scores tended to decrease after all sessions and in the six weeks follow up in the continuous group. Seed-based connectivity with a fixed-effects analysis revealed that functional connectivity increased over sessions in the posterior cingulate cortex, premotor area and part of the insula when looking at all patients while cerebral blood flow did not change significantly over time. Overall, these results show that continuous feedback is suitable for long-term neurofeedback experiments while intermittent feedback presentation promises good results for single session experiments when using the auditory cortex as a target region. In particular, the down-regulation effect is more pronounced in the secondary auditory cortex, which might be more susceptible to voluntary modulation in comparison to a primary sensory region.

YNIMG Journal 2017 Journal Article

OpenNFT: An open-source Python/Matlab framework for real-time fMRI neurofeedback training based on activity, connectivity and multivariate pattern analysis

  • Yury Koush
  • John Ashburner
  • Evgeny Prilepin
  • Ronald Sladky
  • Peter Zeidman
  • Sergei Bibikov
  • Frank Scharnowski
  • Artem Nikonorov

Neurofeedback based on real-time functional magnetic resonance imaging (rt-fMRI) is a novel and rapidly developing research field. It allows for training of voluntary control over localized brain activity and connectivity and has demonstrated promising clinical applications. Because of the rapid technical developments of MRI techniques and the availability of high-performance computing, new methodological advances in rt-fMRI neurofeedback become possible. Here we outline the core components of a novel open-source neurofeedback framework, termed Open NeuroFeedback Training (OpenNFT), which efficiently integrates these new developments. This framework is implemented using Python and Matlab source code to allow for diverse functionality, high modularity, and rapid extendibility of the software depending on the user’s needs. In addition, it provides an easy interface to the functionality of Statistical Parametric Mapping (SPM) that is also open-source and one of the most widely used fMRI data analysis software. We demonstrate the functionality of our new framework by describing case studies that include neurofeedback protocols based on brain activity levels, effective connectivity models, and pattern classification approaches. This open-source initiative provides a suitable framework to actively engage in the development of novel neurofeedback approaches, so that local methodological developments can be easily made accessible to a wider range of users.

YNIMG Journal 2013 Journal Article

Connectivity-based neurofeedback: Dynamic causal modeling for real-time fMRI

  • Yury Koush
  • Maria Joao Rosa
  • Fabien Robineau
  • Klaartje Heinen
  • Sebastian W. Rieger
  • Nikolaus Weiskopf
  • Patrik Vuilleumier
  • Dimitri Van De Ville

Neurofeedback based on real-time fMRI is an emerging technique that can be used to train voluntary control of brain activity. Such brain training has been shown to lead to behavioral effects that are specific to the functional role of the targeted brain area. However, real-time fMRI-based neurofeedback so far was limited to mainly training localized brain activity within a region of interest. Here, we overcome this limitation by presenting near real-time dynamic causal modeling in order to provide feedback information based on connectivity between brain areas rather than activity within a single brain area. Using a visual–spatial attention paradigm, we show that participants can voluntarily control a feedback signal that is based on the Bayesian model comparison between two predefined model alternatives, i. e. the connectivity between left visual cortex and left parietal cortex vs. the connectivity between right visual cortex and right parietal cortex. Our new approach thus allows for training voluntary control over specific functional brain networks. Because most mental functions and most neurological disorders are associated with network activity rather than with activity in a single brain region, this novel approach is an important methodological innovation in order to more directly target functionally relevant brain networks.

YNIMG Journal 2012 Journal Article

Signal quality and Bayesian signal processing in neurofeedback based on real-time fMRI

  • Yury Koush
  • Mikhail Zvyagintsev
  • Miriam Dyck
  • Krystyna A. Mathiak
  • Klaus Mathiak

Real-time fMRI allows analysis and visualization of the brain activity online, i. e. within one repetition time. It can be used in neurofeedback applications where subjects attempt to control an activation level in a specified region of interest (ROI) of their brain. The signal derived from the ROI is contaminated with noise and artifacts, namely with physiological noise from breathing and heart beat, scanner drift, motion-related artifacts and measurement noise. We developed a Bayesian approach to reduce noise and to remove artifacts in real-time using a modified Kalman filter. The system performs several signal processing operations: subtraction of constant and low-frequency signal components, spike removal and signal smoothing. Quantitative feedback signal quality analysis was used to estimate the quality of the neurofeedback time series and performance of the applied signal processing on different ROIs. The signal-to-noise ratio (SNR) across the entire time series and the group event-related SNR (eSNR) were significantly higher for the processed time series in comparison to the raw data. Applied signal processing improved the t-statistic increasing the significance of blood oxygen level-dependent (BOLD) signal changes. Accordingly, the contrast-to-noise ratio (CNR) of the feedback time series was improved as well. In addition, the data revealed increase of localized self-control across feedback sessions. The new signal processing approach provided reliable neurofeedback, performed precise artifacts removal, reduced noise, and required minimal manual adjustments of parameters. Advanced and fast online signal processing algorithms considerably increased the quality as well as the information content of the control signal which in turn resulted in higher contingency in the neurofeedback loop.

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