Clinical trial NCT04040803: tACS and tRNS Studies on Brain Control of Swallowing
Official title: Characterizing the Application of Transcranial Alternating Current Stimulation and Transcranial Random Noise Stimulation Over Human Pharyngeal Motor Cortex
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Dysphagia
Swallowing Disorder
Keywords: transcranial alternating current stimulation
transcranial random noise stimulation
frequency
full spectrum
Lead sponsor: University of Manchester
Sponsor class: OTHER
First posted: 2019-08-01
Enrollment: 17
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: All people studied will have each of the five treatments separately over different days in random order.
Primary purpose: TREATMENT

Brief summary: Transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) are two (CE marked medical devices) new, non-invasive (over the scalp) brain stimulation (NIBS) techniques. Both tACS and tRNS deliver a weak current continuously across the brain using pads placed over the scalp, which has been shown safe and well-tolerated by healthy adults and patients. These two techniques are able to softly alter physiological function within the brain. tACS can influence the brainwaves which have been demonstrated to play important roles in movement, sensation, and thinking functions. tACS and tRNS have been investigated for several years and have been shown to be safe, well tolerated and produce beneficial results in hand movement, hearing, and working memory.

Swallowing problems are life-threatening symptom among patients with brain impairments and elderly people. Until now, there are no studies investigating whether tACS and tRNS can have a beneficial effect on swallowing function in human. Our aim is to examine the effects of different strengths of tACS and tRNS to determine the best approach for brain stimulation that controls swallowing action, before using these techniques in patients with (neurological) swallowing disorders.

Participants: Healthy adults who are aged 18 years old or above with no medical complications or significant past medical history will be recruited in the study.


Eligibility criteria: Inclusion Criteria:

* Healthy adults who are aged 18 years old or above with no medical complications or significant past medical history

Exclusion Criteria:

* a history of epilepsy
* cardiac pacemaker
* previous brain surgery
* previous swallowing problems
* risk of potential pregnancy
* metal in the head or eyes
* use of medication that acts on the central nervous system.

Primary outcomes:
measure: Changes of pharyngeal motor evoked potential amplitudes (PMEPs)
timeFrame: These cortical excitability measurements will be recorded at baseline, followed by immediately after intervention, then every 15 minutes up to 120 minutes afterwards.
Secondary outcomes:
Other outcomes:
Locations:
city: Manchester
country: United Kingdom
facility: Upper G.I laboratory, Salford Royal Hospital
state: Greater Manchester
Study officials:
affiliation: GI-sciences, Salford Royal NHS Foundation Trust, University of Manchester
name: Shaheen Hamdy, MD,PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Antal A, Herrmann CS. Transcranial Alternating Current and Random Noise Stimulation: Possible Mechanisms. Neural Plast. 2016;2016:3616807. doi: 10.1155/2016/3616807. Epub 2016 May 3.
citation: Antal A, Alekseichuk I, Bikson M, Brockmoller J, Brunoni AR, Chen R, Cohen LG, Dowthwaite G, Ellrich J, Floel A, Fregni F, George MS, Hamilton R, Haueisen J, Herrmann CS, Hummel FC, Lefaucheur JP, Liebetanz D, Loo CK, McCaig CD, Miniussi C, Miranda PC, Moliadze V, Nitsche MA, Nowak R, Padberg F, Pascual-Leone A, Poppendieck W, Priori A, Rossi S, Rossini PM, Rothwell J, Rueger MA, Ruffini G, Schellhorn K, Siebner HR, Ugawa Y, Wexler A, Ziemann U, Hallett M, Paulus W. Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines. Clin Neurophysiol. 2017 Sep;128(9):1774-1809. doi: 10.1016/j.clinph.2017.06.001. Epub 2017 Jun 19.
citation: Herrmann CS, Munk MH, Engel AK. Cognitive functions of gamma-band activity: memory match and utilization. Trends Cogn Sci. 2004 Aug;8(8):347-55. doi: 10.1016/j.tics.2004.06.006.
citation: Engel AK, Fries P, Singer W. Dynamic predictions: oscillations and synchrony in top-down processing. Nat Rev Neurosci. 2001 Oct;2(10):704-16. doi: 10.1038/35094565.
citation: Pollok B, Boysen AC, Krause V. The effect of transcranial alternating current stimulation (tACS) at alpha and beta frequency on motor learning. Behav Brain Res. 2015 Oct 15;293:234-40. doi: 10.1016/j.bbr.2015.07.049. Epub 2015 Jul 28.
citation: Wach C, Krause V, Moliadze V, Paulus W, Schnitzler A, Pollok B. Effects of 10 Hz and 20 Hz transcranial alternating current stimulation (tACS) on motor functions and motor cortical excitability. Behav Brain Res. 2013 Mar 15;241:1-6. doi: 10.1016/j.bbr.2012.11.038. Epub 2012 Dec 3.
citation: Jausovec N, Jausovec K. Increasing working memory capacity with theta transcranial alternating current stimulation (tACS). Biol Psychol. 2014 Feb;96:42-7. doi: 10.1016/j.biopsycho.2013.11.006. Epub 2013 Nov 27.
citation: Riecke L, Formisano E, Herrmann CS, Sack AT. 4-Hz Transcranial Alternating Current Stimulation Phase Modulates Hearing. Brain Stimul. 2015 Jul-Aug;8(4):777-83. doi: 10.1016/j.brs.2015.04.004. Epub 2015 Apr 24.
citation: Clave P, Shaker R. Dysphagia: current reality and scope of the problem. Nat Rev Gastroenterol Hepatol. 2015 May;12(5):259-70. doi: 10.1038/nrgastro.2015.49. Epub 2015 Apr 7.
citation: Jefferson S, Mistry S, Singh S, Rothwell J, Hamdy S. Characterizing the application of transcranial direct current stimulation in human pharyngeal motor cortex. Am J Physiol Gastrointest Liver Physiol. 2009 Dec;297(6):G1035-40. doi: 10.1152/ajpgi.00294.2009. Epub 2009 Oct 8.
citation: Moliadze V, Atalay D, Antal A, Paulus W. Close to threshold transcranial electrical stimulation preferentially activates inhibitory networks before switching to excitation with higher intensities. Brain Stimul. 2012 Oct;5(4):505-11. doi: 10.1016/j.brs.2011.11.004. Epub 2012 Feb 22.
citation: Uhlhaas PJ, Singer W. Abnormal neural oscillations and synchrony in schizophrenia. Nat Rev Neurosci. 2010 Feb;11(2):100-13. doi: 10.1038/nrn2774.
citation: Moisa M, Polania R, Grueschow M, Ruff CC. Brain Network Mechanisms Underlying Motor Enhancement by Transcranial Entrainment of Gamma Oscillations. J Neurosci. 2016 Nov 23;36(47):12053-12065. doi: 10.1523/JNEUROSCI.2044-16.2016.
citation: Fertonani A, Pirulli C, Miniussi C. Random noise stimulation improves neuroplasticity in perceptual learning. J Neurosci. 2011 Oct 26;31(43):15416-23. doi: 10.1523/JNEUROSCI.2002-11.2011.
citation: Rjosk V, Kaminski E, Hoff M, Gundlach C, Villringer A, Sehm B, Ragert P. Transcranial Alternating Current Stimulation at Beta Frequency: Lack of Immediate Effects on Excitation and Interhemispheric Inhibition of the Human Motor Cortex. Front Hum Neurosci. 2016 Nov 3;10:560. doi: 10.3389/fnhum.2016.00560. eCollection 2016.
citation: Terney D, Chaieb L, Moliadze V, Antal A, Paulus W. Increasing human brain excitability by transcranial high-frequency random noise stimulation. J Neurosci. 2008 Dec 24;28(52):14147-55. doi: 10.1523/JNEUROSCI.4248-08.2008.