Purpose: To evaluate compliance and validation of the neurofeedback training in patients with mild cognitive impairment, and to identify hemodynamic change on cerebral cortical using f-NIRS.
Background: The importance of prevention, treatment and management of geriatric diseases, especially dementia, is increasing according to aging. Neurofeedback is a training method that measures brain waves and selectively feeds back to brain to improve your homeostasis. This training can improve emotional, behavioral, learning, and health have. Recently, neurofeedback training for dementia patients and healthy people has been reported to improve brain activation. In this study, we aimed to evaluate the effectiveness of neurofeedback in patients with mild cognitive impairment, a pre-dementia stage.
Clinical study plan: This is an exploratory study to evaluate cognitive function improvement and cerebral hemodynamic change in 5 patients with mild cognitive impairment by performing neurofeedback training twice a week and 16 times for 8 weeks.

Treatment

Neurofeedback was performed through a single-channel EEG signal measurement of the dorsolateral prefrontal cortex (dlPFC) (Thought Technology Ltd.'s Neurofeedback). Previous research reported that patients with mild cognitive impairment had reduced alpha-waves (8 to 10.5 Hz) in the prefrontal cortex compared to healthy controls. In this study, the respiration method to regulate the EEG activity of the brain region of interest is divided into concentrating on the nascent, concentrating on the drinking, and concentrating on the subject's autonomous breathing. One session of neurofeedback consists of 5 minutes, which is repeated 9 times. Subjects perform neurofeedback using breathing methods that were instructed by the experimenter.
 In order to measure the respiration rate volume of the subject, respiratory of subject record by belt. Subjects were asked to measure the mean state of the EEG band before and during the neurofeedback session in a relaxed state (~ 30 seconds, natural respiration in a comfortable posture, open eyes and no visual stimulation) and set the threshold value. In the subsequent neurofeedback session, the threshold value of the next session is set according to the feedback level of the subject.

Arm Label

Target Number of Participant

Arm Type

Arm Description

Neurofeedback was performed through a single-channel EEG signal measurement of the dorsolateral prefrontal cortex (dlPFC) (Thought Technology Ltd.'s Neurofeedback). Previous research reported that patients with mild cognitive impairment had reduced alpha-waves (8 to 10.5 Hz) in the prefrontal cortex compared to healthy controls. In this study, the respiration method to regulate the EEG activity of the brain region of interest is divided into concentrating on the nascent, concentrating on the drinking, and concentrating on the subject's autonomous breathing. One session of neurofeedback consists of 5 minutes, which is repeated 9 times. Subjects perform neurofeedback using breathing methods that were instructed by the experimenter.
 In order to measure the respiration rate volume of the subject, respiratory of subject record by belt. Subjects were asked to measure the mean state of the EEG band before and during the neurofeedback session in a relaxed state (~ 30 seconds, natural respiration in a comfortable posture, open eyes and no visual stimulation) and set the threshold value. In the subsequent neurofeedback session, the threshold value of the next session is set according to the feedback level of the subject.

Gender

Age

Description

- Individuals 40 to 80 years of age
- Those who understand the purpose of the study and consent to participate
- at least 6 years of education
- Individuals who meet the Peterson diagnostic criteria for MCI with memory problems at least for 3 months
- Hachinski ischemic score ≤ 6
- Korean version of the Montreal Cognitive Assessment (MoCA-K) score ≤ 22;

- Diagnosed with dementia according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV)
- History of neurological disorder(s) that can cause cognitive decline (e.g., Parkinson's disease, stroke, cerebral hemorrhage, tumors, normal pressure hydrocephalus)
- Received any treatment for MCI during the previous 2 weeks
- Involved in other clinical trials within the previous 4 weeks
- Individuals likely to exhibit a non-cooperative attitude or judged by the researchers to be unable to proceed with the study
- Individuals who cannot undergo fNIRS measurements for any reason

MoCA-K (Korean version of Montreal Cognitive Assessment)

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BDI (Beck Depression Inventory)

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CNS vital sign (computerized neurocognitive assessment vital sign)

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Hemodynamic change during working memory in prefrontal cortex

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Accuracy of working memory

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