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Basal-ganglia fMRI NeurofeedbackBrain-REGNCT05627895

Brain Self-regulation for Parkinson's

An observational study of Basal-ganglia fMRI Neurofeedback, run by Maastricht University at 1 site in Netherlands.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

To investigate feasibility of basal-ganglia regions as fMRI-neurofeedback targets in Parkinson's patients and evaluate self-regulation success Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Basal-ganglia fMRI Neurofeedback
What is being tested?
Neurofeedback
How many people
12 participants
Where
1 siteNetherlands
Study dates
17 Aug 2023to 28 Feb 2024
Phase
Observational
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients with Parkinson's disease as per inclusion/ exclusion criteria

Who may be able to join

  • Diagnosis of Parkinson's disease (see 4.1) according to Movement Disorder Society (MDS) clinical diagnostic criteria (Postuma et al., 2015).
  • Disease stage 1-3 according to the Hoehn and Yahr Scale

Who cannot join

  • Exclusion criteria for MRI (e.g., cardiac pacemaker, certain metallic implants)
  • History of psychotic disorder, bipolar disorder, or psychotic depression
  • Current use of illegal drugs (any in the last four weeks)
  • Current excessive alcohol consumption that interferes with daily functioning
  • Advanced cognitive impairment (MoCA <24) or dementia

Trial locations and contacts

1 site in 1 country.

Netherlands1 site
  • Maastricht University

    Maastricht, 6229ER

Other trials in Netherlands

About this study

Official title: A Feasibility Study of fMRI-neurofeedback in Parkinson's Disease

To investigate feasibility of basal-ganglia regions as fMRI-neurofeedback targets in Parkinson's patients and evaluate self-regulation success

Read the detailed description

This is a single-group proof of mechanism study of Parkinson's Disease (PD) patients receiving neurofeedback (NF) training using supplementary motor area (SMA) and basal ganglia as target areas. At the start of the screening session, consent will be taken. Subsequently, the screening assessment will be performed to determine inclusion and exclusion criteria. After inclusion in the study has been established, the NF sessions at the MRI scanner will be scheduled. The participants will be invited for up to three NF sessions. This will total up to a maximum of four visits, one for screening and up to three for the NF sessions. Due to the feasibility nature of the study, the optimal number of sessions for the patient cohort to learn the NF regulation is unknown. Therefore, flexibility has been introduced in the design to facilitate learning in case it is necessary. The NF training is modelled on the investigators' previous work.

Each NF session will consist of one anatomical scan, one localizer run, and four functional NF runs. The localizer run will be used to identify individualized brain activation patterns in the participants. Each NF run is a measurement sequence that will consist of ten blocks: five regulation blocks and five rest blocks. The participants will be asked to upregulate (increase) their brain activity, which will be displayed on a thermometer bar, during the regulation blocks. During the rest blocks, the participants will be asked to relax. The study will employ a crossover design with two conditions. In one condition the participants will receive feedback on the thermometer bar from the SMA region and in the second condition the participants will receive feedback from the basal ganglia region. Two of the NF runs will be with the SMA condition and two will be with the basal ganglia condition. Both runs in each condition will take place consecutively, i.e., either the first two runs will be SMA and the second two runs will be basal ganglia or vice versa. The sessions will be counter balanced.

At the last NF session, a post-training assessment will be conducted during which the participants will be debriefed about the study. NF is an individualized training method, and therefore, individual differences in learning success are expected during the study, which can lead to different expectations from the subjects. However, since this is an investigation of the feasibility of the approach, all forms of performance are useful datapoints and participants will be debriefed about their valuable contribution to make sure that no outcome is conceived as negative.

Being tested
Neurofeedback
Keywords
Neurofeedback, Self-regulation, Functional MRI
Medical subject headings
Self-Control

What participants receive

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

  • NeurofeedbackOther

    Also called fMRI based neurofeedback, Self-regulation of brain activity using neurofeedback

    Participants will be shown their brain activity measured in real-time using an MRI scanner. They can then use mental strategies, such as imagination to influence and regulate this activity.

Study groups in NCT05627895
Study groupRoleWhat they receive
Patient cohortAll patients will undergo both the SMA and the basal ganglia condition
Receives: Other: Neurofeedback

What is being measured

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

  1. Feasibility of basal-ganglia neurofeedback training (fMRI analysis)

    We will be investigating the ability of the basal ganglia to be used as a neurodeedback target for self-regulation in PD patients. To determine the ability of the basal ganglia to be recruited in the neurofeedback training, we will look at the T-contrast of all basal ganglia regulation blocks vs all baseline blocks in all the runs where basal ganglia was the target region.

    Measured: Measurements will be recorded at each MRI session (approx. 1 week intervals after screening and inclusion)

Secondary outcomes (1)
  1. Performance of basal-ganglia neurofeedback training (fMRI analysis)

    To determine the performance of basal ganglia self-regulation, we will employ a T-contrast of all runs with the basal ganglia as the target region versus all the runs with the SMA as the target region. Additionally, we will assess whole-brain activation changes in the basal ganglia runs to determine specificity of the neurofeedback training. This can give us insight into which brain networks contribute mechanistically to the training and if any of the training performance can be attributed to other factors, such as physiological measures, as compared to neurofeedback self-regulation.

    Measured: Measurements will be recorded at each MRI session (approx. 1 week intervals after screening and inclusion)

Timeline

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

  1. First posted28 Nov 2022
  2. Study start17 Aug 2023
  3. Primary completion19 Feb 2024
  4. Study completion28 Feb 2024

Resources

More details

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

Study design
Study type
Observational
Observational model
Case only
Time perspective
Prospective
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05627895
Sponsor's protocol ID
NL82024.068.22
Acronym
Brain-REG
Status last verified
Apr 2024
First submitted
16 Nov 2022
Last updated
15 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Emmert K, Kopel R, Sulzer J, Bruhl AB, Berman BD, Linden DEJ, Horovitz SG, Breimhorst M, Caria A, Frank S, Johnston S, Long Z, Paret C, Robineau F, Veit R, Bartsch A, Beckmann CF, Van De Ville D, Haller S. Meta-analysis of real-time fMRI neurofeedback studies using individual participant data: How is brain regulation mediated? Neuroimage. 2016 Jan 1;124(Pt A):806-812. doi: 10.1016/j.neuroimage.2015.09.042. Epub 2015 Sep 28.

    PubMed 26419389
  • Hamilton JP, Glover GH, Bagarinao E, Chang C, Mackey S, Sacchet MD, Gotlib IH. Effects of salience-network-node neurofeedback training on affective biases in major depressive disorder. Psychiatry Res Neuroimaging. 2016 Mar 30;249:91-6. doi: 10.1016/j.pscychresns.2016.01.016. Epub 2016 Jan 19.

    PubMed 26862057
  • Jaeckle T, Williams SCR, Barker GJ, Basilio R, Carr E, Goldsmith K, Colasanti A, Giampietro V, Cleare A, Young AH, Moll J, Zahn R. Self-blame in major depression: a randomised pilot trial comparing fMRI neurofeedback with self-guided psychological strategies. Psychol Med. 2023 May;53(7):2831-2841. doi: 10.1017/S0033291721004797. Epub 2021 Dec 2.

    PubMed 34852855
  • Johnston SJ, Boehm SG, Healy D, Goebel R, Linden DE. Neurofeedback: A promising tool for the self-regulation of emotion networks. Neuroimage. 2010 Jan 1;49(1):1066-72. doi: 10.1016/j.neuroimage.2009.07.056. Epub 2009 Jul 29.

    PubMed 19646532
  • Linden DE. Neurofeedback and networks of depression. Dialogues Clin Neurosci. 2014 Mar;16(1):103-12. doi: 10.31887/DCNS.2014.16.1/dlinden.

    PubMed 24733975
  • Linden DE, Habes I, Johnston SJ, Linden S, Tatineni R, Subramanian L, Sorger B, Healy D, Goebel R. Real-time self-regulation of emotion networks in patients with depression. PLoS One. 2012;7(6):e38115. doi: 10.1371/journal.pone.0038115. Epub 2012 Jun 4.

    PubMed 22675513
  • MacDuffie KE, MacInnes J, Dickerson KC, Eddington KM, Strauman TJ, Adcock RA. Single session real-time fMRI neurofeedback has a lasting impact on cognitive behavioral therapy strategies. Neuroimage Clin. 2018 Jun 9;19:868-875. doi: 10.1016/j.nicl.2018.06.009. eCollection 2018.

    PubMed 29922575
  • Mehler DMA, Sokunbi MO, Habes I, Barawi K, Subramanian L, Range M, Evans J, Hood K, Luhrs M, Keedwell P, Goebel R, Linden DEJ. Targeting the affective brain-a randomized controlled trial of real-time fMRI neurofeedback in patients with depression. Neuropsychopharmacology. 2018 Dec;43(13):2578-2585. doi: 10.1038/s41386-018-0126-5. Epub 2018 Jun 23.

    PubMed 29967368
  • Mehler DMA, Williams AN, Krause F, Luhrs M, Wise RG, Turner DL, Linden DEJ, Whittaker JR. The BOLD response in primary motor cortex and supplementary motor area during kinesthetic motor imagery based graded fMRI neurofeedback. Neuroimage. 2019 Jan 1;184:36-44. doi: 10.1016/j.neuroimage.2018.09.007. Epub 2018 Sep 8.

    PubMed 30205210
  • Paret C, Zaehringer J, Ruf M, Ende G, Schmahl C. The orbitofrontal cortex processes neurofeedback failure signals. Behav Brain Res. 2019 Sep 2;369:111938. doi: 10.1016/j.bbr.2019.111938. Epub 2019 May 6.

    PubMed 31071348
  • Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, Obeso J, Marek K, Litvan I, Lang AE, Halliday G, Goetz CG, Gasser T, Dubois B, Chan P, Bloem BR, Adler CH, Deuschl G. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/mds.26424.

    PubMed 26474316
  • Sitaram R, Ros T, Stoeckel L, Haller S, Scharnowski F, Lewis-Peacock J, Weiskopf N, Blefari ML, Rana M, Oblak E, Birbaumer N, Sulzer J. Closed-loop brain training: the science of neurofeedback. Nat Rev Neurosci. 2017 Feb;18(2):86-100. doi: 10.1038/nrn.2016.164. Epub 2016 Dec 22.

    PubMed 28003656
  • Skottnik L, Linden DEJ. Mental Imagery and Brain Regulation-New Links Between Psychotherapy and Neuroscience. Front Psychiatry. 2019 Oct 30;10:779. doi: 10.3389/fpsyt.2019.00779. eCollection 2019.

    PubMed 31736799
  • Skottnik L, Sorger B, Kamp T, Linden D, Goebel R. Success and failure of controlling the real-time functional magnetic resonance imaging neurofeedback signal are reflected in the striatum. Brain Behav. 2019 Mar;9(3):e01240. doi: 10.1002/brb3.1240. Epub 2019 Feb 20.

    PubMed 30790474
  • Subramanian L, Hindle JV, Johnston S, Roberts MV, Husain M, Goebel R, Linden D. Real-time functional magnetic resonance imaging neurofeedback for treatment of Parkinson's disease. J Neurosci. 2011 Nov 9;31(45):16309-17. doi: 10.1523/JNEUROSCI.3498-11.2011.

    PubMed 22072682

Questions about this trial

What is this clinical trial studying?

An observational study of Basal-ganglia fMRI Neurofeedback, run by Maastricht University at 1 site in Netherlands.

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 2 inclusion and 5 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: finished, as of the sponsor's last update on 15 Apr 2024. 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 Netherlands. 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.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility of basal-ganglia neurofeedback training (fMRI analysis) (time frame: Measurements will be recorded at each MRI session (approx. 1 week intervals after screening and inclusion)). 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 NCT05627895, which also lists 18 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 15 Apr 2024.

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