Transcranial Magnetic Stimulation for Episodic Memory

Overseen By Maureen Ritchey, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Boston College

Must not be taking: Tricyclics, Neuroleptics, Centrally-acting drugs

Disqualifiers: Psychiatric illness, Neurological disorder, Heart disease, Drug use, others

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

Compensation: Varies

Number of Visits: 3

40 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this study is to understand the basic brain mechanisms supporting episodic memory in healthy young adults. Transcranial magnetic stimulation will be used to influence brain activity in regions thought to be important for episodic memory. Behavioral testing and MRI will be used to measure the effects of stimulation on memory and on changes in brain network interactions, allowing us to draw causal inferences regarding the role of specific brain regions in memory processes.

Will I have to stop taking my current medications?

The trial requires that you do not use medications that lower the seizure threshold, such as certain antidepressants and neuroleptic agents. Additionally, you should not use centrally-acting medications or drugs, except caffeine, within the last 12 hours before participation.

What data supports the effectiveness of the treatment Transcranial Magnetic Stimulation for improving episodic memory?

Research shows that Transcranial Magnetic Stimulation (TMS) can improve episodic memory by targeting specific brain networks, like the hippocampal-cortical network, which is important for memory. Studies have found that certain TMS protocols, such as 1-Hz and 20-Hz frequencies, can enhance memory performance, although the effects can vary based on how and where the stimulation is applied. ^{1 2 3 4 5}

Is transcranial magnetic stimulation (TMS) safe for humans?

Transcranial magnetic stimulation (TMS) is generally considered safe, but it can cause mild side effects like headaches and nausea, and in rare cases, seizures. Safety guidelines have been established and updated over the years to minimize risks, and TMS has been used safely in both adults and children. ^{6 7 8 9 10}

How does transcranial magnetic stimulation differ from other treatments for episodic memory?

Transcranial magnetic stimulation (TMS) is unique because it uses magnetic fields to non-invasively stimulate specific brain areas, potentially enhancing episodic memory by targeting the brain's network rather than acting as a focal lesion. This approach allows for modulation of memory processes through various parameters like frequency and intensity, which can be adjusted to optimize memory enhancement. ^{1 2 3 11 12}

Eligibility Criteria

This trial is for healthy, right-handed adults aged 18 to 35 who speak English fluently and have normal vision (with or without correction). It's not suitable for those with major neurological or psychiatric illnesses.

Inclusion Criteria

Fluent in English

I do not have any major neurological or psychiatric illnesses.

Right-handed

Exclusion Criteria

I am currently experiencing severe lack of sleep, extreme tiredness, or have recently traveled across time zones.

I have a history of heart disease.

History of a learning disorder (e.g., attention deficit disorder, dyslexia)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

MRI Session

Participants undergo an MRI session for collecting structural and functional brain images

1 session

1 visit (in-person)

Stimulation and Testing

Participants receive transcranial magnetic stimulation followed by MRI and memory tasks

2 sessions

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

1-2 weeks

Treatment Details

Interventions

• Transcranial magnetic stimulation

Trial Overview The study tests how transcranial magnetic stimulation (TMS) affects brain activity related to episodic memory. Participants will undergo TMS, behavioral testing, and MRI scans to see how this influences memory and brain network interactions.

Participant Groups

Group I: All participants Experimental Treatment 1 Intervention

All participants will complete all experimental conditions, which include transcranial magnetic stimulation (continuous theta-burst stimulation) to a brain region of experimental interest and to a control brain region.

Who Is Running the Clinical Trial?

Boston College

Lead Sponsor

Trials

40

Recruited

49,300+

Findings from Research

Repetitive Transcranial Magnetic Stimulation (rTMS) shows promise in enhancing cognitive processes, particularly in patients with epilepsy, by helping to identify verbal memory lateralization and potentially improving memory performance.

Single-pulse TMS is effective for mapping motor output during learning, while rTMS can interfere with the retrieval of episodic and semantic memories, indicating its potential as a valuable tool for studying learning and memory in cognitive neuroscience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial magnetic stimulation can measure and modulate learning and memory. Grafman, J., Wassermann, E.[2019]

Repetitive transcranial magnetic stimulation (rTMS) has not been thoroughly studied for side effects, with the main known risk being the acute production of seizures.

While tissue damage from rTMS is unlikely, there are concerns about potential cognitive effects and the possibility of long-term changes in brain function that have not yet been fully understood.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Side effects of repetitive transcranial magnetic stimulation. Wassermann, EM.[2005]

Repetitive transcranial magnetic stimulation (rTMS) has gained popularity for its ability to modulate brain activity, but safety considerations are crucial, especially with the recent updates to safety guidelines published in 2021.

The guidelines emphasize the importance of screening for risks, monitoring for adverse events, and specific safety measures when using rTMS, particularly in patients with conditions like stroke and traumatic brain injury.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety Review for Clinical Application of Repetitive Transcranial Magnetic Stimulation. Kim, WS., Paik, NJ.[2023]

Transcranial magnetic stimulation (TMS) has a very low seizure risk, with only 0.08 seizures reported per 1,000 sessions, and less than 0.02 seizures per 1,000 sessions when guidelines are followed for individuals without known risk factors.

The study found that exceeding safety guidelines increases the risk of seizures, and seizures are more likely to occur during the first few TMS sessions, suggesting that TMS is generally safe when administered properly.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics. Lerner, AJ., Wassermann, EM., Tamir, DI.[2021]

Mild adverse effects (MAEs) from transcranial magnetic stimulation (TMS) occur in about 5% of sessions, with most symptoms like headache and nausea reported after the sessions, particularly during initial treatments.

The study found no significant links between participant characteristics (age and gender) or TMS parameters (frequency and intensity) and the occurrence of MAEs, suggesting that initial participant anxiety may play a role in these reports.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation. Maizey, L., Allen, CP., Dervinis, M., et al.[2022]

In a study involving 429 pediatric patients undergoing transcranial magnetic stimulation (TMS) for motor and language mapping, most adverse events were benign, with seizures occurring in 5.8% of sessions but not conclusively linked to TMS.

TMS was safely performed in patients with cranial metal, and useful mapping results were achieved in nearly all cases, indicating that TMS is a safe option for functional mapping in pediatric patients with epilepsy or brain tumors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Image-guided TMS is safe in a predominately pediatric clinical population. Braden, AA., Weatherspoon, SE., Boardman, T., et al.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

How Can Transcranial Magnetic Stimulation Be Used to Modulate Episodic Memory?: A Systematic Review and Meta-Analysis. [2020]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Testing network properties of episodic memory using non-invasive brain stimulation. [2023]

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

Transcranial magnetic stimulation can measure and modulate learning and memory. [2019]

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

Network-targeted stimulation engages neurobehavioral hallmarks of age-related memory decline. [2021]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Reproducing the effect of hippocampal network-targeted transcranial magnetic stimulation on episodic memory. [2023]

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

Side effects of repetitive transcranial magnetic stimulation. [2005]

7. Korea (South) pubmed.ncbi.nlm.nih.gov

Safety Review for Clinical Application of Repetitive Transcranial Magnetic Stimulation. [2023]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Seizures from transcranial magnetic stimulation 2012-2016: Results of a survey of active laboratories and clinics. [2021]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Comparative incidence rates of mild adverse effects to transcranial magnetic stimulation. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Image-guided TMS is safe in a predominately pediatric clinical population. [2022]

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

Episodic Memory Retrieval Functionally Relies on Very Rapid Reactivation of Sensory Information. [2022]

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

Excitatory TMS modulates memory representations. [2020]