Activity or connectivity? A randomized controlled feasibility study evaluating neurofeedback training in Huntington's...

Area of Science:

• Neuroscience
• Cognitive Science
• Medical Imaging

Background:

• Huntington's disease (HD) involves cognitive impairments.
• Non-invasive neurofeedback training offers a potential avenue for cognitive symptom management.
• Real-time functional MRI neurofeedback (rtfMRI-NF) allows targeted brain region modulation.

Purpose of the Study:

• To assess the feasibility of rtfMRI-NF for cognitive symptom management in HD.
• To compare activity vs. connectivity rtfMRI-NF methods in HD gene-carriers.
• To evaluate the transfer of learned regulation to behavioral outcomes.

Main Methods:

• Single-blind, sham-controlled study with 32 HD gene-carriers.
• Two rtfMRI-NF methods: supplementary motor area (SMA) activity and SMA-striatum connectivity.
• 16 training runs with sham-controlled groups and follow-up assessments.

Main Results:

• Treatment groups achieved significantly higher neurofeedback target levels during training sessions compared to sham controls.
• No robust evidence of superior transfer of learning (near or far) in treatment groups.
• No significant difference found between activity and connectivity rtfMRI-NF methods.
• No correlation observed between learning success and changes in cognitive/psychomotor function.

Conclusions:

• rtfMRI-NF can guide HD gene-carriers to regulate specific brain activity and connectivity.
• Evidence for robust transfer of learning and clinical benefits from rtfMRI-NF in HD was not established.
• Further research is needed to optimize neurofeedback protocols for clinical efficacy in neurodegenerative diseases.