NCT05513352

Brief Summary

This study will improve the understanding of the cerebral mechanisms that underlie the control of auditory selective attention and evaluate the potential of neuromodulation to enhance neural attention control as a possible way to overcome hearing impairment. First, electroencephalography (EEG) will be applied to identify neural marker of auditory attention in individuals with hearing loss (HL), tinnitus (TI) and normal hearing (NH). Afterwards, the importance of the identified markers for attention control will be tested using non-invasive transcranial alternating current stimulation (tACS) and neurofeedback (NF).

Trial Health

57
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Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
275

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Nov 2023

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 17, 2022

Completed
7 days until next milestone

First Posted

Study publicly available on registry

August 24, 2022

Completed
1.2 years until next milestone

Study Start

First participant enrolled

November 1, 2023

Completed
2.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2026

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2026

Completed
Last Updated

December 7, 2023

Status Verified

November 1, 2023

Enrollment Period

2.4 years

First QC Date

August 17, 2022

Last Update Submit

November 30, 2023

Conditions

Keywords

neuromodulationauditory attentionneurobiology of languageelectroencephalographytranscranial alternating current stimulationneurofeedbackalpha oscillationsspeech tracking

Outcome Measures

Primary Outcomes (5)

  • Experiment 1 - EEG

    The primary endpoint is the comparison of neural alpha power lateralization in response to target selection and distractor suppression in individuals with HL, TI and a NH control group.

    One study session of 4 hours and 40 minutes

  • Experiment 2 - EEG

    The primary endpoint is the comparison of the neural tracking of the amplitude envelope of speech between individuals with HL, TI and NH.

    One study session of 4 hours and 40 minutes

  • Experiment 3 - AAT

    The primary endpoint is the comparison of auditory attention performance between tACS over the left temporo-parietal cortex, and an ineffective sham stimulation during and after stimulation relative to pre-stimulation baseline.

    One study session of 4 hours and 40 minutes

  • Experiment 4 - SAT

    The primary endpoint is the comparison of speech comprehension performance between tACS over the left temporo-parietal cortex, and an ineffective sham stimulation during and after stimulation relative to pre-stimulation baseline.

    One study session of 4 hours and 40 minutes

  • Experiment 5 - EEG 1

    The primary endpoint is the comparison of participants' ability to control alpha power lateralization index during training between training conditions (left NF training vs. right NF training).

    two sessions of 4 hours and 40 minutes on separate days

Secondary Outcomes (9)

  • Experiment 1 - AAT

    One study session of 4 hours and 40 minutes

  • Experiment 2 - SAT

    One study session of 4 hours and 40 minutes

  • Experiment 3 - EEG 1

    One study session of 4 hours and 40 minutes

  • Experiment 3 - EEG 2

    One study session of 4 hours and 40 minutes

  • Experiment 4 - EEG 1

    One study session of 4 hours and 40 minutes

  • +4 more secondary outcomes

Study Arms (19)

Experiment 1 - Normal hearing - AAT

NO INTERVENTION

Each participant assigned to the normal hearing group will undergo one experimental session during which EEG is recorded while participants perform an auditory attention task (AAT).

Experiment 1 - Hearing impaired - AAT

NO INTERVENTION

Each participant assigned to the normal hearing impaired group will undergo one experimental session during which EEG is recorded while participants perform an auditory attention task (AAT).

Experiment 2 - normal hearing _ SAT

NO INTERVENTION

Each participant assigned to the normal hearing group will undergo one experimental session in which EEG is used to measure neural speech tracking while participants undergo the selective speech attention task (SAT).

Experiment 2 - hearing impaired - SAT

NO INTERVENTION

Each participant assigned to the hearing impaired group will undergo one experimental session in which EEG is used to measure neural speech tracking while participants undergo the selective speech attention task (SAT).

Experiment 2 - tinnitus - SAT

NO INTERVENTION

Each participant assigned to the tinnitus group will undergo one experimental session in which EEG is used to measure neural speech tracking while participants undergo the selective speech attention task (SAT).

Experiment 3 - normal hearing (tACS) - AAT

EXPERIMENTAL

The subjects assigned to the normal hearing group will undertake 20min tACS stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) brain stimulation, and (3) post-stimulation. AAT will be conducted in each phase and concurrent EEG will be recorded.

Device: tACS - transcranial alternating current stimulation

Experiment 3 - normal hearing (sham) - AAT

SHAM COMPARATOR

The subjects assigned to the normal hearing group will undertake 20min sham stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) sham brain stimulation, and (3) post-stimulation. AAT will be conducted in each phase and concurrent EEG will be recorded.

Device: sham - transcranial alternating current stimulation

Experiment 3 - hearing impaired (tACS) - AAT

EXPERIMENTAL

The subjects assigned to the hearing impaired group will undertake 20min tACS stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) brain stimulation, and (3) post-stimulation. AAT will be conducted in each phase and concurrent EEG will be recorded.

Device: tACS - transcranial alternating current stimulation

Experiment 3 - hearing impaired (sham) - AAT

SHAM COMPARATOR

The subjects assigned to the hearing impaired group will undertake 20min sham stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) sham brain stimulation, and (3) post-stimulation. AAT will be conducted in each phase and concurrent EEG will be recorded.

Device: sham - transcranial alternating current stimulation

Experiment 3 - tinnitus (tACS) - AAT

EXPERIMENTAL

The subjects assigned to the tinnitus group will undertake 20min tACS stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) brain stimulation, and (3) post-stimulation. AAT will be conducted in each phase and concurrent EEG will be recorded.

Device: tACS - transcranial alternating current stimulation

Experiment 3 - tinnitus (sham) - AAT

SHAM COMPARATOR

The subjects assigned to the tinnitus group will undertake 20min sham stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) sham brain stimulation, and (3) post-stimulation. AAT will be conducted in each phase and concurrent EEG will be recorded.

Device: sham - transcranial alternating current stimulation

Experiment 4 - normal hearing (tACS) - SAT

EXPERIMENTAL

The subjects assigned to the normal hearing group will undertake 20min tACS stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) brain stimulation, and (3) post-stimulation. SAT will be conducted in each phase and concurrent EEG will be recorded.

Device: tACS - transcranial alternating current stimulation

Experiment 4 - normal hearing (sham) - SAT

SHAM COMPARATOR

The subjects assigned to the normal hearing group will undertake 20min sham stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) sham brain stimulation, and (3) post-stimulation. SAT will be conducted in each phase and concurrent EEG will be recorded.

Device: sham - transcranial alternating current stimulation

Experiment 4 - hearing impaired (tACS) - SAT

EXPERIMENTAL

The subjects assigned to the hearing impaired group will undertake 20min tACS stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) brain stimulation, and (3) post-stimulation. SAT will be conducted in each phase and concurrent EEG will be recorded.

Device: tACS - transcranial alternating current stimulation

Experiment 4 - hearing impaired (sham) - SAT

SHAM COMPARATOR

The subjects assigned to the hearing impaired group will undertake 20min sham stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) sham brain stimulation, and (3) post-stimulation. SAT will be conducted in each phase and concurrent EEG will be recorded.

Device: sham - transcranial alternating current stimulation

Experiment 4 - tinnitus (tACS) - SAT

EXPERIMENTAL

The subjects assigned to the tinnitus group will undertake 20min tACS stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) brain stimulation, and (3) post-stimulation. SAT will be conducted in each phase and concurrent EEG will be recorded.

Device: tACS - transcranial alternating current stimulation

Experiment 4 - tinnitus (sham) - SAT

SHAM COMPARATOR

The subjects assigned to the tinnitus group will undertake 20min sham stimulation applied over the temporo-parietal cortex. Each session will include the following three phases: (1) pre-stimulation baseline, (2) sham brain stimulation, and (3) post-stimulation. SAT will be conducted in each phase and concurrent EEG will be recorded.

Device: sham - transcranial alternating current stimulation

Experiment 5 - normal hearing (NF right) - AAT

EXPERIMENTAL

Each participant of the normal hearing group will undergo the neurofeedback training in which the participants learn to increase alpha power in the right relative to the left parietal cortex. Before and after the NF training, participants will perform the AAT and concurrent EEG will be recorded.

Device: NF - Neurofeedback

Experiment 5 - normal hearing (NF left) - AAT

ACTIVE COMPARATOR

Each participant of the normal hearing group will undergo the neurofeedback training in which the participants learn to increase alpha power in the left relative to the right parietal cortex. Before and after the NF training, participants will perform the AAT and concurrent EEG will be recorded.

Device: NF - Neurofeedback

Interventions

TACS is a non-invasive brain stimulation (NIBS) techniques that belong to the class of low current transcranial electric stimulation. In contrast to the better known transcranial direct current stimulation (tDCS), the tACS current is not constant, but alternates with a certain frequency. The stimulation will be applied over the left temporo-parietal cortex at participants' individual alpha frequency. The stimulation intensity will be 2 milliampere (mA, peak-to-peak value, corresponding to a sine wave of ±1 mA amplitude). Stimulation will be delivered through conductive rubber electrodes.

Experiment 3 - hearing impaired (tACS) - AATExperiment 3 - normal hearing (tACS) - AATExperiment 3 - tinnitus (tACS) - AATExperiment 4 - hearing impaired (tACS) - SATExperiment 4 - normal hearing (tACS) - SATExperiment 4 - tinnitus (tACS) - SAT

During "sham stimulation" (placebo), tACS will be ramped up and down for 12 seconds , that is, no electric stimulation wil be applied during the actual experiment. The up and down ramping will be repeated at the end of the experiment. The sham condition serves to evoke sensations associated with tACS stimulation, but without stimulating during the actual experiment.

Experiment 3 - hearing impaired (sham) - AATExperiment 3 - normal hearing (sham) - AATExperiment 3 - tinnitus (sham) - AATExperiment 4 - hearing impaired (sham) - SATExperiment 4 - normal hearing (sham) - SATExperiment 4 - tinnitus (sham) - SAT

Neurofeedback (NF) is a non-invasive approach that combines neurophysiological recordings with real-time sensory feedback (most studies use visual feedback). Through real-time NF, individuals thus can learn to regulate their brain activity. In this study, NF will be based on concurrent EEG recordings. During NF, participants will observe a space ship automatically navigating through a narrow tunnel. The modulation of their neural alpha power lateralization into the trained direction will be rewarded by the acceleration of the space ship, a modulation in the opposite direction will reduce speed and autopilot accuracy.

Experiment 5 - normal hearing (NF left) - AATExperiment 5 - normal hearing (NF right) - AAT

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age: 18-35 / 55-75
  • German as first language
  • Normal or corrected to normal vision
  • Right-handed
  • Normal hearing: ≤20 decibel (dB) hearing level (HL) at frequencies from 250 Hz to 8,000 Hz for both ears.
  • Hearing loss:
  • bilateral symmetrical sensorineural hearing loss
  • pure tone thresholds of ≥25 dB HL at one or more frequencies between 250 Hz and 8,000 Hz and differences in thresholds across the two ears of ≤20 dB at every frequency.
  • Tinnitus:
  • Persistent chronic tinnitus with duration of more than 3 months
  • Tinnitus with a Tinnitus Handicap Inventory Grade 2 to 4 (18-76 points)

You may not qualify if:

  • Non-symmetrical hearing loss
  • Raised bi- or multilingually (second language acquired earlier than 6 years of age)
  • Women who are currently pregnant or breastfeeding
  • History of brain injury or any neurological disorder (y/n)
  • For example, stroke, traumatic brain injury, brain surgery, epilepsy etc.
  • Dyslexia
  • History of psychiatric disorder
  • Recent recreational drug consumption
  • Known or suspected drug or alcohol abuse
  • Medication with cognitive side effects (e.g., psychoactive medications or sleeping pills)
  • Metallic implants in the head region (excluding fixed braces and tooth fillings)
  • Any implanted medical device (e.g., cardiac pacemakers)
  • Previous enrolment in one of the experiments comprising the main investigational plan

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Zurich

Zurich, 8090, Switzerland

RECRUITING

MeSH Terms

Conditions

Hearing LossTinnitus

Condition Hierarchy (Ancestors)

Hearing DisordersEar DiseasesOtorhinolaryngologic DiseasesSensation DisordersNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Basil Preisig, Dr.

    University of Zurich

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Basil Preisig, Dr.

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
Masking Details
single-blind
Purpose
BASIC SCIENCE
Intervention Model
PARALLEL
Model Details: Experiment 1: * between-subject design * 3x4 = 3(hearing group) x 4(condition) * Masking: Single (Participant) * Masking Description: single-blind Experiment 2: * between-subject design * 3x4 = 3(hearing group) x 4(condition) * Masking: Single (Participant) * Masking Description: single-blind Experiment 3: * between-subject design * 3x2x2x4 = 3(hearing group) x 2 (stimulation) x 2(timepoint) x 4(condition) * Masking: Double (Participant, investigator) * Masking Description: double-blind Experiment 4: * between-subject design * 3x2x2x4 = 3(hearing group) x 2 (stimulation) x 2(timepoint) x 4(condition) * Masking: Double (Participant, investigator) * Masking Description: double-blind Experiment 5: * within-subject design * 2x2x4 = 2 (training) x 2(timepoint) x 4(condition) * Masking: Double (Participant, investigator) * Masking Description: double-blind Primary Purpose: Basic Science
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 17, 2022

First Posted

August 24, 2022

Study Start

November 1, 2023

Primary Completion

April 1, 2026

Study Completion

April 1, 2026

Last Updated

December 7, 2023

Record last verified: 2023-11

Data Sharing

IPD Sharing
Will share

The investigators intend to share the raw data of the included participants and the analysis code.

Shared Documents
STUDY PROTOCOL, SAP, ANALYTIC CODE
Time Frame
after the project is completed
Access Criteria
upon personal request

Locations