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Neurofeedback from the supplementary motor area for Tourette Syndrome

抽动秽语综合症辅助运动区的神经反馈

基本信息

批准号：
10619647
负责人：
Michelle Hampson
金额：
$ 81.03万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-05-09 至 2027-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10619647
关键词：
Adolescent Adopted Affect Affective Age Area Attention Basic Science Behavior Therapy Behavioral Biological Psychiatry Brain Child Chronic Clinical Clinical Trials Cognitive Complex Control Groups Corpus striatum structure Crossover Design Cues Data Disease Double-Blind Method Down-Regulation Electric Stimulation Ensure Evidence based treatment Feedback Forms Controls Functional Magnetic Resonance Imaging Functional disorder Generations Gilles de la Tourette syndrome Intervention Involuntary Movements Learning Manuals Measures Monitor Morphologic artifacts Motivation Motor Motor Activity Movement Neurodevelopmental Disorder Participant Patients Pattern Performance Pharmaceutical Preparations Psyche structure Publishing Randomized Relaxation Reporting Research Design Rest Running Sensory Severities Signal Transduction Structure Symptoms Techniques Testing Time Training Treatment Efficacy Up-Regulation Visual association cortex clinical application clinical effect clinical efficacy cognitive task design experimental group follow-up frontier improved interest intervention effect mental imagery neural neural circuit neurofeedback phenomenological models stress reduction symptomatic improvement

项目摘要

Abstract The proposed project is a clinical trial to confirm the efficacy of a real-time fMRI neurofeedback intervention that involves training adolescents with Tourette Syndrome to control a region of their supplementary motor area (SMA) believed to be involved in tic generation. The intervention involves providing feedback on SMA activity to participants while they practice regulating the region. They are cued to up-regulate and to down-regulate the area at different times and encouraged to try mental strategies for both up-regulating and down-regulating that have the potential to improve their symptoms. For up-regulation, this includes engaging in mental imagery of complex motor activities, or doing mentally demanding cognitive tasks, in order to co-opt the relevant neural circuitry for tasks other than tic generation. For down-regulation, this includes imagining relaxing scenarios that tend to be associated with reduced stress levels and an associated reduction in tic severity. This intervention was previously compared with a yoked sham control intervention in a small crossover design study that yielded very promising results: large clinical effects were observed and the groups showed differences in their ability to regulate the SMA during neurofeedback. Here we attempt to confirm that preliminary finding of efficacy in a larger, purely randomized design that includes follow-up of participants, and critically, employs a different form of control condition. In the proposed study, the control group will be trained via neurofeedback to control a region of their visual association cortex that is believed to be unrelated to their symptoms. This control region will be defined for each control subject in a manner that ensures it is not functionally connected to their SMA. By using this new form of control condition, this study ensures that the intervention has been tested against two of the most rigorous forms of control conditions used in clinical applications of real-time fMRI neurofeedback (yoked sham and training on a control region). Given that the different types of control conditions rule out different kinds of confounds, this is the most rigorous approach to testing this intervention: if results are promising, they cannot be dismissed as an artifact of the kind of control condition used. In short, with the proposed clinical trial, we aim to confirm the clinical efficacy of this new intervention, and to verify that it is acting via the hypothesized mechanism of action (enhancement of control over the SMA via neurofeedback). In addition, effects of the intervention on resting state functional connectivity patterns will be examined to better inform our understanding of the network changes induced by the training.

摘要