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Real-time fMRI, broadly speaking, is a type of fMRI in which reconstruction of the raw data obtained by the scanner is done while the scan is happening. In brain scanning, this allows individuals who are undergoing the scan to see the patterns of brain activation which they are generating in one or more regions of interest or ROIs. The theory behind this practice is that since areas of the brain are reliably active when a person does, thinks or experiences particular activities, and relatively inactive when they are doing, thinking or experiencing unrelated activities, the signals from those areas can be used like the global signals of biofeedback to target specific symptomologies. The awareness of localized brain activation patterns made possible by this technology have been used in clinical populations by researchers at Omneuron, Inc. (formerly Neurion, Inc) and Stanford University to investigate whether patients can use these signals to decrease the symptoms of social anxiety disorder and chronic pain, with some success reported at national neuroscience meetings^[1][2]. Other research groups, notably the creators of TurboBrainVoyager, a commercial software package which allows this real-time reconstruction of data, have used it in proof of concept applications to play pong using only their brains (http://www.nature.com/news/2004/040823/pf/040823-18_pf.html).

To date, only blood-oxygen-level dependent (BOLD) fMRI imaging has been used in real-time applications, which adds a delay of approximately 4-5 seconds to the signal due to the physiological delay of the hemodynamic response. In the future, other methods of fMRI which do not rely on a secondary messenger like blood flow may reduce the delay and allow truly instantaneous signal generation.

1. Maeda et al. "Control Over Patterned Brain Activation Achieved Using Real Time fMRI (rtfMRI) With Resultant Changes in Cognition." Proceedings of the 3rd Annual Meeting of Computational and Systems Neuroscience, 2005. http://www.cosyne.org/program05/22.html
2. Adcock et al. "Real-Time fMRI During the Psychotherapy Session: Toward a Methodology to Augment Therapeutic Benefit, Exemplary Data." Proceedings of the 11th Annual Meeting of the Organization for Human Brain Mapping: Toronto, Ontario, 2005.

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