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Multiregional rtfMRI Neurofeedback for the Prevention of Alzheimer's Disease

Periodic Reporting for period 1 - NPAD (Multiregional rtfMRI Neurofeedback for the Prevention of Alzheimer's Disease)

Période du rapport: 2016-05-01 au 2018-04-30

Alzheimer's Disease poses one of the biggest health challenges of our time. More than 10 million people are currently affected by dementia in Europe and by 2030 the number of new cases is going to surpass 13 million. Due to demented patients’ need for continuous support during several years, the sustainability of the European healthcare infrastructure is at stake. Once symptoms such as memory impairment and brain atrophy become apparent, the disease is already too advanced. The majority of future cases are already affected by the silent stage of the disease, however current methods for detecting the pathological hallmarks of the disease are invasive and therefore unsuitable for screening the ageing population at large.

At the Barcelonabeta Brain Research Center, with the support of the European Commission, we have initiated a study that aims to revolutionize the way that we assess risk for Alzheimer's and other neuropsychiatric conditions. We have combined two new technologies, virtual reality and neurofeedback, to create a kind of game that you can play inside the MRI scanner. This game is not controlled by any buttons or movements but instead it is controlled by the activity and the changes of the activity of your brain. The data obtained during the experiment, analysed in relation to existing biomarkers, reveal important information regarding preclinical alterations in brain function.

In brief, we have developed a new method for probing brain function to obtain subtle metrics that correspond with well-established cognitive and biological processes. Our aim is to develop future diagnostic applications that are not only safe but also enjoyable for the patients, in order to facilitate scalability and early prevention.
The project has demonstrated that the metrics derived through the developed real-time neuroimaging paradigm, are sensitive to memory processes, as well as biological, clinical, genetic and neuroanatomical processes. Most importantly, the project’s findings suggest:
a) That the designed experimental paradigm, as implemented in the developed software, offers a valid method for probing brain function to obtain subtle metrics that correspond with well-established cognitive and biological processes.
b) That the developed methods can be used to provide novel, sensitive metrics of memory function that are based on neuroimaging and are therefore unbiased with regards to the self-reporting limitations of standard questionnaires for measuring memory performance.
c) That the developed methods are promising for identifying early alterations in brain function due to Alzheimer’s disease and therefore hold potential for scalable prognostic screening.
d) That genetic factors associated to a neurodegenerative disease, can impact neurofeedback performance of the brain areas that are most vulnerable to that neurodegenerative disease. This opens new avenues for further research applications quantifying and monitoring disease progression in other neurodegenerative diseases, as well as in psychiatric disorders with established genetic risk factors and established patterns of functional aberrancy (e.g. schizophrenia, bipolar disorder, etc.).

The complete list of conferences attended and dissemination activities performed, including outreach activities, is the following:

1) Invited talk at ‘ESOF 2018 - MSCA Satellite event’, 7th-8th July 2018, Toulouse, France.

2) Invited talk at ‘MCAA Annual Conference and General Assembly’, 2nd-3rd February 2018, Leuven, Belgium.

3) Invited talk at ‘MEP-scientist pairing scheme’, 28th November 2017, Brussels, Belgium.

4) Invited talk at ‘1st International Conference on Cognitive Reserve in the Dementias (ResDem); 24th November 2017, Munich, Germany.

5) Poster presentation at ‘1st International Conference on Cognitive Reserve in the Dementias (ResDem); 24th-25th April 2017, Munich, Germany. (Best poster award)

6) Double poster presentation at ‘Real-time functional imaging and neurofeedback conference’; 29th November -1st December; 2017; Nara; Japan. (Meritorious abstract award)

7) Video poster presentation for ‘EU4facts conference’; 26th September; 2017; Brussels; Belgium.

8) Invited talk at ‘Researcher’s Night’, National Center for Scientific Research Demokritos; 29th September; 2017; Athens; Greece.

9) Poster presentation at Alzheimer's Association International Conference, 16th-20th July 2017, London, UK.

10) Attendance of ‘22nd Annual Meeting of the Organization for Human Brain Mapping’; 26th‐30th June 2016; Geneva; Switzerland.

11) Deposition of 3 Scientific Papers, 4 Scientific Posters and 2 Scientific Software Applications in open access repositories.
The project's results so far, suggest specific patterns of alterations in brain function, for the detection of the preclinical stage and for monitoring clinical progression and therapeutic efficacy in Alzheimer's disease.

Importantly, these findings shed light on the mechanisms that enable the human brain to exhibit resilience by reorganizing, compensating and maintaining functionality in the face of the early biological changes associated with one of the most challenging diseases of our time.

Following the successful completion of the project, we aim to follow up by exploring further the predictive capacity of the developed method, by itself and in conjunction with existing risk factors, potentially leading to a scalable, non-invasive procedure for prognostic screening of the population at large.
Illustration of the virtual reality neurofeedback environment developed.