From concept to proof: developing a neurofeedback-fNIRS protocol to train self-regulation for music performance anxiety in adolescent musicians

Introduction: Music Performance Anxiety (MPA) is a prevalent phenomenon among young musicians, affecting both well-being and artistic performance. Despite its early onset and impact, effective interventions supporting the development of self-regulation of MPA in adolescents remain limited, particularly in relation to neurofeedback-based approaches. In response, this study investigates the feasibility of a Neurofeedback-Functional Near-Infrared Spectroscopy (NFDK-fNIRS) training protocol designed to support this process within a proof-of-concept research framework. Methods: The protocol alternated MPA induction and regulation within audio-guided sessions conducted in school settings to ensure ecological validity and to integrate top-down control with gradual exposure to performance contexts. The conceptual development and operationalization of the protocol resulted in a theoretical-methodological framework combining gradual exposure, guided imagery, and neurophysiological self-regulation training. This protocol was implemented through standardized auditory scripts and systematic procedures to ensure replicability and experimental coherence. The proof-of-concept implementation was conducted with three female adolescent participants (aged 12-13) across four individual sessions designed to progressively develop physiological self-regulation in response to MPA. Results: The procedure demonstrated technical feasibility, hemodynamic signal stability, and participants' gradual adaptation to the training. fNIRS data revealed increased modulation of the dorsolateral prefrontal cortex, consistent with top-down self-regulatory learning mechanisms. Researchers' reflective journals emphasized practical aspects such as equipment calibration, session duration, and participant engagement. Discussion: Altogether, the findings indicate that NFDK-fNIRS represents a technically feasible and ecologically applicable approach for training self-regulation of MPA in adolescents, providing a solid foundation for future studies involving larger samples and controlled validation of the protocol.