Brain Stimulation for Dementia and Memory Loss

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: McMaster University

Trial Summary

What is the purpose of this trial?The process of aging is accompanied by normal deterioration of body systems, leading to a decline in various functional domains including cognitive, visual, vestibular, somatosensory, and motor function. With this functional decline, there is an increasing burden of care due to the rise of injury, direct and indirect healthcare costs, and the loss of independence in performing daily activities. Notably, falls in the older population represents one of the greatest costs incurred by Canadians annually. The study investigates whether rTMS delivered to M1 will lead to greater improvement in balance compared to rTMS delivered to DLPFC. Determining this answer will allow greater success in TMS target refinement. Given the profound burden that geriatric medicine has on the Canadian healthcare system, understanding the link between balance and cognition can significantly impact the approach to management of this population.

Eligibility Criteria

This trial is for older adults experiencing cognitive decline, such as dementia or Alzheimer's Disease, who are interested in a non-drug treatment aimed at improving balance and cognitive function. Participants should be able to perform daily activities with some degree of independence.

Inclusion Criteria

I am 50 years old or older.

Participants must demonstrate an understanding of instruction provided in English or have a caregiver present who can translate and be presented during all study sessions

I can walk or stand by myself or with help.

+2 more

Exclusion Criteria

I don't have a pacemaker, metal implants (except titanium), untreated mental disorders, am not pregnant, have no history of seizures, and am not on medication that raises seizure risk.

Participant Groups

The study tests whether rTMS, a non-invasive brain stimulation technique, can improve balance by targeting either the motor cortex (M1) or the part of the brain involved in complex thinking tasks (DLPFC). The effectiveness is compared between active rTMS and placebo-like sham rTMS.

3Treatment groups

Active Control

Placebo Group

Group I: Active rTMS to M1Active Control1 Intervention

iTBS will be delivered using a Magstim Rapid 2 stimulator (Magstim, Whitland, UK) guided with neuronavigation (Brainsight, Rogue Research, Montreal, QC, Canada) to target M1. Participants will receive 14 days of stimulation. During each treatment day, three iTBS sessions separated by 15-minute intervals will be delivered. Each iTBS session consists of 600 stimuli delivered in 50 Hz bursts of 3 pulses at 70% of the resting motor threshold. In total, individuals will receive 1800 stimuli delivered each day as performed elsewhere . Following iTBS individuals will participate in 10 minutes of balance training performed on balance board (BTracks https://balancetrackingsystems.com).

Group II: Active rTMS to DLPFCActive Control1 Intervention

iTBS will be delivered using a Magstim Rapid 2 stimulator (Magstim, Whitland, UK) guided with neuronavigation (Brainsight, Rogue Research, Montreal, QC, Canada) to target DLPFC. Participants will receive 14 days of stimulation. During each treatment day, three iTBS sessions separated by 15-minute intervals will be delivered \[13,22\]. Each iTBS session consists of 600 stimuli delivered in 50 Hz bursts of 3 pulses at 70% of the resting motor threshold. In total, individuals will receive 1800 stimuli delivered each day as performed elsewhere \[13,23,27\]. Following iTBS individuals will participate in 10 minutes of balance training performed on balance board (BTracks https://balancetrackingsystems.com).

Group III: Placebo rTMS to M1Placebo Group1 Intervention

sham iTBS will be delivered using a Magstim Rapid 2 stimulator (Magstim, Whitland, UK) guided with neuronavigation (Brainsight, Rogue Research, Montreal, QC, Canada) to target M1. Participants will receive 14 days of placebo stimulation. Following sham iTBS individuals will participate in 10 minutes of balance training performed on balance board (BTracks https://balancetrackingsystems.com).