Augmenting Cognitive Training in Older Adults - The ACT Grant

增强老年人的认知训练 - ACT 补助金

基本信息

批准号：
9194772
负责人：
RONALD A COHEN
金额：
$ 133.92万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-09-01 至 2021-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9194772
关键词：
Adult Age Age-Years Age-associated memory impairment Aging Alzheimer&apos s Disease Alzheimer&apos s disease risk Area Arizona Arousal Attention Biological Markers Blood Vessels Brain Brain region Cerebrum Characteristics Choline Clinical Clinical Trials Cognitive Cognitive aging Coupled Demographic Factors Diabetes Mellitus Disease Educational Intervention Elderly Elderly man Elderly woman Enrollment Exposure to Family history of Florida Freezing Functional Magnetic Resonance Imaging Gender Genotype Grant Growth Impaired cognition Individual Individual Differences Inferior Institutes Intervention Learning Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Measures Medial Memory Metabolic Metabolism Methods Motor Multi-Institutional Clinical Trial N-acetylaspartate Nature Neurocognitive Neurodegenerative Disorders Neuronal Plasticity Outcome Outcome Measure Parietal Lobe Participant Performance Phase Physiological Placebos Population Predictive Value Prevalence Protons Public Health Randomized Randomized Clinical Trials Readiness Recording of previous events Recruitment Activity Research Research Infrastructure Rest Risk Factors Science Secondary to Shark Short-Term Memory Site Structure System Testing Time Training Training and Education United States Universities Work active control age related association cortex base cognitive ability cognitive function cognitive performance cognitive task cognitive training combat effective intervention experience follow-up frontal lobe functional improvement functional outcomes functional status gamma-Aminobutyric Acid improved insight intervention effect memory encoding memory process multi-site trial myoinositol neuroimaging prevent processing speed relating to nervous system response skills white matter

项目摘要

ABSTRACT: This randomized clinical trial will test whether transcranial direct current stimulation (tDCS) of frontal cortices enhances neurocognitive and functional outcomes achieved from cognitive training in older adults experiencing age-related cognitive decline. Change in well-validated measures of neurocognitive function and everyday abilities will serve as outcome measures. Functional and structural neuroimaging biomarkers of neural plasticity and learning (fMRI, GABA MRS, etc.) will measure intervention-associated alterations in specific brain regions impacted by cognitive aging. tDCS is a noninvasive brain stimulation method that facilitates neural plasticity and learning. Accordingly, when used as an adjunctive intervention, tDCS may augment cognitive training effects. This study will leverage existing multisite clinical trial infrastructure at McKnight Brain Institutes located in two of the states with the largest representation of older adults in the United States: University of Florida, University of Miami, and University of Arizona. Adults over the age of 65 represent the fastest growing group in the US population. As such, age-related cognitive decline represents a major concern for public health. Recent research suggests that cognitive training in older adults can improve cognitive performance, with effects lasting up to 10 years. However, effects are typically limited to the tasks trained, with little transfer to other cognitive abilities or everyday skills. Effects may also be reduced in people with Alzheimer's disease risk factors. A two-phase multisite randomized clinical trial will examine the individual and combined impact of pairing cognitive training with transcranial direct current stimulation (tDCS) in older adults experiencing age-related cognitive decline (n = 360; 120 per site). Participants will consist of elderly men and women 65-90 years of age with evidence of age-related cognitive decline, but not MCI or Alzheimer's disease (MoCA≥25). We will compare changes in cognitive and brain function resulting from CT and CT combined with tDCS using a comprehensive neurocognitive, clinical, and multimodal neuroimaging assessment of brain structure, function, and metabolic state. Functional magnetic resonance imaging (fMRI) will be used to assess brain response during working memory, attention, and memory encoding; the active cognitive abilities trained by CT. Proton magnetic resonance spectroscopy (MRS) will assess markers of neural plasticity, GABA concentrations, and cerebral metabolism. We hypothesize that: 1) tDCS will enhance neurocognitive function, brain function, and functional outcomes from CT; 2) Effects of tDCS on CT will be maintained up to 12 months following training, and 3) Neuroimaging biomarkers of cerebral metabolism, neural plasticity (GABA concentrations) and functional brain response (fMRI) during resting vs. active cognitive tasks will predict individual response to tDCS, with certain Alzheimer's risk factors (e.g., APOE4 genotype, family history of Alzheimer's disease) predicting poorer cognitive and functional outcome. To date, no studies have comprehensively examined combined CT and tDCS intervention in the elderly. This study will provide definitive insight into the value of combating cognitive decline in a rapidly aging US population using tDCS with cognitive training.

抽象的：这项随机临床试验将测试额叶皮质经颅直流电刺激 (tDCS) 是否可以增强经历年龄相关的老年人通过认知训练获得的神经认知和功能结果认知能力下降。经过充分验证的神经认知功能和日常能力测量的变化将作为神经可塑性和学习的功能和结构神经影像生物标志物（fMRI、GABA） MRS 等）将测量受认知老化影响的特定大脑区域的干预相关变化。是一种非侵入性大脑刺激方法，可促进神经可塑性和学习。辅助干预，经颅直流电刺激 (tDCS) 可能会增强认知训练效果。这项研究将利用现有的多中心临床。麦克奈特脑研究所的试验基础设施位于老年人最多的两个州美国：佛罗里达大学、迈阿密大学和亚利桑那大学 65 岁以上的成年人。代表美国人口中增长最快的群体，因此，与年龄相关的认知能力下降是一个主要因素。最近的研究表明，老年人的认知训练可以改善认知能力。表现，效果可持续长达 10 年，但效果通常仅限于所训练的任务，效果甚微。阿尔茨海默病患者对其他认知能力或日常技能的影响也可能会减少。两阶段多中心随机临床试验将检查个体和综合影响。对经历年龄相关的老年人进行认知训练与经颅直流电刺激 (tDCS) 配对的研究认知能力下降（n = 360；每个中心 120 人）。参与者将由 65-90 岁的老年男性和女性组成。与年龄相关的认知能力下降的证据，但不是 MCI 或阿尔茨海默病 (MoCA≥25)。我们将比较变化。 CT 和 CT 结合 tDCS 使用综合神经认知技术对认知和脑功能进行评估，大脑结构、功能和代谢状态的临床和多模式神经影像评估。磁共振成像（fMRI）将用于评估工作记忆、注意力和注意力过程中的大脑反应记忆编码；通过质子磁共振波谱（MRS）训练的主动认知能力。评估神经可塑性、GABA 浓度和脑代谢的标志物我们追求：1) tDCS。将增强 CT 的神经认知功能、脑功能和功能结果 2) tDCS 对 CT 的影响；训练后维持长达 12 个月，以及 3) 脑代谢、神经元的神经影像生物标志物静息与主动认知任务期间的可塑性（GABA 浓度）和功能性大脑反应（fMRI）将预测个体对 tDCS 的反应，以及某些阿尔茨海默氏病风险因素（例如 APOE4 基因型、家族史阿尔茨海默病）预测较差的认知和功能结果。这项研究将全面检查 CT 和 tDCS 联合干预对老年人的影响。探讨使用经颅直流电刺激 (tDCS) 和认知训练来对抗快速老龄化的美国人口认知能力下降的价值。