Using Real-time fMRI Neurofeedback and Motor Imagery to Enhance Motor Timing and Precision in Cerebellar Ataxia

Accuracy at baseline will be compared to that of final assessment, which will take place before and after the 3-week at-home practice sessions, respectively. The delta measure will indicate the magnitude of tapping accuracy improvements. Groups will be compared to examine differences in delta as a function of practice condition (tapping only or imagery plus tapping). RMSE (root mean squared error) is the measure for both the baseline and post-treatment behavioral tasks. RMSE will be based on the actual number of taps per second relative to the expected number of taps per second (e.g., 1 tap for 1Hz). Then post treatment RMSE minus baseline RMSE will determine a delta RMSE. A higher RMSE signifies greater error. For the delta measure, it is expected, lower scores reflect greater improvement on the task.

Time frame: Baseline and At-home sessions (10 minutes/day), up to 23 days

Population: Four people did not complete the MRI component as instructed, and one person in the tapping only (control group) condition did not complete the final 7 at-home exercise sessions. These 5 people were excluded from at-home data analysis (a total of 3 excluded from Tapping and 2 excluded from Imagery).

Accuracy at baseline will be compared to that of final assessment, which will take place before and after the 3-week at-home practice sessions, respectively. The delta measure will indicate the magnitude of tapping accuracy improvements. Groups will be compared to examine differences in delta as a function of practice condition (tapping only or imagery plus tapping). RMSE (root mean squared error) is the measure for both the baseline and post-treatment behavioral tasks. RMSE will be based on the actual number of taps per second relative to the expected number of taps per second (e.g., 4 taps for 4Hz). Then post treatment RMSE minus baseline RMSE will determine a delta RMSE. A higher RMSE signifies greater error. For the delta measure, it is expected, lower scores reflect greater improvement on the task.

Time frame: Baseline and At-home sessions (10 minutes/day), up to 23 days

Population: Four people did not complete the MRI component as instructed, and one person in the tapping only (control group) condition did not complete the final 7 at-home exercise sessions. These 5 people were excluded from at-home data analysis (a total of 3 excluded from Tapping and 2 excluded from Imagery).

During the MRI session, accuracy on overt tapping will be measured by the distance of the actual tapping rate vs. target rate (1Hz). Accuracy at baseline will be compared to that of final assessment, which will take place before and after neurofeedback training, respectively. The difference in accuracy between the two tests create a delta measure (i.e., fewer errors in the final vs. baseline tests). This delta accuracy will indicate the magnitude of tapping accuracy improvements. Root mean squared error (RMSE) is the measure for both the baseline and post-treatment behavioral tasks. RMSE will be based on the actual number of taps per second relative to the expected number of taps per second (e.g., 1 tap for 1Hz). Then post treatment RMSE minus baseline RMSE will determine a delta RMSE. A higher RMSE signifies greater error. For the delta measure, it is expected, lower scores reflect greater improvement on the task.

Time frame: Baseline and MRI duration, up to 1 hour

Population: One person withdrew from the MRI portion and did not complete the task. Four additional participants were unable to complete the functional MRI task as instructed, confirmed by post-experimental questionnaires. Because these people were presumably using strategies that were not of interest to the research question, their data was excluded from analysis.

During the MRI session, accuracy on overt tapping will be measured by the distance of the actual tapping rate vs. target rate (4Hz). Accuracy at baseline will be compared to that of final assessment, which will take place before and after neurofeedback training, respectively. The difference in accuracy between the two tests create a delta measure (i.e., fewer errors in the final vs. baseline tests). This delta accuracy will indicate the magnitude of tapping accuracy improvements. Root mean squared error (RMSE) is the measure for both the baseline and post-treatment behavioral tasks. RMSE will be based on the actual number of taps per second relative to the expected number of taps per second (e.g., 1 tap for 1Hz). Then post treatment RMSE minus baseline RMSE will determine a delta RMSE. A higher RMSE signifies greater error. For the delta measure, it is expected, lower scores reflect greater improvement on the task.

Time frame: Baseline and MRI duration, up to 1 hour

Population: One person withdrew from the MRI portion and did not complete the task. Four additional participants were unable to complete the functional MRI task as instructed, confirmed by post-experimental questionnaires. Because these people were presumably using strategies that were not of interest to the research question, their data was excluded from analysis.

This will assess the correlation between MRI Blood Oxygen Level Dependence (BOLD) during imagery and finger tapping accuracy improvement (pre- vs. post- neurofeedback training) by a correlation coefficient. The correlation coefficient ranging from -1 to 1, where the closer the coefficient is to -1 indicates a negative association and the closer the coefficient is to 1 indicates a strong positive association.

Time frame: MRI duration, up to 1 hour

Population: One person withdrew from the MRI portion and did not complete the task. Four additional participants were unable to complete the functional MRI task as instructed, confirmed by post-experimental questionnaires. Because these people were presumably using strategies that were not of interest to the research question, their data was excluded from analysis.

This will assess the correlation between MRI Blood Oxygen Level Dependence (BOLD) during imagery and finger tapping accuracy improvement (pre- vs. post- neurofeedback training) by a correlation coefficient. The correlation coefficient ranging from -1 to 1, where the closer the coefficient is to -1 indicates a negative association and the closer the coefficient is to 1 indicates a strong positive association.

Time frame: MRI duration, up to 1 hour

Population: One person withdrew from the MRI portion and did not complete the task. Four additional participants were unable to complete the functional MRI task as instructed, confirmed by post-experimental questionnaires. Because these people were presumably using strategies that were not of interest to the research question, their data was excluded from analysis.

The International Cooperative Ataxia Rating Scale (ICARS), overall score ranging from 0-100, where higher scores indicate more severe neurological impairment) will assess neurological impairments. This will be correlated with image accuracy measures described in 'Secondary Outcome Measure 5. The correlation coefficient ranging from -1 to 1, where the closer the coefficient is to -1 indicates a negative association and the closer the coefficient is to 1 indicates a strong positive association.

Time frame: Up to 1.5 hours

Population: One person withdrew from the MRI portion and did not complete the task. Four additional participants were unable to complete the functional MRI task as instructed, confirmed by post-experimental questionnaires. Because these people were presumably using strategies that were not of interest to the research question, their data was excluded from analysis.

The Kinesthetic and Visual Imagery Questionnaire (KVIQ), overall score ranging from 0-100, where higher scores reflect more vivid imagery) will assess imagery vividness. This will be correlated with the image accuracy measures described in Secondary Outcome Measure 5. The correlation coefficient ranging from -1 to 1, where the closer the coefficient is to -1 indicates a negative association and the closer the coefficient is to 1 indicates a strong positive association.

Time frame: Up to 1.5 hours

Population: One person withdrew from the MRI portion and did not complete the task. Four additional participants were unable to complete the functional MRI task as instructed, confirmed by post-experimental questionnaires. Because these people were presumably using strategies that were not of interest to the research question, their data was excluded from analysis.