Ignite Creation Date:
2024-05-06 @ 7:51 PM
Last Modification Date:
2024-10-26 @ 3:15 PM
Study NCT ID:
NCT06155695
Status:
RECRUITING
Last Update Posted:
2023-12-11
First Post:
2023-11-14
Brief Title:
Auditory Control Enhancement ACE in Schizophrenia
Sponsor:
Brian A Coffman PhD
Organization:
University of Pittsburgh
Study Overview
Official Title:
Targeting the Auditory Control Network With Auditory Control Enhancement ACE in Schizophrenia
Status:
RECRUITING
Status Verified Date:
2023-12
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
ACES
Brief Summary:
The purpose of this clinical trial is to investigate neural markers of target engagement to further develop auditory control enhancement ACE as a novel inexpensive and noninvasive intervention to address treatment-refractory auditory hallucinations Here we will address questions about the feasibility and acceptability of ACE as well as the degree to which ACE results in measurable engagement of biophysical and neurophysiological targets
Participants will complete
Auditory Control Enhancement ACE Participants will be assigned by chance such as a coin flip into one of two groups to receive a different dosage or level of transcranial direct current stimulation tDCS during three sessions of cognitive training tDCS is used to stimulate the brain for a short period of time For tDCS one or two thin wet sponges are placed on the head andor upper arm The sponges will be connected to electrodes which will deliver a very weak electrical current The Neuroelectrics Starstim 32 will be used to deliver tDCS
Interviews Before and after ACE in two separate sessions participants will be asked questions about a background b functioning in daily life and across different phases of your life and past present and future medical records
Cognitive Tests During the interview sessions participants will also perform cognitive tests Participants will be asked to complete computerized and pen-and-paper tests of attention concentration reading and problem-solving ability
EEG scan Participants will be asked to complete EEG electroencephalography studies before and after ACE training EEG will be measured using the same Neuroelectrics Starstim 32 system used for tDCS EEG measures the natural activity of the brain using small sensors placed on the scalp These sensors use conductive gel to provide a connection suitable for recording brain activity During EEG participants will watch a silent video while sounds are played over headphones or sometimes count the sounds In addition to these auditory tasks participants will also be asked to perform visual attention tasks such pressing a button for a letter or image
Magnetic Resonance Imaging MRI Scan Participants will also be asked to complete MRI studies before and after ACE training An MRI is a type of brain scan that takes pictures of the brain that will later be used to create a 3D model of the brain The MRI does not use radiation but rather radio waves a large magnet and a computer to create the images
Researchers will compare individuals receiving ACE to those receiving sham tDCS during cognitive training to determine effects of ACE
Participants will complete
Auditory Control Enhancement ACE Participants will be assigned by chance such as a coin flip into one of two groups to receive a different dosage or level of transcranial direct current stimulation tDCS during three sessions of cognitive training tDCS is used to stimulate the brain for a short period of time For tDCS one or two thin wet sponges are placed on the head andor upper arm The sponges will be connected to electrodes which will deliver a very weak electrical current The Neuroelectrics Starstim 32 will be used to deliver tDCS
Interviews Before and after ACE in two separate sessions participants will be asked questions about a background b functioning in daily life and across different phases of your life and past present and future medical records
Cognitive Tests During the interview sessions participants will also perform cognitive tests Participants will be asked to complete computerized and pen-and-paper tests of attention concentration reading and problem-solving ability
EEG scan Participants will be asked to complete EEG electroencephalography studies before and after ACE training EEG will be measured using the same Neuroelectrics Starstim 32 system used for tDCS EEG measures the natural activity of the brain using small sensors placed on the scalp These sensors use conductive gel to provide a connection suitable for recording brain activity During EEG participants will watch a silent video while sounds are played over headphones or sometimes count the sounds In addition to these auditory tasks participants will also be asked to perform visual attention tasks such pressing a button for a letter or image
Magnetic Resonance Imaging MRI Scan Participants will also be asked to complete MRI studies before and after ACE training An MRI is a type of brain scan that takes pictures of the brain that will later be used to create a 3D model of the brain The MRI does not use radiation but rather radio waves a large magnet and a computer to create the images
Researchers will compare individuals receiving ACE to those receiving sham tDCS during cognitive training to determine effects of ACE
Detailed Description:
Auditory hallucinations associated with schizophrenia Sz are pervasive debilitating and disturbing Unfortunately they are also difficult to treat - auditory hallucinations persist in about 25 of cases despite pharmacotherapy and treatment of cognitive symptoms the symptoms most strongly related to global functioning is modest at best We propose a novel inexpensive and noninvasive intervention to address treatment-refractory symptoms a critical need in Sz Auditory hallucinations and impaired cognition in schizophrenia are not independent Both are associated with system-level dysfunction of the fronto-temporal auditory control network comprising auditoryverbal perceptual areas in temporoparietal junction TPJ and cognitivebehavioral control systems in ventrolateral prefrontal cortex VLPFC VLPFC traditionally inhibits and reattributes perceptual misrepresentations in most people For those with schizophrenia impairment of auditory cognitive control makes this impossible Data from our lab suggest that auditory control network dysfunction may be central to the early etiology of the disorder Auditory control enhancement ACE is designed to improve auditory control network function thereby increasing inhibition of spurious auditory system activity in temporoparietal cortex and reducing auditory hallucinations ACE combines a time-tested psychotherapeutic behavioral training program with targeted non-invasive brain stimulation using transcranial Direct Current Stimulation tDCS Our pilot data demonstrate the effectiveness of the behavioral training program and synergistic effects with tDCS of the auditory control network for treating treatment-refractory auditory hallucinations in schizophrenia To further develop ACE for efficacy trials we plan to investigate neural markers of target engagement in two sham-controlled experiments Aim 1 will determine whether tDCS of right vlPFC anode and left TPJ cathode during MRI alters electric field measures and blood oxygenation level dependent BOLD response during stimulation to demonstrate that markers of tDCS current flow and BOLD fluctuate with induced current and these fluctuations align spatially with computer models Aim 2 will examine feasibility of subject retention and blinding for ACE Aim 3 will examine the degree to which ACE modifies behavioral neurophysiological and hemodynamic markers of target engagement using neural oscillatory and cerebral blood flow CBF measures Pilot data show feasibility of our aims and provide preliminary evidence that ACE has strong and lasting effects on auditory hallucinations assessed with the psychotic symptoms rating scale PSYRATS and that changes in cognitive factors associated with auditory hallucinations strongly correlate with changes in neural oscillatory measures of cognitive control ACE represents a novel transformative intervention with long-lasting effects that has the potential to change the treatment of schizophrenia and vastly improve the outcome for afflicted individuals
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
True
Is an Unapproved Device?:
True
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| R21MH128823 | NIH | None | httpsreporternihgovquickSearchR21MH128823 |