Wayfinding Intervention in High-Fidelity Long-Term Memory

Mild Cognitive Impairment Clinical Trial

— LABYR  

Official title:

Cognitive Intervention to Restore Capabilities for Learning and Retrieval of High-Fidelity Memory

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04253587
• Other study ID #: 19-27586-A
• Status: Completed
• Phase: N/A
• Start date: October 1, 2019
• Est. completion date: December 15, 2021

Study information

• Verified date: February 2023
• Source: University of California, San Francisco
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Therapeutic treatment is yet available for declining memory, which is an impairment affecting the quality of life for many older adults and patients with cognitive impairment. Cognitive training with an immersive video game promises to drive hippocampal-cortical plasticity and associated gains that can restore memory capability or provide therapeutic treatment for memory deficits.

Description:

A hallmark of higher cognition is the capability for flexible association of diverse bits of information stored in memory, such that experiences can be remembered in detailed and distinct terms (i.e., high-fidelity long-term memory (LTM)). Interventions capable of sustaining improved learning and flexible association of new information into LTM remain elusive. Interventions have yet to be developed to attenuate the decline of high-fidelity LTM in normal aging or provide therapeutic treatment for patients with cognitive impairment without dementia (i.e., MCI).

This project applies a translational neuroscience approach in development of a cognitive training intervention that targets sustained improvement in capabilities for LTM and cognitive control. Treatments use commercially available head-mounted display Virtual Reality (VR) technology and tablet computers to present a deeply immersive spatial wayfinding video game. Based on preliminary results, the hypothesis is that immersion in a game to navigate errands through unfamiliar, visually complex neighborhoods (i.e., wayfinding) will be an effective means to environmental enrichment, which refers to a process whereby new and complex experiences bring change to brain and behavior.

The significance of this platform is from the effects in brain and behavior arising from cognitive training, which can generalize to improvements in untrained capability for high-fidelity LTM. Research in rodents and humans shows that learning a new, enriched environment spurs the healthy function of the hippocampus and supports lifelong neurogenesis. Adult-borne hippocampal neurogenesis has been linked as the neurobiological basis for the formation of new, high-fidelity memories.

The Labyrinth spatial wayfinding game was developed in-house to incorporate full scientific rigor, as with procedures in any properly controlled behavioral experiment. The game uses 3D and 2.5D computer graphics tools, as well as numerous levels of adaptive challenge, to deliver a dynamic, engaging experience for participants throughout the training regimen. Training can be administered with and without participant ambulation in movement through wayfinding runs.

A participant's pre- and post-training assessments will occur promptly before and after their 15 to 20-hour training regimen, including collection of functional MRI (fMRI) and structural MRI data. Cognitive outcome measures will assess capabilities for high-fidelity LTM retrieval.

The a priori hypothesis is that effectiveness of the wayfinding game intervention would be evidenced by post-training improvements in retrieval of high-fidelity LTM and associated cognitive control capabilities. FMRI results associated with the measured cognitive improvements will localize changes in functional brain networks that support gains in memory capabilities. Structural MRI measures will assess morphometric and volumetric changes from pre- to post-training assessments.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 50
• Est. completion date: December 15, 2021
• Est. primary completion date: December 15, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 62 Years to 85 Years

Eligibility

Inclusion Criteria:

• fluent speakers of English

• completed 12 or more years of education

• normal or corrected-to-normal vision

• dexterity to comfortably operate the scanner-compatible response box

• freedom from physical and neurological conditions contra-indicated for fMRI

• must confirm physical stamina and comfort for 45-minute, brisk walks on level ground

Exclusion Criteria:

• use of psychotropic medications

• history of concussions or dizziness, vestibular or balance problems

• significant discomfort with virtual reality experiences

Related Conditions & MeSH terms

• Cognitive Dysfunction
• Long-Term Memory Decline
• Mild Cognitive Impairment

Intervention

Device:
• LabyrinthVR
Head-mounted display virtual reality game designed to induce environmental enrichment in an adaptive, immersive regimen of wayfinding in novel urban and village neighborhoods.
• Placebo Games
Commercially-available, narrative computer games marketed as cognitively enriching.
• Coherence
Head-mounted display virtual reality game designed to present an adaptive rhythm training routine.
• Tablet
Tablet computer playing Labyrinth VR game but in 2.5D

Locations

Country	Name	City	State
United States	UCSF Mission Bay	San Francisco	California

Sponsors (1)

Lead Sponsor	Collaborator
University of California, San Francisco

Country where clinical trial is conducted

United States, 

References & Publications (1)

Wais PE, Arioli M, Anguera-Singla R, Gazzaley A. Virtual reality video game improves high-fidelity memory in older adults. Sci Rep. 2021 Jan 28;11(1):2552. doi: 10.1038/s41598-021-82109-3. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	MDT Change in Mnemonic Discrimination	Mnemonic discrimination task testing recognition memory for common objects, as reported in scores on a scale of the Lure Discrimination Index ranging from 0.00 to 1.00 where higher values show better performance.	baseline immediately before and post-assessment immediately after training regimen is completed
Primary	WALK Change in Recall	Encoding and test of recent autobiographical long-term memory, as reported in scores on a scale of Percentage of Items Recalled ranging from 0.00 to 1.00 where higher values show better performance.	baseline immediately before and post-assessment immediately after training regimen is completed
Primary	Changes in Volumetric-based Brain Morphometry Associated With Training-induced Changes in Mnemonic Discrimination	Structural MRI T1 data will be analyzed in terms of volumetric-based morphometry and compared between treatment arms and timepoints.	during collection of Outcome 1, baseline immediately before and post-assessment immediately after training regimen is completed
Primary	Changes in Task-based Cortical Functional Connectivity Associated With Training-induced Changes in Mnemonic Discrimination	functional MRI data will be analyzed in terms of beta-series correlations between co-active cortical regions of interest and compared between treatment arms and timepoints.	during collection of Outcome 1, baseline immediately before and post-assessment immediately after training regimen is completed
Secondary	Remote Cognitive Module (RCM)	A tablet application using a speech-to-text interface to administer neuropsychological tests comparable to CVLT-II verbal memory, verbal fluency, digit span and Trail Making Test-B.; Raw scores from the tasks will be transformed to z-scores, relative to population normative values, and a participant's z-scores will be the uniform measures of their performance across RCM tasks.; THESE DATA WERE NOT COLLECTED OR ANALYZED DUE TO FUNDING CONSTRAINTS	baseline immediately before and post-assessment immediately after training regimen is completed
Secondary	Test of Visual Attention Change in Top-down Control	test of speed and accuracy of visual attention and impulsivity	baseline immediately before and post-assessment immediately after training regimen is completed