Brain Stimulation + Behavioral Intervention for Motor Skill Learning

(MEM_MOD Trial)

Overseen By Kirstin-Friederike Heise, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical University of South Carolina

Must not be taking: Carbamazepine, Flunarizine, Sulpiride, others

Disqualifiers: Pregnancy, Neuromuscular disorders, Seizures, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

Sometimes, it is necessary to re-learn a previously learned movement behavior, for example, a bad posture during the golf drive or while playing the piano. Unlearning or relearning an intensively trained behavior is particularly important if the behavior is hampering recovery, for example, in chronic pain or after a stroke. With this pilot study, the brain mechanisms that control the change of pre-existing stable memories of a motor skill will be tested with electroencephalography (EEG). Non-invasive brain stimulation will be used to modulate these brain mechanisms and test if it is possible to change the pre-existing motor memory and the learning of a new motor skill.

Will I have to stop taking my current medications?

If you are taking medications that might interfere with learning or the brain stimulation used in the study, such as carbamazepine, flunarizine, sulpiride, rivastigmine, or dextromethorphan, you may need to stop taking them to participate.

Is transcranial alternating current stimulation (tACS) safe for humans?

Research indicates that transcranial alternating current stimulation (tACS) is generally safe for humans, as studies have shown no significant adverse effects when applied at low intensities, such as 1 mA, over short durations like 10 minutes. ^{1 2 3 4 5}

How does the treatment of tACS combined with behavioral intervention differ from other treatments for motor skill learning?

This treatment is unique because it combines transcranial alternating current stimulation (tACS), a non-invasive brain stimulation technique, with behavioral intervention to enhance motor skill learning. Unlike other treatments, tACS modulates brain activity to improve the retention of motor skills, making it potentially more effective in maintaining motor performance over time. ^{4 6 7 8 9}

What data supports the effectiveness of the treatment involving transcranial alternating current stimulation (tACS) combined with behavioral intervention for motor skill learning?

Research shows that tACS can improve motor learning and retention in healthy individuals, suggesting it may help enhance motor skills when combined with behavioral interventions. Studies found that tACS applied during or after motor training can lead to better long-term retention of motor skills. ^{1 4 5 6 10}

Who Is on the Research Team?

Kirstin-Friederike Heise, PhD

Principal Investigator

Medical University of South Carolina

Are You a Good Fit for This Trial?

This trial is for healthy adults who can use a computer with internet, are 18 or older (with two-thirds being over 60), and can give consent. It's not for pregnant individuals, those with head injuries, brain conditions, metal in the head/neck, severe claustrophobia, neurological disorders, history of seizures or certain medications.

Inclusion Criteria

I have never had a stroke, brain tumor, neurodegenerative disease, or serious head injury.

Access to a personal computer with internet

Ability to give consent for study participation

Exclusion Criteria

Pregnancy

I have a neurological or psychiatric condition.

I have an injury or disease affecting my scalp.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Non-invasive brain stimulation with transcranial alternating current stimulation is applied during a memory interference intervention

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in EEG-derived markers of brain activation and connectivity, and performance precision of a sensorimotor skill

24 hours

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Inactive (sham) stimulation combined with behavioral intervention
• Transcranial alternating current stimulation (tACS) combined with behavioral intervention

Trial Overview The study tests if non-invasive brain stimulation (tACS) combined with behavioral tasks can change existing motor memories and aid new skill learning. Participants will also receive sham stimulation as a comparison while their brain activity is monitored using EEG.

How Is the Trial Designed?

Group I: Active non-invasive brain stimulation during behavioral memory interference Experimental Treatment 1 Intervention

Non-invasive brain stimulation with transcranial alternating current stimulation will be applied during a memory interference intervention.

Group II: Sham stimulation during behavioral memory interference Placebo Group 1 Intervention

Inactive (sham) stimulation will be applied during a memory interference intervention.

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials

994

Recruited

7,408,000+

Published Research Related to This Trial

The study tested a new cerebellar transcranial alternating current stimulation (tACS) protocol on 15 healthy participants but found that it did not enhance motor skill acquisition or retention during training.

Analysis revealed that factors like short intracortical inhibition during movement and baseline performance were key predictors of training success, suggesting that future interventions could be tailored based on these individual differences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cerebellar transcranial alternating current stimulation in the gamma range applied during the acquisition of a novel motor skill. Wessel, MJ., Draaisma, LR., de Boer, AFW., et al.[2022]

Transcranial alternating current stimulation (tACS) significantly improves motor learning abilities in healthy individuals, based on a systematic review of 10 studies involving 270 participants.

While overall motor performance did not show significant improvement compared to sham stimulation, specific types of tACS, like gamma band and online tACS, did enhance motor performance, suggesting potential therapeutic applications for motor behavior improvement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of transcranial alternating current stimulation on motor performance and motor learning for healthy individuals: A systematic review and meta-analysis. Hu, K., Wan, R., Liu, Y., et al.[2022]

In a study with 42 healthy participants, applying 0.75 Hz transcranial alternating current stimulation (tACS) during a thumb abduction motor training task led to significantly better retention of motor performance 24 hours later compared to sham stimulation.

While both active and sham stimulation groups showed immediate improvements in thumb abduction acceleration after training, only the active tACS group maintained these benefits over time, indicating that tACS can enhance the effectiveness of motor training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Motor training is improved by concurrent application of slow oscillating transcranial alternating current stimulation to motor cortex. Sale, MV., Kuzovina, A.[2022]

In a study with 20 adults, applying beta-band transcranial alternating current stimulation (tACS) immediately after practicing a motor skill significantly improved retention of that skill, with better performance observed 1 and 7 days later compared to a sham stimulation group.

The increase in beta-band corticomuscular coherence (CMC) correlated with improved motor performance, suggesting that enhancing oscillatory beta activity in the corticospinal system may play a key role in consolidating motor skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial Alternating Current Stimulation of the Primary Motor Cortex after Skill Acquisition Improves Motor Memory Retention in Humans: A Double-Blinded Sham-Controlled Study. Yamaguchi, T., Svane, C., Forman, CR., et al.[2023]

Transcranial alternating current stimulation (TACS) has demonstrated significant efficacy in improving symptoms of depression, with a standardized mean difference (SMD) of 1.14, indicating a strong positive effect compared to sham stimulation in patients.

TACS also showed a notable improvement in cognitive function among patients with psychiatric disorders, with an SMD of 0.60, suggesting it may enhance cognitive abilities in both patients and healthy individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial alternating current stimulation and its effects on cognition and the treatment of psychiatric disorders: a systematic review and meta-analysis. Lee, ARYB., Yau, CE., Mai, AS., et al.[2022]

In a study involving 18 healthy volunteers, sinusoidal transcranial alternating current stimulation (tACS) at 5 kHz for 10 minutes at 1 mA was found to be safe, as indicated by stable neuron-specific enolase (NSE) levels and no significant changes in EEG or MRI results.

The findings suggest that tACS does not cause structural or pathological changes in the brain, supporting its safety for use under the tested conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety of 5 kHz tACS. Chaieb, L., Antal, A., Pisoni, A., et al.[2022]

In a study involving 15 healthy adults, transcranial alternating current stimulation (tACS) at 5 Hz and 1 mA significantly improved working memory scores and increased brain activity in theta and delta frequency bands, indicating its potential to enhance cognitive function.

The study also established a closed-loop evaluation method that uses individual brain signals to optimize tACS protocols, suggesting that personalized stimulation durations can prevent overstimulation and improve effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness assessment of repetitive transcranial alternating current stimulation with concurrent EEG and fNIRS measurement. Yang, D., Ghafoor, U., Eggebrecht, AT., et al.[2023]

In a preliminary study with 28 participants, three common non-invasive brain stimulation (NIBS) methods (anodal tDCS, PAS25, and iTBS) were tested for their effects on motor learning, but no consistent differences in effectiveness were found among the groups.

The study highlighted the variability in responses to NIBS, suggesting that while these methods are promising, their effects on motor learning and cortical excitability may not be reliably reproducible, indicating a need for larger studies to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Preliminary Comparison of Motor Learning Across Different Non-invasive Brain Stimulation Paradigms Shows No Consistent Modulations. Lopez-Alonso, V., Liew, SL., Fernández Del Olmo, M., et al.[2020]

Noninvasive electrical brain stimulation (NEBS) using transcranial direct current stimulation (tDCS) and random noise stimulation (tRNS) significantly enhances motor skill learning in a tracing task, with effects observed during the training sessions rather than after.

The study found that unilateral tDCS led to immediate skill improvements, while tRNS produced more gradual enhancements, suggesting that these two stimulation methods may work through different mechanisms in facilitating motor learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of different electrical brain stimulation protocols on subcomponents of motor skill learning. Prichard, G., Weiller, C., Fritsch, B., et al.[2018]

In a study with 30 healthy participants, gamma transcranial alternating current stimulation (γ-tACS) applied over the primary motor cortex and cerebellum significantly improved motor learning retention compared to sham stimulation, indicating its potential to enhance the ability to maintain learned motor skills.

While γ-tACS showed benefits for retaining motor performance, it did not significantly affect the efficiency of motor learning or re-motor learning, suggesting that its primary effect may be on the retention aspect of motor skills rather than the initial learning process.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects on motor learning of transcranial alternating current stimulation applied over the primary motor cortex and cerebellar hemisphere. Miyaguchi, S., Inukai, Y., Matsumoto, Y., et al.[2020]

Citations

1. England pubmed.ncbi.nlm.nih.gov

Cerebellar transcranial alternating current stimulation in the gamma range applied during the acquisition of a novel motor skill. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Effects of transcranial alternating current stimulation on motor performance and motor learning for healthy individuals: A systematic review and meta-analysis. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Motor training is improved by concurrent application of slow oscillating transcranial alternating current stimulation to motor cortex. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Transcranial Alternating Current Stimulation of the Primary Motor Cortex after Skill Acquisition Improves Motor Memory Retention in Humans: A Double-Blinded Sham-Controlled Study. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Transcranial alternating current stimulation and its effects on cognition and the treatment of psychiatric disorders: a systematic review and meta-analysis. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Safety of 5 kHz tACS. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Effectiveness assessment of repetitive transcranial alternating current stimulation with concurrent EEG and fNIRS measurement. [2023]

8. Switzerland pubmed.ncbi.nlm.nih.gov

A Preliminary Comparison of Motor Learning Across Different Non-invasive Brain Stimulation Paradigms Shows No Consistent Modulations. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Effects of different electrical brain stimulation protocols on subcomponents of motor skill learning. [2018]

10. Scotland pubmed.ncbi.nlm.nih.gov

Effects on motor learning of transcranial alternating current stimulation applied over the primary motor cortex and cerebellar hemisphere. [2020]