Interactions Between Attentional Networks and Their Influence on Perception

NCT02467114 | Completed

• 1 other identifier: 036/15
• Study Type: interventional
• Target: 214
• Locations: 1 country
• Sites: 1

Brief Summary

Attention can be defined as the preparedness to rapidly and accurately respond to stimuli coming from the investigators environment and to effectively select between relevant and irrelevant information. According to a current model, visual attentional control is based on two separate groups of brain regions, so called brain networks. These networks control different attentional aspects (e.g., spatial/non-spatial attention) and they interact with each other. A disruption of these interactions can lead to attentional disorders such as hemispatial neglect. Patients with hemispatial neglect have difficulties directing their attention to the left visual field and they act as though the latter does not exist. To date, the interactions between the two attentional networks are poorly understood. The aim of this study consists in further clarifying different aspects of these interactions and their influence on visual perception in healthy participants and in patients with hemispatial neglect. Transcranial magnetic stimulation (TMS) will be the principal method applied in this study. TMS is a painless and non-invasive method, with which the activity of brain areas can be influenced temporarily. This allows us to draw conclusions regarding the functions and interactions of these brain areas. This study is designed to have a significant impact on the basic understanding of attentional control in the human brain and it can benefit the comprehension and treatment of attentional disorders, such as hemispatial neglect.

Conditions

Hemispatial Neglect

Outcome Measures

Primary Outcomes (4)

• Cortical excitability, as measured by motor evoked potentials (MEPs)

  During or within 1 hour after application

• Spatial attentional performance, as measured by cognitive testing

  During or within 1 hour after application

• Number of perceptual switches

  During or within 1 hour after application

• Duration of dominance phases of perceptual switches

  Measured in seconds

  During or within 1 hour after application

Secondary Outcomes (4)

• Alertness level, as measured subjectively by a visual analogue scale (VAS)

  During or 1 hour after application

• Alertness level, as measured objectively by cognitive testing

  During or 1 hour after application

• Spatial bias of attentional allocation, as measured by standardised paper-pencil neuropsychological tests

  During or 1 hour after application

• Spatial bias of attentional allocation, as measured by free visual exploration with eye movement measurement

  During or 1 hour after application

Study Arms (1)

All study participants

EXPERIMENTAL

Stimulation with TMS, a sham coil \& no intervention

Device: Transcranial magnetic stimulation (TMS); Device: Sham coil stimulation; Other: Control without stimulation

Interventions

Transcranial magnetic stimulation (TMS) DEVICE

This method will be applied to measure cortical excitability and as an interference approach; real TMS stimulation will be compared with sham stimulation and no stimulation

All study participants

Sham coil stimulation DEVICE

Stimulation with a sham coil as a comparison

All study participants

Control without stimulation OTHER

All study participants

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Written informed consent
• Healthy participants:
• Age 18-80 years
• Neurologically healthy, i.e., with no documented or present neurological disease or brain injury
• normal or corrected-to-normal visual acuity
• Patients:
• Age 18-80 years
• Showing signs of left hemispatial neglect after a right-hemispheric brain lesion, as assessed by previous neuropsychological testing and clinical judgment
• Normal or corrected-to-normal visual acuity

You may not qualify if:

• Healthy participants:
• Any instable medical condition, in particular epilepsy (past or present, including seizures or febrile convulsions)
• Any surgical intervention to the brain
• Implanted medical devices (e.g., cochlear implants, infusion pumps, neurostimulators, pacemakers)
• Presence of metal in the region of the head (excluding fixed dental implants such as tooth fillings or fixed dental braces)
• Drug or alcohol abuse
• Intake of any medication that is likely to lower seizure threshold
• For female participants: pregnancy or breast feeding or intention to become pregnant during the course of the experiment. All participants of childbearing potential will be asked to take a pregnancy test.
• Patients:
• Any instable medical condition, in particular epilepsy (past or present, including seizures or febrile convulsions)
• Implanted medical devices (e.g., cochlear implants, infusion pumps, neurostimulators, pacemakers)
• Presence of metal in the region of the head (excluding fixed dental implants such as tooth fillings or fixed dental braces)
• Drug or alcohol abuse
• Intake of any medication that is likely to lower seizure threshold
• For female participants: pregnancy or breast feeding or intention to become pregnant during the course of the experiment. All participants of childbearing potential will be asked to take a pregnancy test

Sponsors & Collaborators

• Insel Gruppe AG, University Hospital Bern: lead
• University of Bern: collaborator
• Luzerner Kantonsspital: collaborator

Study Sites (1)

Division of Cognitive and Restorative Neurology, Department of Neurology, Inselspital, Bern University Hospital; Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern

Bern, 3010, Switzerland

Location

Related Publications (5)

• Corbetta M, Patel G, Shulman GL. The reorienting system of the human brain: from environment to theory of mind. Neuron. 2008 May 8;58(3):306-24. doi: 10.1016/j.neuron.2008.04.017.

  PMID: 18466742 BACKGROUND

• Corbetta M, Shulman GL. Control of goal-directed and stimulus-driven attention in the brain. Nat Rev Neurosci. 2002 Mar;3(3):201-15. doi: 10.1038/nrn755.

  PMID: 11994752 BACKGROUND

• Corbetta M, Shulman GL. Spatial neglect and attention networks. Annu Rev Neurosci. 2011;34:569-99. doi: 10.1146/annurev-neuro-061010-113731.

  PMID: 21692662 BACKGROUND

• Koch G, Oliveri M, Cheeran B, Ruge D, Lo Gerfo E, Salerno S, Torriero S, Marconi B, Mori F, Driver J, Rothwell JC, Caltagirone C. Hyperexcitability of parietal-motor functional connections in the intact left-hemisphere of patients with neglect. Brain. 2008 Dec;131(Pt 12):3147-55. doi: 10.1093/brain/awn273. Epub 2008 Oct 22.

  PMID: 18948300 BACKGROUND

• Sack AT. Using non-invasive brain interference as a tool for mimicking spatial neglect in healthy volunteers. Restor Neurol Neurosci. 2010;28(4):485-97. doi: 10.3233/RNN-2010-0568.

  PMID: 20714073 BACKGROUND

MeSH Terms

Conditions

Perceptual Disorders

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Magnetic Field Therapy; Therapeutics

Study Officials

• René M. Müri, Prof. Dr. med.

  Department of Neurology, Inselspital, Bern University Hospital

  PRINCIPAL INVESTIGATOR

• Thomas Nyffeler, Prof. Dr. med.

  Center for Neurology and Neurorehabilitation, Luzerner Kantonsspital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: BASIC SCIENCE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 27, 2015
• First Posted: June 9, 2015
• Study Start: June 1, 2015
• Primary Completion: February 1, 2020
• Study Completion: February 1, 2020
• Last Updated: November 18, 2020

Record last verified: 2020-11

Locations

CH (1)