This is an exploratory mixed-methods control-treatment study to evaluate if participation in rhythmic musical activities improves social attention and connectedness in individuals living with mild to moderate bvFTD and AD, and their caregivers. Secondary objectives include evaluating the potential relationships between brain networks associated with rhythm production, social attention, and connectedness in these populations.
The proposed research will evaluate potential relationships between synchronous rhythm production, social attention, and connectedness in persons living with mild to moderate bvFTD and AD and their caregivers. To evaluate these relationships, the proposed research will include data collection and analysis of the following: 1) pre-post evaluation of social attention and connectedness in individuals living with dementia and their caregivers; 2) control-treatment participation in a synchronous (treatment) or solo (control) rhythm production activity; and 3) secondary analysis of structural and functional MRI of resting state network connectivity between networks of the brain including areas associated with rhythm perception and production, namely the fronto-parietal, executive control, sensorimotor, dorsal and ventral attention networks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
80
The treatment group will take part in a dyad-based musical rhythm production activity facilitated by a trained musician. This activity will involve two rhythm conditions. The first condition requires tapping along to one pre-recorded audio track composed of an ensemble of Brazilian percussion instruments. The second condition requires tapping along with prerecorded audio tracks of rhythms progressively increasing in difficulty. Participants who indicate proficiency in learning to tap along in both conditions will be able to progress to more complex rhythms. All tapping data will be gathered through a Roland digital hand percussion controller.
Participants randomized to the control condition will complete the same rhythm conditions to the same recorded audio tracks described in the experimental condition. However, they will not interchange their tapping with their caregiver. They will participate in the rhythm task as a solo producer.
Sandler Neurosciences Center
San Francisco, California, United States
Social Attention (TASIT)
Dependent Variable. Change in social attention will be measured by the TASIT, a 16-item instrument that measures social attention from the care recipient perspective. Items are sectioned by emotion recognition, social inference minimum (sarcasm) or enriched (lies) and assessed using standardized yes-no questions at the end of each section based on four types: think, feel, say, or do.
Time frame: Baseline, 2-weeks
Degree of rhythmic synchronization between dyad-pairs as determined by autocorrelated inter-tap intervals
Independent variable. Degree of rhythmic synchronization will be measured via a musical instrument, digital interface (MIDI) and assessed using an automated data analysis tool created explicitly for the purposes of this study.
Time frame: Through study completion, an average of one year
Caregiver perceived connectedness questionnaire
A 1-item, 1-7 Likert based scale (1 = very disconnected ... 7 = very connected)
Time frame: Baseline, 2-weeks
Mutuality Scale
A 15-item instrument using a 0-4 Likert (0 = not at all … 4 = a great deal) that measures mutuality from the caregiver perspective. Examples include "How close do you feel to the person you care for?" or "How much do you confide in the person you care for?"
Time frame: Baseline, 2-weeks
Zarit burden
A 12-item instrument using a 0-4 Likert (0 = never … 4 = nearly always) that measures burden from the caregiver perspective. An example is "Do you feel that your social life has suffered because you are caring for your relative?"
Time frame: Baseline, 2-weeks
Positive and Negative Experience
A 12-item instrument using a 1-5 Likert (1 = very rarely or never … 5 = very often or always) that measures an overall affect score that can also be divided into positive and negative feelings. It measures how the participant has felt over the past 4-weeks.
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Time frame: Baseline, 2-weeks
Positive Aspects of Caregiving
A 9-item instrument using a 1-5 Likert (1 = disagree a lot … 5 = agree a lot) that measures a caregiver's perceptions of their positive experiences in caregiving for their care recipient. An example is "Providing help to \[enter name of care recipient\] has made me feel more useful."
Time frame: Baseline, 2-weeks
Trait Empathy (Interpersonal Reactivity Index)
A 28-item instrument using an A-E Likert (A = does not describe me well … E = describes me very well) that measures participants' trait empathic disposition. Four dimensions of trait empathy are used: fantasy scale, empathic concert, perspective taking, and personal distress.
Time frame: Baseline
Patient Health
A 2-item instrument using a 0-3 Likert (0 = not at all … 3 = nearly every day) that measures participants' perceived depression over the last 2-weeks.
Time frame: Baseline, 2-weeks
Revised Self-Monitoring
A 13-item instrument using a 1-5 Likert (1 = … 5 = ) to measure socioemotional sensitivity and responsiveness to the behavioral expressions of others. An example is "In conversations, the subject is sensitive to even the slightest change in the facial expression of the other person he/she is conversing with."
Time frame: Baseline, 2-weeks
Self-Compassion
A 12-item instrument using a 1-5 Likert (1 = almost never … 5 = almost always) to measure an individual's self-compassion. An example is "When I fail at something important to me I become consumed by feelings of inadequacy."
Time frame: Baseline, 2-weeks
Inclusion of Self in Other
A 7-item instrument using concentric circles (1 = no overlap … 7 = most overlap) to measure an individual's perceived relationship between self to other.
Time frame: Baseline, 2-weeks
Patient resting state functional connectivity (RSFC)
Pre-gathered RSFC will be used in mixed models to determine its predictive potential on rhythm production, social attention, and connectedness.
Time frame: From date of completion of collection of all primary outcome measures, assessed up to 24 months
Perceptions of relationship quality between participants as determined by word frequency analysis of semi-structured interview data
Semi-structured interviews between participants of the dyad-pair will be analyzed using qualitative data analysis software for word frequencies of subjective and objective perceptions of their relationship with one another.
Time frame: From date of completion of collection of all primary outcome measures, assessed up to 24 months