Neurofeedback to Aid Vets' Memory

Study Overview
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Brief Summary
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Military deployment is associated with increased risk of mild cognitive impairment (MCI). Combat stress related memory deficits has been well documented. Mild cognitive impairment such as memory deficits are the most common and earliest symptoms of Alzheimer's disease and related dementia (ADRD). The complaints about declined memory are common in healthy and cognitively intact civilian older adults, but less understood in aging Veterans. Brain training strategies to enhance cognitive skills and especially memory processes are unmet needs in aging Veterans who are at additional risk for MCI induced by ADRD. Since currently there is no effective drug treatment to stop cognitive decline, non-invasive brain training to boost memory functions in older Veterans is an increasingly attractive option to attenuating decline in memory.

Detailed Description
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The proposed project is poised to investigate state-of-art neurofeedback (NF; biofeedback of brain activity) training for self-modulation of neural plasticity to boost memory performance in Veterans. The recent advance of NF with Brian-Computer Interface (BCI) has provided a novel way to examine brain functions and plasticity. Thus far, there have been limited applications that have developed effective experimental and clinical paradigms for rehabilitation in Veterans. Historically, brainwave patterns during memory task performance have been analysed offline, a methodology which does not allow real-time NF modulation and training. The central hypothesis guiding this research is that optimal memory-related brainwave patterns of a Veteran can be trained. The online NF allows maximization of brainwave patterns associated with healthier memory states. The development of efficient NF paradigms to augment memory performance is an important first step for the application of this nonpharmacologic intervention to improve combat Veterans' memory functions and potential for treating MCI due to mild TBI or pain. The pilot work will start with wider range of Veterans using state-of-the-art wearable wireless brain-computer interface headset, which is affordable and can be easily set up in VAMCs and eventually in remote assessment settings. This innovative, cognitive neuroscience based, nonpharmacologic intervention serves to revolutionize the diagnosis and treatment of combat Veterans who are at risk for degenerative dementia.

Official Title
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Tuning Up Memory-related Brain Potentials Using Real-time Neurofeedback in Older Veterans

Conditions
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Mild Cognitive Impairment

Intervention / Treatment
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* Device: Neurofeedback


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Veterans age 60 and older Exclusion Criteria: Veterans diagnosed with PTSD, epilepsy schizophrenia, or use benzodiazapines

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Exp1. Protocol establishment: 15 cognitively intact and 15 Vets with mild cognitive impairment Exp2. Efficacy Testing: 20 Vets over the age of 60
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MCI patients<br>Vets with mild cognitive impairment | Device: Neurofeedback<br>* Neurofeedback will be tested in both groups of Vets<br>* Other names: biofeedback;|
| Active Comparator: NC<br>Normal healthy Veterans | Device: Neurofeedback<br>* Neurofeedback will be tested in both groups of Vets<br>* Other names: biofeedback;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| EEG alpha band | alpha power under eyes closed and eyes open are linked to better mental state; likely biomarker for mild cognitive impairment. | 6-8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| memory-related potentials | Brainwaves that are linked to better memory performance | 6-8 weeks | 
| California Verbal Learning Test | A battery of neuropsychological testing cognitive functions | About 6-8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neurofeedback, amnestic MCI, wireless EEG, Bluegrass Memory Test, working memory