The purpose of this study is to evaluate the feasibility of combining repetitive transcranial magnetic stimulation (rTMS), gaze and gait training to improve walking and balance in people with or without mild cognitive impairment.
The study plan is to recruit a total of 15 cognitively impaired and 15 healthy adults. The study will involve two visits. Each study visit will involve: * Real rTMS or sham rTMS that last about 60 minutes * Gaze stabilization exercise via a virtual reality headset for about 1-hour * Target stepping on a treadmill for about 1-hour Researchers will compare changes in gaze and gait following training sessions with real rTMS and sham rTMS.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
SINGLE
Enrollment
30
10 Hz rTMS for 5 seconds over the frontal eye fields with 25 second intertrain interval for 10 trains (500 pulses) at 90% of the resting motor threshold,
Subjects will practice stepping on virtual targets with real-time feedback of their foot position displayed on a screen while walking on a treadmill.
Subjects will perform gaze stabilization and gaze shifting exercise via a virtual reality headset.
Change in Foot Placement Error from baseline 1
Foot position relative to stepping targets.
Time frame: Beginning and end of Visit 1, an average of 8 hours
Change in VOR Gain from baseline 1
The amount of eye relative to head movement during active head rotations.
Time frame: Beginning and end of Visit 1, an average of 8 hours
Change in Foot Placement Error from baseline 2
Foot position relative to stepping targets.
Time frame: Beginning and end of Visit 2, an average of 8 hours
Change in VOR Gain from baseline 2
The amount of eye relative to head movement during active head rotations.
Time frame: Beginning and end of Visit 2, an average of 8 hours
Change in Timed Up and Go (TUG) from baseline 1
The TUG assesses mobility, balance, waking ability and fall risk in older adults. A higher risk for falling is indicated by \>= 12 seconds to complete the test.
Time frame: Beginning and end of Visit 1, an average of 8 hours
Change in Timed Up and Go (TUG) from baseline 2
The TUG assesses mobility, balance, waking ability and fall risk in older adults. A higher risk for falling is indicated by \>= 12 seconds to complete the test.
Time frame: Beginning and end of Visit 2, an average of 8 hours
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Sham rTMS stimulation will produce discharge noise and vibration without stimulating the cerebral cortex.