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The objective of the current proposal is to identify 1) how aging-related changes in GABAergic cortical inhibition affect motor performance, and 2) how aerobic exercise may improve inhibitory function and facilitate motor learning.
The current proposal seeks quantify neural inhibition using magnetic resonance spectroscopy (MRS) and transcranial magnetic stimulation (TMS) in older Veterans to identify how each measures contributes to aging-related changes in motor performance. Currently, over 56% (11.8 million) of Veterans are over age 60. Recent research has shown that aging is associated with decreased cortical inhibition and impaired hand motor function. However, this loss of inhibition is not an inescapable consequence of aging. The investigators' previous work that healthy older adults who engage in regular physical activity show increased cortical inhibition and improved dexterity as compared to their sedentary age cohort. This indicates that aerobic training may reverse aging related changes in cortical inhibition and alteration of tonic levels of cortical excitability can have a powerful impact on motor performance in the aging brain. In the current proposal, the investigators will enroll older adults to assess how different measurements (TMS and MRS) of the dominant inhibitory neurotransmitter in the brain - GABA differ in relation to motor control. During the MRS scan, participants will perform a motor learning task to assess change in GABA level throughout the acquisition session. These data will be compared with measures of cortical inhibition using TMS to quantify neurotransmitter receptor activity with respect to aging-related changes in motor performance. The investigators will also be comparing the effects of an aerobic exercise intervention as compared to a contact matched stretching control. The investigators believe this project is the first inquiry of its kind and will have an important impact in the understanding of aging-related neurophysiological changes in the brain and how it can remediate associated behavioral declines.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Aerobic Exercise | Experimental | Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. |
|
| Stretching and Balance Training | Active Comparator | Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Aerobic Exercise | Behavioral | Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Magnetic Resonance Spectroscopy | Measuring changes in dynamic magnetic resonance spectroscopy of primary motor cortex during motor learning. | Baseline and12 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joe R. Nocera, PhD | Atlanta VA Medical and Rehab Center, Decatur, GA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atlanta VA Medical and Rehab Center, Decatur, GA | Decatur | Washington | 30033-4004 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Aerobic Exercise | Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. Aerobic Exercise: Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. |
| FG001 | Stretching and Balance Training | Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. Stretching and Balance Training: Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Aerobic Exercise | Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. Aerobic Exercise: Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. |
| BG001 | Stretching and Balance Training |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Magnetic Resonance Spectroscopy | Measuring changes in dynamic magnetic resonance spectroscopy of primary motor cortex during motor learning. | 4 participants in the Aerobic exercise group and 10 participants in the Stretching and Balance Training group did not complete the 12 week follow up assessment | Posted | Mean | Standard Deviation | ppm | Baseline and12 weeks |
|
14 weeks from baseline assessment through 12-week intervention to follow up assessment.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Aerobic Exercise | Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. Aerobic Exercise: Participants will engage in an aerobic exercise program meeting thrice weekly for a period of 12 weeks. |
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COVID-19 impacted the in person exercise interventions
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Joe Nocera, PI | Department of Veterans Affairs | 404 321 6111 | 121662 | joe.nocera2@va.gov |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 30, 2022 | Sep 26, 2024 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Nov 26, 2021 | Sep 23, 2024 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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Two group parallel design
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| Stretching and Balance Training | Behavioral | Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. |
|
|
Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. Stretching and Balance Training: Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks.
Stretching and Balance Training: Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks.
|
|
|
| 0 |
| 12 |
| 0 |
| 12 |
| 0 |
| 12 |
| EG001 | Stretching and Balance Training | Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. Stretching and Balance Training: Participants will engage in a balance and stretching comparator condition meeting thrice weekly for 12 weeks. | 0 | 18 | 0 | 18 | 0 | 18 |
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