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The purpose of this study is to evaluate the feasibility of combining repetitive transcranial magnetic stimulation (rTMS), gaze and gait training to improve walking and balance in people with or without mild cognitive impairment.
The study plan is to recruit a total of 15 cognitively impaired and 15 healthy adults. The study will involve two visits. Each study visit will involve:
Researchers will compare changes in gaze and gait following training sessions with real rTMS and sham rTMS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Real 10 Hz rTMS | Active Comparator | Participants will receive 1 hour of real rTMS followed by 1 hour of gaze and gait training. |
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| sham rTMS | Sham Comparator | Participants will receive 1 hour of sham rTMS followed by 1 hour of gaze and gait training. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Repetitive Transcranial Magnetic Stimulation (rTMS) | Device | 10 Hz rTMS for 5 seconds over the frontal eye fields with 25 second intertrain interval for 10 trains (500 pulses) at 90% of the resting motor threshold, |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Foot Placement Error from baseline 1 | Foot position relative to stepping targets. | Beginning and end of Visit 1, an average of 8 hours |
| Change in VOR Gain from baseline 1 | The amount of eye relative to head movement during active head rotations. | Beginning and end of Visit 1, an average of 8 hours |
| Change in Foot Placement Error from baseline 2 | Foot position relative to stepping targets. | Beginning and end of Visit 2, an average of 8 hours |
| Change in VOR Gain from baseline 2 | The amount of eye relative to head movement during active head rotations. | Beginning and end of Visit 2, an average of 8 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Timed Up and Go (TUG) from baseline 1 | The TUG assesses mobility, balance, waking ability and fall risk in older adults. A higher risk for falling is indicated by >= 12 seconds to complete the test. | Beginning and end of Visit 1, an average of 8 hours |
| Change in Timed Up and Go (TUG) from baseline 2 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Julia Choi, Ph.D. | University of Florida | Principal Investigator |
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| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D050781 | Transcranial Magnetic Stimulation |
| ID | Term |
|---|---|
| D055909 | Magnetic Field Therapy |
| D013812 | Therapeutics |
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| Gait training | Behavioral | Subjects will practice stepping on virtual targets with real-time feedback of their foot position displayed on a screen while walking on a treadmill. |
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| Gaze training | Behavioral | Subjects will perform gaze stabilization and gaze shifting exercise via a virtual reality headset. |
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| Sham rTMS | Device | Sham rTMS stimulation will produce discharge noise and vibration without stimulating the cerebral cortex. |
|
The TUG assesses mobility, balance, waking ability and fall risk in older adults. A higher risk for falling is indicated by >= 12 seconds to complete the test. |
| Beginning and end of Visit 2, an average of 8 hours |