Neurofeedback fMRI in the motor system elicits bi-directional changes in activity and white-matter structure in the healthy adult human brain

Neurofeedback can be used to alter brain activity and is therefore an attractive tool for neuromodulation in clinical contexts. Different contexts might call for different patterns of activity modulation. For example, following stroke, alternative therapeutic strategies could involve up or down-regulation of activity in the ipsilateral motor cortex. However, effects of such strategies on activity and brain structure are unknown. In a proof of concept study in healthy individuals, we showed that fMRI neurofeedback can be used to drive activity up or down in ipsilateral motor cortex during hand movement. Given evidence for activitydependent white matter plasticity, we also tested effects of activity modulation on white matter microstructure using diffusion tensor imaging (DTI). We show rapid opposing changes in corpus callosum microstructure that depend on the direction of activity modulation. Bidirectional modulation of ipsilateral motor cortex activity is therefore possible, and results not only in online changes in activity patterns, but also in changes in microstructure detectable 24 hours later.