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AnxietyPhase 1NF-AANCT02463136

Fmri-based Neurofeedback With Anxious Adolescents Study

A Phase 1 study testing questionnaires and Functional magnetic resonance imaging w neurofeedback in people with Anxiety, run by University of Oxford at 1 site in United Kingdom.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Adolescents are particularly vulnerable to psychological problems, partly because of dramatic changes in the brain, along with changes in social interactions patterns as they move from childhood towards adulthood. One of the most common problems is anxiety, which affects up to 1 in 4 adolescents. Read more about this study

Who is it for?
Ages 14 to 17 years, women onlyHealthy volunteers can take part
Conditions the study is for
Anxiety
What is being tested?
questionnaires and Functional magnetic resonance imaging w neurofeedback
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteUnited Kingdom
Study dates
Nov 2015to Oct 2017
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 14 to 17 years
  • Women only
  • Healthy volunteers accepted
  • Child

Who may be able to join

  • Female
  • Aged 14-17 years
  • Trait-anxiety score between 20-60

Who cannot join

  • A past or current diagnosis of a psychological or psychiatric disorder, such as anxiety, depression, psychosis, autism, substance abuse, learning difficulties.
  • Known incompatibility with the scanner requirements, such as braces, non-removable piercings, tattoos or pregnancy.

Trial locations and contacts

1 site in 1 country.

Kathrin Cohen Kadosh, PhD contact

01865 ext. 271349

kathrin.cohenkadosh@psy.ox.ac.uk

Jennifer YF Lau, PhD contact

0207790 ext. 0253

j.lau@kcl.ac.uk

United Kingdom1 site, 1 recruiting
  • University of Oxford

    Oxford, Oxfordshire, OX1 3UD

    Kathrin Cohen Kadosh, PhD, ++44 1865 271349, kathrin.cohenkadosh@psy.ox.ac.uk

    Recruiting

Other trials in United Kingdom

About this study

Official title: Using Real-time fMRI-based Neurofeedback With Anxious Adolescents

Adolescents are particularly vulnerable to psychological problems, partly because of dramatic changes in the brain, along with changes in social interactions patterns as they move from childhood towards adulthood. One of the most common problems is anxiety, which affects up to 1 in 4 adolescents. Moreover, paediatric anxiety predicts lifelong persistent mental health problems, which are estimated to cost the UK taxpayer £8.6 billion annually. Young people with anxiety experience intense fears and worries, leading to problems with friendships, poor school performance, and long-term mental health difficulties. Research investigating how and why some young people develop anxiety is therefore critically needed so that strategies for early intervention can be developed.

This research will test the hypothesis that using a novel training intervention, - which teaches participants to change the way that their brain responds to emotional stimuli - will allow the investigators to influence response strategies while they are being established and possibly reduce the risk for anxiety in the long run. To achieve this, the investigators will test 50 adolescent females (aged 14-17 years) varying in anxiety levels to investigate whether brain responses in emotion regulation regions can be up/down regulated using fMRI-based neurofeedback.The rationale behind this research approach is that successful changes in brain response may then provide the participant with an additional, 'bodily' feeling of how respond to an emotional stimulus in real life situations, thereby paving the path towards the development of effective, age-appropriate intervention approaches.

Read the detailed description

This study is part of workpackage 4 of the Braintrain project (EU-FP7 n°602186), which responds to a huge clinical need for mechanism-driven therapies in psychiatry. Advances in neuroimaging and other neuroscience techniques have produced a wealth of information about the neural networks that can contribute to these disorders and their treatment (Linden, 2012). This information can now be harnessed to pinpoint both dysfunction and potential compensatory mechanisms in individual patients. It is important for the choice of neuroimaging technique that major nodes of such disordered networks are in deep regions of the brain such as subcortical nuclei (amygdala and nucleus accumbens) and/or midline cortical regions (medial prefrontal cortex, subgenual cingulate cortex, retrosplenial cortex), which are very difficult to probe via EEG alone. Through the development of fMRI-based NF (henceforth NF) techniques over the last decade by collaboration of members of this consortium (Weiskopf et al., 2004a; Weiskopf et al., 2004b), it has become a realistic proposition to train patients in the self-regulation of these networks and thus obtain clinical benefits (deCharms, 2007). In addition to this therapeutic option, NF can also take the investigation of the neural mechanisms of mental disorders to a new level because it allows the investigators to establish causal relationships by changing regional activity and assessing effects on behaviour and mental states in real-time.

In the current study, the investigators aim to provide proof of concept for using NF with adolescents with varying anxiety levels aged 14-17 years. Anxiety disorders are common, having an estimated lifetime prevalence of 10-25%, and often begin in late childhood/early adolescence. There are currently no effective prevention programmes and current treatments yield variable outcomes. Improving our understanding of the mechanisms by which anxiety disorders first develop can inform the design of effective and targeted interventions for prevention. The transition to adolescence may mark one such developmentally-sensitive juncture for the onset of lifelong persistent anxiety problems, where new interventions such as NF may be particularly effective (Cohen Kadosh et al., 2013). Particularly, it has been suggested that increased emotionality and ongoing development in the neuro-cognitive bases of emotion regulation abilities during adolescence may be one of the factors contributing to the increased risk of anxiety disorders in this age group (Haller et al., in press).

This study builds on previous work by the investigators, which has established the suitability of using NF with paediatric populations (Cohen Kadosh et al., in preparation). Specifically, here, the investigators will use NF to train 50 adolescent girls with varying anxiety levels to increase effective connectivity in the neural networks involved in emotion regulation abilities (Cohen Kadosh et al., in preparation; Kohn et al., 2014; Ruiz et al., 2013). The rationale for this approach is that by improving the information flow in these brain regions, emotion regulation abilities will also improve. Moreover, the investigators hope to be able to show that in turn, improvements in emotion regulation abilities will affect overall anxiety levels. Last, by recruiting participants across a wide range of anxiety levels, the investigators will also be able to assess variations in regulation success as a function of individual anxiety levels.

Conditions
Anxiety
Being tested
questionnaires, Functional magnetic resonance imaging w neurofeedback
Keywords
Adolescence, Brain Development, Neuroimaging, Neurofeedback, Anxiety
Medical subject headings
Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • questionnairesBehavioural

    Clinical questionnaires and behavioural computer-based paradigms, such as the Overlap task (Cohen Kadosh et al., 2014)

  • Functional magnetic resonance imaging w neurofeedbackDevice

    The general framework of the scanning part of this experiment consists of a localiser task (lasting approximately 8 minutes), 4 neurofeedback runs (each lasting approximately 5 minutes) and an anatomical scan (approximately 10 minutes).

    Immediately prior and following the scanning session, participants will also be asked to completed several), as well as an attentional control task with emotional stimuli, such as a behavioural version of the Overlap task (Cohen Kadosh et al., 2014).

Study groups in NCT02463136
Study groupRoleWhat they receive
Behaviour and brain trainingExperimentalfMRI-based neurofeedback
Receives: Behavioral: questionnaires; Device: Functional magnetic resonance imaging w neurofeedback

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proof of concept for using NF in anxious adolescents

    Primary outcome will be that anxious participants learn to self-regulate brain activation. This will be assessed by quantifying the percent signal change in the BOLD signal in specific brain regions.

    Measured: 12 months

Secondary outcomes (8)
  1. Improved emotion regulation skills (questionnaires, behavioural tasks)

    Significant change in questionnaire scores

    Measured: 12 months

  2. Successful reduction in anxious mood (questionnaire)

    Significant reduction in anxiety scores

    Measured: 12 months

  3. Demographics (Demographic questionnaire)

    General assessment

    Measured: 12 months

  4. Thought control abilities (questionnaire)

    General assessment

    Measured: 12 months

  5. IQ levels (Wechsler Abbreviated Intelligence Scale)

    General assessment

    Measured: 12 months

  6. Emotion regulation skills (Cognitive Emotion Regulation Questionnaire)

    General assessment

    Measured: 12 months

  7. Mood and feelings (Moods and feelings questionnaire)

    General assessment

    Measured: 12 months

  8. Debriefing interview questionnaire

    General assessment

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Jun 2015 (estimated)
  2. Study startNov 2015
  3. Primary completionOct 2017 (estimated)
  4. Study completionOct 2017 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02463136
Sponsor's protocol ID
MSD-IDREC-C2-2013-014
Acronym
NF-AA
Status last verified
Nov 2016
First submitted
22 May 2015
Last updated
10 Nov 2016
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: Data may be shared across the Braintrain consortium

Publications

  • Cohen Kadosh K, Linden DE, Lau JY. Plasticity during childhood and adolescence: innovative approaches to investigating neurocognitive development. Dev Sci. 2013 Jul;16(4):574-83. doi: 10.1111/desc.12054. Epub 2013 May 28.

    PubMed 23786475
  • deCharms RC. Reading and controlling human brain activation using real-time functional magnetic resonance imaging. Trends Cogn Sci. 2007 Nov;11(11):473-81. doi: 10.1016/j.tics.2007.08.014. Epub 2007 Nov 7.

    PubMed 17988931
  • Haller SP, Cohen Kadosh K, Scerif G, Lau JY. Social anxiety disorder in adolescence: How developmental cognitive neuroscience findings may shape understanding and interventions for psychopathology. Dev Cogn Neurosci. 2015 Jun;13:11-20. doi: 10.1016/j.dcn.2015.02.002. Epub 2015 Feb 28.

    PubMed 25818181
  • Kohn N, Eickhoff SB, Scheller M, Laird AR, Fox PT, Habel U. Neural network of cognitive emotion regulation--an ALE meta-analysis and MACM analysis. Neuroimage. 2014 Feb 15;87:345-55. doi: 10.1016/j.neuroimage.2013.11.001. Epub 2013 Nov 9.

    PubMed 24220041
  • Linden DE. The challenges and promise of neuroimaging in psychiatry. Neuron. 2012 Jan 12;73(1):8-22. doi: 10.1016/j.neuron.2011.12.014.

    PubMed 22243743
  • Ruiz S, Lee S, Soekadar SR, Caria A, Veit R, Kircher T, Birbaumer N, Sitaram R. Acquired self-control of insula cortex modulates emotion recognition and brain network connectivity in schizophrenia. Hum Brain Mapp. 2013 Jan;34(1):200-12. doi: 10.1002/hbm.21427. Epub 2011 Oct 22.

    PubMed 22021045
  • Weiskopf N, Mathiak K, Bock SW, Scharnowski F, Veit R, Grodd W, Goebel R, Birbaumer N. Principles of a brain-computer interface (BCI) based on real-time functional magnetic resonance imaging (fMRI). IEEE Trans Biomed Eng. 2004 Jun;51(6):966-70. doi: 10.1109/TBME.2004.827063.

    PubMed 15188865
  • Weiskopf N, Scharnowski F, Veit R, Goebel R, Birbaumer N, Mathiak K. Self-regulation of local brain activity using real-time functional magnetic resonance imaging (fMRI). J Physiol Paris. 2004 Jul-Nov;98(4-6):357-73. doi: 10.1016/j.jphysparis.2005.09.019. Epub 2005 Nov 10.

    PubMed 16289548
  • Haugg A, Renz FM, Nicholson AA, Lor C, Gotzendorfer SJ, Sladky R, Skouras S, McDonald A, Craddock C, Hellrung L, Kirschner M, Herdener M, Koush Y, Papoutsi M, Keynan J, Hendler T, Cohen Kadosh K, Zich C, Kohl SH, Hallschmid M, MacInnes J, Adcock RA, Dickerson KC, Chen NK, Young K, Bodurka J, Marxen M, Yao S, Becker B, Auer T, Schweizer R, Pamplona G, Lanius RA, Emmert K, Haller S, Van De Ville D, Kim DY, Lee JH, Marins T, Megumi F, Sorger B, Kamp T, Liew SL, Veit R, Spetter M, Weiskopf N, Scharnowski F, Steyrl D. Predictors of real-time fMRI neurofeedback performance and improvement - A machine learning mega-analysis. Neuroimage. 2021 Aug 15;237:118207. doi: 10.1016/j.neuroimage.2021.118207. Epub 2021 May 25.

    PubMed 34048901
  • Zich C, Johnstone N, Luhrs M, Lisk S, Haller SP, Lipp A, Lau JY, Kadosh KC. Modulatory effects of dynamic fMRI-based neurofeedback on emotion regulation networks in adolescent females. Neuroimage. 2020 Oct 15;220:117053. doi: 10.1016/j.neuroimage.2020.117053. Epub 2020 Jun 20.

    PubMed 32574803

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing questionnaires and Functional magnetic resonance imaging w neurofeedback in people with Anxiety, run by University of Oxford at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 10 Nov 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Kathrin Cohen Kadosh, PhD (01865 ext. 271349, kathrin.cohenkadosh@psy.ox.ac.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proof of concept for using NF in anxious adolescents (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02463136, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Nov 2016.

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