Transcranial Direct Current Stimulation and Cognitive Remediation Therapy for Psychosis

NCT02085421 | Completed Results FDA Device

• 1 other identifier: PSYCH-2016-23547
• Study Type: interventional
• Target: 33
• Locations: 1 country
• Sites: 1

Brief Summary

The proposed pilot study is a randomized controlled study to assess effectiveness of transcranial direct current stimulation (tDCS) to enhance cognitive remediation therapy in patients with psychotic disorders. tDCS. Patients will be randomized into two arms: active tDCS vs. sham tDCS. The active tDCS will be applied at a current of 1-2 mA (milliamperes) via two saline soaked electrode sponges (3 cm x 4.5 cm) applied to the side of the head. The investigators hypothesis is that the use of tDCS will enhance the improvement seen with cognitive remediation therapy.

Conditions

Psychosis

Keywords

tdcs, neuromodulation, CRT, psychosis, schizophrenia

Outcome Measures

Primary Outcomes (3)

• Change in Brief Assessment of Cognition in Schizophrenia (BACS) From Baseline to Post-Training

  Clinician-administered neurocognitive battery that assesses the aspects of cognition found to be most impaired and most strongly correlated with outcome in patients with schizophrenia. Brief Assessment of Cognition in Schizophrenia (BACS) - post training composite z-score range Arm 1 = -2.46 - 2.24 range Arm 2 = -7.67 - 0.83 Higher scores represent better cognitive performance. The BAC APP composite z-score is calculated as the sum of the subscale z-scores (i.e., verbal memory, digit sequencing, verbal fluency, symbol coding, and tower of london), adjusted by participant age and sex. The primary outcome measure from the BACS is a composite z score, with 0 representing the population mean, normed by age and gender.

  Baseline, 3-5 weeks

• Change in the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) From Baseline to Post-Training

  The VRFCAT is a performance-based functional capacity measure and the 'total recipes accessed' variable represents one component of the full measure. Using a realistic virtual reality environment, the VRFCAT assesses a subject's ability to complete instrumental activities associated with a shopping trip. This provides an estimate of performance on everyday functional tasks. The summary measures include: total time (seconds), total errors, total progressions, total bus schedule checks, total recipe checks. There is no combined total score for this Tool. The minimum number of recipe checks is 0 and there is no maximum number of recipe checks for this task. A higher score on the summary measure 'total recipe checks' indicates worse performance. This means that the higher the number of times a subject consults the reference materials (i.e., recipe), the worse the performance. Based o

  Baseline, 3-5 weeks

• Change in the D-prime Score of the N-Back Working Memory Test From Baseline to Post-Training

  N-back testing is a performance task used to assess working memory. In this task, pairs of numbers are presented on a computer screen, and participant are instructed to press a button whenever the pair of numbers corresponds to the pair of numbers presented two trials before (2-back). Number of hits and number of false alarms are used to calculate d-prime, the primary outcome. Depending on the number of trials completed, the range of d-prime is expected to be from -4.46 (0 hits, 80 FA) to +4.46 (20 hits, 0 FA), based on the literature. In our study, hits ranged from 3-56 and false alarms ranged from 1-146, therefore d-prime ranged from -0.42-4.02 in the full sample for the 2-back condition. A lower score on d-prime indicates worse performance.

  Baseline, 3-5 weeks

Secondary Outcomes (2)

• N-Back - Post Training 2-back Number of Hits Provided Here

  3-5 weeks

• N-Back - Post Training 2-back Number of False Alarms Provided Here

  3-5weeks

Study Arms (2)

Active tDCS

ACTIVE COMPARATOR

The active tDCS will be applied at a current of 1-2mA via two saline soaked electrode sponges (3 cm x 4.5 cm) for the first 20 minutes of each CRT session in the active condition.

Device: tDCS

Sham tDCS

SHAM COMPARATOR

In the sham condition, tDCS will be ramped up to 1-2 mA via two saline soaked electrode sponges (3 cm x 4.5 cm) over the first 30 seconds of each CRT session and then turned off.

Device: tDCS

Interventions

tDCS DEVICE

Transcranial direct current stimulation (tDCS) is a form of non-invasive neuromodulation that has been shown to enhance learning. tDCS is applied with current intensity of 1-2 mA of direct current and can be applied both before and during each cognitive remediation treatment session. Two saline soaked electrode sponges will be applied to the scalp.

Also known as: transcranial direct current stimulation

Active tDCS; Sham tDCS

Eligibility Criteria

• Age: 18 Years - 64 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Meet diagnostic criteria for schizophrenia or schizoaffective disorder
• Are age 18-64
• Fluent in written and spoken English
• Have an outpatient status of at least 1 month prior to participation
• Has been on a stable dose of psychiatric medication for at least one month prior to participation

You may not qualify if:

• History of seizures or epilepsy
• Metallic cranial plates, screws, or implanted devices
• History of craniotomy
• History of stroke
• History of eczema on scalp
• Pre-existing sores or lesions at sites of tDCS electrode placement
• Non removable facial piercings
• Current or possibility of current pregnancy
• Has received a clinically meaningful dose of a targeted cognitive training intervention in the last 12 months

Sponsors & Collaborators

• University of Minnesota: lead

Study Sites (1)

University of Minnesota

Minneapolis, Minnesota, 55454, United States

Location

MeSH Terms

Conditions

Psychotic Disorders; Creatine deficiency, X-linked; Schizophrenia

Interventions

Transcranial Direct Current Stimulation

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Convulsive Therapy; Psychiatric Somatic Therapies; Behavioral Disciplines and Activities; Electroshock; Psychological Techniques

Results Point of Contact

• Title: Caroline Demro
• Organization: University of Minnesota

schi0599@umn.edu

(612) 625-3330

Study Officials

• Ian S Ramsay, PhD

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 6, 2014
• First Posted: March 12, 2014
• Study Start: March 14, 2019
• Primary Completion: February 9, 2023
• Study Completion: February 9, 2023
• Last Updated: March 12, 2025
• Results First Posted: March 12, 2025

Record last verified: 2025-02

Locations

US (1)