MRI Neurofeedback for Enhancing Motivation

Overseen By R. Alison Adock, MD, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Duke University

Must not be taking: Psychiatric medications

Disqualifiers: Neurological disorders, Serious medical illness, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

190 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial excludes people who have used prescription medications for psychiatric conditions in the past six months, so if you're taking such medications, you may not be eligible to participate.

What data supports the effectiveness of the treatment Ventral tegmental area of dopaminergic midbrain (VTA) fMRI neurofeedback?

Research shows that people can learn to control the activity in the VTA, a brain area important for motivation, using neurofeedback. This training helps them activate the VTA without needing external rewards, which could improve motivation and learning. Similar studies with other brain areas, like the nucleus accumbens, also show that neurofeedback can enhance self-regulation of brain activity. ^{1 2 3 4 5}

Is MRI neurofeedback generally safe for humans?

Research on MRI neurofeedback, including studies on different brain regions and conditions like ADHD, suggests that it is generally safe for humans. These studies have shown feasibility and safety without reporting significant adverse effects. ^{1 2 3 6 7}

How does MRI neurofeedback for enhancing motivation differ from other treatments?

MRI neurofeedback for enhancing motivation is unique because it uses real-time brain imaging to help individuals learn to control specific brain regions associated with motivation, like the ventral tegmental area (VTA) and nucleus accumbens (NAcc). Unlike traditional treatments, this method allows participants to actively engage in self-regulation of brain activity, potentially leading to improved motivation without the need for medication. ^{1 2 3 5 8}

What is the purpose of this trial?

The purpose of this research study is to understand how healthy individuals self-regulate motivation by observing brain activity using magnetic resonance imaging (MRI).

Research Team

R. Alison Adock, MD, PhD

Principal Investigator

Duke University

Eligibility Criteria

This trial is for healthy right-handed individuals aged 18-45 who use effective birth control if of childbearing capacity. It's not suitable for those with psychiatric medication use in the past six months, serious medical conditions, certain neurological disorders, metal implants, claustrophobia, or a weight over 250 pounds.

Inclusion Criteria

I am either male or female.

Right-handed

I am in good overall health.

Exclusion Criteria

I have been on medication for a mental health condition in the past 6 months.

I do not have major neurological disorders or conditions that prevent MRI use.

I have had a head injury that made me lose consciousness.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Baseline and Memory Encoding

Participants undergo baseline assessments and memory encoding tasks

1 week

1 visit (in-person)

Memory Retrieval and Encoding

Participants complete memory retrieval and encoding tasks, 24 hours apart

1 week

2 visits (in-person)

Effort-Based Decision Making

Participants complete effort-based learning tasks and questionnaires

1 week

2 visits (in-person)

Follow-up

Participants are monitored for changes in effort-based decision making and motivated memory

2 weeks

Treatment Details

Interventions

• Ventral tegmental area of dopaminergic midbrain (VTA) fMRI neurofeedback

Trial Overview The study aims to understand self-regulation of motivation by providing participants with real-time feedback on their brain activity using MRI technology focused on a specific area related to dopamine production.

Participant Groups

Group I: Intentional Versus Cue-Evoked Midbrain Activation Experimental Treatment 1 Intervention

Participants meeting study inclusion will be scheduled for two sessions: one baseline behavioral visit and an fMRI session to assess the ability to self-stimulate VTA activation. Session one will include a battery of cognitive assessments and a demonstration of the reward-based learning task in session two. The experimental imaging task session will be done within one week of session one. Participants will been randomly split into two group: group one will complete a reward-based learning task before the VTA activation task and group two will complete reward task after VTA activation. During the VTA activation task, participants will be instructed to achieve a heightened state of motivation using personally relevant thoughts and imagery.

Group II: Intentional Midbrain Activation Effects on Motivated Memory Experimental Treatment 1 Intervention

Participants will take part in four sessions: visit 1-baseline + memory encoding, visit 2-memory retrieval, visit 3-memory encoding, visit 4-memory retrieval). Encoding and retrieval of the memoranda will occur 24 hours apart. Study visits will take place no more than 7 days apart. One group of participants will complete all sessions at the Center for Cognitive Neuroscience. The remainder of participants will complete the encoding sessions in the MRI machine, .

Group III: Intentional Midbrain Activation Effects on Effort-Based Decision Making Experimental Treatment 1 Intervention

Participants will be randomly assigned to an MRI group or a behavioral control group. All participants will complete an effort-based learning task and a series of questionnaires in session one. Session two may include an MRI based on group assignment. Participants in the MRI group will complete the VTA activation task. Following, they will complete the effort task and questionnaires a second time. The behavioral control group will complete a second session consisting of the effort task and questionnaires.

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials

2,495

Recruited

5,912,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Participants who underwent real-time VTA neurofeedback training were able to voluntarily activate the ventral tegmental area (VTA) without external aids, indicating a new method to enhance motivation and learning.

This self-activation of the VTA was linked to increased connectivity in the mesolimbic network, suggesting that neurofeedback training can lead to lasting changes in brain function related to motivation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive Neurostimulation: Learning to Volitionally Sustain Ventral Tegmental Area Activation. MacInnes, JJ., Dickerson, KC., Chen, NK., et al.[2019]

Individuals can voluntarily activate the dopaminergic system in the substantia nigra/ventral tegmental area (SN/VTA) using mental imagery, with real-time feedback enhancing this ability.

Participants receiving direct feedback on their SN/VTA activity were better able to increase this activity compared to those receiving inverted feedback, suggesting that neurofeedback can improve self-regulation of dopamine release.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurofeedback-mediated self-regulation of the dopaminergic midbrain. Sulzer, J., Sitaram, R., Blefari, ML., et al.[2021]

The study involving 59 participants found that successful self-regulation of dopaminergic midbrain activity through neurofeedback is linked to individual differences in prefrontal reward sensitivity, suggesting that reinforcement learning plays a key role in this process.

Increased activity in cognitive control areas during the transfer phase (when feedback is no longer available) indicates that effective self-regulation may rely on the ability to manage cognitive processes, which could help in tailoring neurofeedback training for clinical applications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Analysis of individual differences in neurofeedback training illuminates successful self-regulation of the dopaminergic midbrain. Hellrung, L., Kirschner, M., Sulzer, J., et al.[2022]

Healthy volunteers can successfully increase activity in the left premotor cortex (PMC) during a motor imagery task using fMRI neurofeedback, indicating the potential for self-regulation of brain activity.

The neurofeedback group not only enhanced PMC activity but also showed increased activation in other motor control regions, suggesting that this technique could be beneficial for rehabilitation in conditions like stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing Motor Network Activity Using Real-Time Functional MRI Neurofeedback of Left Premotor Cortex. Marins, TF., Rodrigues, EC., Engel, A., et al.[2020]

In a study using fMRI-based neurofeedback, participants were able to increase their own activity in the nucleus accumbens (NAcc), a brain region important for motivation and learning, especially when provided with real-time feedback.

The ability to control NAcc activity was linked to positive emotional arousal, suggesting that neurofeedback could be a potential therapeutic tool for enhancing motivation and learning, although participants struggled to decrease NAcc activity and the control did not last after feedback was removed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Control of nucleus accumbens activity with neurofeedback. Greer, SM., Trujillo, AJ., Glover, GH., et al.[2021]

A randomized controlled trial involving 31 boys with ADHD demonstrated that real-time functional magnetic resonance neurofeedback (rtfMRI-NF) targeting the right inferior prefrontal cortex (rIFG) significantly reduced ADHD symptoms and improved cognitive function over a follow-up period of 11 months.

The study found that only the rIFG group showed a transfer effect to everyday life, correlating with symptom reductions and increased activation in the rIFG during tasks requiring inhibition, highlighting the potential of rtfMRI-NF as a targeted intervention for ADHD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Real-time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder. Alegria, AA., Wulff, M., Brinson, H., et al.[2018]

In a double-blind, sham-controlled trial involving 88 boys with ADHD, fMRI neurofeedback targeting the right inferior frontal cortex did not show significant improvements in ADHD symptoms compared to a sham treatment, indicating it may not be an effective intervention.

Both groups experienced similar reductions in symptoms, with the sham group even showing greater improvements in irritability and motor inhibition, suggesting that the active fMRI-NF did not provide the expected benefits and had no significant side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Double-Blind, Sham-Controlled Randomized Trial Testing the Efficacy of fMRI Neurofeedback on Clinical and Cognitive Measures in Children With ADHD. Lam, SL., Criaud, M., Lukito, S., et al.[2023]

In a study involving 24 healthy participants, 74% of those trained to self-regulate their nucleus accumbens (NAcc) using real-time fMRI neurofeedback successfully learned to do so, leading to improved motivation in cognitive tasks.

Participants who effectively self-regulated their NAcc showed changes in brain connectivity related to reward processing, while the control group did not experience these benefits, highlighting the potential of neurofeedback as a novel intervention for motivation-related issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving motivation through real-time fMRI-based self-regulation of the nucleus accumbens. Li, Z., Zhang, CY., Huang, J., et al.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Cognitive Neurostimulation: Learning to Volitionally Sustain Ventral Tegmental Area Activation. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Neurofeedback-mediated self-regulation of the dopaminergic midbrain. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Analysis of individual differences in neurofeedback training illuminates successful self-regulation of the dopaminergic midbrain. [2022]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Enhancing Motor Network Activity Using Real-Time Functional MRI Neurofeedback of Left Premotor Cortex. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Control of nucleus accumbens activity with neurofeedback. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Real-time fMRI neurofeedback in adolescents with attention deficit hyperactivity disorder. [2018]

7. United States pubmed.ncbi.nlm.nih.gov

Double-Blind, Sham-Controlled Randomized Trial Testing the Efficacy of fMRI Neurofeedback on Clinical and Cognitive Measures in Children With ADHD. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Improving motivation through real-time fMRI-based self-regulation of the nucleus accumbens. [2019]