Enhancing Working Memory Based on Mismatch Negativity Neurofeedback in Subjective Cognitive Decline Patients: A Preliminary Study

Abstract

Mismatch negativity (MMN) is suitable for studies of preattentive auditory discriminability and the auditory memory trace. Subjective cognitive decline (SCD) is an ideal target for early therapeutic intervention because SCD occurs at preclinical stages many years before the onset of Alzheimer’s disease (AD). According to a novel lifespan-based model of dementia risk, hearing loss is considered the greatest potentially modifiable risk factor of dementia among nine health and lifestyle factors, and hearing impairment is associated with cognitive decline. Therefore, we propose a neurofeedback training based on MMN, which is an objective index of auditory discriminability, to regulate sensory ability and memory as a non-pharmacological intervention (NPI) in SCD patients. Seventeen subjects meeting the standardized clinical evaluations for SCD received neurofeedback training. The auditory frequency discrimination test, the visual digital N-back (1-, 2-, and 3-back), auditory digital N-back (1-, 2-, and 3-back), and auditory tone N-back (1-, 2-, and 3-back) tasks were used pre- and post-training in all SCD patients. The intervention schedule comprised five 60-min training sessions over 2 weeks. The results indicate that the subjects who received neurofeedback training had successfully improved the amplitude of MMN at the parietal electrode (Pz). A slight decrease in the threshold of auditory frequency discrimination was observed after neurofeedback training. Notably, after neurofeedback training, the working memory (WM) performance was significantly enhanced in the auditory tone 3-back test. Moreover, improvements in the accuracy of all WM tests relative to the baseline were observed, although the changes were not significant. To the best of our knowledge, our preliminary study is the first to investigate the effects of MMN neurofeedback training on WM in SCD patients, and our results suggest that MMN neurofeedback may represent an effective treatment for intervention in SCD patients and the elderly with aging memory decline.

A multidimensional model of memory complaints in elderly individuals and the associated hub regions

“…This rewiring could be seen as a compensatory response employed by the brain in the face of SCD, wherein the brain attempts to preserve or reinstate functional connectivity by redistributing its resources to other regions. Identifying these hubs could hold significance in optimizing the effectiveness of therapeutic interventions, such as neurofeedback or transcranial stimulation, which target specific brain regions and their activity and have been used with success in SCD (86,87).…”

“…Research has shown that SCD is linked to an elevated risk of developing Alzheimer's disease (AD) and progressive cognitive impairment, as evidenced by various clinical and neuroimaging studies (8,12). To investigate the key brain regions involved in SCD, biochemical, structural, and functional approaches have been utilized, with several regions such as the medial temporal and occipitoparietal regions being implicated (for review, see Wang et al, 2020). Graph theory is a useful methodology for investigating the human connectome.…”

Sharpening Working Memory With Real-Time Electrophysiological Brain Signals: Which Neurofeedback Paradigms Work?

“…These studies mainly investigate the decoding method of single-trial responses ( Brandmeyer et al, 2013 ) as well as the neural mechanism underling reward stimuli ( Moser et al, 2014 ; Zioga et al, 2019 ; Wang et al, 2021 ). Research in the literature demonstrates broad applications of ERP-based NF training in cognitive deficits, including Attention-deficit/hyperactivity disorder (ADHD), Post-traumatic stress disorder (PTSD), and Subjective cognitive decline (SCD) ( Askovic et al, 2020 ; Pei et al, 2020 ; Deiber et al, 2021 ). The main challenge of developing NF training using ERP is designing reward functions associated with components of ERP as the adjustment target in single-trial responses.…”

Treatment Enhances Betweenness Centrality of Fronto-Parietal Network in Parkinson’s Patients

“…For example, degree centrality (DC) shows many connections between cognition and behavior. The complex functional network of the brain is affected by brain diseases such as schizophrenia, Alzheimer's disease and PD (Xie et al, 2019;Li et al, 2020;Pei et al, 2020). Graph theory is a great way to uncover the impact of these diseases on brain function.…”