# A Novel Neuromonitoring Guided Cognitive Intervention for Targeted Enhancement of Working Memory

> **NIH NIH R61** · STANFORD UNIVERSITY · 2020 · $348,865

## Abstract

PROJECT SUMMARY
Working memory (WM) is one of the core components of executive functions essential for everyday life
activities. It is one of the central cognitive constructs included in the NIMH Research Domains Criteria (RDoC)
that depends critically on sustained active maintenance in the prefrontal cortex which interacts with parietal
regions in a task dependent manner. Accumulating evidence suggest that WM deficits present in a wide range
of brain disorders including attention deficit hyperactivity disorder (ADHD). Without early intervention, WM
deficits will continue to reduce the likelihood of academic and occupational success.
 In line with NIMH's emphasis on developing personalized interventions that focus on operationally
defined functional domains of mental disorders, particularly intervention targets related to RDoC constructs, we
are proposing a novel intervention to enhance WM by probing the individualized neural systems underlying
WM. Particularly, the proposed intervention integrates computerized WM training with real-time
neuromonitoring and neurofeedback to guide the intervention through reinforcement of a strategy that
maximizes the engagement of the target WM network. We will particularly focus on the frontal-parietal circuit
(target) which is the core system underlying WM. We will test the proposed intervention on children with ADHD
with WM deficits, given a wealth of data demonstrating prevalence of WM impairment in this population that is
often associated with hypoactivation in the frontal and parietal circuits indicated by fMRI and fNIRS studies.
 In the R61 proof-of-concept phase, we will assess target engagement, effective dose and feasibility.
Sixty children with ADHD with WM deficits will be randomized to treatment (N = 30) or control (N = 30). Both
groups will be assessed using a set of neuroimaging, clinical and behavioral assessments. Particularly, we will
test if the intervention results in normalized activity (reduced hypoactivity) in the frontal-parietal network and
improved WM performance during N-back task. If the intervention results in improvement in target engagement
and WM performance based on the proposed criteria, we will advance to the R33 phase to replicate and
validate the effects of the optimal dose of the proposed intervention, versus an active comparison intervention,
in a larger sample of children with ADHD (N = 100) with WM deficits. We will also test if enhanced activity in
the frontal-parietal network is associated with improvement in BRIEF WM scale (clinical outcome) and N-back
performance (functional outcome). Finally, we will assess retention, adherence, satisfaction and acceptability
of randomization and will develop and standardize the protocols for a larger trial if the milestones for (a) target
engagement, (b) association between target engagement and clinical WM outcomes, and (c) feasibility are
met. Validation of the proposed approach will provide a foundation for developing personalized...

## Key facts

- **NIH application ID:** 9930661
- **Project number:** 5R61MH119289-02
- **Recipient organization:** STANFORD UNIVERSITY
- **Principal Investigator:** Hadi Hosseini
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $348,865
- **Award type:** 5
- **Project period:** 2019-05-16 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9930661

## Citation

> US National Institutes of Health, RePORTER application 9930661, A Novel Neuromonitoring Guided Cognitive Intervention for Targeted Enhancement of Working Memory (5R61MH119289-02). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/9930661. Licensed CC0.

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