Mental Strategy Training in Mild Cognitive Impairment

July 14, 2026 updated by: Jessica Peter

Reducing Hippocampal Hyperactivity in Patients With Mild Cognitive Impairment

This study aims to reduce hippocampal activity in people at high risk of developing Alzheimer's disease (AD) and aims to examine whether this improves their episodic memory performance. We apply mental strategy trainings with strategies extracted from our previous study that applied real-time fMRI neurofeedback to reduce hippocampal activity. Participants take part in mental strategy trainings 2, 4, or 6 times. At baseline and after each 2 trainings, we assess their hippocampal activity as well as their episodic memory performance using an fMRI pattern separation task. In addition, we will gather blood samples to obtain Apolipoprotein E gene status (ApoE, only once) as well as plasma pTau (pTau217; 4 time-points). ApoE will be included as a covariate in our statistical models. For pTau217, we will calculate the change between each assessment to examine whether the mental strategy training will change the accumulation of pTau217.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
55

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Switzerland
    • Canton of Bern
      • Bern, Canton of Bern, Switzerland, 3000
        • Universitäre Psychiatrische Dienste Bern

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • diagnosis of Mild Cognitive Impairment
  • between 60 - 80 years of age
  • fluent in German
  • normal or corrected-to-normal vision
  • normal or corrected-to-normal hearing

Exclusion Criteria:

  • any history of seizures
  • current psychotropic medication
  • other severe neurological or psychiatric disease
  • current or lifetime drug or alcohol abuse
  • severe brain damage other than atrophy in the hippocampus or the medial temporal lobe
  • claustrophobia
  • magnetisable implants (e.g., cardiac pacemakers, brain stimulator)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Group A: 15 participants will be assigned to group A
Group A will attend 6 mental strategy trainings and will start the training after the first assessment. The training content is identical for all groups. The groups differ only in the number of training sessions and in the timing of the intervention onset (i.e., after the first assessment or after three assessment time points).
Other: Mental Strategy Training
Trainings will be done in groups of up to five people. During training, participants will be presented with an implicit pattern separation task (i.e., for which no response is necessary). At the same time, they will apply mental strategies that were beneficial for hippocampal activity reduction in our previous study. We will use four different mental strategies ("Imagination", "Bodily Perception", "Active Thinking" and "Visual Perception") during each of the training sessions. During imagination participants will need to vividly imagine a scene that exerts a calming effect on them. During "bodily perception" participants will be instruced to focus on their feet or hands while slowly contracting and relaxing them. During active thinking they will perform cognitive tasks such as reciting the alphabet or counting. During visual perception they will focus on a specific part of the presented image. The order of the mental strategies is similar for all participants and all trainings.
Experimental: Group B: 15 participants will be assigned to group B
Group B will attend 4 mental strategy trainings and will start with the training after the first assessment. The training content is identical for all groups. The groups differ only in the number of training sessions and in the timing of the intervention onset (i.e., after the first assessment or after three assessment time points).
Other: Mental Strategy Training
Trainings will be done in groups of up to five people. During training, participants will be presented with an implicit pattern separation task (i.e., for which no response is necessary). At the same time, they will apply mental strategies that were beneficial for hippocampal activity reduction in our previous study. We will use four different mental strategies ("Imagination", "Bodily Perception", "Active Thinking" and "Visual Perception") during each of the training sessions. During imagination participants will need to vividly imagine a scene that exerts a calming effect on them. During "bodily perception" participants will be instruced to focus on their feet or hands while slowly contracting and relaxing them. During active thinking they will perform cognitive tasks such as reciting the alphabet or counting. During visual perception they will focus on a specific part of the presented image. The order of the mental strategies is similar for all participants and all trainings.
Experimental: Group C: 15 participants will be assigned to group C
Group C will attend 2 mental strategy trainings and will start with the training after the first assessment. The training content is identical for all groups. The groups differ only in the number of training sessions and in the timing of the intervention onset (i.e., after the first assessment or after three assessment time points).
Other: Mental Strategy Training
Trainings will be done in groups of up to five people. During training, participants will be presented with an implicit pattern separation task (i.e., for which no response is necessary). At the same time, they will apply mental strategies that were beneficial for hippocampal activity reduction in our previous study. We will use four different mental strategies ("Imagination", "Bodily Perception", "Active Thinking" and "Visual Perception") during each of the training sessions. During imagination participants will need to vividly imagine a scene that exerts a calming effect on them. During "bodily perception" participants will be instruced to focus on their feet or hands while slowly contracting and relaxing them. During active thinking they will perform cognitive tasks such as reciting the alphabet or counting. During visual perception they will focus on a specific part of the presented image. The order of the mental strategies is similar for all participants and all trainings.
Active Comparator: Group D: 10 participants will be assigned to group D
Group D will attend 2 mental strategy trainings and will start with the training after the third assessment. The training content is identical for all groups. The groups differ only in the number of training sessions and in the timing of the intervention onset (i.e., after the first assessment or after three assessment time points).
Other: Mental Strategy Training
Trainings will be done in groups of up to five people. During training, participants will be presented with an implicit pattern separation task (i.e., for which no response is necessary). At the same time, they will apply mental strategies that were beneficial for hippocampal activity reduction in our previous study. We will use four different mental strategies ("Imagination", "Bodily Perception", "Active Thinking" and "Visual Perception") during each of the training sessions. During imagination participants will need to vividly imagine a scene that exerts a calming effect on them. During "bodily perception" participants will be instruced to focus on their feet or hands while slowly contracting and relaxing them. During active thinking they will perform cognitive tasks such as reciting the alphabet or counting. During visual perception they will focus on a specific part of the presented image. The order of the mental strategies is similar for all participants and all trainings.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Hippocampal activity during the pattern separation task
Time Frame: We assess hippocampal activity 4 times from baseline until the last assessment (approximately 10 weeks later).
In each 4 fMRI sessions, we apply a pattern separation task (i.e., the mnemonic similarity test, MST). Participants need to answer to specific trial types. These are stimuli of everyday objects and the participants have to identify if a stimulus is "new" (they have not seen it before), "old" (exactly the same stimulus has been presented already) or "similar" (a stimulus has been shown before but was different in shape or colour). During each task, we will evaluate their hippocampal activity using similar "lure" trials that rely on pattern separation.
We assess hippocampal activity 4 times from baseline until the last assessment (approximately 10 weeks later).

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Pattern completion errors
Time Frame: We will assess pattern completion errors 4 times from baseline until the last assessment (approximately 10 weeks later).
In each 4 fMRI sessions, we apply a pattern separation task (i.e., the mnemonic similarity test, MST). Participants need to answer to specific trial types. These are stimuli of everyday objects and the participants have to identify if a stimulus is "new" (they have not seen it before), "old" (exactly the same stimulus has been presented already) or "similar" (a stimulus has been shown before but was different in shape or colour). Pattern completion errors refer to the mis-identification of similar objects as being old.
We will assess pattern completion errors 4 times from baseline until the last assessment (approximately 10 weeks later).
Pattern Separation success
Time Frame: We will asssess pattern separation success 4 times from baseline until the last assessment (approximately 10 weeks later).
Correct pattern separation occurs when a participant correctly identifies a similar objects as "similar" in the pattern separation task. Compared to the LDI, here we only focus only on correct responses without considering potential response biases.
We will asssess pattern separation success 4 times from baseline until the last assessment (approximately 10 weeks later).
Lure Discrimination Index
Time Frame: We will evaluate the LDI 4 times from baseline until the last assessment (approximately 10 weeks later).
In each 4 fMRI sessions, participants will perform a pattern separation task (i.e., mnemonic similarity test, MST). A widely used metric to report performance in this task is the lure discrimination index (LDI) which is used to determine pattern separation abilities while accounting for response biases
We will evaluate the LDI 4 times from baseline until the last assessment (approximately 10 weeks later).

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Jessica Peter

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Jessica Peter, Professor, University Hospital of Old Age Psychiatry and Psychotherapy

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 13, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
October 22, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 22, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
July 14, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 14, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 22, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 22, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 14, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 50089

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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