Fundamentals of Mental Health

Fundamentals of Mental Health

Neurofeedback for motor networks: A comparative systematic review of fMRI, fNIRS, and EEG protocols, neural mechanisms, and functional transfer

Document Type : Review Article

Authors
1 Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Science, Mashhad, Iran.
2 Elumind Centres for Brain Excellence, Vancouver, Canada.
3 Department of Speech Therapy, Ibn-e-Sina Psychiatric Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
4 Neurotech brain health clinic, Mashhad, Iran.
10.22038/jfmh.2026.95919.3359
Abstract
Introduction: Neurofeedback (NF) enables volitional modulation of neural activity, yet the comparative clinical utility of electroencephalography (EEG)-, functional Magnetic Resonance Imaging (fMRI)-, and functional Near-Infrared Spectroscopy (fNIRS)-based NF for motor rehabilitation remains uncertain.
Materials and Methods: We systematically searched MEDLINE, Scopus, Embase, Web of Science, and PsycINFO (2010-2025) for studies pairing NF with motor-system targets, using combinations of “neurofeedback”, imaging modality, and “motor cortex”. Forty-six studies met the inclusion criteria (22 fMRI-NF, 17 EEG-NF, 7 fNIRS-NF).
Results: All three modalities up-regulated activity in primary motor, premotor, and supplementary motor areas, demonstrating short-term neuroplasticity. Sustained behavioral gains, however, appeared chiefly in multi-session EEG-NF and fNIRS-NF protocols, whereas most single-session fMRI-NF studies showed limited functional transfer. The evidence base is constrained by small samples, heterogeneous outcomes, and frequent absence of sham controls.
Conclusion: Robust, multi-arm trials with larger cohorts, extended follow-up, and rigorously blinded comparators are needed to clarify dose-response relationships and optimize NF protocols for motor rehabilitation.
Keywords

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