Therapy of Alzheimer's Disease With Neurofeedback

University Hospital, Aachen30 enrolled

Overview

The project aims to investigate in patients of Alzheimer's disease in a prodromal state (early state of the disease) compared to healthy subjects whether neurofeedback training with functional MRI (fMRI) can improve cognitive ability. It is of interest if voluntary modulation of brain activation with real-time (rt) fMRI as a novel method affects cognitive ability, as well as functional and structural measures of the brain. Over the course of the study subjects will learn a real-world footpath. During neurofeedback training subjects are then asked to recall this footpath while simultaneously trying to modulate their own brain activation based on feedback. Feedback is given about the parahippocampal gyrus - a region of the brain associated with episodic and visuo-spatial memory, which is known to be affected early by Alzheimer's disease pathology. Before and after the training cognitive ability is assessed using neuropsychological tests mainly measuring numerous domains of memory. The investigators hypothesise that the training leads to an improvement of the trained cognitive domain, but also induces changes in brain structure and function.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Alzheimer Dementia (AD)Elderly

Interventions

rtfMRI neurofeedback trainingOTHER

Information about the state of brain activation was given to subjects. That information was visualised as a thermometer bar. Subjects tried to modulate that activation while performing a mental imagery task.

3T MRIDEVICE

A 3T Siemens MRI scanner was used to implement rtfMRI neurofeedback training.

Eligibility

Sex: ALLMin age: 50 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Native speakers of German * Naive to neurofeedback experiments * Ability to provide written informed consent Exclusion Criteria: * Metallic implants (MR-safety) * Neurological/psychiatric disease (except Alzheimer's disease in the patient group) * Use of psychoactive medication (expect medication for Alzheimer's disease) * Familiarity with the study site

Outcomes

Primary Outcomes

Visual and Verbal Memory Test (VVM)

Neuropsychological assessment including visuo-spatial memory

Time frame: 2.5 weeks

Secondary Outcomes

Montreal Cognitive Assessment (MoCA)

Neuropsychological instrument for a general cognitive screening

Time frame: 2.5 weeks

Wechsler Memory Scale Revised (WMS-R)

Subtests from the WMS-R were used to assess several domains of memory

Time frame: 2.5 weeks

Trail Making Test (TMT)

TMT-A and -B were used to assess cognitive processing speed and task switching capabilities.

Time frame: 2.5 weeks

Visual Patterns Test (VPT)

The VPT was used to assess visual working memory capabilities.

Time frame: 2.5 weeks

Parahippocampal activation

Activation of the parahippocampal gyrus during neurofeedback training as measured with fMRI

Time frame: 2.5 weeks

Memory-related functional connectivity using Granger Causality Analysis (GCA)

Change of functional connectivity mainly between memory-associated brain regions over the course of neurofeedback training characterised by GCA

Time frame: 2.5 weeks

Change of brain structure

Assessment of grey matter volume in the entire brain

Time frame: 2.5 weeks

Change of brain function

Assessment of activation in the entire brain

Time frame: 2.5 weeks

Data from ClinicalTrials.gov

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