Cognitive Rehabilitation Using Neurofeedback With Brain-computer Interface

September 17, 2026 updated by: Teo Jia Hui, KK Women's and Children's Hospital

Cognitive Rehabilitation Using Neurofeedback With Brain-computer Interface - CONNECT: A Prospective Randomised Controlled Trial

The goal of this clinical trial is to determine whether a Brain-Computer Interface Neurofeedback Training (BCI-NFT) programme can improve cognitive outcomes, and whether electroencephalography (EEG)-based measures can serve as objective markers of cognitive impairment, in children and adolescents aged 7 to 21 years with acquired brain injury (ABI), including traumatic brain injury (TBI), stroke, encephalitis, brain tumour, or epilepsy.

A group of children and adolescents aged 7 to 21 years without any history of brain injury or epilepsy will also be enrolled to provide normative EEG data for comparison.

The main questions the study aims to answer are:

  1. Can EEG-derived measures of sustained attention, relaxation, and selective attention detect and quantify cognitive impairment in children and adolescents following ABI?
  2. Does a structured BCI-NFT programme improve cognitive and behavioural outcomes, including attention, memory, and executive function, compared with standard care alone?

Researchers will compare an Intervention Group, who will receive BCI-NFT in addition to standard cognitive rehabilitation, with a Waitlist-Control Group, who will initially receive standard care alone before subsequently crossing over to receive BCI-NFT. This design will allow researchers to determine whether BCI-NFT leads to greater improvements in cognitive and behavioural outcomes compared with standard care alone.

Participants in the main ABI cohort will:

  • Complete behavioural assessments using the Behavior Assessment System for Children, Third Edition (BASC-3), including parent and/or teacher reports.
  • Complete 12 BCI-NFT sessions over a 10-week period. Each session will last approximately 60 minutes. During each session, participants will wear a wireless EEG headset and interact with neurofeedback computer games designed to respond to their sustained attention, selective attention, and response time.
  • Repeat the BASC-3 behavioural assessments at the end of the study period.
  • Have undergone a recent neuropsychological assessment within the preceding 2 years and ongoing review by a neuropsychologist.

Participants in the normative EEG cohort, comprising children and adolescents without a history of brain injury or epilepsy, will attend a single study session. During this session, EEG activity will be recorded both at rest and while participants interact with a three-dimensional (3D) computer game. These recordings will provide normative EEG data against which findings from participants with ABI can be compared.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

70

Phase

  • 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 Contact

Study Locations

  • Singapore
      • Singapore, Singapore
        • Recruiting
        • KK Women's and Children's Hospital
        • Contact:
        • Contact:
          • Nabil
          • Phone Number: 6563947254

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

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Normaitve cohort:

- Patients with no history of epilepsy

Inclusion Criteria:

  • Post acquired brain injury (stroke, encephalitis, brain tumour, traumatic brain injury)
  • Epilepsy

Exclusion Criteria:

  • History of photosensitive seizures
  • Diagnosis of intellectual disability
  • Presence of psychotic symptoms
  • Diagnosis of attention deficit and hyperactivity disorder
  • Diagnosis of autism spectrum disorder
  • Children on methylphenidate
  • Children who are unable to cooperate with neuropsychological assessment of cognitive function

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: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: BCI
Intervention then standard of care
Other: Brain-computer interface with neurofeedback with 3D game sessions
12 sessions of BCI-NFT computer games over 10 weeks
Other Names:
  • BCI-NFT
Experimental: Usual care
Usual care followed by intervention
Other: Brain-computer interface with neurofeedback with 3D game sessions
12 sessions of BCI-NFT computer games over 10 weeks
Other Names:
  • BCI-NFT

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Attention Threshold
Time Frame: Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in the game's adaptive attention threshold value, measured at each session, on a normalised scale between 0 to 1, where the greater value indicates greater sustained attention.
Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in Relaxation Threshold
Time Frame: Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in the game's adaptive threshold value, measured at each session, according to the normalised scale between 0 and 1, where higher value means greater sustained relaxation.
Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in Response Time
Time Frame: Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in mean response time to in-game stimuli, measured in milliseconds, at each session.
Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in Alpha-Lateralization Index
Time Frame: Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in the alpha-lateralization index, a unitless measure derived from posterior EEG channels (P7/P8, O1/O2), ranging from -1 to +1, measured at each session.
Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in Beta-to-Alpha Power Ratio
Time Frame: Baseline (Session 1) to final session (Session 12), over 10 weeks
Change in the ratio of EEG beta-band to alpha-band spectral power, a unitless ratio, measured at each session.
Baseline (Session 1) to final session (Session 12), over 10 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Internalising problem score on Behavior Assessment System for Children, Third Edition (BASC-3)
Time Frame: From enrollment to 20 weeks
Total internalising symptoms (anxiety, depression, somatisation) on BASC-3 questionnaire. T-scores for the BASC-3 Internalizing Problems composite range from a minimum of 20 to a maximum of 120. Higher scores indicate greater severity of mood disorder.
From enrollment to 20 weeks
Externalising symptoms score in Behavior Assessment System for Children, Third Edition (BASC-3)
Time Frame: From enrollment to end of study 20 weeks
Degree of change in total score for externalising symptoms (Hyperactivity, aggression, conduct problems) in BASC-3 questionnaire. Raw score will be converted to T-score with range from 20 to 120. Higher score suggests a high level of maladjustment or severe impairment
From enrollment to end of study 20 weeks

Collaborators and Investigators

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

Sponsor

KK Women's and Children's Hospital

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)

November 1, 2025

Primary Completion (Estimated)

February 1, 2028

Study Completion (Estimated)

June 30, 2028

Study Registration Dates

First Submitted

September 3, 2026

First Submitted That Met QC Criteria

September 17, 2026

First Posted (Actual)

September 18, 2026

Study Record Updates

Last Update Posted (Actual)

September 18, 2026

Last Update Submitted That Met QC Criteria

September 17, 2026

Last Verified

September 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2024/2114

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Consent for sharing of individual patient data was not obtained from participants

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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