Treatment of Post-Chemo Cognitive Impairment w/Transcranial Magnetic Stimulation (Chemobrain TMS)

Not Applicable

Terminated

Conditions: Chemo-brain

Interventions: Device: Transcranial magnetic stimulation (TMS)

Registration Number: NCT04295720

Lead Sponsor: University of Arizona

Brief Summary: In this pilot study, the investigators propose to test the efficacy of rTMS for the treatment of PCCI. Efficacy measures will include baseline and post-rTMS neuropsychological testing, functional MRI and biometry data using body worn sensors.

Detailed Description: Transcranial magnetic stimulation (TMS) is a safe and non-invasive brain stimulation technique. It uses a magnetic coil to stimulate brain tissue painlessly using only a magnet (no electrodes or electrical wires) in a procedure that does not involve any surgery or sedation. TMS is currently FDA approved to treat depression and migraines. Although this technology is applicable to many other brain conditions as well, it has not been systematically examined in individuals with "Chemo-brain". Chemo-brain or Post-Chemotherapy Cognitive Impairment (PCCI) is defined as cognitive changes including impairment of memory, learning, concentration, reasoning, executive function, attention and visuo visio-spatial skills that occur during or after chemotherapy treatment.

In this study, investigators will:

1. use high-resolution magnetic resonance imaging (MRI) of individuals' brains to determine precisely where to place the TMS magnetic coil in order to stimulate the target brain region based off their unique brain structure.

2. use TMS to stimulate the target region of the brain.

3. take high-resolution MRI pictures of the brain both baseline and post-TMS to study whether the brain activity of the target region changes as a result of the TMS stimulation.

4. perform neuropsychological tasks baseline and post-TMS to study if performance is improved following stimulation of the target brain region.

5. collect data from completing Frailty assessments, baseline and post-TMS.

6. study the short-term and long-term treatment effects.

7. collect subject's daily activity and sleep/wake patterns from watch style device (http://www.actigraphy.com/solutions/actiwatch/actiwatch-plus-specifications.html).

8. perform behavioral assessments, baseline and post-TMS, to study whether there are measurable changes following stimulation of the target brain region.

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 1

Inclusion Criteria

Adult (>=18).
PCCI diagnosis (see information below).
Right Handed (We will not enroll left-handed dominant people because they tend to have more symmetric brain function and thus targeting the left frontal region may not be as effective.)
English speaking.
Cancer treatment completed and considered curative with the exception of endocrine therapy after chemotherapy.
Able to attend daily intervention (Monday-Friday) for 2 weeks.
Not enrolled in another interventional study within 6 months prior to beginning this study.

Exclusion Criteria

Pregnancy or thinking of becoming pregnant.
Undergoing active treatment for cancer.
Routine contraindications for MRI (including incompatible medical implants or metal fragments in the body at risk for migration or heating with application of the magnetic field) including severe claustrophobia.
History of brain metastasis or other brain tumor.
History of stroke or traumatic brain injury.
Frequent or severe headaches.
Cognitive or mood disorder prior to chemotherapy (i.e. dementia or depression).
History of epilepsy, or other seizure disorders.
History mental health disorders, such as substance misuse, bipolar disorder or psychosis.
Taking medication for seizures or that could lower seizure threshold if withdrawn.
Inability to complete neuropsychological testing.
Prior treatment with rTMS. We will enroll subjects without prior experience with rTMS.

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Transcranial magnetic stimulation (TMS)	Transcranial magnetic stimulation (TMS)	We propose to test the efficacy of rTMS for the treatment of PCCI. Efficacy measures will include baseline and post-rTMS neuropsychological testing, functional MRI and biometry data using body worn sensors.

Primary Outcome Measures

Name	Time	Method
Memory Testing	14 days	Efficacy measures will include baseline and post-rTMS neuropsychological testing. The Outcome Measure is the difference between the pre and post scores of the following Neuropsychological tests. The score from each test was added together to come up with a single value. A higher score indicates better performance. Minimum is score of 0 and maximum is not applicable (a timed test). The Neuropsychological tests we analyzed: Forward Digit Span Backward Digit Span Rey Auditory Verbal Learning Test Verbal Fluency Task Stroop Color-Word Interference Task

Secondary Outcome Measures