Cognitive Improvement and Brain Changes after Real-Time Functional MRI Neurofeedback Training in Healthy Elderly and Prodromal Alzheimer’s Disease

Frontiers in Neurology

卷:8

Rainer Goebel¹  Armin Heinecke¹  Christine Müller⁵  Jörg B. Schulz⁵  Federica Papa⁵  N. Jon Shah⁵  Martina Reske⁵  Hanna Kuhn⁵  Simon Ketteler⁵  Nils Nellessen⁵  Christian Hohenfeld⁵  Kathrin Reetz⁵  Imis Dogan⁵ 

[1] Brain Innovation, Maastricht, Netherlands;

[2] Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands;

[3] Department of Neurology, RWTH Aachen University, Aachen, Germany;

[4] Institute of Neuroscience and Medicine (INM-4, 6), Research Centre Jülich GmbH, Jülich, Germany;

[5] JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany;

[6] Maastricht Brain Imaging Centre, Maastricht University, Maastricht, Netherlands;

关键词: cognitive training;    mental imagery;    parahippocampus;    plasticity;    visuospatial memory;    neurofeedback;   

DOI  :  10.3389/fneur.2017.00384

来源: DOAJ

【 摘 要 】

BackgroundCognitive decline is characteristic for Alzheimer’s disease (AD) and also for healthy ageing. As a proof-of-concept study, we examined whether this decline can be counteracted using real-time fMRI neurofeedback training. Visuospatial memory and the parahippocampal gyrus (PHG) were targeted.MethodsSixteen healthy elderly subjects (mean age 63.5 years, SD = 6.663) and 10 patients with prodromal AD (mean age 66.2 years, SD = 8.930) completed the experiment. Four additional healthy subjects formed a sham-feedback condition to validate the paradigm. The protocol spanned five examination days (T1–T5). T1 contained a neuropsychological pre-test, the encoding of a real-world footpath, and an anatomical MRI scan of the brain. T2–T4 included the fMRI neurofeedback training paradigm, in which subjects learned to enhance activation of the left PHG while recalling the path encoded on T1. At T5, the neuropsychological post-test and another anatomical MRI brain scan were performed. The neuropsychological battery included the Montreal Cognitive Assessment (MoCA); the Visual and Verbal Memory Test (VVM); subtests of the Wechsler Memory Scale (WMS); the Visual Patterns Test; and Trail Making Tests (TMT) A and B.ResultsHealthy elderly and patients with prodromal AD showed improved visuospatial memory performance after neurofeedback training. Healthy subjects also performed better in a working-memory task (WMS backward digit-span) and in the MoCA. Both groups were able to elicit parahippocampal activation during training, but no significant changes in brain activation were found over the course of the training. However, Granger-causality-analysis revealed changes in cerebral connectivity over the course of the training, involving the parahippocampus and identifying the precuneus as main driver of activation in both groups. Voxel-based morphometry showed increases in grey matter volumes in the precuneus and frontal cortex. Neither cognitive enhancements, nor parahippocampal activation were found in the control group undergoing sham-feedback.ConclusionThese findings suggest that cognitive decline, either related to prodromal AD or healthy ageing, could be counteracted using fMRI-based neurofeedback. Future research needs to determine the potential of this method as a treatment tool.

【 授权许可】

Unknown