Targeting hippocampal hyperactivity with real-time fMRI neurofeedback: protocol of a single-blind randomized controlled trial in mild cognitive impairment.
Episodic memory
Hippocampal hyperactivity
Neurofeedback
Pattern separation
Real-time fMRI
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
09 02 2021
09 02 2021
Historique:
received:
22
12
2020
accepted:
02
02
2021
entrez:
10
2
2021
pubmed:
11
2
2021
medline:
27
4
2021
Statut:
epublish
Résumé
Several fMRI studies found hyperactivity in the hippocampus during pattern separation tasks in patients with Mild Cognitive Impairment (MCI; a prodromal stage of Alzheimer's disease). This was associated with memory deficits, subsequent cognitive decline, and faster clinical progression. A reduction of hippocampal hyperactivity with an antiepileptic drug improved memory performance. Pharmacological interventions, however, entail the risk of side effects. An alternative approach may be real-time fMRI neurofeedback, during which individuals learn to control region-specific brain activity. In the current project we aim to test the potential of neurofeedback to reduce hippocampal hyperactivity and thereby improve memory performance. In a single-blind parallel-group study, we will randomize n = 84 individuals (n = 42 patients with MCI, n = 42 healthy elderly volunteers) to one of two groups receiving feedback from either the hippocampus or a functionally independent region. Percent signal change of the hemodynamic response within the respective target region will be displayed to the participant with a thermometer icon. We hypothesize that only feedback from the hippocampus will decrease hippocampal hyperactivity during pattern separation and thereby improve memory performance. Results of this study will reveal whether real-time fMRI neurofeedback is able to reduce hippocampal hyperactivity and thereby improve memory performance. In addition, the results of this study may identify predictors of successful neurofeedback as well as the most successful regulation strategies. The study has been registered with clinicaltrials.gov on the 16th of July 2019 (trial identifier: NCT04020744 ).
Sections du résumé
BACKGROUND
Several fMRI studies found hyperactivity in the hippocampus during pattern separation tasks in patients with Mild Cognitive Impairment (MCI; a prodromal stage of Alzheimer's disease). This was associated with memory deficits, subsequent cognitive decline, and faster clinical progression. A reduction of hippocampal hyperactivity with an antiepileptic drug improved memory performance. Pharmacological interventions, however, entail the risk of side effects. An alternative approach may be real-time fMRI neurofeedback, during which individuals learn to control region-specific brain activity. In the current project we aim to test the potential of neurofeedback to reduce hippocampal hyperactivity and thereby improve memory performance.
METHODS
In a single-blind parallel-group study, we will randomize n = 84 individuals (n = 42 patients with MCI, n = 42 healthy elderly volunteers) to one of two groups receiving feedback from either the hippocampus or a functionally independent region. Percent signal change of the hemodynamic response within the respective target region will be displayed to the participant with a thermometer icon. We hypothesize that only feedback from the hippocampus will decrease hippocampal hyperactivity during pattern separation and thereby improve memory performance.
DISCUSSION
Results of this study will reveal whether real-time fMRI neurofeedback is able to reduce hippocampal hyperactivity and thereby improve memory performance. In addition, the results of this study may identify predictors of successful neurofeedback as well as the most successful regulation strategies.
TRIAL REGISTRATION
The study has been registered with clinicaltrials.gov on the 16th of July 2019 (trial identifier: NCT04020744 ).
Identifiants
pubmed: 33563242
doi: 10.1186/s12888-021-03091-8
pii: 10.1186/s12888-021-03091-8
pmc: PMC7871643
doi:
Banques de données
ClinicalTrials.gov
['NCT04020744']
Types de publication
Clinical Trial Protocol
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
87Subventions
Organisme : Velux Stiftung
ID : 17/1163
Références
Behav Res Methods. 2019 Feb;51(1):195-203
pubmed: 30734206
Br J Clin Psychol. 2004 Sep;43(Pt 3):245-65
pubmed: 15333231
Front Hum Neurosci. 2015 Mar 30;9:160
pubmed: 25870552
J Intern Med. 2014 Mar;275(3):214-28
pubmed: 24605806
Elife. 2017 Feb 08;6:
pubmed: 28177283
Int J Behav Med. 2012 Sep;19(3):372-81
pubmed: 21633905
J Am Geriatr Soc. 2005 Apr;53(4):695-9
pubmed: 15817019
Radiology. 2016 Jul;280(1):237-43
pubmed: 26824710
Neuron. 2012 May 10;74(3):467-74
pubmed: 22578498
Brain. 2015 Apr;138(Pt 4):1023-35
pubmed: 25678559
Hippocampus. 2011 Sep;21(9):968-79
pubmed: 20865732
Alzheimers Res Ther. 2020 Sep 28;12(1):118
pubmed: 32988409
Nat Rev Neurosci. 2017 Feb;18(2):86-100
pubmed: 28003656
Behav Res Methods. 2009 Nov;41(4):1149-60
pubmed: 19897823
Acta Neuropathol. 1991;82(4):239-59
pubmed: 1759558
Transl Psychiatry. 2013 Apr 30;3:e250
pubmed: 23632454
Trends Neurosci. 2011 Aug;34(8):430-42
pubmed: 21696834
Brain. 2015 Apr;138(Pt 4):831-3
pubmed: 25802317
Neurology. 2010 Jun 15;74(24):1969-76
pubmed: 20463288
Neuroimage. 2017 Aug 1;156:489-503
pubmed: 28645842
J Neuroimaging. 2012 Jan;22(1):58-66
pubmed: 20977537
J Clin Psychiatry. 2016 Mar;77(3):e305-11
pubmed: 26891108
Neuroimage. 2012 Aug 15;62(2):682-92
pubmed: 22019880
Alzheimers Dement (Amst). 2020 Aug 03;12(1):e12043
pubmed: 32775595
Front Hum Neurosci. 2020 Feb 25;14:60
pubmed: 32161529
Neuroimage. 2019 Feb 1;186:256-265
pubmed: 30423429
Neuron. 2002 Jan 31;33(3):341-55
pubmed: 11832223
Brain. 2011 Jun;134(Pt 6):1694-709
pubmed: 21576110
Neuroimage. 2013 Aug 1;76:386-99
pubmed: 23541800
Learn Mem. 2010 Dec 16;18(1):15-8
pubmed: 21164173
N Engl J Med. 2000 Aug 17;343(7):450-6
pubmed: 10944562
Alzheimers Dement. 2011 May;7(3):280-92
pubmed: 21514248