Alzheimer Dementia (AD), Elderly
Conditions
Keywords
neurofeedback, real-time functional MRI, parahippocampus
Brief summary
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.
Interventions
OTHERrtfMRI neurofeedback training
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.
DEVICE3T MRI
A 3T Siemens MRI scanner was used to implement rtfMRI neurofeedback training.
Sponsors
Alzheimer Forschung Initiative e.V.
University Hospital, Aachen
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Masking description
Healthy subjects in the sham feedback condition were not aware of their group membership, but were debriefed at the end of the study.
Intervention model description
The design is a pre-test/post-test study with an intervention of three parallel groups. The groups are a healthy elderly experimental group, a patient group and a healthy elderly sham-feedback group.
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
Yes
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual and Verbal Memory Test (VVM) | 2.5 weeks | Neuropsychological assessment including visuo-spatial memory |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Wechsler Memory Scale Revised (WMS-R) | 2.5 weeks | Subtests from the WMS-R were used to assess several domains of memory |
| Trail Making Test (TMT) | 2.5 weeks | TMT-A and -B were used to assess cognitive processing speed and task switching capabilities. |
| Visual Patterns Test (VPT) | 2.5 weeks | The VPT was used to assess visual working memory capabilities. |
| Montreal Cognitive Assessment (MoCA) | 2.5 weeks | Neuropsychological instrument for a general cognitive screening |
| Memory-related functional connectivity using Granger Causality Analysis (GCA) | 2.5 weeks | Change of functional connectivity mainly between memory-associated brain regions over the course of neurofeedback training characterised by GCA |
| Change of brain structure | 2.5 weeks | Assessment of grey matter volume in the entire brain |
| Change of brain function | 2.5 weeks | Assessment of activation in the entire brain |
| Parahippocampal activation | 2.5 weeks | Activation of the parahippocampal gyrus during neurofeedback training as measured with fMRI |
Outcome results
None listed