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Language and Lewy Body Diseases: Sentence Comprehension Problems and Modifying Noninvasive Brain Stimulation Treatment (LANG-LBD)

Primary Purpose

Lewy Body Disease, Healthy Aging

Status
Recruiting
Phase
Not Applicable
Locations
Czechia
Study Type
Interventional
Intervention
transcranial direct current stimulation (tDCS)
Sponsored by
Masaryk University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Lewy Body Disease

Eligibility Criteria

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

Inclusion Criteria: right-handedness Czech as their first language age (60-80 years) presence of PD-MCI (Litvan et al. 2012) or MCI-LB (McKeith et al. 2020) for LBD subjects Exclusion Criteria: cardio pacemaker any MRI-incompatible metal in the body epilepsy any diagnosed psychiatric disorders alcohol/drug abuse for HC group the presence of LBDs or other neurodegenerative disorder or MCI/dementia

Sites / Locations

  • Masaryk University CEITECRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Differences between LBDs patients and HC in regulation of language functions

Long-term effects of repeated sessions of home-based tDCS delivered via telepractice

Arm Description

In this study, 25 LBDs patients and 25 HC will undergo neuropsychological assessment, speech and writing recording, and MRI (structural T1 sequences, sentence comprehension fMRI task, neuromelanin-sensitive MRI sequence, and resting state measurement). The HC group will be matched to the LBDs patients with MCI for gender and age.

The investigators will use a parallel-group, double-blinded, randomized, sham-stimulation-controlled design. Forty LBDs patients will be randomized into two parallel groups, n = 20 subjects in each arm. For the active group, the investigators will use the stimulation protocol with the anode over the left IFG (cathode over the right supraorbital area, 2mA, 20 minutes). Participants will undergo a baseline assessment (A0, as described in arm 1); 10 stimulation sessions (in a two-week period); a follow-up assessment immediately after tDCS treatment (A1), and follow-up assessments 8 weeks (A2) after the baseline assessment. Each assessment will consist of a brief neuropsychological assessment, speech and writing recording and MRI scanning.

Outcomes

Primary Outcome Measures

sentence comprehension performance - accuracy
the investigators will study comprehension of syntactically complex sentences - accuracy in sentence comprehension task
sentence comprehension performance - reaction times
the investigators will study comprehension of syntactically complex sentences - reaction times in sentence comprehension task

Secondary Outcome Measures

relation of sentence comprehension performance to cognitive performance
the investigators will correlate sentence comprehension with cognitive functions: z-scores in following domains - memory, attention, executive function, visuospatial function and language function of Short Neuropsychological Battery (Bolcekova et al. 2020)
The neural underpinning of sentence comprehension deficits - sentence comprehension fMRI task data
The investigators will identify connectivity differences between HC and LBDs patients with MCI in language-related domain-specific and domain-general networks. In the task-based fMRI study, LBDs patients with MCI will show reduced activation and altered functional connectivity within and between these large-scale cortical networks compared to HC.
The neural underpinning of sentence comprehension deficits - resting state data
Abnormal intra- and inter-network dynamics will be apparent in resting-state fMRI of LBDs patients with MCI as compared to HC.
The neural underpinning of sentence comprehension deficits - structural MRI data
LBDs patients with MCI will show structural changes in language-related domain-specific and domain-general networks with neural degeneration as assessed by NMS-MRI as compared to HC.
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - accuracy
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on sentence comprehension of syntactically complex sentences - accuracy in sentence comprehension task (as was described in outcome 1)
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - reaction times
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on sentence comprehension of syntactically complex sentences - reaction times in sentence comprehension task (as was described in outcome 2)
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - The neural underpinning of sentence comprehension deficits - resting state data
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on resting state data (as was described in outcome 5)
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - The neural underpinning of sentence comprehension deficits - sentence comprehension fMRI task data
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on sentence comprehension fMRI task data (as was described in outcome 4)
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - The neural underpinning of sentence comprehension deficits - structural MRI data
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on structural MRI data (as was described in outcome 6)

Full Information

First Posted
April 13, 2023
Last Updated
May 25, 2023
Sponsor
Masaryk University
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1. Study Identification

Unique Protocol Identification Number
NCT05847985
Brief Title
Language and Lewy Body Diseases: Sentence Comprehension Problems and Modifying Noninvasive Brain Stimulation Treatment
Acronym
LANG-LBD
Official Title
Language and Lewy Body Diseases: Sentence Comprehension Problems and Modifying Noninvasive Brain Stimulation Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2023 (Actual)
Primary Completion Date
December 31, 2026 (Anticipated)
Study Completion Date
December 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Masaryk University

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
Lewy body diseases (LBDs) represents a group of neurodegenerative disorders characterized by the abnormal accumulation of aggregates of α-synuclein protein leading to the formation of Lewy bodies (LB) and Lewy neurites resulting in cell death. LBDs consists of two major clinical entities - Parkinson's disease (PD) and dementia with LB (DLB). Vast majority of patients with LBDs either already have mild cognitive impairment (MCI) at the time of the diagnosis or will develop it during the course of the disease. Language dysfunctions in LBDs patients with MCI are often unrecognized, which are difficult to treat, but even subtle changes might lead to impairment of social and occupational functioning with profound effect on their quality of lives. Current pharmacological or surgical strategies are effective for tackling the motor issues of LBDs with very limited effects on other symptoms such as language dysfunctions. Therefore, non-pharmacological approaches are gaining more attention. One of these non-pharmacological strategies is the use of noninvasive brain stimulation (NIBS) techniques that are able to modulate the brain functions with the effects on human nervous system plasticity. In this proposed project the investigators aim to first describe specific alterations in the language domain in LBDs patients with MCI as compared to healthy controls (HC) and identify the neural underpinnings of these changes using novel combination of advanced multimodal imaging techniques and various analytical methods. Secondly, the investigators aim to use NIBS as a supervised and individualized home-based therapeutical approach to tackle the language dysfunctions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lewy Body Disease, Healthy Aging

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Differences between LBDs patients and HC in regulation of language functions
Arm Type
No Intervention
Arm Description
In this study, 25 LBDs patients and 25 HC will undergo neuropsychological assessment, speech and writing recording, and MRI (structural T1 sequences, sentence comprehension fMRI task, neuromelanin-sensitive MRI sequence, and resting state measurement). The HC group will be matched to the LBDs patients with MCI for gender and age.
Arm Title
Long-term effects of repeated sessions of home-based tDCS delivered via telepractice
Arm Type
Experimental
Arm Description
The investigators will use a parallel-group, double-blinded, randomized, sham-stimulation-controlled design. Forty LBDs patients will be randomized into two parallel groups, n = 20 subjects in each arm. For the active group, the investigators will use the stimulation protocol with the anode over the left IFG (cathode over the right supraorbital area, 2mA, 20 minutes). Participants will undergo a baseline assessment (A0, as described in arm 1); 10 stimulation sessions (in a two-week period); a follow-up assessment immediately after tDCS treatment (A1), and follow-up assessments 8 weeks (A2) after the baseline assessment. Each assessment will consist of a brief neuropsychological assessment, speech and writing recording and MRI scanning.
Intervention Type
Device
Intervention Name(s)
transcranial direct current stimulation (tDCS)
Intervention Description
tDCS using electric currents to modulate underlying neurons
Primary Outcome Measure Information:
Title
sentence comprehension performance - accuracy
Description
the investigators will study comprehension of syntactically complex sentences - accuracy in sentence comprehension task
Time Frame
through study completion, an average of 1 year
Title
sentence comprehension performance - reaction times
Description
the investigators will study comprehension of syntactically complex sentences - reaction times in sentence comprehension task
Time Frame
through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
relation of sentence comprehension performance to cognitive performance
Description
the investigators will correlate sentence comprehension with cognitive functions: z-scores in following domains - memory, attention, executive function, visuospatial function and language function of Short Neuropsychological Battery (Bolcekova et al. 2020)
Time Frame
through study completion, an average of 1 year
Title
The neural underpinning of sentence comprehension deficits - sentence comprehension fMRI task data
Description
The investigators will identify connectivity differences between HC and LBDs patients with MCI in language-related domain-specific and domain-general networks. In the task-based fMRI study, LBDs patients with MCI will show reduced activation and altered functional connectivity within and between these large-scale cortical networks compared to HC.
Time Frame
through study completion, an average of 1 year
Title
The neural underpinning of sentence comprehension deficits - resting state data
Description
Abnormal intra- and inter-network dynamics will be apparent in resting-state fMRI of LBDs patients with MCI as compared to HC.
Time Frame
through study completion, an average of 1 year
Title
The neural underpinning of sentence comprehension deficits - structural MRI data
Description
LBDs patients with MCI will show structural changes in language-related domain-specific and domain-general networks with neural degeneration as assessed by NMS-MRI as compared to HC.
Time Frame
through study completion, an average of 1 year
Title
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - accuracy
Description
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on sentence comprehension of syntactically complex sentences - accuracy in sentence comprehension task (as was described in outcome 1)
Time Frame
On the beginning of the study, after completion of two-week stimulation a eight weeks after the baseline assessment
Title
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - reaction times
Description
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on sentence comprehension of syntactically complex sentences - reaction times in sentence comprehension task (as was described in outcome 2)
Time Frame
On the beginning of the study, after completion of two-week stimulation a eight weeks after the baseline assessment
Title
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - The neural underpinning of sentence comprehension deficits - resting state data
Description
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on resting state data (as was described in outcome 5)
Time Frame
On the beginning of the study, after completion of two-week stimulation a eight weeks after the baseline assessment
Title
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - The neural underpinning of sentence comprehension deficits - sentence comprehension fMRI task data
Description
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on sentence comprehension fMRI task data (as was described in outcome 4)
Time Frame
On the beginning of the study, after completion of two-week stimulation a eight weeks after the baseline assessment
Title
the long-term effects of repeated sessions of home-based tDCS on sentence comprehension - The neural underpinning of sentence comprehension deficits - structural MRI data
Description
the investigators will investigate the long-term effects of repeated sessions of home-based tDCS on structural MRI data (as was described in outcome 6)
Time Frame
On the beginning of the study, after completion of two-week stimulation a eight weeks after the baseline assessment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: right-handedness Czech as their first language age (60-80 years) presence of PD-MCI (Litvan et al. 2012) or MCI-LB (McKeith et al. 2020) for LBD subjects Exclusion Criteria: cardio pacemaker any MRI-incompatible metal in the body epilepsy any diagnosed psychiatric disorders alcohol/drug abuse for HC group the presence of LBDs or other neurodegenerative disorder or MCI/dementia
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lubomira Novakova
Phone
+420 549 497 766
Email
lubomira.novakova@ceitec.muni.cz
Facility Information:
Facility Name
Masaryk University CEITEC
City
Brno
ZIP/Postal Code
62500
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lubomira Novakova
Phone
+420549497766

12. IPD Sharing Statement

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Language and Lewy Body Diseases: Sentence Comprehension Problems and Modifying Noninvasive Brain Stimulation Treatment

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