Parent-Adolescent Training on Neurofeedback and Synchrony

This study will utilize a rigorous multi-method, multi-informant design to examine the effects of dyadic neurofeedback (dnf) on adolescent brain activation with fMRI hyperscanning. Parents and adolescents will also report on emotion regulation, depressive symptoms, and parenting practices. Data collection procedures will take place at the Laureate Institute for Brain Research (LIBR), which is equipped with two identical scanners that have advanced real-time fMRI systems capable of conducting parallel fMRI hyperscanning, including the capacity for neurofeedback. Parents will complete a phone screen to determine initial eligibility. If initial study criteria are met, a 2-hour in-person lab visit will be scheduled where mothers and daughters will complete consent/assent; diagnostic interviews; surveys on emotion regulation, parenting practices, depression, and anxiety; and additional screening. Survey data will be used for preliminary exploratory analyses. Based on data collected from the screening visit, participants will be invited to participate in the full study: a 4-hour visit where mothers and daughters will complete emotion ratings, mock scanner training, and fMRI tasks individually and together using hyperscanning (scan time = 16 min resting-state \[2 runs\], 7 min structural MRI, 40 min fMRI tasks, 10 min clinical MRI scans).

• Real-time fMRI neurofeedback (Behavioral): Participants will attempt to regulate own and/or their partner's brain activation in a specified brain region via real-time fMRI neurofeedback.

Primary outcomes

• Neurofeedback Rating Scale [Baseline (Acquired during scan session)]: Rating scale of perceived effectiveness in completing the task and changing brain activation. Likert scale ranging from 0-10, with higher numbers indicating greater perceived effectiveness.
• Emotion Rating Scale [Baseline (Acquired during scan session)]: Rating scale asking about current experience of various emotions (happy, sad, angry, etc.). Scale ranges from 0-10, with higher numbers indicating more intense emotions.
• Blood Oxygen Level-Dependent (BOLD) Signal Changes (Brain Activation) [Baseline (Acquired during scan session)]: Activation in the brain region targeted for neurofeedback and associated regions; resting-state network activity

Sex: Female, ages: 13 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Eligible for fMRI
* Sufficient English fluency to complete tasks
* BMI ≦ 40.0
* Right-handed
* Biological female
* Co-residing at least 4 days/week
* Adult participants: Biological mother of adolescent participant
* Adult participants:Primary caregiver > 50% of child's lifespan
* Adult participants:BMI ≧ 18.0
* Adolescent participants: Age 13-17 years
* Adolescent participants: BMI ≧ 16.0

Exclusion Criteria:

* Current psychiatric diagnosis
* Medications influencing fMRI
* Medical conditions influencing fMRI
* Alcohol or psychoactive drug on scan day
* Adolescent participants: Neurodevelopmental delay
* Adolescent participants: History of mood or psychotic disorder
* Adolescent participants: History of obsessive-compulsive disorder (OCD) or attention-deficit/hyperactivity disorder (ADHD)

Participant flow

Outcome results

• Neurofeedback Rating Scale (Primary), Mean, units on a scale: Real-time fMRI Neurofeedback 5.7 +/- 2.14
• Emotion Rating Scale (Primary), Mean, units on a scale: Real-time fMRI Neurofeedback 2.11 +/- 1.46
• Blood Oxygen Level-Dependent (BOLD) Signal Changes (Brain Activation) (Primary), Mean, percent signal change: Real-time fMRI Neurofeedback 0.15 +/- 0.38

Adverse events

Time frame: 3 months (Participants completed baseline measures over the course of approximately 1 month followed by 2 months of biweekly follow-ups.)

Limitations and caveats: This is a feasibility study with a small sample and no control group.

• Results publication: Kerr KL, Ratliff EL, Cohen ZP, Fuller S, Cosgrove KT, DeVille DC, Misaki M, Morris AS, Bodurka J. Real-Time Functional Magnetic Resonance Imaging Dyadic Neurofeedback for Emotion Regulation: A Proof-of-Concept Study. Front Hum Neurosci. 2022 May 26;16:910951. doi: 10.3389/fnhum.2022.910951. eCollection 2022. PMID 35721350

• Study Protocol and Statistical Analysis Plan (PDF, 2019-03-15)
• Informed Consent Form (PDF, 2019-05-22)

• Kara L Kerr, PhD, Principal investigator, Oklahoma State University