Non-invasive Brain Stimulation and Injury Risk Biomechanics

NCT ID: NCT06093295

Last Updated: 2025-01-09

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

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-03

Study Completion Date

2024-05-30

Brief Summary

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The goal of this clinical trial is to test the effects of repetitive transcranial magnetic stimulation (theta burst stimulation) on movement biomechanics (jump landing) among individuals with and without a concussion history. The main question it aims to answer is if theta burst stimulation to the left dorsolateral prefrontal cortex improves single- and dual-task jump landing reaction time and jump landing biomechanics compared to a control site (vertex) for individuals with and without a concussion history.

Participants will be asked to perform a jump landing before and after the experimental (left dorsolateral prefrontal cortex) and control (vertex) theta burst stimulation protocol. The researchers will compare individuals with and without a concussion history to see if the effects differ between groups.

Detailed Description

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The overall goal of the project is to determine how repetitive transcranial magnetic stimulation (theta burst stimulation) influences movement among individuals with and without a concussion history. The purpose of this study is prevention via improving injury risk biomechanics to reduce the risk of future musculoskeletal injury.

Participants will complete 2 testing sessions separated by a minimum of 7 days.

During the first testing session, participants will complete single-task serial subtraction, single- and dual-task jump landing, and a theta burst stimulation intervention. The jump landing will be completed before and after theta burst stimulation and under single- and dual-task (serial 7s) conditions. During the second testing session, participants will complete the jump landing before and after theta burst stimulation under single- and dual-task (serial 7s) conditions.

On both testing sessions, the symptom checklist and Tampa Scale of Kinesiophobia 11 (TSK-11) will be administered upon arrival to the lab (after informed consent on day 1), and immediately after repetitive transcranial magnetic stimulation. The Godin Leisure Activity Questionaire will be administered on both days before the jump landing. The NASA Task Load index will be administered on both days immediately after the completion of every cognitive and motor task.

At the end of the second day of testing, the participants will be asked which day the participants believed the participants received the experimental and control conditions of the theta burst stimulation intervention.

This is a single-blinded cross-over design study. The participants will be unaware of when the participants receive the true (experimental) and control (placebo) theta burst stimulation intervention. Experimental (left dorsolateral prefrontal cortex) and control (vertex) conditions will be counterbalanced for the concussion history group. The control group will be matched to their respective concussion history group counterpart's counterbalanced order.

Conditions

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Concussion, Mild

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

The researchers will employ a single-blinded cross-over study design.
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants
The researchers will employ a single-blinded cross-over study design. The participant will not know which day the participant receives the true (experimental) or control (placebo) repetitive transcranial magnetic stimulation condition.

Study Groups

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Left Dorsolateral Prefrontal Cortex (experimental)

This is the experimental condition where participants will receive theta burst stimulation to the left dorsolateral prefrontal cortex.

Group Type EXPERIMENTAL

Repetitive Transcranial Magnetic Stimulation (Theta Burst Stimulation)

Intervention Type DEVICE

The repetitive transcranial magnetic stimulation device will generate successive magnetic pulses to the left dorsolateral prefrontal cortex (experimental condition) and the vertex (control condition).

The theta burst stimulation protocol is as follows:

* Total stimulation time \~190 seconds
* Intensity: 80% of active motor threshold
* 2 seconds train, repeated every 10 seconds
* In every 2-second train, 3 pulses of stimulation are delivered at 50 Hz, repeated every 200 milliseconds (i.e., 5 Hz) for a total of 600 pulses

Vertex (control)

This is the control condition where participants will receive theta burst stimulation to the vertex.

Group Type PLACEBO_COMPARATOR

Repetitive Transcranial Magnetic Stimulation (Theta Burst Stimulation)

Intervention Type DEVICE

The repetitive transcranial magnetic stimulation device will generate successive magnetic pulses to the left dorsolateral prefrontal cortex (experimental condition) and the vertex (control condition).

The theta burst stimulation protocol is as follows:

* Total stimulation time \~190 seconds
* Intensity: 80% of active motor threshold
* 2 seconds train, repeated every 10 seconds
* In every 2-second train, 3 pulses of stimulation are delivered at 50 Hz, repeated every 200 milliseconds (i.e., 5 Hz) for a total of 600 pulses

Interventions

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Repetitive Transcranial Magnetic Stimulation (Theta Burst Stimulation)

The repetitive transcranial magnetic stimulation device will generate successive magnetic pulses to the left dorsolateral prefrontal cortex (experimental condition) and the vertex (control condition).

The theta burst stimulation protocol is as follows:

* Total stimulation time \~190 seconds
* Intensity: 80% of active motor threshold
* 2 seconds train, repeated every 10 seconds
* In every 2-second train, 3 pulses of stimulation are delivered at 50 Hz, repeated every 200 milliseconds (i.e., 5 Hz) for a total of 600 pulses

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

All participants

* self-report to be physically active at least 90 minutes per week
* aged 18-35 years old
* self-report cleared for sports and physical activity

Concussion history group

\- self-report experiencing a concussion with the National Institute of Health common data element form

No concussion history group - self-report not experiencing a concussion with the National Institute of Health common data element form

Exclusion Criteria

All Participants

* self-report attention deficit disorder and/or attention deficit hyperactivity disorder
* self-report uncorrected vision problems (not included color blindness)
* self-reported history of neurological disease
* self-reported history of seizures/syncope or family history of epilepsy
* self-reported history of frequent severe headaches or migraine.
* self-reported history of respiratory or heart disease.
* self-reported structural brain lesions (e.g., stroke)
* self-reported increased intracranial pressure, such as after infarctions or trauma.
* self-reported currently using antidepressants, neuroleptic medication, medication that lowers seizure threshold, or any other medication that would interfere with testing.
* self-reported currently experiencing a high fever (day of testing; \>102.9 degrees)
* self-reported currently undergoing immunosuppressive therapy
* pregnancy
* metal anywhere in the head (except the mouth).
* any electronic implant, such as a cardiac pacemakers, cochlear implant, or deep brain stimulator.
* any implanted medication pump or intracardiac lines.
* self-report not being cleared for sport/physical activity by a medical practitioner (i.e., must be cleared by a medical practitioner to participate if the participant had previous traumatic musculoskeletal injury)
* students working directly in the PI's lab (concussion laboratory, biomechanics laboratory)
* NCAA athletes

Concussion history group

\- ≥13 symptom severity on the Sport Concussion Assessment Tool (22 total symptoms are graded on a scale of 0-6. Any symptom with a score \>0 \[1-6\], is summed to get symptom severity).
Minimum Eligible Age

18 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Georgia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robert C Lynall, Phd, ATC

Role: PRINCIPAL_INVESTIGATOR

University of Georgia

Locations

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University of Georgia

Athens, Georgia, United States

Site Status

Countries

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United States

References

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Huang YZ, Edwards MJ, Rounis E, Bhatia KP, Rothwell JC. Theta burst stimulation of the human motor cortex. Neuron. 2005 Jan 20;45(2):201-6. doi: 10.1016/j.neuron.2004.12.033.

Reference Type BACKGROUND
PMID: 15664172 (View on PubMed)

Ngetich R, Jin D, Li W, Song B, Zhang J, Jin Z, Li L. Enhancing Visuospatial Working Memory Performance Using Intermittent Theta-Burst Stimulation Over the Right Dorsolateral Prefrontal Cortex. Front Hum Neurosci. 2022 Mar 17;16:752519. doi: 10.3389/fnhum.2022.752519. eCollection 2022.

Reference Type BACKGROUND
PMID: 35370586 (View on PubMed)

Shumski EJ, Anderson MN, Oh J, Schmidt JD, Lynall RC. Computerized and functional reaction time in varsity-level female collegiate athletes with and without a concussion history. J Sci Med Sport. 2023 Mar;26(3):189-194. doi: 10.1016/j.jsams.2023.02.008. Epub 2023 Mar 3.

Reference Type BACKGROUND
PMID: 36906428 (View on PubMed)

Lynall RC, Blackburn JT, Guskiewicz KM, Marshall SW, Plummer P, Mihalik JP. Reaction Time and Joint Kinematics During Functional Movement in Recently Concussed Individuals. Arch Phys Med Rehabil. 2018 May;99(5):880-886. doi: 10.1016/j.apmr.2017.12.011. Epub 2018 Jan 11.

Reference Type BACKGROUND
PMID: 29337022 (View on PubMed)

Said S, Gozdzik M, Roche TR, Braun J, Rossler J, Kaserer A, Spahn DR, Nothiger CB, Tscholl DW. Validation of the Raw National Aeronautics and Space Administration Task Load Index (NASA-TLX) Questionnaire to Assess Perceived Workload in Patient Monitoring Tasks: Pooled Analysis Study Using Mixed Models. J Med Internet Res. 2020 Sep 7;22(9):e19472. doi: 10.2196/19472.

Reference Type BACKGROUND
PMID: 32780712 (View on PubMed)

Chimenti RL, Post AA, Silbernagel KG, Hadlandsmyth K, Sluka KA, Moseley GL, Rio E. Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise. Front Pain Res (Lausanne). 2021 Sep 1;2:739051. doi: 10.3389/fpain.2021.739051. eCollection 2021.

Reference Type BACKGROUND
PMID: 35295417 (View on PubMed)

Woby SR, Roach NK, Urmston M, Watson PJ. Psychometric properties of the TSK-11: a shortened version of the Tampa Scale for Kinesiophobia. Pain. 2005 Sep;117(1-2):137-44. doi: 10.1016/j.pain.2005.05.029.

Reference Type BACKGROUND
PMID: 16055269 (View on PubMed)

Other Identifiers

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PROJECT00007759

Identifier Type: -

Identifier Source: org_study_id

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