- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05492032
Cumulative and Booster Effects of Multisession Prefrontal tDCS in Adolescents With ASD
Cumulative and Booster Effects of Multisession Prefrontal Transcranial Direct-Current Stimulation (tDCS) on Cognitive and Social Impairments in Adolescents With Autism Spectrum Disorder
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Melody Chan, PhD
- Email: mei-yan-melody.chan@connect.polyu.hk
Study Contact Backup
- Name: Yvonne Han, PhD
- Phone Number: +852 2766 7578
- Email: yvonne.han@polyu.edu.hk
Study Locations
-
-
Kowloon
-
Hung Hom, Kowloon, Hong Kong
- Recruiting
- The Hong Kong Polytechnic University
-
Contact:
- Melody Chan, PhD
- Email: mei-yan-melody.chan@connect.polyu.hk
-
Contact:
- Yvonne Han, PhD
- Phone Number: 27667578
- Email: yvonne.han@polyu.edu.hk
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Individuals who are confirmed by a clinical psychologist based on the Diagnostic and Statistical Manual of Mental Disorders-5th Ed (DSM-V) criteria of Autism spectrum disorder and structured interview with their parents or primary caregivers on their developmental history using the Autism Diagnostic Interview-Revised (ADI-R).
- Individuals with ASD who are comorbid with ADHD symptoms will be included if they were willing to abstain from the use of these medications at least 96 hours before the commencement, until the completion, of the treatment.
- In view of the fact that neuroadaptation to antipsychotics typically occurs within six months, potential participants who are prescribed antipsychotic medications will only be included if the dosage of the medication remained unchanged for six months or more before the experimental period.
Exclusion Criteria:
- Individuals without a confirmed diagnosis from the clinical psychologist, with a history of other neurological and psychiatric disorders and head trauma, or on psychiatric medication will be excluded from the study.
- In view of the possibility of seizure induction by tDCS, potential ASD participants comorbid with epilepsy will be excluded.
- Potential participants comorbid with mood or anxiety disorders will also be excluded.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Active cathodal (inhibitory) tDCS vs. Sham-tDCS condition
Experimental group: active multisession tDCS + active booster tDCS vs Active control group: sham multisession tDCS + sham booster tDCS To test whether active cathodal [inhibitory] tDCS over the left dlPRC will facilitate learning through stimulation and thus improve cognitive function in patients with ASD, the primary outcomes (SRS-2 scores) of the two groups at the start (T0), 1-month (T1), 3-month (T2), 6-month (T3), and at the end of study i.e. 12-months (T4) will be compared. |
For active-tDCS condition, participants will receive stimulation on the dorsolateral prefrontal cortex with ramp up and ramp down mode for 10 seconds, eliciting a tingling sensation on the scalp that fades over seconds.
Following that, a twenty-minute executive functional training task will be initiated five minutes subsequent to the stimulation mode, and the stimulation will be terminated when the training task ends.
For sham-tDCS condition, participants will receive initial stimulation with ramp up and ramp down mode for 30 seconds, eliciting a tingling sensation on the scalp then it will be discontinued.
Participants will also receive the twenty-minute executive functional training task five minutes subsequent to the stimulation mode.
Participants will complete an online cognitive training program consisting of 10 consecutive daily weekday training sessions while they receive either the active or sham tDCS stimulation.
Each training session will last for 20 minutes.
The online cognitive training program will comprise five exercises assessing information processing speed and executive function capacities.
Each exercise will take approximately 4 minutes to complete.
Given many studies, across different neurological/neuropsychiatric diagnoses, especially for people with autism, it has long been established that social skills and functioning are closely related, and multiple studies have shown that executive function training can improve social functioning in autism or vice versa (i.e.
social skills training improves executive functioning in autism), it is reasonable to include cognitive training in this tDCS protocol.
|
Experimental: Active booster tDCS treatment vs. Sham booster tDCS treatment
Experimental group: active multisession tDCS + active booster tDCS vs Active control group: active multisession tDCS + sham booster tDCS To test whether booster treatment cycles of tDCS will prolong the cognitive benefits in individuals with ASD), the primary outcome, the total SRS-2 score, and the secondary outcomes, the E/I ratio and the cognitive composite score at the start (T0), 1-month (T1), 3-month (T2), 6-month (T3), and at the end of study i.e. 12-months (T4), will be compared. |
For active-tDCS condition, participants will receive stimulation on the dorsolateral prefrontal cortex with ramp up and ramp down mode for 10 seconds, eliciting a tingling sensation on the scalp that fades over seconds.
Following that, a twenty-minute executive functional training task will be initiated five minutes subsequent to the stimulation mode, and the stimulation will be terminated when the training task ends.
For sham-tDCS condition, participants will receive initial stimulation with ramp up and ramp down mode for 30 seconds, eliciting a tingling sensation on the scalp then it will be discontinued.
Participants will also receive the twenty-minute executive functional training task five minutes subsequent to the stimulation mode.
Participants will complete an online cognitive training program consisting of 10 consecutive daily weekday training sessions while they receive either the active or sham tDCS stimulation.
Each training session will last for 20 minutes.
The online cognitive training program will comprise five exercises assessing information processing speed and executive function capacities.
Each exercise will take approximately 4 minutes to complete.
Given many studies, across different neurological/neuropsychiatric diagnoses, especially for people with autism, it has long been established that social skills and functioning are closely related, and multiple studies have shown that executive function training can improve social functioning in autism or vice versa (i.e.
social skills training improves executive functioning in autism), it is reasonable to include cognitive training in this tDCS protocol.
|
Experimental: Change in EEG E/I ratios in the active tDCS vs. sham tDCS groups
Experimental group: active multisession tDCS + active booster tDCS vs Active control group: sham multisession tDCS + sham booster tDCS To test whether enhanced neuronal network organization, as indicated by EEG E/I ratios, in patients with ASD will mediate the beneficial effects of tDCS in terms of improvements in cognitive function, measurements taken at baseline, 1-day and 1-month after tDCS treatment will be compared. The change in EEG E/I ratios in patients in the active tDCS and sham tDCS groups will be compared using E/I ratios averaged from channels Fp1, F3, and F7 to increase the signal-to-noise ratio of the EEG data and to represent the left frontal E/I ratio. |
For active-tDCS condition, participants will receive stimulation on the dorsolateral prefrontal cortex with ramp up and ramp down mode for 10 seconds, eliciting a tingling sensation on the scalp that fades over seconds.
Following that, a twenty-minute executive functional training task will be initiated five minutes subsequent to the stimulation mode, and the stimulation will be terminated when the training task ends.
For sham-tDCS condition, participants will receive initial stimulation with ramp up and ramp down mode for 30 seconds, eliciting a tingling sensation on the scalp then it will be discontinued.
Participants will also receive the twenty-minute executive functional training task five minutes subsequent to the stimulation mode.
Participants will complete an online cognitive training program consisting of 10 consecutive daily weekday training sessions while they receive either the active or sham tDCS stimulation.
Each training session will last for 20 minutes.
The online cognitive training program will comprise five exercises assessing information processing speed and executive function capacities.
Each exercise will take approximately 4 minutes to complete.
Given many studies, across different neurological/neuropsychiatric diagnoses, especially for people with autism, it has long been established that social skills and functioning are closely related, and multiple studies have shown that executive function training can improve social functioning in autism or vice versa (i.e.
social skills training improves executive functioning in autism), it is reasonable to include cognitive training in this tDCS protocol.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in social responsiveness - Social Responsiveness Scale-2nd edition (SRS-2)
Time Frame: First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
SRS-2 is a sensitive measure of social functioning in children that detects even subtle symptoms that are highly related to ASD.
It uses a four-point scale and focuses on different aspects of socialization.
The total score reflects the clinical effectiveness of tDCS, and higher scores indicate greater symptom severity.
It has been shown that SRS-2 is sensitive to detect changes in social communication improvement related to improved cognitive functioning after treatment.
SRS-2 assessments will be conducted before and immediately after tDCS treatment.
|
First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
tDCS safety and clinical response in tDCS outcome
Time Frame: First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
To assess tDCS safety, participants will be asked to complete an adverse effects questionnaire (AEQ) which charts the presence of uncomfortable sensations and changes emotions, cognition and perceptions. Based on the tDCS outcome recorded immediately after tDCS treatment, participants will be categorized into responders and non-responders based on the percentage of change in the total SRS score. Participants who show reductions of at least 10% in total SRS scores as compared to baseline scores will be considered responders. This percentage reduction benchmark was set with reference to the minimal clinically important difference (MCID) and calculated using the standard error measurement method from an ASD sample in a previous randomized controlled trial. |
First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
Change in neuropsychological measures - CANTAB® cognitive tests
Time Frame: First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
Cambridge Neuropsychological Test Automated Battery (CANTAB®) includes computerized tests that are correlated to neural networks and have demonstrated high sensitivity in detecting changes in neuropsychological performance.
The tests in this battery-the Reaction Time (RTI), Spatial Working Memory (SWM), and Multitasking Tests (MTT)-are well validated and are highly sensitive to the core domains impaired in patients with ASD, including to response/reaction time, working memory, attention, inhibition, and cognitive flexibility.
|
First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
Change in EEG E/I ratio measurement
Time Frame: First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
Each participant will be tested individually using the Starstim 32 hybrid EEG/tCS device (Neuroelectrics®) to collect EEG data.
EEG measurements will be taken in the resting state before and immediately after the 10-session intervention program.
Participants will be instructed to sit still and focus their attention on a "+" displayed on a computer monitor during eyes-open resting conditions for 5 minutes.
Raw data will be processed with the EEGLAB Toolbox using MATLAB® R2019a (The MathWorks Inc., Natick, Massachusetts, USA).
Data from 19 electrode positions (Fp1, Fp2, F3, F4, F7, F8, Fz, T3, T4, T5, T6, C3, C4, Cz, P3, P4, Pz, O1, and O2) will be used for analysis.
|
First day of intervention, 1-month, 3-month, 6-month and 12-months after treatment (5 time points)
|
Collaborators and Investigators
Investigators
- Principal Investigator: Yvonne Han, PhD, The Hong Kong Polytechnic University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HSEARS20220216004-01
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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