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The aim of our single-blind, sham-controlled study was to collect rigorous evidence regarding the feasibility of neurofeedback training in Huntington\u2019s disease by examining two different methods, activity and connectivity real-time functional MRI neurofeedback training. Thirty-two Huntington\u2019s disease gene-carriers completed 16 runs of neurofeedback training, using an optimized real-time functional MRI protocol. Participants were randomized into four groups, two treatment groups, one receiving neurofeedback derived from the activity of the supplementary motor area, and another receiving neurofeedback based on the correlation of supplementary motor area and left striatum activity (connectivity neurofeedback training), and two sham control groups, matched to each of the treatment groups. We examined differences between the groups during neurofeedback training sessions and after training at follow-up sessions. Transfer of training was measured by measuring the participants\u2019 ability to upregulate neurofeedback training target levels without feedback (near transfer), as well as by examining change in objective, a priori defined, behavioural measures of cognitive and psychomotor function (far transfer) before and at 2\u2009months after training. We found that the treatment group had significantly higher neurofeedback training target levels during the training sessions compared to the control group. However, we did not find robust evidence of better transfer in the treatment group compared to controls, or a difference between the two neurofeedback training methods. We also did not find evidence in support of a relationship between change in cognitive and psychomotor function and learning success. We conclude that although there is evidence that neurofeedback training can be used to guide participants to regulate the activity and connectivity of specific regions in the brain, evidence regarding transfer of learning and clinical benefit was not robust.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaa049","type":"journal-article","created":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T13:05:51Z","timestamp":1587647151000},"source":"Crossref","is-referenced-by-count":17,"title":["Activity or connectivity? A randomized controlled feasibility study evaluating neurofeedback training in Huntington\u2019s disease"],"prefix":"10.1093","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0971-8361","authenticated-orcid":false,"given":"Marina","family":"Papoutsi","sequence":"first","affiliation":[{"name":"UCL Huntington\u2019s Disease Centre, Queen Square Institute of Neurology, University College London, London WC1B 5EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Magerkurth","sequence":"additional","affiliation":[{"name":"Birkbeck-UCL Centre for Neuroimaging, University College London, London WC1H 0AP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Josephs","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Human Neuroimaging, Queen Square Institute of Neurology, University College London, London WC1N 3AR, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia 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