Enhancing Spatial Navigation Using Non-Invasive Brain Stimulation

Not Applicable

Completed

• Conditions: Alzheimer's Disease; Mild Cognitive Impairment
• Interventions: Device: Transcranial direct current stimulation (tDCS)

• Registration Number: NCT01958437
• Lead Sponsor: VA Office of Research and Development

Brief Summary

Remembering how to travel from one location to another is critical in everyday life, yet this vital ability declines with normal aging and can be further affected by conditions that disproportionately affect the elderly, such as vision loss or progressive dementia. Human and animal research has shown that two distinct memory systems interact during navigation. The first, referred to as allocentric navigation, is very flexible and uses spatial knowledge of key features or landmarks to develop and use a mental map of the environment. This approach involves brain regions that are critical for new learning and memory but that decline with age. The second, referred to as egocentric navigation, is inflexible and relies on "habit" memories that link specific features with specific directions. This approach relies on brain regions that are critical for "automatic" responses and that are relatively unaffected by age.

The main problem is that allocentric navigation declines with age and is accompanied increased dependence on egocentric navigation. This change increases the risk of becoming disoriented or "lost" when traveling in unfamiliar areas or even when traveling new routes in familiar areas. Therefore, the main goal of this project is to examine whether non-invasive brain stimulation, specifically transcranial direct current stimulation, can improve allocentric navigation in healthy older adults and patients with mild cognitive impairment.

Participants will complete two functional magnetic resonance imaging sessions while learning new environments. Before one of these sessions, participants will receive active brain stimulation over the parietal cortex. Before the other session, participants will receive sham brain stimulation over the parietal cortex. The effects of this stimulation will be evaluated using both an allocentric and an egocentric memory test. Physiologic effects will be evaluated using both task-based and resting-state MRI.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2013-09-23
• Study Start: 2013-10-01
• Study First Submitted QC: 2013-10-04
• Study First Posted: 2013-10-09
• Primary Completion: 2017-03-23
• Study Completion: 2017-03-24
• Results First Submitted: 2018-04-16
• Status Verified: 2018-08
• Results First Submitted QC: 2018-08-28
• Last Update Submitted: 2018-08-28
• Results First Posted: 2018-08-31
• Last Update Posted: 2018-08-31

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

General inclusion criteria (all participants):

• All medications stable for approximately 1-2 months;
• No history of severe mental illness;
• No current untreated alcohol or substance abuse/dependence;
• English as native and preferred language;
• MRI-compatible if taking part in fMRI studies
• Able to give informed consent.

MCI Inclusion Criteria:

• Diagnosis of amnestic MCI based on criteria set forth by Petersen (2004). Additionally, other potential causes of cognitive deficit ruled out by the referring physician;

Healthy older adults

• intact cognitive functioning as measured by neuropsychological testing

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Exclusion Criteria

• History of neurological disease or injury
• History of severe mental illness
• Current untreated alcohol or substance abuse
• Other conditions may exclude; please discuss with contact

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Cognitively intact older adults - ACTIVE tDCS	Transcranial direct current stimulation (tDCS)	Group receives active brain stimulation
Cognitively intact older adults - SHAM tDCS	Transcranial direct current stimulation (tDCS)	Group receives sham brain stimulation
MCI ACTIVE tDCS	Transcranial direct current stimulation (tDCS)	Group receives active brain stimulation
MCI SHAM tDCS	Transcranial direct current stimulation (tDCS)	Group receives sham brain stimulation

Primary Outcome Measures

Name	Time	Method
Accuracy in Centimeters From Target Location for Allocentric	Outcome assessed after each of 2 sessions (estimated within 1 week of each other)	1 active tDCS; 1 sham tDCS for each measure. Participants touched a screen (using a ELO 19" touchscreen monitor) to document the location of the landmark. The distance between the actual vs. selected location served as the dependent measure.
Egocentric	Outcome assessed after each of the 2 sessions	Number of turns correctly recalled for each egocentric environment
Hippocampal BOLD Signal During Task-based fMRI	change between active and sham tDCS sessions (<1month)	BOLD signal change comparing active to sham tDCS during Allocentric navigation (i.e., active HD-tDCS \> sham HD-tDCS). Activation maps thresholded at p\<.01 with minimum cluster size of 5 voxels.
Dorsal Attention Network Connectivity During Resting-state fMRI	change between active and sham tDCS sessions (<1month)	Change in resting state functional connectivity strength between active and sham tDCS sessions. Strength is measured by Pearson r correlations between nodes, which are z-transformed, and summated.

Trial Locations

Locations (2)

VA Ann Arbor Healthcare System, Ann Arbor, MI; 🇺🇸 Ann Arbor, Michigan, United States

Atlanta VA Medical and Rehab Center, Decatur, GA; 🇺🇸 Decatur, Georgia, United States