Autonomic Mechanisms of Sleep-dependent Memory Consolidation

NCT ID: NCT04021797

Last Updated: 2021-05-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-15

Study Completion Date

2020-03-15

Brief Summary

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The goal of the proposed project is to identify the impact vagal activity during sleep for memory formation. Nearly 100 years of research contends that sleep plays a critical role in memory consolidation (i.e. the transformation of recent experiences into stable, long-term memories), yet much of this literature has focused on the central nervous system and technologies like electroencephalography (EEG) to unpack neural correlates involved in memory processing. Sleep is also a unique period of autonomic variation and an expansive literature has indicated the critical importance of the autonomic nervous system for memory formation. This project would be amongst the first to examine the autonomic nervous system during sleep as a critical, causal pathway linking sleep to memory processing. The investigators will assess the impact of non-invasive, transcutaneous vagal nerve stimulation on sleep and post-sleep memory performance. Autonomic physiology, including electrocardiography and impedance cardiography, will be gathered at baseline, before the memory task and continuously during sleep to examine vagal tone (i.e. heart rate variability) and sympathetic activation (i.e. pre-ejection period) in response to both active and sham stimulation conditions. Polysomnography will also be gathered during the nap to examine sleep architecture. The proposed research will address a critical gap in the literature by: 1) examining the causal role of the ANS for memory functioning in humans, 2) extending the current understanding of sleep's impact on memory processing, and 3) set the groundwork for novel, sleep-based interventions with the goal of improving cognitive health.

Detailed Description

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Poor sleep is associated with significant cognitive health decline. Recently, sleep disturbances have emerged as notable predictive and exacerbating factors in the onset and development of neurodegenerative disease. Decades of research have implicated that sleep plays a critical role in memory consolidation (i.e. the transformation of recent experiences into stable, long-term memories), the decline of which is critical in the early stages of dementia. This literature affords that sleep, a period of reduced external interference, provides an optimal window for memory consolidation and that electrophysiological features that emerge during sleep are integrally involved in the consolidation process. Most of this literature has focused on the central nervous system and technologies like electroencephalography (EEG) to unpack neural correlates involved in memory processing. However, little impact from this work has translated into practical treatments and recent reviews of the literature question these sleep - memory associations. This lack of clarity suggests that there may be other factors critical to our understanding of sleep-dependent memory consolidation that have not been given due consideration. This proposal suggests that the autonomic nervous system (ANS) during sleep may reflect a critical, though understudied, pathway linking sleep and memory.

An expansive body of research has supported the role of the ANS for memory formation. Rodent studies have found that the storage of new information in memory is either enriched or impaired following learning acquisition by directly modifying peripheral activity through the vagus nerve. The vagus nerve is responsible for communicating information about peripheral excitation and arousal via projections to the brainstem, which then projects to memory-related areas including the amygdala complex, hippocampus, and prefrontal cortex. Indeed, in humans, researchers have demonstrated that direct stimulation of the vagus nerve, via surgical implants, can enhance declarative memory in epileptic patients and in patients with Alzheimer's Disease. Recently, in a sample of healthy older adults, non-invasive (transcutaneous) vagal nerve stimulation during wake boosted memory for face-name associations. Importantly, previous research has demonstrated the predominance of parasympathetic/vagal activity during sleep, particularly during slow wave sleep, which has received critical attention for its causal role in declarative memory consolidation. More so, the PI's work has shown that sleep acts as a regulatory influence over vagal activity and that vagally-mediated activity during sleep can predict post-sleep memory improvement. Yet, few investigations have examined the causal impact of vagal activity during sleep for memory outcomes, which is the central aim of this application.

In this project, the investigators will utilize a within-subject, sham-controlled, counterbalanced design to determine the impact of active (inside of left ear) vs. sham (left earlobe) transcutaneous vagal nerve stimulation (tVNS) on: 1) sleep architecture, 2) autonomic activity during sleep, and 3) memory performance post-sleep. To this end, the investigators will utilize a daytime nap protocol, a common methodological tool used to assess the role of sleep for cognition. A nap approach allows for strict circadian-control of cognition and provides for an examination of tVNS's impact on a full cycle of sleep that includes both NREM and REM stages. The researchers will assess declarative memory performance, using a word-pair associates task, before and after the nap period for both the active and sham stimulation conditions. Autonomic physiology, including electrocardiography and impedance cardiography, will be gathered at baseline before the word-pairs task and continuously during sleep to examine vagal tone (i.e. heart rate variability) and sympathetic activation (i.e. pre-ejection period) in response to both the active and sham stimulation conditions. Polysomnography will also be gathered during the nap to examine sleep architecture.

Conditions

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Memory Sleep

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

We will employ a within-subjects, crossover, sham-controlled design. Each participant will be exposed to both active and sham conditions over two visits (5-days apart).
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Participant's will not be aware which configuration represents the sham vs active stimulation condition. Data analyses will be conducted blind to sham or active stimulation.

Study Groups

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Sham

For the sham condition, the electrodes will be attached to an ear location that has not been shown to engage the vagus nerve. The stimulation frequency, intensity and duration will be aligned with the same parameters presented for the active tVNS condition (8Hz frequency, 5.0 mA electrical current and 200 ms pulse width).

Group Type SHAM_COMPARATOR

transcutaneous vagal nerve stimulation

Intervention Type DEVICE

The transcutaneous stimulator engages the cymba conchae in the left inner ear, compared to the left earlobe in the sham stimulation condition.

Active

For the active condition, the electrodes will be attached to the ear at a place previously demonstrated to stimulate the vagus nerve. The stimulation frequency, intensity and duration will be aligned with the same parameters presented for the sham condition (8Hz frequency, 5.0 mA electrical current and 200 ms pulse width).

Group Type EXPERIMENTAL

transcutaneous vagal nerve stimulation

Intervention Type DEVICE

The transcutaneous stimulator engages the cymba conchae in the left inner ear, compared to the left earlobe in the sham stimulation condition.

Interventions

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transcutaneous vagal nerve stimulation

The transcutaneous stimulator engages the cymba conchae in the left inner ear, compared to the left earlobe in the sham stimulation condition.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Healthy, adult volunteers between the ages of 18-64.
* English speaking
* Self-reported napping

Exclusion Criteria

* Aged greater than 64 years
* Lack of adherence to sleep/wake schedule of at least 7 hours a night for 5-days prior to study and during study timeline.
* Body mass index of 35 or above
* Presence of any clinical sleep disorder, including insomnia and obstructive sleep apnea (OSA)
* Presence of medical or psychiatric condition that is likely to affect sleep/wake function or cardiovascular functioning, including doctor diagnosed arrhythmia, bradycardia, hypertension, congestive heart failure, major depression, bipolar disorder, post-traumatic stress disorder.
* Medication use that is likely to affect sleep/wake function or cardiovascular functioning, including antidepressants, anxiolytic or soporific medication, and beta-blockers.
* Pregnancy
* Epilepsy
* head trauma
* alcoholism
* migraines
* metal pieces in the body (may confound tVNS delivery)
* history of substance abuse
Minimum Eligible Age

18 Years

Maximum Eligible Age

64 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Center for Advancing Translational Sciences (NCATS)

NIH

Sponsor Role collaborator

University of California, San Francisco

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lauren N Whitehurst, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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Langley Porter Psychiatric Institute

San Francisco, California, United States

Site Status

Countries

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United States

References

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Clark KB, Naritoku DK, Smith DC, Browning RA, Jensen RA. Enhanced recognition memory following vagus nerve stimulation in human subjects. Nat Neurosci. 1999 Jan;2(1):94-8. doi: 10.1038/4600.

Reference Type BACKGROUND
PMID: 10195186 (View on PubMed)

Whitehurst LN, Cellini N, McDevitt EA, Duggan KA, Mednick SC. Autonomic activity during sleep predicts memory consolidation in humans. Proc Natl Acad Sci U S A. 2016 Jun 28;113(26):7272-7. doi: 10.1073/pnas.1518202113. Epub 2016 Jun 13.

Reference Type BACKGROUND
PMID: 27298366 (View on PubMed)

Whitehurst LN, Naji M, Mednick SC. Comparing the cardiac autonomic activity profile of daytime naps and nighttime sleep. Neurobiol Sleep Circadian Rhythms. 2018 Mar 15;5:52-57. doi: 10.1016/j.nbscr.2018.03.001. eCollection 2018 Jun.

Reference Type BACKGROUND
PMID: 31236511 (View on PubMed)

Kreuzer PM, Landgrebe M, Husser O, Resch M, Schecklmann M, Geisreiter F, Poeppl TB, Prasser SJ, Hajak G, Langguth B. Transcutaneous vagus nerve stimulation: retrospective assessment of cardiac safety in a pilot study. Front Psychiatry. 2012 Aug 7;3:70. doi: 10.3389/fpsyt.2012.00070. eCollection 2012.

Reference Type BACKGROUND
PMID: 22891061 (View on PubMed)

Diekelmann S, Born J. The memory function of sleep. Nat Rev Neurosci. 2010 Feb;11(2):114-26. doi: 10.1038/nrn2762. Epub 2010 Jan 4.

Reference Type BACKGROUND
PMID: 20046194 (View on PubMed)

Ghacibeh GA, Shenker JI, Shenal B, Uthman BM, Heilman KM. The influence of vagus nerve stimulation on memory. Cogn Behav Neurol. 2006 Sep;19(3):119-22. doi: 10.1097/01.wnn.0000213908.34278.7d.

Reference Type BACKGROUND
PMID: 16957488 (View on PubMed)

Cellini N, Whitehurst LN, McDevitt EA, Mednick SC. Heart rate variability during daytime naps in healthy adults: Autonomic profile and short-term reliability. Psychophysiology. 2016 Apr;53(4):473-81. doi: 10.1111/psyp.12595. Epub 2015 Dec 16.

Reference Type BACKGROUND
PMID: 26669510 (View on PubMed)

Clancy JA, Mary DA, Witte KK, Greenwood JP, Deuchars SA, Deuchars J. Non-invasive vagus nerve stimulation in healthy humans reduces sympathetic nerve activity. Brain Stimul. 2014 Nov-Dec;7(6):871-7. doi: 10.1016/j.brs.2014.07.031. Epub 2014 Jul 16.

Reference Type BACKGROUND
PMID: 25164906 (View on PubMed)

Other Identifiers

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A127552

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

Memory+Stimulation

Identifier Type: -

Identifier Source: org_study_id

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