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| Name | Class |
|---|---|
| University of Zurich | OTHER |
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Increased activity in the hippocampus (i.e., hyperactivity) during a fMRI memory task was found in patients with Mild Cognitive Impairment due to Alzheimer's disease (MCI). Those with increased hippocampal activity exhibited elevated clinical progression. Reducing hippocampal hyperactivity with pharmacological treatment reduced hyperactivity and improved memory performance. The investigators of this study will test whether real-time fMRI neurofeedback will also downregulate hippocampal activity and thereby improve memory performance.
Alzheimer's disease (AD) is an insidious and progressive neurodegenerative disorder accompanied by extracellular deposits of beta-amyloid ( aβ) and the increase of cognitive dysfunctions. Several functional magnet resonance imaging (fMRI) studies in the prodromal stage of AD (i.e., in MCI) have found increased hippocampal activity during a memory task to be predictive of memory worsening and disease progression. In this study the investigators are aiming to reduce hippocampal hyperactivity with real-time fMRI neurofeedback and test whether this will improve memory performance.
This study will use a randomized, single-blind, parallel group design. Patients with MCI and healthy participants will be assigned to receive feedback from either the hippocampus (experimental group, N=42) or from another brain area (alternate ROI feedback group, N=42). All participants will be instructed to downregulate activity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| healthy elderly participants receiving feedback from the hippocampus | Active Comparator | This group will consist of healthy elderly volunteers, who will receive feedback from their hippocampal activity. |
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| healthy elderly participants receiving feedback from another area | Sham Comparator | This group will consist of healthy elderly volunteers, who will receive feedback from another brain area. |
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| patients with MCI receiving feedback from the hippocampus | Experimental | This group will consist of patients with mild cognitive impairment, who will receive feedback from their hippocampal activity. |
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| patients with MCI receiving feedback from another brain area | Sham Comparator | This group will consist of patients with mild cognitive impairment, who will receive feedback from another brain area. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| real-time fMRI based neurofeedback from the hippocampus | Other | During real-time fMRI neurofeedback, participants are trained to 'control' hippocampal activity. The training is accomplished by continuously measuring brain activity, analysing it in real-time, and then providing feedback about the current (and the targeted) brain activity to the participant. |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of change in hippocampal activity during a memory task | Measured by fMRI (rate of change in activity from baseline to after the intervention) | Directly after the intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of change in memory performance | Measured by fMRI (memory performance change from baseline to after the intervention) | Directly after the intervention |
| Rate of change from in memory performance (behavioural) |
| Measure | Description | Time Frame |
|---|---|---|
| Strategies for Regulation of hippocampal activity | Which strategies were particularly helpful in downregulation of hippocampal activity (number of times the strategies were mentioned) | Intervention |
| Predictors of neurofeedback success |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jessica Peter, PD Dr. | University of Bern | Principal Investigator |
| Stefan Klöppel, Prof. Dr. | University of Bern | Principal Investigator |
| Frank Scharnowski, Prof. Dr. | University of Vienna | Study Chair |
| Roland Wiest, Prof. Dr. | University of Bern | Study Chair |
| Katharina Klink | University of Bern | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SITEM (Swiss Institute for Translational and Entrepreneurial Medicine) | Bern | 3010 | Switzerland | |||
| University of Zurich |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33563242 | Derived | Klink K, Jaun U, Federspiel A, Wunderlin M, Teunissen CE, Kiefer C, Wiest R, Scharnowski F, Sladky R, Haugg A, Hellrung L, Peter J. Targeting hippocampal hyperactivity with real-time fMRI neurofeedback: protocol of a single-blind randomized controlled trial in mild cognitive impairment. BMC Psychiatry. 2021 Feb 9;21(1):87. doi: 10.1186/s12888-021-03091-8. |
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| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
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For blinding of the participants, they will be told that they will be asked to regulate one of two brain regions, without mentioning the specific area.
|
| real-time fMRI based neurofeedback from another brain area | Other | During real-time fMRI neurofeedback, participants are trained to 'control' hippocampal activity. The training is accomplished by continuously measuring brain activity, analysing it in real-time, and then providing feedback about the current (and the targeted) brain activity to the participant. |
|
Measured behaviourally (memory performance change from baseline to after the intervention)
| Directly after the intervention |
Variables extracted from questionnaires that may predict who will respond to neurofeedback
| Post-Intervention |
| Zurich |
| 8092 |
| Switzerland |