Improving Visual Perception and Visuo-motor Learning With Neurofeedback of Brain Network Interaction.

NCT ID: NCT05732649

Last Updated: 2025-11-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

65 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-01

Study Completion Date

2025-05-31

Brief Summary

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Neuroscience has long focused on understanding brain activity during task performance. As a result, current training methods aim to maximize brain activation during a trained task. However, new evidence shows that this may not be an efficient way to go. Human subjects achieve maximum performance only when the brain network is in a state of high spontaneous interaction and communication between brain regions before training or, in other words, in a state of high "network communication." In this case, minimal effort is required during the task. This requires new learning strategies aimed at inducing higher network communication prior to task execution. The investigators have previously shown that healthy people can learn to increase network communication of motor areas (i.e., the areas that control movement) when they receive real-time feedback on their current activity, which is known as neurofeedback. In neurofeedback, subjects receive continuous feedback about the state of their brain activity in a present moment. Through this feedback, they can learn to change their own brain activity.

The aim of the present study is to validate neurofeedback as a new treatment approach for inducing high network communication at rest (i.e., when participants are not engaged in a task), and to test whether this heightened network communication can enhance visual perception and motor learning.

Detailed Description

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As the investigators have seen in a pilot study, participants are unable to improve the network communication of visual brain regions (i.e., regions that process light stimuli) through neurofeedback when the feedback is perceived with the eyes. Therefore, the goal of Experiment 1 is to find an alternative form of feedback through which participants can efficiently increase network communication. Specifically, participants will receive neurofeedback in the form of a sound, a vibration on the skin, or both. For neurofeedback as sound, the investigators will use relaxing sounds which have previously been found to enhance network communication. For neurofeedback as vibration, electrical or vibrotactile stimulators will stimulate both hands and feet, as previous research has found a positive effect on brain network communication. The sensory stimulation intensity will be modulated based on the current level of network communication between the target brain area and the rest of the brain. Thus, greater communication leads to reduced feedback intensity. The idea is that subjects learn to maintain states of high communication without sensory feedback. Subjects will receive the instruction to lower the feedback level without indication of any particular strategy of mental imagery, as the investigators have previously observed that no specific mental imagery task is able to enhance alpha-band FC without feedback. Finally, to explore effects on the behavioral level, the investigators will additionally assess visual perception at the beginning and at the end of each session, similarly as in a previous study.

In Experiment 2, the neurofeedback modality from Experiment 1 is adopted to test whether increasing network communication through neurofeedback can lead to improved visuo-motor learning. Visuo-motor learning will be measured with the mirror-drawing task because the investigators have evidence for feasibility from a previous study and because it represents a good model for re-learning as needed in clinics.

In both experiments, participants will undergo magnetic resonance imaging (MRI). This MRI will increase the precision of neurofeedback.

Conditions

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Healthy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

In Experiment 1, to disentangle which is the neurofeedback modality that most efficiently modulates brain connectivity, the investigators will compare auditory, tactile, or both modalities in a within subject design.

In Experiment 2, to investigate whether enhanced brain connectivity at visual areas through real-time neurofeedback can boost visuo-motor learning, the investigators will compare Group A (active) to Group B (first control) and C (second control) in a between subjects design.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
In Experiment 1, participants will receive three different interventions (auditive neurofeedback, tactile neurofeedback, or both) in different sessions. The order of interventions will be counterbalanced across participants.

In Experiment 2, participants will be randomized to one out of three parallel treatment arms (i.e., Group A, B, or C). Randomization, stratified for age and gender, will be generated with a computer random number generator.

In both Experiments, participants will be blinded to the intervention order and group allocation.

Study Groups

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Experiment 1

Participants will take part in three different sessions. In each session, network communication at visual areas will be coupled with the intensity of a sound, of a tactile stimulation, or both.

Group Type EXPERIMENTAL

Auditory neurofeedback

Intervention Type BEHAVIORAL

Network interaction measured with EEG at visual areas will be coupled with the intensity of a sound.

Tactile neurofeedback

Intervention Type BEHAVIORAL

Network interaction measured with EEG at visual areas will be coupled with the intensity of tactile stimulation (i.e., electrical or vibrotactile stimulators applied on both hands and feet).

Auditory and tactile neurofeedback

Intervention Type BEHAVIORAL

Network interaction measured with EEG at visual areas will be coupled with the intensity of a sound and tactile stimulation.

Experiment 2 (Group A)

Participants undergo neurofeedback training of network communication between the target brain area (i.e., the left superior parietal area) and the rest of the brain during about 20 minutes (the precise duration will be defined with the experience of Experiment 1), using the sensory feedback modality defined in Experiment 1. Then, they perform the mirror-drawing task.

Group Type EXPERIMENTAL

Neurofeedback

Intervention Type BEHAVIORAL

Participants train to decrease the intensity of a sensory stimulation (defined in Experiment 1) that is coupled with the network interaction at a specific brain region.

Experiment 2 (Group B)

Participants will use neurofeedback to train network communication of a control brain area in the other (right) hemisphere which is not directly linked to visuo-motor processing or learning, using otherwise the same duration and feedback setup. This control condition allows to obtain a similar feedback experience and hence a true blinding. Moreover, it enables an evaluation of the spatial specificity of the feedback training. After neurofeedback, they perform the mirror-drawing task.

Group Type ACTIVE_COMPARATOR

Neurofeedback

Intervention Type BEHAVIORAL

Participants train to decrease the intensity of a sensory stimulation (defined in Experiment 1) that is coupled with the network interaction at a specific brain region.

Experiment 2 (Group C)

Participants will not receive neurofeedback, but directly train the mirror-drawing task.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Auditory neurofeedback

Network interaction measured with EEG at visual areas will be coupled with the intensity of a sound.

Intervention Type BEHAVIORAL

Tactile neurofeedback

Network interaction measured with EEG at visual areas will be coupled with the intensity of tactile stimulation (i.e., electrical or vibrotactile stimulators applied on both hands and feet).

Intervention Type BEHAVIORAL

Auditory and tactile neurofeedback

Network interaction measured with EEG at visual areas will be coupled with the intensity of a sound and tactile stimulation.

Intervention Type BEHAVIORAL

Neurofeedback

Participants train to decrease the intensity of a sensory stimulation (defined in Experiment 1) that is coupled with the network interaction at a specific brain region.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Signed informed consent
* Age at least 18 years old
* Normal or corrected-to-normal vision
* No neurological or psychiatric diseases
* No regular consumption of benzodiazepines or neuroleptics

Exclusion Criteria

* Any surgical intervention to the brain
* Drug or alcohol abuse
* Presence of non-MRI safe metal in the body
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Bern

OTHER

Sponsor Role collaborator

Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Adrian Guggisberg, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

Division of Neurorehabilitation, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Locations

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Division of Neurorehabilitation, Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland.

Bern, , Switzerland

Site Status

Countries

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Switzerland

References

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Paszkiel S, Dobrakowski P, Lysiak A. The Impact of Different Sounds on Stress Level in the Context of EEG, Cardiac Measures and Subjective Stress Level: A Pilot Study. Brain Sci. 2020 Oct 13;10(10):728. doi: 10.3390/brainsci10100728.

Reference Type BACKGROUND
PMID: 33066109 (View on PubMed)

Freyer F, Reinacher M, Nolte G, Dinse HR, Ritter P. Repetitive tactile stimulation changes resting-state functional connectivity-implications for treatment of sensorimotor decline. Front Hum Neurosci. 2012 May 23;6:144. doi: 10.3389/fnhum.2012.00144. eCollection 2012.

Reference Type BACKGROUND
PMID: 22654748 (View on PubMed)

Mottaz A, Solca M, Magnin C, Corbet T, Schnider A, Guggisberg AG. Neurofeedback training of alpha-band coherence enhances motor performance. Clin Neurophysiol. 2015 Sep;126(9):1754-60. doi: 10.1016/j.clinph.2014.11.023. Epub 2014 Dec 6.

Reference Type BACKGROUND
PMID: 25540133 (View on PubMed)

Allaman L, Mottaz A, Guggisberg AG. Disrupted resting-state EEG alpha-band interactions as a novel marker for the severity of visual field deficits after brain lesion. Clin Neurophysiol. 2021 Sep;132(9):2101-2109. doi: 10.1016/j.clinph.2021.05.029. Epub 2021 Jun 28.

Reference Type BACKGROUND
PMID: 34284245 (View on PubMed)

Manuel AL, Guggisberg AG, Theze R, Turri F, Schnider A. Resting-state connectivity predicts visuo-motor skill learning. Neuroimage. 2018 Aug 1;176:446-453. doi: 10.1016/j.neuroimage.2018.05.003. Epub 2018 May 4.

Reference Type BACKGROUND
PMID: 29730496 (View on PubMed)

Allaman L, Mottaz A, Kleinschmidt A, Guggisberg AG. Spontaneous Network Coupling Enables Efficient Task Performance without Local Task-Induced Activations. J Neurosci. 2020 Dec 9;40(50):9663-9675. doi: 10.1523/JNEUROSCI.1166-20.2020. Epub 2020 Nov 6.

Reference Type BACKGROUND
PMID: 33158966 (View on PubMed)

Dubovik S, Pignat JM, Ptak R, Aboulafia T, Allet L, Gillabert N, Magnin C, Albert F, Momjian-Mayor I, Nahum L, Lascano AM, Michel CM, Schnider A, Guggisberg AG. The behavioral significance of coherent resting-state oscillations after stroke. Neuroimage. 2012 May 15;61(1):249-57. doi: 10.1016/j.neuroimage.2012.03.024. Epub 2012 Mar 13.

Reference Type BACKGROUND
PMID: 22440653 (View on PubMed)

Guggisberg AG, Honma SM, Findlay AM, Dalal SS, Kirsch HE, Berger MS, Nagarajan SS. Mapping functional connectivity in patients with brain lesions. Ann Neurol. 2008 Feb;63(2):193-203. doi: 10.1002/ana.21224.

Reference Type BACKGROUND
PMID: 17894381 (View on PubMed)

Guggisberg AG, Dalal SS, Zumer JM, Wong DD, Dubovik S, Michel CM, Schnider A. Localization of cortico-peripheral coherence with electroencephalography. Neuroimage. 2011 Aug 15;57(4):1348-57. doi: 10.1016/j.neuroimage.2011.05.076. Epub 2011 Jun 7.

Reference Type BACKGROUND
PMID: 21672634 (View on PubMed)

Other Identifiers

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2022-00976

Identifier Type: -

Identifier Source: org_study_id

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