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Cerebellar Involvement in Cognitive Sequencing

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Johns Hopkins University

Status

Enrolling

Conditions

Effects of Cerebellar Stimulation on Brain Activation

Treatments

Procedure: TMS during sequence-demanding task
Procedure: No TMS during sequence-demanding task
Procedure: No TMS during non-sequence-demanding task
Procedure: TMS during non-sequence-demanding task

Study type

Interventional

Funder types

Other
NIH

Identifiers

NCT06108336
IRB00328214
R01MH128278 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

Although there is increasing recognition that the cerebellum is involved in cognition as well as motor function, the manner in which the cerebellum contributes to cognition is uncertain. One theory that might account for both motor and cognitive contributions of the cerebellum is that the cerebellum is involved in sequencing of relevant events or stimuli. Previous experiments have suggested that disruption of the cerebellum impairs the prediction of the next event in a sequence. The present experiment will examine the impact of cerebellar stimulation on brain activation during the performance of both sequence-demanding and non-sequence-demanding tasks.

Full description

Although there is increasing recognition that the cerebellum, which contains half of the brain's neurons, is involved in cognition as well as motor function, the manner in which the cerebellum contributes to cognition is uncertain. The uniform circuitry of the cerebellum and the extensive connectivity of the cerebellum with numerous neocortical regions has suggested to some researchers that there is a common computation that the cerebellum performs for both motor and cognitive functions. The cerebellar sequencing hypothesis posits that the cerebellum acquires sequence information, makes sequence predictions, and detects sequence violations. These functions, executed via a forward model, could underlie cerebellar involvement in both motor and cognitive behavior. In motor control, such predictions can be used to guide limb trajectory without reliance on movement-generated sensory feedback. In cognition, sequencing requirements are prominent in both verbal working memory (VWM) and language acquisition; eg, in VWM, keeping a phone number in mind requires encoding and rehearsing a sequence of digits. In language, words consist of sequences of syllables, and the learning of syllable transition probabilities is an important component of recognizing legal words in a language. Importantly, prominent cerebellar activation has been observed in many functional MRI (fMRI) VWM and language studies. However, the brainstem/cerebellar neural correlates of sequencing in cognition, and the influence of cerebellar sequence predictions on neocortical targets, are poorly understood. In this experiment, studying healthy individuals the investigators will Investigate the cerebellum as a source of sequence prediction and its influence on forebrain areas. The cerebellum is hypothesized to provide its forward model sequence prediction to forebrain targets, but to date no study has attempted to visualize with concurrent TMS/fMRI the consequences of disrupting this cerebellar input on forebrain activation. In the investigators previous work, the investigators show that transcranial magnetic stimulation (TMS) during the rehearsal of a sequence of letters results in errors in determining if a probe letter matches the next letter in the sequence, suggesting that TMS disrupted this predictive input. In accordance with this finding, the investigators hypothesize that, using concurrent TMS/fMRI, TMS disruption during a sequencing task will produce greater changes in neocortical activation relative to an analogous control task that does not have the predictive component brought out by sequencing demands. The investigators further hypothesize that different patterns of neocortical activations in response to cerebellar TMS will be observed depending on whether a probe letter matches the expected next letter in a sequence.

Enrollment

50 estimated patients

Sex

All

Ages

18 to 50 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • 1) Age 18-50;
  • 2) educational attainment of at least 8 years;
  • 3) capable of giving informed consent;
  • 4) fluent speaker of English by self-report;
  • 5) right handed.

Exclusion criteria

  • 1) illicit drug use within 30 days of MRI scanning;
  • 2) neurological or systemic disorder which can cause dementia or cognitive dysfunction;
  • 3) history of an Axis I psychiatric disorder including substance use disorder;
  • 4) history of definite stroke;
  • 5) focal lesion on MRI exam;
  • 6) uncorrected visual deficits by self-report
  • 7) contraindications for MRI scanning
  • 8) use of anxiolytic, antidepressant, neuroleptic, or sedative medication
  • 9) Additional exclusion criteria recommended by Wassermann for TMS neuromodulation, including: History of seizure or a family history of epilepsy, heart disease, intracardiac lines, increased intracranial pressure, history of head trauma, and history of respiratory disease

Trial design

Primary purpose

Basic Science

Allocation

Non-Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

50 participants in 2 patient groups

Cerebellar Stimulation
Experimental group
Description:
TMS will be administered to the cerebellum on half the trials of a sequence-demanding task, and on half the trials of a non-sequence-demanding task. Task order will be counterbalanced.
Treatment:
Procedure: TMS during non-sequence-demanding task
Procedure: No TMS during non-sequence-demanding task
Procedure: No TMS during sequence-demanding task
Procedure: TMS during sequence-demanding task
Occipital Stimulation
Active Comparator group
Description:
TMS will be administered to an occipital control region on half the trials of a sequence-demanding task, and on half the trials of a non-sequence-demanding task. Task order will be counterbalanced.
Treatment:
Procedure: TMS during non-sequence-demanding task
Procedure: No TMS during non-sequence-demanding task
Procedure: No TMS during sequence-demanding task
Procedure: TMS during sequence-demanding task

Trial contacts and locations

1

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Central trial contact

John E Desmond, Ph.D.; JoAnna Mathena, MS

Data sourced from clinicaltrials.gov

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