Activity or connectivity? A randomized controlled feasibility study evaluating neurofeedback training in Huntington’s disease

Abstract Non-invasive methods, such as neurofeedback training, could support cognitive symptom management in Huntington’s disease by targeting brain regions whose function is impaired. The aim of our single-blind, sham-controlled study was to collect rigorous evidence regarding the feasibility of neurofeedback training in Huntington’s disease by examining two different methods, activity and connectivity real-time functional MRI neurofeedback training. Thirty-two Huntington’s disease gene-carriers completed 16 runs of neurofeedback training, using an optimized real-time functional MRI protocol. Participants were randomized into four groups, two treatment groups, one receiving neurofeedback derived from the activity of the supplementary motor area, and another receiving neurofeedback based on the correlation of supplementary motor area and left striatum activity (connectivity neurofeedback training), and two sham control groups, matched to each of the treatment groups. We examined differences between the groups during neurofeedback training sessions and after training at follow-up sessions. Transfer of training was measured by measuring the participants’ ability to upregulate neurofeedback training target levels without feedback (near transfer), as well as by examining change in objective, a priori defined, behavioural measures of cognitive and psychomotor function (far transfer) before and at 2 months after training. We found that the treatment group had significantly higher neurofeedback training target levels during the training sessions compared to the control group. However, we did not find robust evidence of better transfer in the treatment group compared to controls, or a difference between the two neurofeedback training methods. We also did not find evidence in support of a relationship between change in cognitive and psychomotor function and learning success. We conclude that although there is evidence that neurofeedback training can be used to guide participants to regulate the activity and connectivity of specific regions in the brain, evidence regarding transfer of learning and clinical benefit was not robust.

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Activity or Connectivity? Evaluating neurofeedback training in Huntington’s disease

10.1101/481903 ◽

2018 ◽

Cited By ~ 3

Author(s):

Marina Papoutsi ◽

Joerg Magerkurth ◽

Oliver Josephs ◽

Sophia E Pépés ◽

Temi Ibitoye ◽

...

Keyword(s):

Treatment Group ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Real Time ◽

Clinical Benefit ◽

Controlled Study ◽

Psychomotor Function ◽

Neurofeedback Training ◽

Treatment Groups ◽

Non Invasive

AbstractNon-invasive methods, such as neurofeedback training (NFT), could support cognitive symptom management in Huntington’s disease (HD) by targeting brain regions whose function is impaired. The aim of our single-blind, sham-controlled study was to collect rigorous evidence regarding the feasibility of NFT in HD by examining two different methods, activity and connectivity real-time fMRI NFT. Thirty-two HD gene-carriers completed 16 runs of NFT training, using an optimized real-time fMRI protocol. Participants were randomized into four groups, two treatment groups, one receiving neurofeedback derived from the activity of the Supplementary Motor Area (SMA), and another receiving neurofeedback based on the correlation of SMA and left striatum activity (connectivity NFT), and two sham control groups, matched to each of the treatment groups. We examined differences between the groups during NFT training sessions and after training at follow-up sessions. Transfer of training was measured by measuring the participants’ ability to upregulate NFT target levels without feedback (near transfer), as well as by examining change in objective, a-priori defined, behavioural measures of cognitive and psychomotor function (far transfer) before and at 2 months after training. We found that the treatment group had significantly higher NFT target levels during the training sessions compared to the control group. However, we did not find robust evidence of better transfer in the treatment group compared to controls, or a difference between the two NFT methods. We also did not find evidence in support of a relationship between change in cognitive and psychomotor function and NFT learning success. We conclude that although there is evidence that NFT can be used to guide participants to regulate the activity and connectivity of specific regions in the brain, evidence regarding transfer of learning and clinical benefit was not robust. Although the intervention is non-invasive, given the costs and absence of reliable evidence of clinical benefit, we cannot recommend real-time fMRI NFT as a potential intervention in HD.

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The Frontal Aslant Tract and Supplementary Motor Area Syndrome: Moving towards a Connectomic Initiation Axis

Cancers ◽

10.3390/cancers13051116 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1116 ◽

Cited By ~ 1

Author(s):

Robert G. Briggs ◽

Parker G. Allan ◽

Anujan Poologaindran ◽

Nicholas B. Dadario ◽

Isabella M. Young ◽

...

Keyword(s):

Treatment Group ◽

Frontal Lobe ◽

Supplementary Motor Area ◽

Motor Area ◽

Control Group ◽

Glioma Surgery ◽

Treatment Groups ◽

Sma Syndrome ◽

Significant Difference ◽

Frontal Aslant Tract

Connectomics is the use of big data to map the brain’s neural infrastructure; employing such technology to improve surgical planning may improve neuro-oncological outcomes. Supplementary motor area (SMA) syndrome is a well-known complication of medial frontal lobe surgery. The ‘localizationist’ view posits that damage to the posteromedial bank of the superior frontal gyrus (SFG) is the basis of SMA syndrome. However, surgical experience within the frontal lobe suggests that this is not entirely true. In a study on n = 45 patients undergoing frontal lobe glioma surgery, we sought to determine if a ‘connectomic’ or network-based approach can decrease the likelihood of SMA syndrome. The control group (n = 23) underwent surgery avoiding the posterior bank of the SFG while the treatment group (n = 22) underwent mapping of the SMA network and Frontal Aslant Tract (FAT) using network analysis and DTI tractography. Patient outcomes were assessed post operatively and in subsequent follow-ups. Fewer patients (8.3%) in the treatment group experienced transient SMA syndrome compared to the control group (47%) (p = 0.003). There was no statistically significant difference found between the occurrence of permanent SMA syndrome between control and treatment groups. We demonstrate how utilizing tractography and a network-based approach decreases the likelihood of transient SMA syndrome during medial frontal glioma surgery. We found that not transecting the FAT and the SMA system improved outcomes which may be important for functional outcomes and patient quality of life.

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Functional MRI study of a serial reaction time task in Huntington's disease

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2004.03.002 ◽

2004 ◽

Vol 131 (1) ◽

pp. 23-30 ◽

Cited By ~ 62

Author(s):

Jin-Suh Kim ◽

Sarah A.J Reading ◽

Thomas Brashers-Krug ◽

Vince D Calhoun ◽

Christopher A Ross ◽

...

Keyword(s):

Reaction Time ◽

Huntington's Disease ◽

Huntington’S Disease ◽

Functional Mri ◽

Reaction Time Task ◽

Serial Reaction Time Task ◽

Serial Reaction Time ◽

Time Task ◽

Serial Reaction ◽

Mri Study

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Premovement activity of the pre-supplementary motor area and the readiness for action: Studies of time-resolved event-related functional MRI

Human Movement Science ◽

10.1016/j.humov.2005.10.001 ◽

2005 ◽

Vol 24 (5-6) ◽

pp. 644-656 ◽

Cited By ~ 98

Author(s):

Ross Cunnington ◽

Christian Windischberger ◽

Ewald Moser

Keyword(s):

Functional Mri ◽

Supplementary Motor Area ◽

Motor Area ◽

Time Resolved

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A feasibility study of real-time displays of brain activity as a treatment for symptoms in Huntington's disease

http://isrctn.com/ ◽

10.1186/isrctn35734205 ◽

2020 ◽

Author(s):

Marina Papoutsi

Keyword(s):

Huntington's Disease ◽

Huntington’S Disease ◽

Real Time ◽

Feasibility Study ◽

Brain Activity

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Roles of default-mode network and supplementary motor area in human vigilance performance: evidence from real-time fMRI

Journal of Neurophysiology ◽

10.1152/jn.00533.2011 ◽

2013 ◽

Vol 109 (5) ◽

pp. 1250-1258 ◽

Cited By ~ 40

Author(s):

Oliver Hinds ◽

Todd W. Thompson ◽

Satrajit Ghosh ◽

Julie J. Yoo ◽

Susan Whitfield-Gabrieli ◽

...

Keyword(s):

Real Time ◽

Default Mode Network ◽

Human Performance ◽

Supplementary Motor Area ◽

Brain Regions ◽

Motor Area ◽

Neural Systems ◽

Brain State ◽

Default Mode ◽

Brain States

We used real-time functional magnetic resonance imaging (fMRI) to determine which regions of the human brain have a role in vigilance as measured by reaction time (RT) to variably timed stimuli. We first identified brain regions where activation before stimulus presentation predicted RT. Slower RT was preceded by greater activation in the default-mode network, including lateral parietal, precuneus, and medial prefrontal cortices; faster RT was preceded by greater activation in the supplementary motor area (SMA). We examined the roles of these brain regions in vigilance by triggering trials based on brain states defined by blood oxygenation level-dependent activation measured using real-time fMRI. When activation of relevant neural systems indicated either a good brain state (increased activation of SMA) or a bad brain state (increased activation of lateral parietal cortex and precuneus) for performance, a target was presented and RT was measured. RTs on trials triggered by a good brain state were significantly faster than RTs on trials triggered by a bad brain state. Thus human performance was controlled by monitoring brain states that indicated high or low vigilance. These findings identify neural systems that have a role in vigilance and provide direct evidence that the default-mode network has a role in human performance. The ability to control and enhance human behavior based on brain state may have broad implications.

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Language supplementary motor area syndrome correlated with dynamic changes in perioperative task-based functional MRI activations: case report

Journal of Neurosurgery ◽

10.3171/2020.4.jns193250 ◽

2020 ◽

pp. 1-5

Author(s):

Jaime A. Quirarte ◽

Vinodh A. Kumar ◽

Ho-Ling Liu ◽

Kyle R. Noll ◽

Jeffrey S. Wefel ◽

...

Keyword(s):

Functional Mri ◽

Supplementary Motor Area ◽

Blood Oxygen Level Dependent ◽

Motor Area ◽

Blood Oxygen ◽

Blood Oxygen Level ◽

Dynamic Changes ◽

Anterior Aspect ◽

Sma Syndrome ◽

The Right

Supplementary motor area (SMA) syndrome is well known; however, the mechanism underlying recovery from language SMA syndrome is unclear. Herein the authors report the case of a right-handed woman with speech aphasia following resection of an oligodendroglioma located in the anterior aspect of the left superior frontal gyrus. The patient exhibited language SMA syndrome, and functional MRI (fMRI) findings 12 days postoperatively demonstrated a complete shift of blood oxygen level–dependent (BOLD) activation to the contralateral right language SMA/pre-SMA as well as coequal activation and an increased volume of activation in the left Broca’s area and the right Broca’s homolog. The authors provide, to the best of their knowledge, the first description of dynamic changes in task-based hemispheric language BOLD fMRI activations across the preoperative, immediate postoperative, and more distant postoperative settings associated with the development and subsequent complete resolution of the clinical language SMA syndrome.

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