Plasticity of Deep Brain Structures in Mild Cognitive Impairment and Healthy Aging

Friedhelm Hummel19 enrolled

Overview

Acute and chronic cognitive impairment (TBI and MCI) is one of the most common problems in the growing and aging society of the 21st century. At an individual level, not all brain structures are affected with the same rate. There are subcortical structures less involved (e.g., the cerebellum), and other more involved (e.g., the hippocampus) in the cognitive decline with age or following a traumatism. To pave the way for personalized precision medicine in the field of cognitive preservation and recovery, there is a need for testing the impact of individually tailored innovative non-invasive neuro-technologies. In this project, we aim at testing the benefit of non-invasively stimulating subcortical structures to boost resilience in supporting motor and non-motor memory.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

QUADRUPLE

Enrollment

Conditions

Traumatic Brain Injury

Interventions

tTIS is an innovative non-invasive brain stimulation approach, in which two or more independent stimulation channels deliver high-frequency currents in the kHz range (oscillating at f1 and f1 + Δf). These high-frequency currents are assumed to be too high to effectively modulate neuronal activity. Still, by applying a small shift in frequency, they result in a modulated electric field with the envelope oscillating at the low-frequency Δf (target frequency) where the two currents overlap. The peak of the modulated envelope amplitude can be steered towards specific areas located deep in the brain, by tuning the positions of the electrodes and the current ratio across stimulation channels. Here, we applied tTIS via surface electrodes applying a low-intensity (2mA baseline to peak), sub-threshold protocol following the safety guidelines for low-intensity transcranial electric stimulation in humans.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: TBI patients: * Age ≥ 18 years * Clinical diagnosis of TBI * No history of other severe neurological or psychiatric disorders Exclusion Criteria: * Unable to consent * Severe neuropsychiatric (e.g., major depression, severe dementia) or unstable systemic diseases (e.g., severe progressive and unstable cancer, life threatening infectious diseases) * Severe sensory or cognitive impairment or musculoskeletal dysfunctions prohibiting to understand instructions or to perform the experimental tasks * Inability to follow or non-compliance with the procedures of the study * Contraindications for NIBS or MRI (1): * Electronic or ferromagnetic medical implants/device, non-MRI compatible metal implant * History of seizures * Medication that significantly interacts with NIBS being benzodiazepines, tricyclic antidepressants and antipsychotics * Regular use of narcotic drugs * Pregnancy * Request of not being informed in case of incidental findings * Concomitant participation in another trial involving probing of neuronal plasticity

Locations (2)

EPFL Valais, Clinique Romande de readaptation

Sion, Valais, Switzerland

EPFL, Campus Biotech

Geneva, Switzerland

Outcomes

Primary Outcomes

Motor learning performance

The primary outcome of the study is the amount of motor learning in a sequential finger-tapping task evaluated during and following training

Time frame: From baseline to 24 hours after training

Secondary Outcomes

Brain connectivity

Diffusion-weighted and resting-state MRI is performed at baseline and allows to evaluate inter-individual anatomical factors associated to the primary outcome

Time frame: Baseline measure (before the intervention)