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Noninvasive Temporal Interference Stimulation: Modulating Associative Memory by Targeting Deep-brain Targets (Deep-HiPs)

Primary Purpose

Healthy Aging, Memory Disorders in Old Age, Mild Cognitive Impairment

Status
Not yet recruiting
Phase
Not Applicable
Locations
Czechia
Study Type
Interventional
Intervention
Non-invasive Temporal Interference stimulation and Face-name association training task targeting the hippocampus
Non-invasive Temporal Interference stimulation and Face-name association training task targeting the Precuneus
High-frequency stimulation (placebo) with Face-name association training task
Sponsored by
Masaryk University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Healthy Aging focused on measuring temporal interference stimulation, associative memory, hippocampus, precuneus, fMRI, EEG

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Intact cognition with the ability to comprehend the experimental task right-handed Exclusion Criteria: left-handed severe internal disease, cancer brain tumour, intracranial surgery, psychiatric disorder severe neurological brain disease; i.e.: epilepsy, stroke etc. the presence of a pacemaker/defibrillator, metal incompatible with magnetic resonance in the body incapacitating musculoskeletal disorders cognitive impairment based on screening tests severe impairment of vision

Sites / Locations

  • CEITEC Masaryk university

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Active TIS of the hippocampus

Active TIS of the precuneus

High-frequency stimulation

Arm Description

Participants will undergo Active TIS of the hippocampus as one of the 3 conditions within the trial in randomized order.

Participants will undergo Active TIS of the precuneus as one of the 3 conditions within the trial in randomized order.

High frequency >1Khz stimulation; Assumption: The intrinsic low-pass filtering of electrical signals by the neural membrane prevents neural electrical activity from following very high-frequency oscillating (e.g., > 1 kHz) electric fields.

Outcomes

Primary Outcome Measures

Accuracy in Face-Name association task
The face-name association task will be composed of blocks of encoding and recall. Each block contained a unique face-name pair. Multiple pairs followed by a delay and a recall period, where participants tried to select the correct name of each face out of five options (i.e., one target name, two foil names that were present in the block but associated with a different face, and two distracting names that were not present during the task). After each name selection, participants were asked to rate their choice confidence (1, not confident at all to 4, extremely confident)
Speed in Face-Name association task
The face-name association task will be composed of blocks of encoding and recall. Each block contained a unique face-name pair. Multiple pairs followed by a delay and a recall period, where participants tried to select the correct name of each face out of five options (i.e., one target name, two foil names that were present in the block but associated with a different face, and two distracting names that were not present during the task). After each name selection, participants were asked to rate their choice confidence (1, not confident at all to 4, extremely confident)

Secondary Outcome Measures

changes in resting-state functional connectivity in regions of interest
resting-state fMRI: the analysis will be primarily focused on alterations within nodes in the Default mode Network and between network connectivity; Secondary focus on task-positive networks, namely: Central executive network and Dorsal attentional network
Transcranial magnetic stimulation evoked activity change over the regions of interest (Precuneus, prefrontal cortex)
Transcranial magnetic stimulation (TMS) evoked potentials; Investigation of local cortical circuits and networks activated following stimulation

Full Information

First Posted
March 28, 2023
Last Updated
October 18, 2023
Sponsor
Masaryk University
Collaborators
St. Anne's University Hospital Brno, Czech Republic
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1. Study Identification

Unique Protocol Identification Number
NCT05805215
Brief Title
Noninvasive Temporal Interference Stimulation: Modulating Associative Memory by Targeting Deep-brain Targets
Acronym
Deep-HiPs
Official Title
Noninvasive Temporal Interference Stimulation: An Approach for Modulating Associative Memory by Targeting Deep-brain Targets
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 30, 2024 (Anticipated)
Primary Completion Date
November 1, 2025 (Anticipated)
Study Completion Date
December 12, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Masaryk University
Collaborators
St. Anne's University Hospital Brno, Czech Republic

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Alzheimer's disease and its preclinical stages are characterized by progressive neurodegenerative changes in the hippocampi and default mode network resulting in dysfunctions in episodic memory and its central part the associative memory. Associative memory allows for learning and remembering the relationship between unrelated items. Previous research suggests that non-invasive brain stimulation can influence associative memory but with the caveat of quite a small precision and relatively small effects due to the ability only influence superficial brain areas. Novel Brain stimulation techniques such as temporal interference stimulation (TIS) allow overcoming these caveats by allowing focal non-invasive deep brain stimulation. The main goal of this pilot clinical trial is to modulate associative memory among healthy seniors by influencing the cortico-hippocampal circuits using TIS. Secondly, the goal is to use functional magnetic resonance imaging (fMRI) and EEG to explore the neural correlates of TIS effects on brain networks and find biomarkers that allow predicting better response to brain stimulation.
Detailed Description
Alzheimer's disease and its preclinical stages are characterized by progressive neurodegenerative changes in the hippocampi and default mode network resulting in dysfunctions in episodic memory and its central part the associative memory. Encoding of associative information occurs in the distributed brain networks involving the inferior frontal cortex, fusiform cortex, medial temporal lobe, premotor and posterior parietal cortex including the precuneus. Previous studies have shown that by targeting specific nodes within the cortico-hippocampal circuits via the tools of non-invasive brain stimulation the associative memory (AM) performance can be manipulated, however, only relatively surface areas of this circuit were accessible by current non-invasive stimulation techniques. Novel modalities of non-invasive transcranial electrical stimulation such as temporal interference stimulation (TIS) holds a promise to stimulate deeper brain structures without compromising the focality. TIS relies on high frequencies which can penetrate with relatively low loss. High-frequency carriers (>1 kHz) emitted by two (or more) pairs of cutaneous electrodes can temporally interfere at deep peripheral nerve targets. The effective stimulation frequency is equal to the offset frequency between the carriers. By controlling field orientation and frequency offset, the hot spot of constructive interference can be precisely targeted. The key aspect of this method is the use of carrier waves at frequencies higher than 1 kHz. Frequencies above this range are regarded as non-stimulating and pass-through tissues with relatively low loss. While these higher frequencies do not stimulate neural tissue, the interference envelope of two phase-shifted frequencies can elicit action potentials because the offset (aka "beat") frequency can be tuned accordingly to < 100 Hz. The latest studies showed positive behavioral effects of TIS applied over the primary motor cortex or motor striatum in healthy young adults. To date, no studies have investigated the effect of TIS on AM. The specific objectives include: 1) Implement a novel temporal interference stimulation (TIS) technique in a proof-of-concept study targeting deep structures of the cortico-hippocampal circuit, which were until this date unattainable reliably by non-invasive stimulation techniques, with the aim to modulate associative memory in healthy seniors. 2) Explore neural underpinnings of TIS effects and find biomarkers associated with better temporal interference stimulation outcomes and with optimal candidates' selection by using EEG/fMRI techniques

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Healthy Aging, Memory Disorders in Old Age, Mild Cognitive Impairment, Alzheimer Disease
Keywords
temporal interference stimulation, associative memory, hippocampus, precuneus, fMRI, EEG

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Participants will undergo 3 types of TIS in randomized order: targeting the hippocampus targeting the precuneus control condition with high-frequency stimulation
Masking
ParticipantCare Provider
Masking Description
The study participant and researcher applying brain stimulation will be blinded to the stimulation condition. high-frequency stimulation (>1Khz) will be used as a control condition.
Allocation
Randomized
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active TIS of the hippocampus
Arm Type
Experimental
Arm Description
Participants will undergo Active TIS of the hippocampus as one of the 3 conditions within the trial in randomized order.
Arm Title
Active TIS of the precuneus
Arm Type
Experimental
Arm Description
Participants will undergo Active TIS of the precuneus as one of the 3 conditions within the trial in randomized order.
Arm Title
High-frequency stimulation
Arm Type
Placebo Comparator
Arm Description
High frequency >1Khz stimulation; Assumption: The intrinsic low-pass filtering of electrical signals by the neural membrane prevents neural electrical activity from following very high-frequency oscillating (e.g., > 1 kHz) electric fields.
Intervention Type
Combination Product
Intervention Name(s)
Non-invasive Temporal Interference stimulation and Face-name association training task targeting the hippocampus
Intervention Description
TIS relies on high frequencies which can penetrate with relatively low loss. High-frequency carriers (>1 kHz) emitted by two (or more) pairs of cutaneous electrodes can temporally interfere at deep peripheral nerve targets. The effective stimulation frequency is equal to the offset frequency between the carriers. By controlling field orientation and frequency offset, the hot spot of constructive interference can be precisely targeted. The key aspect of this method is the use of carrier waves at frequencies higher than 1 kHz. Frequencies above this range are regarded as non-stimulating and pass-through tissues with relatively low loss. While these higher frequencies do not stimulate neural tissue, the interference envelope of two phase-shifted frequencies can elicit action potentials because the offset (aka "beat") frequency can be tuned accordingly to < 100 Hz.
Intervention Type
Combination Product
Intervention Name(s)
Non-invasive Temporal Interference stimulation and Face-name association training task targeting the Precuneus
Intervention Description
TIS relies on high frequencies which can penetrate with relatively low loss. High-frequency carriers (>1 kHz) emitted by two (or more) pairs of cutaneous electrodes can temporally interfere at deep peripheral nerve targets. The effective stimulation frequency is equal to the offset frequency between the carriers. By controlling field orientation and frequency offset, the hot spot of constructive interference can be precisely targeted. The key aspect of this method is the use of carrier waves at frequencies higher than 1 kHz. Frequencies above this range are regarded as non-stimulating and pass-through tissues with relatively low loss. While these higher frequencies do not stimulate neural tissue, the interference envelope of two phase-shifted frequencies can elicit action potentials because the offset (aka "beat") frequency can be tuned accordingly to < 100 Hz.
Intervention Type
Combination Product
Intervention Name(s)
High-frequency stimulation (placebo) with Face-name association training task
Intervention Description
High-frequency (>1 kHz) stimulation; Standardly used as a carrier frequency; Effects are expected to he high-pass filtered by neurons
Primary Outcome Measure Information:
Title
Accuracy in Face-Name association task
Description
The face-name association task will be composed of blocks of encoding and recall. Each block contained a unique face-name pair. Multiple pairs followed by a delay and a recall period, where participants tried to select the correct name of each face out of five options (i.e., one target name, two foil names that were present in the block but associated with a different face, and two distracting names that were not present during the task). After each name selection, participants were asked to rate their choice confidence (1, not confident at all to 4, extremely confident)
Time Frame
Measured during stimulation procedure; assessed through study completion, an average of 2 years
Title
Speed in Face-Name association task
Description
The face-name association task will be composed of blocks of encoding and recall. Each block contained a unique face-name pair. Multiple pairs followed by a delay and a recall period, where participants tried to select the correct name of each face out of five options (i.e., one target name, two foil names that were present in the block but associated with a different face, and two distracting names that were not present during the task). After each name selection, participants were asked to rate their choice confidence (1, not confident at all to 4, extremely confident)
Time Frame
Measured during stimulation procedure; assessed through study completion, an average of 2 years
Secondary Outcome Measure Information:
Title
changes in resting-state functional connectivity in regions of interest
Description
resting-state fMRI: the analysis will be primarily focused on alterations within nodes in the Default mode Network and between network connectivity; Secondary focus on task-positive networks, namely: Central executive network and Dorsal attentional network
Time Frame
Baseline measurement approximately 20 minutes prior stimulation; immediately after stimulation protocol up to 30 minutes
Title
Transcranial magnetic stimulation evoked activity change over the regions of interest (Precuneus, prefrontal cortex)
Description
Transcranial magnetic stimulation (TMS) evoked potentials; Investigation of local cortical circuits and networks activated following stimulation
Time Frame
Baseline measurement approximately 30 minutes prior stimulation; immediately after stimulation protocol up to 40 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Intact cognition with the ability to comprehend the experimental task right-handed Exclusion Criteria: left-handed severe internal disease, cancer brain tumour, intracranial surgery, psychiatric disorder severe neurological brain disease; i.e.: epilepsy, stroke etc. the presence of a pacemaker/defibrillator, metal incompatible with magnetic resonance in the body incapacitating musculoskeletal disorders cognitive impairment based on screening tests severe impairment of vision
Facility Information:
Facility Name
CEITEC Masaryk university
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Patrik Simko, PhD.
Phone
+420 54949 7643
Email
patrik.simko@ceitec.muni.cz
First Name & Middle Initial & Last Name & Degree
Monika Pupikova, PhD.
Phone
+420 54949 8313
Email
monika.pupikova@ceitec.muni.cz

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
25422457
Citation
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Results Reference
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PubMed Identifier
24028960
Citation
Preston AR, Eichenbaum H. Interplay of hippocampus and prefrontal cortex in memory. Curr Biol. 2013 Sep 9;23(17):R764-73. doi: 10.1016/j.cub.2013.05.041.
Results Reference
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PubMed Identifier
28655882
Citation
Eichenbaum H. Prefrontal-hippocampal interactions in episodic memory. Nat Rev Neurosci. 2017 Sep;18(9):547-558. doi: 10.1038/nrn.2017.74. Epub 2017 Jun 29.
Results Reference
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PubMed Identifier
16054861
Citation
Wagner AD, Shannon BJ, Kahn I, Buckner RL. Parietal lobe contributions to episodic memory retrieval. Trends Cogn Sci. 2005 Sep;9(9):445-53. doi: 10.1016/j.tics.2005.07.001.
Results Reference
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PubMed Identifier
29277405
Citation
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Results Reference
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PubMed Identifier
31189985
Citation
Lang S, Gan LS, Alrazi T, Monchi O. Theta band high definition transcranial alternating current stimulation, but not transcranial direct current stimulation, improves associative memory performance. Sci Rep. 2019 Jun 12;9(1):8562. doi: 10.1038/s41598-019-44680-8.
Results Reference
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PubMed Identifier
25170153
Citation
Wang JX, Rogers LM, Gross EZ, Ryals AJ, Dokucu ME, Brandstatt KL, Hermiller MS, Voss JL. Targeted enhancement of cortical-hippocampal brain networks and associative memory. Science. 2014 Aug 29;345(6200):1054-7. doi: 10.1126/science.1252900.
Results Reference
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PubMed Identifier
33192388
Citation
Wang H, Jin J, Cui D, Wang X, Li Y, Liu Z, Yin T. Cortico-Hippocampal Brain Connectivity-Guided Repetitive Transcranial Magnetic Stimulation Enhances Face-Cued Word-Based Associative Memory in the Short Term. Front Hum Neurosci. 2020 Oct 30;14:541791. doi: 10.3389/fnhum.2020.541791. eCollection 2020.
Results Reference
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PubMed Identifier
28575667
Citation
Grossman N, Bono D, Dedic N, Kodandaramaiah SB, Rudenko A, Suk HJ, Cassara AM, Neufeld E, Kuster N, Tsai LH, Pascual-Leone A, Boyden ES. Noninvasive Deep Brain Stimulation via Temporally Interfering Electric Fields. Cell. 2017 Jun 1;169(6):1029-1041.e16. doi: 10.1016/j.cell.2017.05.024.
Results Reference
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Links:
URL
https://www.fnusa-icrc.org/en/npo-project-coordinated-by-fnusa-approved/
Description
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Noninvasive Temporal Interference Stimulation: Modulating Associative Memory by Targeting Deep-brain Targets

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