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The Effect of Transcranial Direct Current Stimulation (tDCS) on Motor and Cognitive Functions in Idiopathic Fallers

20 april 2017 uppdaterad av: michal roll, Tel-Aviv Sourasky Medical Center

The concurrent performance of two tasks, i.e., dual tasking (DT), is a common and ubiquitous every day phenomena. For example, people frequently walk while talking on a cellphone or drive while talking to a passenger. Often, the performance of one or more of these simultaneously performed tasks may deteriorate when another task is carried out at the same time, even in healthy young adults. This reduction in performance is referred to as the DT deficit or DT cost and is typically much higher in Idiopathic Fallers (IF) than in age-matched controls. In this population the DT cost impairs the gait pattern, as manifested, for example, in increased gait variability, exacerbating instability and fall risk.

In the proposed study, would be evaluated the effects of tDCS on dual tasking performance following tDCS.

The researchers expect that stimulation of the Pre Frontal Cortex (PFC) (using tDCS) will increase DT performance and prefrontal activation.

Studieöversikt

Status

Okänd

Intervention / Behandling

Detaljerad beskrivning

tDCS intervention: Noninvasive tDCS will be delivered by study personnel uninvolved with any other study procedures. In the study will be used a battery-driven electrical stimulator. Stimulation and sham condition will be performed based on previous studies. Briefly, the anode will be placed over the PFC and the cathode over the right supraorbital region. The real tDCS condition will consist of 20 min of continuous stimulation at target intensity of 1.5 mA. This amount of stimulation is safe for healthy young and older adults and has been shown to induce acute beneficial changes in cortical excitability and cognitive functions. For the sham condition, an inactive stimulation protocol would be followed, as compared with an 'off-target' active protocol, in order to minimize participant risk.

Pre- and post-tDCS assessments will include:

Gait assessment: Gait parameters will include both spatial and temporal parameters obtained using body fixed wearable sensors (accelerometers and gyroscopes) [Weiss et al. 2015; Ben et al. 2015]. Parameters will include (but are not limited to) gait speed, stride length and stride time as well as rhythmicity measures such as stride to stride variability and gait regularity.

Fall history and fear of falling will also be assessed (e.g., Falls Efficacy Scale International, FES-I) to further characterize the cohort and explore possible confounds.

Cognitive assessment: A detailed computerized cognitive battery that has been used extensively at TASMC in different cohorts [Dwolatzky et al. 2003;Hausdorff et al. 2006;Springer et al. 2006;Yogev et al. 2005;Aarsland et al. 2003] will quantify several cognitive domains including working memory, executive function, verbal function, problem solving, a global cognitive score, and attention.

Studietyp

Interventionell

Inskrivning (Förväntat)

40

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studieorter

    • Massachusetts
      • Roslindale, Massachusetts, Förenta staterna, 02121
        • Rekrytering
        • Hebrew Rehabilitation Center / Harvard Medical School
        • Underutredare:
          • Lewis Lipsitz, MD
        • Huvudutredare:
          • Brad Manor, PhD
        • Kontakt:
        • Kontakt:
          • Lewis Lipsitz, MD
      • Tel Aviv, Israel, 64239

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

65 år till 85 år (Äldre vuxen)

Tar emot friska volontärer

Ja

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. age 65-85 years,
  2. ability to walk for 6 minutes unassisted,
  3. adequate vision capabilities, and
  4. stable medications for the past month.

Exclusion Criteria:

  1. diagnosis of stroke, Parkinson's disease, peripheral neuropathy or other neurologic disorder,
  2. lower-extremity deformity, joint replacement, severe arthritis or other diagnosed musculoskeletal disorder that may influence gait,
  3. orthostatic hypotension, recent history of syncope or vertigo,
  4. myocardial infarction or surgery within the past 6 months,
  5. any unstable medical condition,
  6. psychiatric co-morbidity (e.g., major depressive disorder as determined by DSM V criteria),
  7. likely dementia (i.e., Mini Mental State Exam score < 24 or based on DSM V),
  8. sedating medications (sedatives, anti-psychotics, hypnotics, anti-depressants,
  9. colorblindness (confounder for cognitive assessment), or
  10. contraindications to tDCS

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Förebyggande
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: tDCS

The active tDCS condition will consist of 4 visit:

During each visit, subject will receive a single 20-minute session targeting the prefrontal cortices of either real (1.5 mA) or sham tDCS. Total 4 different targets:

  1. Sham
  2. motor M1 area
  3. motor M1 + Dorsolateral Prefrontal cortex
  4. Dorsolateral Prefrontal cortex.

The tDCS condition will be randomized and double blinded

The active tDCS condition will consist of 20 min of continuous stimulation. This amount of stimulation is safe for healthy young and older adults and has been shown to induce acute beneficial changes in cortical excitability and cognitive functions.
Andra namn:
  • Transkraniell likströmsstimulering

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Immediate change in gait speed
Tidsram: 1st measure will be taken at baseline ans 2nd immediate post intervention
Gait speed will be assessed under usual and dual task conditions and while negotiating physical obstacles, using a sensorized 7 meter carpet (PKMAS) and wearable body fixed sensors. These measures will be compared to baseline performance.
1st measure will be taken at baseline ans 2nd immediate post intervention

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
fNIRS related frontal lobe activation - changes in tissue oxygenation
Tidsram: 1st measure will be taken at baseline ans 2nd immediate post intervention
fNIRS will be used to investigate the role of the frontal lobe in DT walking and how it is affected by tDCS.The fNIR system provides with real-time monitoring of tissue oxygenation in the brain as subjects take different tests.
1st measure will be taken at baseline ans 2nd immediate post intervention
Changes in cognitive performance - Executive Function composite score
Tidsram: 1st measure will be taken at baseline ans 2nd immediate post intervention
The NeuroTrax software uses tests of cognitive performance that measure similar cognitive functions to traditional paper-based tests.
1st measure will be taken at baseline ans 2nd immediate post intervention

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Huvudutredare: Nir Giladi, Prof., Tel Aviv Sourasky medical Center, Tel Aviv, Israel

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 november 2016

Primärt slutförande (Förväntat)

1 december 2017

Avslutad studie (Förväntat)

1 december 2017

Studieregistreringsdatum

Först inskickad

31 oktober 2016

Först inskickad som uppfyllde QC-kriterierna

1 november 2016

Första postat (Uppskatta)

3 november 2016

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

21 april 2017

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

20 april 2017

Senast verifierad

1 april 2017

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • TASMC-16-NG-0699-CTIL

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

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Kliniska prövningar på Elderly Idiopathic Fallers

Kliniska prövningar på tDCS

3
Prenumerera