Clinical trial NCT03994120: Modulating the Hippocampal and Striatal Memory Networks With rTMS
Official title: Modulating the Hippocampal and Striatal Memory Networks With rTMS
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Normal Behavioral Patterns
Keywords: Memory Systems
Repetitive Transcranial Magnetic Stimulation
Behavioral Efficiency
Hippocampal and Striatal Memory Networks
Lead sponsor: National Institutes of Health Clinical Center (CC)
Sponsor class: NIH
First posted: 2019-06-21
Enrollment: 13
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: BASIC_SCIENCE

Brief summary: Background:

People have 2 memory systems. One helps them learn skills and the other helps them learn facts. Repetitive transcranial magnetic stimulation (rTMS) uses electric currents to activate brain cells. This can make small changes in how brain systems operate. Researchers will use rTMS to change how memory systems work and to see if changing one system causes the other to change too. This could help find ways to improve learning and memory in people with memory disorders.

Objective:

To learn how different memory systems work with each other.

Eligibility:

Healthy adults ages 18-40 who are not pregnant

Design:

Potential participants will be screened with a neurological exam if they have not had one from NINDS in the past 2 years. They may have urine tests.

Eligible participants will have 5-10 visits at NIH. Each visit will last 1-6 hours. Visits 1-4 will each take place 1 day apart.

At visit 1, participants will have an MRI and take memory tests. For MRI, they will lie on a table that slides in and out of a cylinder that takes pictures of their brain. They will also have rTMS. For rTMS, a metal coil is held on their scalp. Brief electrical currents pass through the coil.

At visits 2 and 3, participants will have rTMS.

At visit 4, participants will have an MRI and do memory tests.

About a week later, participants will have visit 5. They will have an MRI and do memory tests. Participants may be asked to have more visits if any technical problems occur. Participant involvement will last 2 weeks.

...

Detailed description: Objective

The Behavioral Neurology Unit studies the human brain systems underlying learning and adaptation with the ultimate goal of finding interventions to make these processes more efficient. We are interested in whether repetitive transcranial magnetic stimulation (rTMS) can alter functional connectivity (FC) and behavioral efficiency in two memory networks in the brain: the hippocampal network, which supports the storage and retrieval of recallable facts, concepts, and events, and the striatal network, which supports the storage and retrieval of skills and habits. Additionally, because these networks interact behaviorally and can interfere with each other, an important question is whether neuromodulation of one network changes connectivity and efficiency in the other network. Pilot data from our group suggest that exogenous stimulation of one network causes it to expand its range of FC and co-opt resources from the other, which is a potential mechanism for the observed behavioral interaction. This study is designed to test a) whether rTMS- modulates within-network FC and memory supported by that network, and b) whether this also causes FC and behavioral changes in the other network.

Study population: Healthy Volunteers

Design

This study contains four between-subjects experiments and is a mixed inter/intra subject design. Experiment 1 will use nominally excitatory stimulation targeting the hippocampal network to increase FC within the hippocampal network. We also expect to increase FC between the hippocampal and striatal networks, increased declarative memory, and a possible decrease in procedural, learning. Experiment 2 will use excitatory stimulation targeted to the striatal network. We expect this to cause stronger within- network FC in the striatal network, increased FC between the hippocampus and the striatal network and concomitant behavioral effects. Experiments 3 and 4 will be similar except that we will target nominally inhibitory stimulation to these networks and look for the inverse results. FC will be measured under resting and task-activated conditions and active rTMS will be compared to vertex sham.

Outcome measures

The primary outcome measure is the change in FC produced by rTMS within the targeted network. Between-network FC changes and corresponding memory changes will be secondary outcomes. Exploratory measures will include correlations between individual cognitive differences (questionnaires and NIH Toolbox scores), and our primary and secondary outcome measures.

Eligibility criteria: INCLUSION CRITERIA:

-Age 18-40 (inclusive)

EXCLUSION CRITERIA:

* Any current major neurological or psychiatric disorder such as (but not limited to) stroke, Parkinson disease, Alzheimer disease, schizophrenia or major depression
* History of seizure
* Medications acting on the central nervous system, such as those that lowers the seizure threshold such as neuroleptics, beta lactams, isoniazid, metronidazole; benzodiazepines, tricyclic or other antidepressants; or prescription stimulants.
* Ferromagnetic metal in the cranial cavity or eye, implanted neural stimulator, cochlear implant, or ocular foreign body
* Implanted cardiac pacemaker or auto-defibrillator or pump
* Non-removable body piercing
* Claustrophobia
* Inability to lie supine for 2 hours
* Pregnancy, or plans to become pregnant during the study.
* Members of the NINDS BNU
* Subjects that received rTMS under protocol 17-N-0055 are excluded in order avoid learning effects from previously being exposed to the same behavioral tasks
* Subjects who have contraindications to MRI (we will follow the NMR Center guidelines for MR safety). Some of the exclusions are:
* Have non-MRI compatible metal in the body, such as a cardiac pacemaker, brain stimulator, shrapnel, surgical metal, clips in the brain or on blood vessels, cochlear implants, artificial heart valves or ferromagnetic fragments in the eye or oral cavity as these make having an MRI unsafe.

  * Unable to lie flat on the back for the expected length of the experiment (2 hours).
  * Have an abnormality on the brain imaging or neurologic examination not related to the diagnosis.
  * Non-removable body piercing or
  * Pregnancy (urine pregnancy test)

Primary outcomes:
measure: Change From Baseline in Resting-state Functional Connectivity Between the Caudate and the Caudate Network
timeFrame: Baseline, 1 day and 14-21 days after rTMS
measure: Change From Baseline in Task-based Functional Connectivity Between the Caudate and the Caudate Network
timeFrame: Baseline, one day and 14-21 days after rTMS
Secondary outcomes:
measure: Feedback Weather Prediction Task (WPT-F)
timeFrame: Changes are calculated before and one day after rTMS and before and 14-21 days after rTMS
measure: Observational Weather Prediction Task (WPT-O)
timeFrame: Changes are calculated before and one day after rTMS and before and 14-21 days after rTMS
measure: Change From Baseline in Resting-state Functional Connectivity Between the Caudate and the Hippocampal Network
timeFrame: Baseline, one day and 14-21 days after rTMS
measure: Change From Baseline in Task-based Functional Connectivity Between the Caudate and the Hippocampal Network
timeFrame: Baseline, one day and 14-21 days after rTMS
Other outcomes:
Locations:
city: Bethesda
country: United States
facility: National Institutes of Health Clinical Center
state: Maryland
Study officials:
affiliation: National Institute of Neurological Disorders and Stroke (NINDS)
name: Eric M Wassermann, M.D.
role: PRINCIPAL_INVESTIGATOR
References: