An interventional study of LabyrinthVR and Placebo Games in Long-Term Memory Decline and Mild Cognitive Impairment, sponsored by University of California, San Francisco. Completed at 1 site in United States. Open to participants aged 62 Years to 85 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-02-27.
Sponsored by University of California, San Francisco · Not applicable, Interventional, and Basic science
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.
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.
3,843 studies on the registry are indexed under Cognitive Dysfunction; 1,100 are open to participants now.
This study's enrollment of 50 is below the median of 65 across 2,808 interventional studies indexed under Cognitive Dysfunction.
Browse Cognitive Dysfunction studies →University of California, San Francisco is the lead sponsor of 2,132 studies on the registry; 375 are open to participants now.
Of its 262 completed or terminated interventional studies of FDA-regulated products, 196 (75%) have results posted.
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Exclusion Criteria:
Multi-session cognitive intervention with head-mounted display virtual reality computer game that presents an adaptive spatial wayfinding challenge. Game movement via participant ambulation wearing leg-position trackers.
Device: LabyrinthVR
Multi-session cognitive intervention with head-mounted display virtual reality computer game that presents an adaptive spatial wayfinding challenge. Game movement via teleporting technique.
Device: LabyrinthVR
Multi-session cognitive intervention with handheld tablet or wireless virtual reality headset presentation of commercially available, narrative computer games.
Device: Placebo Games
Multi-session cognitive intervention with head-mounted display virtual reality computer game that presents an adaptive rhythm training game.
Device: Coherence
Multi-session cognitive intervention with tablet computer, displaying 2.5D version of Labyrinth game in an adaptive spatial wayfinding challenge. Game movement via on-screen control buttons.
Device: Tablet
Multi-session cognitive intervention with head-mounted display virtual reality computer game using wireless, narrower filed technology to presents an adaptive spatial wayfinding challenge. Game movement via teleporting technique.
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.
Commercially-available, narrative computer games marketed as cognitively enriching.
Head-mounted display virtual reality game designed to present an adaptive rhythm training routine.
Tablet computer playing Labyrinth VR game but in 2.5D
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.
Time frame: baseline immediately before and post-assessment immediately after training regimen is completed
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.
Time frame: baseline immediately before and post-assessment immediately after training regimen is completed
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.
Time frame: during collection of Outcome 1, baseline immediately before and post-assessment immediately after training regimen is completed
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.
Time frame: during collection of Outcome 1, baseline immediately before and post-assessment immediately after training regimen is completed
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
Time frame: baseline immediately before and post-assessment immediately after training regimen is completed
Test of Visual Attention Change in Top-down Control
test of speed and accuracy of visual attention and impulsivity
Time frame: baseline immediately before and post-assessment immediately after training regimen is completed
| Milestone | LabyrinthVR Trackers | Placebo Controls |
|---|---|---|
| Started | 25 | 25 |
| Baseline t1 | 24 | 21 |
| Post training t2 | 21 | 21 |
| Completed | 21 | 21 |
| Not completed | 4 | 4 |
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.
| LDI score on a scale | LabyrinthVR Trackers | Placebo Controls |
|---|---|---|
| MDT Change in Mnemonic Discrimination | 0.09 ± 0.03 | 0.01 ± 0.03 |
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.
| Items Recalled score on a scale | LabyrinthVR Trackers | Placebo Controls |
|---|---|---|
| WALK Change in Recall | 0.03 ± 0.02 | 0.00 ± 0.02 |
Structural MRI T1 data will be analyzed in terms of volumetric-based morphometry and compared between treatment arms and timepoints.
No measurements were reported for this outcome.
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.
No measurements were reported for this outcome.
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
No measurements were reported for this outcome.
test of speed and accuracy of visual attention and impulsivity
No measurements were reported for this outcome.
Collected over Over the total study period of 18 months, individual participants were observed during an approximate six-week period from baseline through post-training assessments.. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| LabyrinthVR Trackers | 0/25 (0%) | 0/25 (0%) | 0/25 (0%) |
| Placebo Controls | 0/24 (0%) | 0/24 (0%) | 0/24 (0%) |
| Age, Categorical(Participants) | LabyrinthVR Trackers | Placebo Controls | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 1 | 1 | 2 |
| >=65 years | 23 | 20 | 43 |
| Age, Continuous(years) | LabyrinthVR Trackers | Placebo Controls | Total |
|---|---|---|---|
| Mean | 69.1 (64 to 81) | 68.3 (63 to 79) | 68.7 (63 to 81) |
| Sex: Female, Male(Participants) | LabyrinthVR Trackers | Placebo Controls | Total |
|---|---|---|---|
| Female | 10 | 10 | 20 |
| Male | 14 | 11 | 25 |
| Ethnicity (NIH/OMB)(Participants) | LabyrinthVR Trackers | Placebo Controls | Total |
|---|---|---|---|
| Hispanic or Latino | 2 | 1 | 3 |
| Not Hispanic or Latino | 16 | 12 | 28 |
| Unknown or Not Reported | 6 | 8 | 14 |
| Region of Enrollment(Participants) | LabyrinthVR Trackers | Placebo Controls | Total |
|---|---|---|---|
| United States | 24 | 21 | 45 |
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University of California, San Francisco