Skip to content

Modulating Cortical Dynamics of Dual-task Standing in MCI

Understanding and Modulating Cortical Dynamics of Dual-task Standing in Older Adults With Mild Cognitive Impairment

Status
UNKNOWN
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05680701
Enrollment
60
Registered
2023-01-11
Start date
2023-03-13
Completion date
2025-01-31
Last updated
2023-03-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Aging, Mild Cognitive Impairment

Keywords

aging, mild cognitive impairment, non-invasive brain stimulation

Brief summary

The investigators have designed a brain stimulation study to understand its effect on an individual's standing, walking, and thinking abilities in older adults with and without mild cognitive impairments (MCI). The transcranial alternating current stimulation (tACS) technology has been safely and effectively used in hundreds of individuals. The purpose of this study is to test whether a single session of tACS as compared to sham intervention, improves standing, walking, and thinking in older adults with and without mild cognitive impairments (MCI). Approximately 60 people will take part in this study.

Detailed description

Mild Cognitive Impairment (MCI) represents a common prodromal phase of dementia1. As compared to older adults who are cognitively-intact, those with MCI tend to exhibit poor dual-task standing balance performance; that is, the ability to maintain balance when standing and simultaneously performing an unrelated cognitive task. Moreover, those older adults who have worse dual-task standing balance are more likely to suffer falls and develop dementia. As such, strategies designed to understand and enhance the brain functionality involved in dual-task standing balance hold great promise to improve daily life function, and potentially, reduce the risk of dementia in this population. Surface electroencephalography (EEG) allows non-invasive assessment of brain activity dynamics over short periods of time, even when standing. It has been demonstrated in younger and older adults that dual-task standing is associated with brain activity fluctuations at specific frequencies. A recent study from our laboratory demonstrated that in older adults, 1) performance of a serial subtraction cognitive task when standing reduces fronto-central alpha power (i.e., fluctuations in the 8-13 Hz band), and 2) those with lower fronto-central alpha power when dual tasking exhibit worse dual task standing balance. Intriguingly, numerous studies have separately linked diminished alpha activity with worse performance on executive function and visuomotor tasks, as well as global cognitive decline in older adults. We therefore contend that therapeutic strategies designed to increase alpha activity hold promise to improve dual-task standing performance, and many other cognitive-motor functions in older adults with and without MCI. To date, however, the effects of enhancing fronto-central alpha activity to improve dual-task balance in older adults with and without MCI have not been studied. Transcranial alternating stimulation (tACS) is a safe, non-invasive brain stimulation technique that utilizes low-amplitude alternating currents to modulate brain activity and entrain specific cortical rhythms depending on the applied stimulation frequency. Targeting alpha band (10 Hz) in the frontal region has been shown to improve cognitive functioning in healthy older adults. However, no studies have investigated the effect of 10 Hz fronto-central stimulation on EEG alpha activity and postural sway outcomes during dual-task standing in older adults with and without MCI. We thus propose to conduct a within-subject cross-over, sham-controlled study in 30 older adults without an overt disease and 30 older adults with MCI. Participants will undergo dual-task standing and cognitive assessments immediately before and after single sessions of 10 Hz tACS (fronto-central alpha stimulation), and active-sham to understand the effect of different stimulation parameters on dual-task standing performance in older adults. We hypothesize that (1) older adults with MCI will demonstrate decreased EEG alpha power during dual-task standing compared to healthy controls, and decreased alpha power will be associated with worse balance outcomes during dual-task standing, and (2) compared to the pre-stimulation condition, participants will exhibit a greater increase in alpha power during the dual-task standing condition following tACS as compared to sham stimulation, and the increase in alpha power from pre-to-post tACS will correlate with a decrease in dual-task postural sway speed from pre-to-post tACS in older adults with and without MCI.

Interventions

The participant will receive one session of 10 Hz tACS for 20-minutes

The participant will receive one session of active-sham tACS for 20-minutes

Sponsors

Hebrew SeniorLife
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
65 Years to 95 Years
Healthy volunteers
Yes

Inclusion criteria

Healthy older adults: Our target population will be healthy older men and women who are cognitively intact. We will also ensure that participants are not so impaired that they cannot safely participate nor potentially benefit from the intervention. * Age 65+ without any cognitive impairment (based in MoCA or TICS) * Willing and capable to give informed consent for the participation in the study after it has been thoroughly explained able and willing to comply with all study requirements informed consent form was signed * Ability to stand and walk independently * Understanding of the informed consent form (ICF) will be assessed by asking the participant to answer the following three questions: 1) What is the purpose of this study? 2) What are the risks of study involvement? 3) If you decide to participate, are you allowed to withdraw from the study at any time? Answers will be recorded by study personnel on the Assessment of Protocol Understanding form. Insufficient understanding will be defined by one or more incorrect answers, as determined at the discretion of the investigator. Older MCI participants: * Age 65+ * Who have been diagnosed with cognitive impairment (based in MoCA or TICS and Clinical Dementia Rating: CDR 0.5) * Ability to stand and walk independently * Willing and capable to give informed consent for the participation in the study after it has been thoroughly explained * Cut off of MOCA score \>18 will be applied * Able and willing to comply with all study requirements informed consent form was signed * Understanding of the ICF will be assessed by asking the participant to answer the following three questions: 1) What is the purpose of this study? 2) What are the risks of study involvement? 3) If you decide to participate, are you allowed to withdraw from the study at any time? Answers will be recorded by study personnel on the Assessment of Protocol Understanding form (see attached). Insufficient understanding will be defined by one or more incorrect answers, as determined at the discretion of the investigator.

Exclusion criteria

Healthy older adults:

Design outcomes

Primary

MeasureTime frameDescription
EEG alpha-band powerChange from immediately before and after each 20-minute session of tACSEEG oscillations and frequency coupling at 8-13 Hz
Postural sway speedChange from immediately before and after each 20-minute session of tACSThis metric assesses the ability to control standing posture

Secondary

MeasureTime frameDescription
Postural sway pathThis outcome will be assessed immediately before and after each 20-minute session of tACSThis metric assesses the ability to control standing posture
Timed Up and Go Test (TUG)This outcome will be assessed immediately before and after each 20-minute session of tACSA common field test of mobility
EEG beta-band powerThis outcome will be assessed immediately before and after each 20-minute session of tACSEEG oscillations and frequency coupling at 13-30 Hz
EEG theta-band powerThis outcome will be assessed immediately before and after each 20-minute session of tACSEEG oscillations and frequency coupling at 4-7 Hz
Postural sway areaThis outcome will be assessed immediately before and after each 20-minute session of tACSThis metric assesses the ability to control standing posture

Countries

United States

Contacts

Primary ContactNicole LaGanke
nicolelaganke@hsl.harvard.edu617-971-5358
Backup ContactKathy Tasker
kathytasker@hsl.harvard.edu6179715351

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026