Using real-time fMRI to learn voluntary regulation of the anterior insula in the presence of threat-related stimuli

Soc Cogn Affect Neurosci. 2012 Aug;7(6):623-34. doi: 10.1093/scan/nsr061. Epub 2011 Oct 7.


Previous studies have shown that healthy participants learn to control local brain activity with operant training by using real-time functional magnetic resonance imaging (rt-fMRI). Very little data exist, however, on the dynamics of interaction between critical brain regions during rt-fMRI-based training. Here, we examined self-regulation of stimulus-elicited insula activation and performed a psychophysiological interaction (PPI) analysis of real-time self-regulation data. During voluntary up-regulation of the left anterior insula in the presence of threat-related pictures, differential activations were observed in the ventrolateral prefrontal cortex, the frontal operculum, the middle cingulate cortex and the right insula. Down-regulation in comparison to no-regulation revealed additional activations in right superior temporal cortex, right inferior parietal cortex and right middle frontal cortex. There was a significant learning effect over sessions during up-regulation, documented by a significant improvement of anterior insula control over time. Connectivity analysis revealed that successful up-regulation of the activity in left anterior insula while viewing aversive pictures was directly modulated by dorsomedial and ventrolateral prefrontal cortex. Down-regulation of activity was more difficult to achieve and no learning effect was observed. More extensive training might be necessary for successful down-regulation. These findings illustrate the functional interactions between different brain areas during regulation of anterior insula activity in the presence of threat-related stimuli.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biofeedback, Psychology
  • Brain Mapping*
  • Emotions*
  • Female
  • Functional Laterality
  • Gyrus Cinguli / blood supply*
  • Gyrus Cinguli / physiology*
  • Humans
  • Image Processing, Computer-Assisted
  • Learning / physiology*
  • Magnetic Resonance Imaging*
  • Male
  • Oxygen / blood
  • Photic Stimulation
  • Self Report
  • Time Factors
  • Young Adult


  • Oxygen