Cognition Disorder Clinical Trial
Official title:
Facilitating Numerical Processing With Transcranial DC Stimulation in Developmental Dyscalculia
Background:
- Developmental dyscalculia is a learning disability in which individuals have difficulty
learning or comprehending mathematics or other number concepts (such as keeping score during
games, measuring time, or estimating distance). Developmental dyscalculia affects certain
parts of the brain that are required for processing numbers. Research has shown that a form
of brain stimulation called transcranial direct current stimulation (tDCS), applied when
healthy individuals are being trained to carry out tasks with numbers, improved the ability
to process numbers and solve math problems. More research is needed about whether tDCS can
improve number processing in people with developmental dyscalculia.
Objectives:
- To examine whether the effects of transcranial direct current stimulation can help
individuals with developmental dyscalculia perform mathematical calculations.
Eligibility:
- Individuals between 18 and 50 years of age who have been diagnosed with developmental
dyscalculia, or are healthy volunteers without dyscalculia.
Design:
- Participants will have a screening visit and seven study visits. The screening visit and
six of the study visits will take place consecutively over the course of 6 days, and the
final visit will take place 3 months after the initial participation.
- Participants will be screened with a medical history, physical and neurological
examination, and a brief examination to test for dyscalculia and determine the
participant's dominant hand.
- Participants will be randomly assigned to one of two groups for the study. One group
will receive tDCS during training to perform a task with numbers, and the other group
will receive the same training with sham stimulation. Participants will not know which
group they are in.
- During the study visits, participants will be trained on number tasks on 6 consecutive
days. Before the tDCS or sham stimulation is applied at the beginning of the experiment
and at the end of each training day, participants will perform other tasks with numbers.
Participants will be evaluated based on the accuracy and speed with which they respond
to the questions.
- At the followup visit, participants will perform the same number tasks they completed
during the study visits. No tDCS will be performed at this visit.
Objectives
Developmental dyscalculia (DD) is a condition in which subjects cannot process adequately
numerical concepts. Performance of arithmetical calculations is associated with fMRI activity
in an extended brain network that includes parietal and prefrontal cortices. Areas within the
parietal lobe, required for numerical processing in healthy subjects, are abnormal in
subjects with DD. The purpose of this single-blinded study is to determine if facilitatory
transcranial direct current stimulation (tDCS) of these parietal areas in association with
numerical training will improve processing of numerical information relative to sham in
subjects with DD and in healthy volunteers.
Study population
30 healthy volunteers and 30 subjects with developmental dyscalculia (DD).
Design
Healthy volunteers and subjects with DD will be randomly assigned to one of two groups. Each
group will receive anodal tDCS or sham with numerical training. All subjects will participate
in 7 sessions. First, they will be trained on an ordinal numerical task (numerical training
task) in which they will learn the magnitude relations between two numbers on 6 consecutive
days while receiving sham stimulation or tDCS during the training. Subjects will see two
numbers on the screen, one viewed on the left side of the screen and the other on the right
side of the screen (example, 2, 4), and they have to decide which one is larger. Performance
will be evaluated by fitting a power-law function. Before the beginning of the experiment and
after each training day subjects will perform a numerical Stroop task that assesses the
automaticity of numerical processing, and a number-space task that will provide information
on the subject's accuracy of mapping numbers into space. At the end of each of the 6 training
days (immediately post training) and 3 months (seventh session) later (retention measure)
subjects will be tested on a dyscalculia test (The Dyscalculia Screener),the numerical Stroop
task, and the number-space task
Outcome Measures
The primary outcome measure will be the improvement in automatic numerical processing
(numerical Stroop task) as reflected by reaction times. Secondary outcomes are accuracy when
mapping numbers into space (number-space task) and improvement in the dyscalculia score
(Dyscalculia Screener).
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