Brain Imaging and Behavioural Changes Following Cued-movement Training of Finger Sequences in Healthy Older Adults
NCT ID: NCT06174740
Last Updated: 2024-12-05
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
50 participants
Study Classification
INTERVENTIONAL
Study Start Date
2023-07-01
Study Completion Date
2024-10-15
Brief Summary
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The goal of this study is to examine changes in the brain, behavior, and personal experience when music is used to guide learning of finger movement sequences (compared to visual stimuli alone) in healthy older adults. The main research questions this study aims to answer are:
1. Is auditory-based motor training associated with increased structural integrity of brain white matter tracts (connecting auditory-motor regions) compared to motor training with visual cues only?
2. Is auditory-based motor training (as compared to visual clues only) associated with increased brain cortical thickness, and changes in brain activation while performing a task in the MRI and while at rest, in auditory and sensorimotor regions?
3. Does auditory-based motor training lead to greater motor improvement on the trained task compared to a visually cued motor training?
4. Does auditory-based motor training lead to greater improvement on thinking, movement, and self-reported wellbeing measures, compared to visual cues alone?
In an 8-week home training, participants will be randomized into either the music-cued motor learning (Experimental Group) or visually cued only condition (Control Group), participants will complete the following measures before-and-after the training is administered at week 1 and in the end of the 8-week trial:
* MRI scans (structural and functional)
* Behavioral measures (motor, cognition)
* Questionnaires administered pre-and-post training (psychosocial functioning).
* Questionnaires administered once only (personality traits, musical background)
* In between measures, participants will follow an online computer-based training at home of 20 minutes per session, 3 times per week for 8 weeks, for a total of 24 sessions constituting 8 hours of training.
1. Is auditory-based motor training associated with increased structural integrity of brain white matter tracts (connecting auditory-motor regions) compared to motor training with visual cues only?
2. Is auditory-based motor training (as compared to visual clues only) associated with increased brain cortical thickness, and changes in brain activation while performing a task in the MRI and while at rest, in auditory and sensorimotor regions?
3. Does auditory-based motor training lead to greater motor improvement on the trained task compared to a visually cued motor training?
4. Does auditory-based motor training lead to greater improvement on thinking, movement, and self-reported wellbeing measures, compared to visual cues alone?
In an 8-week home training, participants will be randomized into either the music-cued motor learning (Experimental Group) or visually cued only condition (Control Group), participants will complete the following measures before-and-after the training is administered at week 1 and in the end of the 8-week trial:
* MRI scans (structural and functional)
* Behavioral measures (motor, cognition)
* Questionnaires administered pre-and-post training (psychosocial functioning).
* Questionnaires administered once only (personality traits, musical background)
* In between measures, participants will follow an online computer-based training at home of 20 minutes per session, 3 times per week for 8 weeks, for a total of 24 sessions constituting 8 hours of training.
Detailed Description
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Rationale: Music interventions targeting motor recovery are increasingly used in clinical settings with motorically impaired patients. In recent years, research started to demonstrate the mechanism underlying motor recovery by moving to music. While neuroimaging studies began to elucidate the neural correlates of music-based movement, most of these studies have been conducted on young adults, whereas the average age at onset of movement disorders which are the target of music therapy is in the 6th decade of life. Therefore, in this study the investigators aim to elucidate the underlying mechanisms of music-based movement in healthy older adults using a motor learning, finger sequence task to a musical rhythm. The results of the study have implications for motor learning with music in the aging person and neural plasticity in old age, and may reveal the benefit of adding music-cues to motor activities for motor, cognitive, and motivational outcomes in older adults.
Objective: The goal of the current study is to examine structural and functional neural correlates, as well as changes in behavioral and self-report measures of audiovisual music-based motor training compared to an identical motor training using visual cues only. The study focuses on white matter changes as the primary objective as the researchers are interested in connections between auditory and motor brain regions implicated in music-cued motor training. The research will examine brain activation, and changes in grey matter volume as secondary neuroimaging outcomes. Moreover, the study will also examine improvement on the trained task (outside of the MRI scanner), and changes on standardized measures of motor and cognitive function, as well as self-report measures of psychological wellbeing.
The main hypothesis is that the music-based motor training group will show greater white matter integrity of the arcuate fasciculus and greater density of cortical thickness in motor areas in the right brain hemisphere opposite to the trained left hand, as well as greater changes in brain activation while performing the task and at rest. The music group is expected to show greater improvement on the trained task, and measures of motor and cognitive function, as well as self-report measures of wellbeing (motivational, mood, and experience). As an exploratory measure, the study will assess changes in dual-task interference before and after the training as a far-transfer measure of the training, both in motor function and the underlying brain function.
Study design: In an 8-week longitudinal between-group design, participants will be randomized into two groups and will participate in pre-and-post MRI scans and behavioral measures, administered at baseline (week 1) and end of trial (week 8). The learning of an audio-visual finger movement sequence task will be compared to training on the same motor sequence with visual cues only. Participants will be assessed before and after the 8-week training on MRI and behavioral measures.
Study population: A total of 50 healthy older adults (60 years and older) will be recruited for this study and randomized into two groups of 25 participants each. Inclusion criteria are being right-handed (assessed by the Edinburgh Handedness Inventory), neurologically and physically healthy adult aged 60 or older (a previous diagnosis of a neurological/psychiatric illness that is symptom-free and for which no treatment was necessary for at least 5 years may be included), other physical health conditions that are stable (no change in diagnosis or treatment in the past 2 years may be included), having age-normal cognitive function (as assessed by a score of ≥24 on the MMSE), age appropriate normal or corrected vision and hearing ability, speaking fluent Dutch, and not currently receiving musical training. Participants should have access to a computer to complete the training at home. Participants will be recruited through various channels in the Netherlands including ageing organizations, (social) media, and study recruitment websites.
Sample Size: In a previous study with a longitudinal design using the same learning task in healthy young adults, the researchers found a medium size effect for changes in white matter tracts connecting auditory and motor regions (i.e., arcuate fasciculus) in the brain hemisphere opposite the trained hand. Therefore, it is estimated that the sample size needed to show a similar medium sized effect would be 22 per group, however, this number is increased to 25 healthy older participants per group to account for additional drop out at the analysis stage.
Intervention: Two groups will receive a similar intervention of finger sequence movement learning following visual cues with (or without) rhythmic auditory stimulation. Participants will be trained on the task at the laboratory before baseline measures. Participants will continue training at home online on a computer and keyboard for 20 minutes per session 3 times per week for 8 weeks for a total of 24 sessions. The Music group will train the finger sequence with the aid of visual cues in synchrony with a musical rhythm, while the Control group will receive the same visual stimulation with no auditory component.
Main study parameters/endpoints: The main parameter is change in white matter tracts underlying auditory-motor regions (arcuate fasciculus) in the brain hemisphere opposite the trained hand, contrasting before and after training, and between hemispheres. Secondary MRI parameters focus on cortical thickness changes in primary, premotor, and supplementary motor areas, task-related brain activation in the premotor cortex, and resting-state functional connectivity of auditory-motor regions. Motor performance on the cued motor sequence task will be assessed by measuring the accuracy of the key presses and the timing stability in synchrony with the onset of the cue. Changes in the scores of standardized motor and cognitive measures, and self-reported questionnaires on motivational and mood indices will be compared between groups and timepoints. As an exploratory outcome, the study will also assess changes in dual-task interference before and after the training both behaviorally and in terms of associated brain activity while performing the task.
Objective: The goal of the current study is to examine structural and functional neural correlates, as well as changes in behavioral and self-report measures of audiovisual music-based motor training compared to an identical motor training using visual cues only. The study focuses on white matter changes as the primary objective as the researchers are interested in connections between auditory and motor brain regions implicated in music-cued motor training. The research will examine brain activation, and changes in grey matter volume as secondary neuroimaging outcomes. Moreover, the study will also examine improvement on the trained task (outside of the MRI scanner), and changes on standardized measures of motor and cognitive function, as well as self-report measures of psychological wellbeing.
The main hypothesis is that the music-based motor training group will show greater white matter integrity of the arcuate fasciculus and greater density of cortical thickness in motor areas in the right brain hemisphere opposite to the trained left hand, as well as greater changes in brain activation while performing the task and at rest. The music group is expected to show greater improvement on the trained task, and measures of motor and cognitive function, as well as self-report measures of wellbeing (motivational, mood, and experience). As an exploratory measure, the study will assess changes in dual-task interference before and after the training as a far-transfer measure of the training, both in motor function and the underlying brain function.
Study design: In an 8-week longitudinal between-group design, participants will be randomized into two groups and will participate in pre-and-post MRI scans and behavioral measures, administered at baseline (week 1) and end of trial (week 8). The learning of an audio-visual finger movement sequence task will be compared to training on the same motor sequence with visual cues only. Participants will be assessed before and after the 8-week training on MRI and behavioral measures.
Study population: A total of 50 healthy older adults (60 years and older) will be recruited for this study and randomized into two groups of 25 participants each. Inclusion criteria are being right-handed (assessed by the Edinburgh Handedness Inventory), neurologically and physically healthy adult aged 60 or older (a previous diagnosis of a neurological/psychiatric illness that is symptom-free and for which no treatment was necessary for at least 5 years may be included), other physical health conditions that are stable (no change in diagnosis or treatment in the past 2 years may be included), having age-normal cognitive function (as assessed by a score of ≥24 on the MMSE), age appropriate normal or corrected vision and hearing ability, speaking fluent Dutch, and not currently receiving musical training. Participants should have access to a computer to complete the training at home. Participants will be recruited through various channels in the Netherlands including ageing organizations, (social) media, and study recruitment websites.
Sample Size: In a previous study with a longitudinal design using the same learning task in healthy young adults, the researchers found a medium size effect for changes in white matter tracts connecting auditory and motor regions (i.e., arcuate fasciculus) in the brain hemisphere opposite the trained hand. Therefore, it is estimated that the sample size needed to show a similar medium sized effect would be 22 per group, however, this number is increased to 25 healthy older participants per group to account for additional drop out at the analysis stage.
Intervention: Two groups will receive a similar intervention of finger sequence movement learning following visual cues with (or without) rhythmic auditory stimulation. Participants will be trained on the task at the laboratory before baseline measures. Participants will continue training at home online on a computer and keyboard for 20 minutes per session 3 times per week for 8 weeks for a total of 24 sessions. The Music group will train the finger sequence with the aid of visual cues in synchrony with a musical rhythm, while the Control group will receive the same visual stimulation with no auditory component.
Main study parameters/endpoints: The main parameter is change in white matter tracts underlying auditory-motor regions (arcuate fasciculus) in the brain hemisphere opposite the trained hand, contrasting before and after training, and between hemispheres. Secondary MRI parameters focus on cortical thickness changes in primary, premotor, and supplementary motor areas, task-related brain activation in the premotor cortex, and resting-state functional connectivity of auditory-motor regions. Motor performance on the cued motor sequence task will be assessed by measuring the accuracy of the key presses and the timing stability in synchrony with the onset of the cue. Changes in the scores of standardized motor and cognitive measures, and self-reported questionnaires on motivational and mood indices will be compared between groups and timepoints. As an exploratory outcome, the study will also assess changes in dual-task interference before and after the training both behaviorally and in terms of associated brain activity while performing the task.
Conditions
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Aging
Music
Motor Activity
Magnetic Resonance Imaging
Neuronal Plasticity
Keywords
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auditory
multisensory
stimulation
auditory cued
music based
music therapy training
rhythmic auditory stimulation
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
motor learning
movement training
Study Design
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Allocation Method
RANDOMIZED
Intervention Model
PARALLEL
Participants will be randomized into either the audiovisual condition (Experimental Group) or visual cues only condition (Control Group). A randomization list stratified by gender will be generated before commencing data collection.
Primary Study Purpose
BASIC_SCIENCE
Blinding Strategy
SINGLE
Outcome Assessors
The order of the allocation for new inclusions will be concealed from the assessors. Researchers administering assessments at the two time points will be masked and concealed from the randomization and participant allocation. Researchers involved in the MRI acquisition and analysis will collect the data under a different participant identifier (ID) than the ID used to conduct MRI analysis, and will follow an analysis script designed before data collection is completed, where applicable. Participants, and researchers may not be masked from the conditions due to practical reasons relating to the presence of auditory stimuli in the same or nearby vicinity, or interacting with the participants regarding the presence of auditory stimuli, which is the main intervention being investigated.
Study Groups
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Music-Cued Audiovisual Motor Training
Participants will be instructed on the task which they will perform at home online using a keyboard. The training involved auditory-cued audiovisual finger movement sequence learning task. Participants will complete an online computer-based training of 20 minutes at home 3 times per week for the duration of 8 weeks, and a total of 24 sessions, the duration and number of sessions.
Group Type
EXPERIMENTAL
Music-cued audiovisual motor training
Intervention Type
BEHAVIORAL
In addition to visual cues, music stimuli guide finger sequence movement both rhythmically (temporal component) and sonically (pitch-finger alignment).
Visually-Cued Motor Training
Participants will be instructed on the task which they will perform at home online using a keyboard. The training involved visual cues for finger-movement sequence learning task. Participants will complete an online computer-based training of 20 minutes at home 3 times per week for the duration of 8 weeks, and a total of 24 sessions, the duration and number of sessions
Group Type
ACTIVE_COMPARATOR
Visually-cued motor training
Intervention Type
BEHAVIORAL
Visual cues guide finger sequence movement by indicating which finger to move in alignment with the position and of the visual cue.
Interventions
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Music-cued audiovisual motor training
In addition to visual cues, music stimuli guide finger sequence movement both rhythmically (temporal component) and sonically (pitch-finger alignment).
Intervention Type
BEHAVIORAL
Visually-cued motor training
Visual cues guide finger sequence movement by indicating which finger to move in alignment with the position and of the visual cue.
Intervention Type
BEHAVIORAL
Other Intervention Names
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music-based training
music-cued training
music-based motor learning
multisensory stimulation
rhythmic auditory stimulation
Control Group
Eligibility Criteria
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Inclusion Criteria
* Right-handed (assessed by the Edinburgh Handedness Inventory),
* Neurologically and physically healthy adults (a previous diagnosis of a neurological/psychiatric illness that is symptom-free and for which no treatment was necessary for at least 5 years may be included), other physical health conditions that are stable (no change in diagnosis or medication in the past 2 years may be included)
* aged 60 or older,
* Age-normal cognitive function (as assessed by a score of ≥24 on the MMSE),
* Age appropriate normal or corrected vision and hearing ability,
* Speaking fluent Dutch,
* Not currently receiving musical training.
* Participants should have access to a computer and internet to complete the training at home.
* Neurologically and physically healthy adults (a previous diagnosis of a neurological/psychiatric illness that is symptom-free and for which no treatment was necessary for at least 5 years may be included), other physical health conditions that are stable (no change in diagnosis or medication in the past 2 years may be included)
* aged 60 or older,
* Age-normal cognitive function (as assessed by a score of ≥24 on the MMSE),
* Age appropriate normal or corrected vision and hearing ability,
* Speaking fluent Dutch,
* Not currently receiving musical training.
* Participants should have access to a computer and internet to complete the training at home.
Exclusion Criteria
* MRI contraindications (e.g., having ferromagnetic metals, such as implants, or claustrophobia)
* Starting or currently engaged in hand training, including musical training, and for example knitting, type-writing, or other hobbies (musical activities such as dancing or singing that do not involve the hand).
* Changes in medications that may affect fMRI measures.
* Not being able to follow the training at the laboratory or at home, or not completing the practice at home despite alerts and reminders.
* Starting or currently engaged in hand training, including musical training, and for example knitting, type-writing, or other hobbies (musical activities such as dancing or singing that do not involve the hand).
* Changes in medications that may affect fMRI measures.
* Not being able to follow the training at the laboratory or at home, or not completing the practice at home despite alerts and reminders.
Minimum Eligible Age
60 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
Sponsors
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Universiteit Leiden
OTHER
Sponsor Role
lead
Responsible Party
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Rebecca Schaefer
Associate Professor
Responsibility Role
PRINCIPAL_INVESTIGATOR
Principal Investigators
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Hanneke E Hulst, PhD
Role: STUDY_CHAIR
Universiteit Leiden
Locations
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Faculty of Social Science, Leiden University
Leiden, , Netherlands
Site Status
Countries
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Netherlands
References
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Mas-Herrero E, Maini L, Sescousse G, Zatorre RJ. Common and distinct neural correlates of music and food-induced pleasure: A coordinate-based meta-analysis of neuroimaging studies. Neurosci Biobehav Rev. 2021 Apr;123:61-71. doi: 10.1016/j.neubiorev.2020.12.008. Epub 2021 Jan 10.
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Shany O, Singer N, Gold BP, Jacoby N, Tarrasch R, Hendler T, Granot R. Surprise-related activation in the nucleus accumbens interacts with music-induced pleasantness. Soc Cogn Affect Neurosci. 2019 May 17;14(4):459-470. doi: 10.1093/scan/nsz019.
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Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
2022-08-23-RS Schaefer-V2-4097
Identifier Type: -
Identifier Source: org_study_id