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Cognitive-motor Intervention Using Virtual Reality for Middle-aged Individuals at High Dementia Risk

Not Applicable
Conditions
Alzheimer's Disease (AD)
Interventions
Behavioral: cognitive training by virtual reality
Behavioral: watching a scientific TV documentary
Device: treadmill
Registration Number
NCT02832921
Lead Sponsor
Sheba Medical Center
Brief Summary

The primary objective of this program is to apply a virtual reality (VR) cognitive-motor intervention (compared to active and passive control groups) to delay or slow cognitive decline of middle-aged adults who have a family history of Alzheimer's disease (AD) and thus are at particularly high risk of developing the disease.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
200
Inclusion Criteria
  • The participants of the study must have at least one parent with Alzheimer's disease.
  • Fluency in Hebrew, in order to understand the instructions of the cognitive tests.
  • Availability of an informant for the participant.
Exclusion Criteria
  • Severe neurological or psychological conditions that may affect cognitive performance.
  • Substantial orthopedic limitations which prevent the use of treadmill.
  • Unstable medical condition such as an active cancer.
  • Incapability of adherence to the training program.
  • The participant is undergoing a treatment that may interfere with the study program.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
VR cognitive tasks + treadmillcognitive training by virtual realityThis is the primary group of interest, in which the investigators hypothesize the greatest cognitive gains since motor activity will augment cognitive activity.
VR cognitive tasks - treadmillcognitive training by virtual realityThis group will be an active control, receiving the VR cognitive training without treadmill walking, to examine whether the motor component augments the effect of the VR in the experimental group.
scientific TV documentary + treadmilltreadmillThis group will watch a scientific TV documentary while walking on the treadmill. This control group will permit examination of whether the VR cognitive training, which requires an especially active cognitive effort while walking on the treadmill, is more advantageous than passively watching a scientific TV documentary while performing the same motor task as the experimental group.
scientific TV documentary + treadmillwatching a scientific TV documentaryThis group will watch a scientific TV documentary while walking on the treadmill. This control group will permit examination of whether the VR cognitive training, which requires an especially active cognitive effort while walking on the treadmill, is more advantageous than passively watching a scientific TV documentary while performing the same motor task as the experimental group.
VR cognitive tasks + treadmilltreadmillThis is the primary group of interest, in which the investigators hypothesize the greatest cognitive gains since motor activity will augment cognitive activity.
Primary Outcome Measures
NameTimeMethod
change in overall cognition- measured by averaging z-scores from 14 paper and pencil neuropsychological tests covering episodic memory and executive functions cognitive domains.baseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

summary of the z-scores of all 14 paper and pencil cognitive tests

change in cerebral blood flow from arterial spin labeling (ASL)baseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

acquired by structural MRI using background-suppressed pseudo-continuous ASL (pcASL) featuring a 3D fast spin echo spiral sequence

Secondary Outcome Measures
NameTimeMethod
hippocampal volumebaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

3D T1-weighted MRI imaging

frontal inferior cortex volumebaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

3D T1-weighted MRI imaging

white matter hyperintensity (WMH) burdenbaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

3D T2-FLAIR MRI imaging

specific cognitive domains- average of z-scores of paper and pencil memory tests and of executive functions testsbaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

summary of z-scores of executive functions tests and of episodic memory tests

blood oxygenation level dependent (BOLD) functional MRI (fMRI) signal in the fronto-parietal network associated with working memorybaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

T2\*-weighted fMRI during an n-back working memory task; contrasts: 1-back minus 0-back; 2-back minus 0-back; 2-back minus 1-back

brain resting state functional connectivity by resting state network fMRI BOLD signal correlationsbaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

T2\*-weighted fMRI while relaxing with eyes closed; functional connectivity between seed regions of resting state networks (e.g., default mode, attentional, salience) and other regions by correlation of BOLD signal in seed regions with that in other regions

diffusion-tensor imaging (DTI) measuresbaseline, immediately after 12-week training, and 3 months post-training (or corresponding time points in passive control group)

diffusion-weighted MRI imaging (DWI) to map white matter tractography

Trial Locations

Locations (1)

Sheba Medical Center

🇮🇱

Ramat Gan, Israel

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