Network-targeted Theta-burst Stimulation for Episodic Memory Improvement in Mild Cognitive Impairment
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Sonja Hiller
- Phone Number: 310-210-6978
- Email: suthanalab@mednet.ucla.edu
Study Locations
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California
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Los Angeles, California, United States, 90024
- University of California Los Angeles
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Agreement to participate in the study
- 55-100 years of age
- Right-handedness
- In good general health
- Living independently
- Subjective memory complaints (self-report and positive score on MFQ)
- Katz ADL scale and Lawton iADL scale: We will review scores on a case-by-case basis if they did not score 100%. We will exclude if the scores show impairment in ADLs that suggests problems with independent functioning due to cognitive impairment.
- MMSE score > 24
- PHQ Depression score =< 7
- Ability to read, write, and speak English fluently
- Diagnosis of mild neurocognitive disorder according to DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) criteria. Participants with subjective memory complaints without an aMCI diagnosis will be reviewed on a case-by-case basis based on neuropsychological scores. Participants scoring a raw score of 0 or 3 standard deviations below normative expectations on the long delay recall in two or more of the three tasks (BVMT-R, RCFT, and CVLT-III) will be excluded.
- No change in use of psychotropic medication for treatment of depression, anxiety, ADHS or psychosis 1 month prior and during the study.
Screening diagnostic criteria for aMCI will be subjective memory complaints, intact instrumental and basic activities of daily living (Smith et al., 1996), PHQ, MMSE, BVMT-R (25-minute delay), CVLT-II (20-minute delay), Rey-Osterrieth Complex Figure Task (30-minute delay). Baseline assessments will include neuropsychological testing of all study subjects.
Exclusion Criteria:
- Unwilling or unable to provide informed consent
- Diagnosis of dementia
- Active major medical, psychiatric, or neurologic disorder associated with neurocognitive impairment
- History of alcohol or substance abuse
- Recent (< 6 months) alcohol or substance abuse (excluding nicotine or caffeine)
- History of stroke (if the stroke in our judgment is related to the memory problem), traumatic brain injury with loss of consciousness, or other neurologic disorder (e.g., epilepsy, Huntington's disease, Parkinson's disease)
- Non-English speaking participants
- Not right handed based on self-report or evaluation based on a standard report
- Has received TMS before (not TMS naïve)
- Poorly controlled hypertension or cardiovascular disease
- Current enrollment in a memory-enhancement study or course
- Contraindication to TMS or MRI including claustrophobia, metal in body, surgery within 60 days, certain implants, or previous abnormal MRI results.
- scanning facial tattoos is okay if safe with MRI
is taking:
- anticholinergic medication (e.g., Detrol, Cogentin);
- sedating antihistamine (e.g., Benadryl);
- any drug that has significant anticholinergic or antihistaminic side effects (e.g., tricyclic antidepressant medications, Remeron).
- benzodiazepines. While not a strict rule out, this will be decided on a case-by-case basis depending on the dose.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Active TBS
Theta burst stimulation (TBS) will be delivered at 100% of motor threshold (MT).
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Theta burst transcranial magnetic stimulation (TBS) will be delivered at 80-100% of motor threshold (MT).
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Sham Comparator: Sham TBS
Sham stimulation will be delivered at 0% of motor threshold (MT), with all other parameters matching the active TBS condition.
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Sham stimulation will be delivered at 0-10% of motor threshold (MT), with all other parameters matching the active TBS condition.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Verbal recall performance change
Time Frame: Baseline: Day 2; During stimulation: Day 3, Day 7, Day 12, Day 17; Follow-up appointments: Day 18, Day 19, Day 20.
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Verbal memory will be measured using a free recall task where participants learn a list of everyday words and are asked to recall as many words as they can remember after a period of distraction.
Proportion of recollected words will be used to quantify memory performance changes.
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Baseline: Day 2; During stimulation: Day 3, Day 7, Day 12, Day 17; Follow-up appointments: Day 18, Day 19, Day 20.
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Object recognition memory performance change
Time Frame: Baseline: Day 2; During stimulation: Day 3, Day 7, Day 12, Day 17; Follow-up appointments: Day 18, Day 19, Day 20.
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Object memory will be measured using an recognition task where participants view photos of everyday objects and are asked to identify them as OLD or NEW during a memory test wherein unseen novel objects and very similar but new photos of identical objects are shown.
Recollection and discrimination index will be used to quantify memory performance changes.
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Baseline: Day 2; During stimulation: Day 3, Day 7, Day 12, Day 17; Follow-up appointments: Day 18, Day 19, Day 20.
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Associative memory performance change
Time Frame: Baseline: Day 2; During stimulation: Day 3, Day 7, Day 12, Day 17; Follow-up appointments: Day 18, Day 19, Day 20.
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Associative memory will be tested using the Face Name Memory Test wherein participants are shown faces and associated names.
Participants are then shown faces only and asked to recall the associated name.
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Baseline: Day 2; During stimulation: Day 3, Day 7, Day 12, Day 17; Follow-up appointments: Day 18, Day 19, Day 20.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Resting state fMRI functional connectivity
Time Frame: Baseline (Day 2) before the first treatment and after the last treatment (Day 17)
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Resting state fMRI activity will be measured before the first and after the last TBS treatment
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Baseline (Day 2) before the first treatment and after the last treatment (Day 17)
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EEG activity
Time Frame: During treatment (Days 3, 7 and 12), after the last treatment (Day 17), and 2 month follow-up session (Day 20)
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EEG functional connectivity with stimulated region and medial temporal source localized power in the theta band will be recorded during a resting period as well as during the treatment itself both before and after treatments
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During treatment (Days 3, 7 and 12), after the last treatment (Day 17), and 2 month follow-up session (Day 20)
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Andrew Leuchter, MD, University of California, Los Angeles
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 20-001417
- R01AG068317 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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