MedPath

Treating Mild Traumatic Brain Injury with High Definition Transcranial Direct Current Stimulation

Not Applicable
Recruiting
Conditions
Traumatic Brain Injury
Interventions
Device: sham tDCS
Device: Transcranial direct current stimulation
Registration Number
NCT04869059
Lead Sponsor
The University of Texas at Dallas
Brief Summary

The purpose of the study is to test whether low level electric stimulation, called transcranial Direct Current Stimulation (tDCS), on the part of the brain (i.e., presupplementary motor area) thought to aid in memory will improve verbal retrieval in military veteran participants with histories of traumatic brain injuries. The primary outcome measures are neuropsychological assessments of verbal retrieval, and the secondary measures are neuropsychological assessments of other cognitive abilities and electroencephalography (EEG) measures. Additionally, the study will examine the degree to which baseline assessments of cognition and concussion history predict responses to treatment over time, both on assessments administered within the intervention period and at follow-up.

Detailed Description

Using two treatment arms, the study will examine improvement of verbal retrieval and other cognitive deficits associated with remote traumatic brain injury by comparing (1) 1 milliamp transcranial direct current stimulation (tDCS) active treatment applied to presupplementary motor area for 20 minutes over 15 sessions to (2) sham tDCS following the same schedule. Additionally, after completing the initial active or sham treatment and 3-month follow-up testing sessions, selected participants will be invited back for newly assigned treatment conditions, 20 minutes over 15 sessions and will be and re-evaluated at 2- and 3-months follow-up testing sessions.

Veterans with histories of traumatic brain injuries and observed cognitive deficits will be randomly assigned to one of the two treatment arms (and re-assigned for the second round of intervention, as described above). Primary outcome verbal retrieval measures, secondary neuropsychological and electroencephalography (EEG) measures, and prescreening assessments for study concussion history and contraindications for treatment will be collected prior to being assigned to a treatment arm (i.e., baseline).

Primary outcome verbal retrieval measures and secondary neuropsychological and electroencephalography (EEG) measures will be collected after treatment sessions 5, 10, and 15 and two times following treatment competition (i.e., 2-months and 3-months). For participants selected for the second round of intervention, primary outcome verbal memory measures and secondary neuropsychological and electroencephalography (EEG) measures will be collected again after treatment sessions 5, 10, and 15 and two times following competition of the second treatment (i.e., 2-months and 3-months).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
80
Inclusion Criteria

Participants are to be between the ages of 18-75, have previously served in the US armed services, and have had a traumatic brain injury that has led to a verbal retrieval deficit based on neuropsychological testing criteria. Traumatic brain injury must be in the mild to moderate range based on evaluation, including, the Ohio State TBI Identification Method (administered by our research group). You must be fluent in speaking and reading English.

Exclusion Criteria

Exclusion criteria include a history of a psychological or neurological disorder, including, dementia of any type, epilepsy or other seizure disorders, severe traumatic brain injury, post-traumatic stress disorder, brain tumor, present drug abuse, stroke, blood vessel abnormalities in the brain, Parkinson's disease, Huntington's disease, or multiple sclerosis. Additionally, exclusion criteria include inability to give informed consent; cranial implants or skull defects that affect tDCS administration; and use of medications that interact with or potentially interact with tDCS effects, including, anti-convulsants, amphetamines, L-dopa, carbamazepine, sulpiride, pergolide, lorazepam, rivastigmine, dextromethorphan, D-cycloserine, flunarizine, ropinirole, or citalopram.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sham transcranial direct current stimulationsham tDCS20 minutes of sham transcranial direct current stimulation to presupplementary motor area for 15 sessions
Transcranial direct current stimulationTranscranial direct current stimulation20 minutes of 1 milliamp transcranial direct current stimulation to presupplementary motor area for 15 sessions
Primary Outcome Measures
NameTimeMethod
Treatment group differences in change from Baseline to 3-months Post-Treatment in Category FluencyOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in Category Fluency from baseline to 3-months. Metric: Number of Correct Items Generated

Benton, L.A., Hamsher, K., \& Sivan, A.B., (1994). Multilingual aphasia examination. Iowa City: AJA Associates.

Treatment group differences in change from Baseline to 2-months Post-Treatment in Category FluencyOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in Category Fluency from baseline to 2-months. Metric: Number of Correct Items Generated

Benton, L.A., Hamsher, K., \& Sivan, A.B., (1994). Multilingual aphasia examination. Iowa City: AJA Associates.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Semantic Object Retrieval TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in Semantic Object Retrieval Test from baseline to 3-months. Metric: Number of Correct Retrievals

Kaplan, E., Goodglass, H., \& Weintraub, S., (1983). Boston Naming Test (2nd ed.). Lea \& Febiger: Philadelphia.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Semantic Object Retrieval TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in Semantic Object Retrieval Test from baseline to 2-months. Metric: Number of Correct Retrievals

Kaplan, E., Goodglass, H., \& Weintraub, S., (1983). Boston Naming Test (2nd ed.). Lea \& Febiger: Philadelphia.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Controlled Oral Word Association TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change on the Control Word Association Test from baseline to 2-months. Metric: Number of Correct Items Generated

Benton, L.A., Hamsher, K., \& Sivan, A.B., (1994). Multilingual aphasia examination. Iowa City: AJA Associates.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Controlled Oral Word Association TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change on the Control Word Association Test from baseline to 3-months. Metric: Number of Correct Items Generated

Benton, L.A., Hamsher, K., \& Sivan, A.B., (1994). Multilingual aphasia examination. Iowa City: AJA Associates.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Boston Naming TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in Boston Naming Test from baseline to 3-months. Metric: Number of Correct Names Retrieved

Kraut, M.A., Cherry, B., Pitcock, C.B., Anand, R., Li, J. Vestal, L., Henderson, V.W., and Hart, J. Jr. (2007). The Semantic Object Retrieval Test (SORT) in amnestic cognitive impairment. Cogn. Behav. Neurol. 20, 62- 67.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Boston Naming TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in Boston Naming Test from baseline to 2-months. Metric: Number of Correct Names Retrieved

Kraut, M.A., Cherry, B., Pitcock, C.B., Anand, R., Li, J. Vestal, L., Henderson, V.W., and Hart, J. Jr. (2007). The Semantic Object Retrieval Test (SORT) in amnestic cognitive impairment. Cogn. Behav. Neurol. 20, 62- 67.

Treatment group differences in change from Baseline to 3-months Post-Treatment on California Verbal Learning TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in California Verbal Learning Test from baseline to 3-months. Metric: Number of Correct Retrievals

Delis DC, Kramer JH, Kaplan E, Ober BA. (2017). California verbal learning test (3rd Ed.). Pearson Publishing: San Antonio, TX.

Treatment group differences in change from Baseline to 2-months Post-Treatment on California Verbal Learning TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in California Verbal Learning Test from baseline to 2-months. Metric: Number of Correct Retrievals

Delis DC, Kramer JH, Kaplan E, Ober BA. (2017). California verbal learning test (3rd Ed.). Pearson Publishing: San Antonio, TX.

Secondary Outcome Measures
NameTimeMethod
Treatment group differences in change from Baseline to 3-months Post-Treatment on the Delis Kaplan Color Word Interference TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change on the Delis Kaplan Color Word Interference Test from baseline to 3-months. Metric: Time to Name Items

Delis, D.C., Kaplan, E., \& Kramer, J.H., (2001). Delis-Kaplan Executive Function System. San Antonio, TX: The Psychological Corporation.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Digit Span BackwardOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in Digit Span Backward from baseline to 3-months. Metric: Memory Span

Wechsler, D., (2008). Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). San Antonio, TX: NCS Pearson.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Grooved Pegboard TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change on the Grooved Pegboard Test from baseline to 2-months. Metric: Completion Time

Matthews, C.G., and Klove, H. (1964). Instruction manual for the adult neuropsychology test. Madison. Wis: University of Wisconsin Medical School.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Trail Making Test (Part A)Outcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change on the Trail Making Test (Part A) from baseline to 3-months. Metric: Time to Solution

Reitan, R.M., (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Motor Skill., 8, 271-276.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Trail Making Test (Part A)Outcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change on the Trail Making Test (Part A) from baseline to 2-months. Metric: Time to Solution

Reitan, R.M., (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Motor Skill., 8, 271-276.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Trail Making Test (Part B)Outcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change on the Trail Making Test (Part B) from baseline to 3-months. Metric: Time to Solution

Reitan, R.M., (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Motor Skill., 8, 271-276.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Trail Making Test (Part B)Outcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change on the Trail Making Test (Part B) from baseline to 2-months. Metric: Time to Solution

Reitan, R.M., (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Motor Skill., 8, 271-276.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Delis Kaplan Color Word Interference TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change on the Trail Making Test (Part B) from baseline to 2-months. Metric: Time to Name Items

Reitan, R.M., (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Percept. Motor Skill., 8, 271-276.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Digit Span ForwardOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in Digit Span Forward from baseline to 2-months. Metric: Memory Span

Wechsler, D., (2008). Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). San Antonio, TX: NCS Pearson.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Digit Span BackwardOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in Digit Span Backward from baseline to 2-months. Metric: Memory Span

Wechsler, D., (2008). Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). San Antonio, TX: NCS Pearson.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Rey-Osterrieth Complex Figure TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change in Rey-Osterrieth Complex Figure Test scores from baseline to 2-months. Metric: Score

Rey, A. (1941). L'examen psychologique dans les cas d'encéphalopathie traumatique. (Les problems.). \[The psychological examination in cases of traumatic encepholopathy. Problems.\]. Archives de Psychologie, 28, 215- 285.

Treatment group differences in change from Baseline to 2-months Post-Treatment on the Digit Symbol Substitution TestOutcome measures will be assessed as change over a period of 13 weeks: Change from baseline to 2-month Post-Treatment

Evaluation of treatment group differences in change on the Digit Symbol Substitution Test from baseline to 2-months. Metric: Number of Items

Wechsler, D., (2008). Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). San Antonio, TX: NCS Pearson.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Digit Span ForwardOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in Digit Span Forward from baseline to 3-months. Metric: Memory Span

Wechsler, D., (2008). Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). San Antonio, TX: NCS Pearson.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Rey-Osterrieth Complex Figure TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change in Rey-Osterrieth Complex Figure Test scores from baseline to 3-months. Metric: Score

Rey, A. (1941). L'examen psychologique dans les cas d'encéphalopathie traumatique. (Les problems.). \[The psychological examination in cases of traumatic encepholopathy. Problems.\]. Archives de Psychologie, 28, 215- 285.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Digit Symbol Substitution TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change on the Digit Symbol Substitution Test from baseline to 3-months. Metric: Number of Items

Wechsler, D., (2008). Wechsler adult intelligence scale-Fourth Edition (WAIS-IV). San Antonio, TX: NCS Pearson.

Treatment group differences in change from Baseline to 3-months Post-Treatment on the Grooved Pegboard TestOutcome measures will be assessed as change over a period of 17 weeks: Change from baseline to 3-month Post-Treatment

Evaluation of treatment group differences in change on the Grooved Pegboard Test from baseline to 3-months. Metric: Completion Time

Matthews, C.G., and Klove, H. (1964). Instruction manual for the adult neuropsychology test. Madison. Wis: University of Wisconsin Medical School.

Trial Locations

Locations (1)

The University of Texas at Dallas

🇺🇸

Dallas, Texas, United States

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