NCT04286776

Brief Summary

The purpose of this research is to understand biomarkers of human memory through correlational analyses and to use focal electrical stimulation as a causal manipulation to understand how biomarkers of memory relate to other brain states and behavioral measures.

Trial Health

55
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
800

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Oct 2014

Longer than P75 for not_applicable

Geographic Reach
1 country

11 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 12, 2014

Completed
5.4 years until next milestone

First Submitted

Initial submission to the registry

February 24, 2020

Completed
3 days until next milestone

First Posted

Study publicly available on registry

February 27, 2020

Completed
4.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2024

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 31, 2024

Completed
Last Updated

November 5, 2024

Status Verified

November 1, 2024

Enrollment Period

10.2 years

First QC Date

February 24, 2020

Last Update Submit

November 4, 2024

Conditions

Keywords

episodic memory

Outcome Measures

Primary Outcomes (6)

  • To use direct electrical stimulation to disentangle causal versus correlative biomarkers of verbal and spatial episodic memory

    1\. We will use linear mixed effects models and L2-penalized logistic regression classifiers to compare periods of successful and unsuccessful performance in our tasks

    Up to 4 weeks (typical duration of hospital stay)

  • To develop and test models of human brain dynamics in the presence of electrical stimulation

    2\. We will compare spectral indices of brain activity before and after stimulation as a function of stimulation parameters.

    Up to 4 weeks (typical duration of hospital stay)

  • To assess how reactivation of prior memories shapes subsequent recall and memory organization, including memory for the content, context and value of experiences.

    3\. We will mathematical models of neural similarity described in detail in Halpern (2024) and Manning (2011, 2012) to test the reactivation mechanisms described in Lohnas et al. (2014) and Healey and Kahana (2015).

    Up to 4 weeks (typical duration of hospital stay)

  • To determine whether state-dependent stimulation can separately be used to modulate encoding and retrieval processes

    4\. We will evaluate the closed-loop stimulation protocol described in Kahana et al. (2023) in both encoding and retrieval.

    Up to 4 weeks (typical duration of hospital stay)

  • To determine whether stimulation is more effective at modulating memory when targeted to regions with specific connectivity profiles to the medial temporal lobe

    5\. We will compare recall rates during a free recall experiment with brain stimulation at sites with high network-mediated activation, as described in Solomon et al. (2018), versus low network-mediated activation.

    Up to 4 weeks (typical duration of hospital stay)

  • To determine how simultaneous stimulation at multiple target sites can be optimized to modulate memory

    6\. We will compare recall rates during a free recall experiment with no brain stimulation, stimulation at one site, and stimulation at multiple sites.

    Up to 4 weeks (typical duration of hospital stay)

Study Arms (1)

Direct Electrical Stimulation

EXPERIMENTAL

Stimulation will be applied concurrently with the task, if applicable, and stimulation trials will be interleaved with sham trials, where no stimulation is delivered.

Device: Direct electrical stimulation

Interventions

Stimulation will not exceed 0.75 mA and will be approved prior by study investigators. Each subject will have a safety threshold testing at the beginning of each session and if 'afterdischarges' occur the subject's stimulation threshold will be lowered.

Direct Electrical Stimulation

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Expected to undergo intracranial implantation and postoperative electroencephalographic monitoring as part of a standard clinical procedure for the treatment of pharmacologically resistant epilepsy
  • Age 18 or older

You may not qualify if:

  • Any physical or cognitive disability or illness that would limit their ability to perform cognitive tasks
  • Any medical condition that would, in the investigator's opinion, limit the subject's participation in the study.
  • Unable or unwilling to provide informed consent
  • MRI contraindications
  • Standard clinical care includes a pregnancy test for female patients prior to the surgical implantation of the electrodes. Pregnant women are not surgically implanted.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (11)

University of Colorado, Denver

Aurora, Colorado, 80045, United States

Location

Emory University Hospital

Atlanta, Georgia, 30322, United States

Location

National Institute of Neurological Disorders and Stroke

Bethesda, Maryland, 20892, United States

Location

Beth Israel Deaconess Medical Center

Boston, Massachusetts, 02215, United States

Location

Mayo Clinic

Rochester, Minnesota, 55905, United States

Location

Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, 03766, United States

Location

Columbia University

New York, New York, 10027, United States

Location

Hospital of the University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

Location

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, 19107, United States

Location

UT Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

University of Texas Health Science Center at San Antonio

San Antonio, Texas, 78229, United States

Location

Related Publications (3)

  • Ezzyat Y, Kragel JE, Solomon EA, Lega BC, Aronson JP, Jobst BC, Gross RE, Sperling MR, Worrell GA, Sheth SA, Wanda PA, Rizzuto DS, Kahana MJ. Functional and anatomical connectivity predict brain stimulation's mnemonic effects. bioRxiv [Preprint]. 2023 Aug 11:2023.07.27.550851. doi: 10.1101/2023.07.27.550851.

    PMID: 37609181BACKGROUND
  • Ezzyat Y, Wanda PA, Levy DF, Kadel A, Aka A, Pedisich I, Sperling MR, Sharan AD, Lega BC, Burks A, Gross RE, Inman CS, Jobst BC, Gorenstein MA, Davis KA, Worrell GA, Kucewicz MT, Stein JM, Gorniak R, Das SR, Rizzuto DS, Kahana MJ. Closed-loop stimulation of temporal cortex rescues functional networks and improves memory. Nat Commun. 2018 Feb 6;9(1):365. doi: 10.1038/s41467-017-02753-0.

    PMID: 29410414BACKGROUND
  • Kragel JE, Ezzyat Y, Lega BC, Sperling MR, Worrell GA, Gross RE, Jobst BC, Sheth SA, Zaghloul KA, Stein JM, Kahana MJ. Distinct cortical systems reinstate the content and context of episodic memories. Nat Commun. 2021 Jul 21;12(1):4444. doi: 10.1038/s41467-021-24393-1.

    PMID: 34290240BACKGROUND

MeSH Terms

Conditions

Drug Resistant Epilepsy

Interventions

Transcranial Direct Current Stimulation

Condition Hierarchy (Ancestors)

EpilepsyBrain DiseasesCentral Nervous System DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsConvulsive TherapyPsychiatric Somatic TherapiesBehavioral Disciplines and ActivitiesElectroshockPsychological Techniques

Study Officials

  • Michael Kahana, PhD

    University of Pennsylvania

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
SINGLE GROUP
Model Details: All enrolled patients are considered eligible to receive direct electrical stimulation. Subjects have the option to receive non stimulation testing only.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 24, 2020

First Posted

February 27, 2020

Study Start

October 12, 2014

Primary Completion

December 31, 2024

Study Completion

December 31, 2024

Last Updated

November 5, 2024

Record last verified: 2024-11

Data Sharing

IPD Sharing
Will share

De-identified data will be shared in a public repository at regular intervals during the project. De-identified data sets will be anonymized prior to posting on the public repository. These de-identified data are likely to be analyzed for secondary purposes other than those described in this protocol (e.g. seizure prediction). Shared data will include, at a minimum, digital spreadsheets used to summarize all participant behavioral data. De-identified electrophysiology data, demographic information, electrode localization information, and task information (e.g. timing of each trial, timing of responses) will be shared in a central repository. Descriptions of the tasks and stimuli will be shared. De-identified references to individual participant data may also appear in scientific journal publications or presented at scientific meetings.

Time Frame
Study data will become available within six months of publication of the relevant results, with no planned expiration.
Access Criteria
Data is freely available, will require a formal request for access.

Locations