A feasibility study of real-time displays of brain activity as a treatment for symptoms in Huntington's disease

INTERVENTION: The study tests real‐time fMRI neurofeedback training (NFT). Participants are randomized into four groups, two treatment groups, one receiving neurofeedback derived from the activity of the Supplementary Motor Area (SMA), and another receiving neurofeedback based on the correlation of SMA and left striatum activity (connectivity NFT), and two sham control groups, matched to each of the treatment groups. Participants are randomized into the four groups based on the UHDRS total motor score. The participants take part in one baseline visit, four NFT visits and three post‐training follow‐up visits. The baseline and follow‐up visits include advanced structural and functional MRI scanning up to two months post‐training. CONDITION: Huntington's disease ; Nervous System Diseases ; Huntington disease PRIMARY OUTCOME: ; Participants’ ability to upregulate NFT target levels without feedback (near transfer) measured using fMRI at baseline and follow up (two months after training); SECONDARY OUTCOME: ; Measures of cognitive and psychomotor function at baseline and follow‐up (two months after training):; 1. Stroop word reading; 2. Symbol Digit Modalities Task; 3. Emotion Recognition; 4. Circle Tracing; 5. Paced and Speeded Tapping; INCLUSION CRITERIA: 1. > 18 years old 2. Pre‐symptomatic gene‐carriers, i.e. they will carry the HD gene, but will not have been clinically diagnosed (UHDRS diagnostic score of 4 or less) at the time of enrolment, OR 3. Early‐stage 1 HD patients, i.e. patients with Total Functional Capacity (TFC) score between 11‐13