Memory Drilling for Memory Loss

(PMIS Trial)

Overseen By Sabine Kunrath, MSc., MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Los Angeles

Disqualifiers: Acute substance abuse, No computer access, others

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

Compensation: Varies

Number of Visits: 10

Duration: 2 weeks

75 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this clinical trial is to memory drilling works in improving the ability to remember to do something later in treatment-seeking veterans. The main question it aims to answer is: Does adding memory drilling to intensive treatment programs improve the patient's ability to remember to do something later? Researchers will compare typical standardized memory training to the memory training with drilling to see if drilling improves the veterans' ability to remember tasks they are supposed to do later. Participants will: * complete the Operation Mend intensive treatment program with either standard care (either with or without Post-Traumatic Stress Disorder \[PTSD\] focused trauma therapy) or standard care + memory drilling * complete a virtual memory assessment at entrance, exit, and three months post exit. This assessment will include questionnaires, interviews, and computerized and naturalistic memory tasks.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Memory Drilling for memory loss?

Research from the Memory Centre Erlangen shows that a similar cognitive training program improved attention, cognitive speed, and short-term memory in patients with mild cognitive impairment and dementia. Additionally, techniques like spaced retrieval and visual imagery have been effective in enhancing memory in Alzheimer's patients. ^{1 2 3 4 5}

Is Memory Drilling safe for humans?

The research on errorless learning, which is similar to Memory Drilling, suggests it is safe for use in people with Alzheimer's disease and dementia, as it focuses on improving memory without causing harm. ^{6 7 8 9 10}

How does the Memory Drilling treatment for memory loss differ from other treatments?

Memory Drilling is unique because it uses spaced retrieval training, a method that involves recalling information over increasingly longer intervals to improve memory retention. Unlike other treatments, it can be self-administered using a tablet-based program, making it convenient and accessible for individuals with mild cognitive impairment or dementia. ^{1 11 12 13 14}

Research Team

Delany Thrasher, PhD

Principal Investigator

University of California, Los Angeles

Kevin Bickart, MD, PhD

Principal Investigator

University of California, Los Angeles

Eligibility Criteria

This trial is for veterans experiencing memory loss or mild cognitive impairment. Participants must complete the Operation Mend intensive treatment program and can do so with standard care, with or without PTSD-focused therapy, or add memory drilling to their regimen.

Inclusion Criteria

All patients accepted and scheduled to participate in an Operation Mend BRAIN Intensive Treatment Program and PTSD Intensive Treatment Program are eligible to participate in the study.

Exclusion Criteria

Patients with acute substance abuse disorders are not accepted into Operation Mend programs and are therefore excluded from the study.

Patients who are scheduled for arrival at the ITP sooner than 2.5 or 3 weeks are not eligible to participate for logistical reasons.

Patients who do not have tablet, iPad, or computer access are not eligible to participate due to the technical requirements of the computer-based assessments.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants complete the Operation Mend intensive treatment program with either standard care or standard care plus memory drilling

2 weeks

7 sessions (in-person)

Assessment

Participants complete a virtual memory assessment at entrance, exit, and three months post exit

15-17 weeks

3 assessments (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Treatment Details

Interventions

• Memory Drilling

Trial Overview The study tests if adding memory drills to standard memory training helps improve veterans' ability to remember future tasks. It compares typical training against training plus drilling using assessments at the start, end, and three months after the program.

Participant Groups

Group I: Memory Drilling BRAIN ITP (EXP) Experimental Treatment 2 Interventions

In the BRAIN ITP, the standard PM training for both the experimental (EXP) and control group (CON1), takes place during the patient's individual cognitive training sessions with the cognitive trainer. In total, there are seven sessions. At each of these sessions the cognitive trainer will review a new compensatory strategy for PM and assign a naturalistic PM practice task as homework to practice the strategy. The experimental group will receive the additional computerized "memory drills" training.

Group II: Standard of Care PTSD ITP (CON2) Active Control 2 Interventions

The PTSD ITP group (CON2) will receive the traditional standard of care (cognitive training and cognitive processing therapy). There is no spaced training or practice.

Group III: Standard of Care BRAIN ITP (CON1) Active Control 1 Intervention

In the BRAIN ITP, the standard PM training for both the experimental (EXP) and control group (CON1), takes place during the patient's individual cognitive training sessions with the cognitive trainer. In total, there are seven sessions. At each of these sessions the cognitive trainer will review a new compensatory strategy for PM and assign a naturalistic PM practice task as homework to practice the strategy. The CON1 group will not receive the additional memory drilling.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Findings from Research

A 12-week cognitive stimulation intervention at the Memory Centre Erlangen showed positive effects on cognitive performance in patients with Mild Cognitive Impairment (MCI), with significant improvements in attention, general cognitive speed, and short-term memory.

Even patients diagnosed with dementia did not experience a decline in cognitive abilities during the intervention, and some showed improvements in the same cognitive areas, suggesting the potential benefits of cognitive training for various levels of memory impairment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Erlangen Memory Center--a partial inpatient gerontopsychiatric facility]. Engel, S., Mück, A., Steinwachs, KC., et al.[2015]

Memory stimulation programs, including errorless learning, spaced retrieval, and dyadic approaches, show promise in improving memory function in Alzheimer's disease patients based on preliminary evidence.

These techniques can be used alone or in combination, suggesting a flexible approach to enhance memory stimulation in individuals with Alzheimer's disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A critical review of memory stimulation programs in Alzheimer's disease. Grandmaison, E., Simard, M.[2022]

The USMART program, a tablet-based spaced retrieval training, showed a significant improvement in memory recall among 41 participants with mild cognitive impairment (MCI) over a 4-week period, with an effect size of 0.49.

No adverse events were reported during the study, indicating that USMART is a safe and well-accepted intervention for enhancing memory retrieval in older adults with MCI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial. Han, JW., Son, KL., Byun, HJ., et al.[2018]

References

1. China (Republic : 1949- ) pubmed.ncbi.nlm.nih.gov

[Application of spaced retrieval training on patients with dementia]. [2018]

2. Germany pubmed.ncbi.nlm.nih.gov

[Erlangen Memory Center--a partial inpatient gerontopsychiatric facility]. [2015]

3. Germany pubmed.ncbi.nlm.nih.gov

[Gedächtniszentrum Erlangen (Memory Centre Erlangen) - Gerontopsychiatric Day-Care] [2019]

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

Imagery mnemonic training in a patient with primary degenerative dementia. [2019]

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

A critical review of memory stimulation programs in Alzheimer's disease. [2022]

6. England pubmed.ncbi.nlm.nih.gov

The use of errorless learning strategies for patients with Alzheimer's disease: a literature review. [2015]

7. United Arab Emirates pubmed.ncbi.nlm.nih.gov

Bridging neurocognitive aging and disease modification: targeting functional mechanisms of memory impairment. [2021]

8. England pubmed.ncbi.nlm.nih.gov

Study protocol of the multi-site randomised controlled REDALI-DEM trial--the effects of structured relearning methods on daily living task performance of persons with dementia. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Targeting the CREB pathway for memory enhancers. [2005]

11. England pubmed.ncbi.nlm.nih.gov

The effects of modified spaced-retrieval training on learning and retention of face-name associations by individuals with dementia. [2009]

12. England pubmed.ncbi.nlm.nih.gov

Efficacy of the Ubiquitous Spaced Retrieval-based Memory Advancement and Rehabilitation Training (USMART) program among patients with mild cognitive impairment: a randomized controlled crossover trial. [2018]

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

Structured practice: a memory intervention for persons with dementia. [2019]

14. Switzerland pubmed.ncbi.nlm.nih.gov

People with dementia use schemata to support episodic memory. [2022]