Working memory helps us hold information for a short time so one can think and make decisions. It keeps thoughts on track. As one gets older, working memory gets weaker. In people with dementia, it gets much worse, making it harder to talk with others, follow directions, or remember things like shopping lists.
This may happen because brain waves that support working memory fall out of sync. Researchers can see these brain waves using a test called EEG. In this study, the investigators will try to get these brain waves back in sync using a safe, non-invasive form of brain stimulation called transcranial magnetic stimulation (TMS), and will time it to each person's brain waves to make it more effective. The goal is to improve working memory in people with dementia. If successful, dementia patients may be able to be more independent taking pressure off their families.
Individuals must be diagnosed with Alzheimer's Disease or related dementias by a clinician.
Individuals must exhibit adequate oral communication skills and cognitive function sufficient to obtain a score above 10 on the MMSE
Instructions will be delivered in English; therefore participants must demonstrate an understanding of instruction provided in English.
Individuals must be at least 55 years or older
Contraindications to TMS; presence of a pacemaker, metal/electrical/magnetic implants not including titanium, known history of untreated or uncontrolled psychological disorders, pregnancy, history of seizure or diagnoses of epilepsy, are taking any prescription medications that increase the risk of seizure.
Allergy to rubbing alcohol, which is needed to prepare electromyography for TMS
Single group
EEG-triggered TMS
DeviceThis intervention involves delivering transcranial magnetic stimulation (TMS) to the dorsolateral prefrontal cortex (dlPFC) during working memory maintence timed to a specific electroencephalography (EEG) phase from the temporal cortex. The intervention is attempting to facilitate improved communication between the dlPFC and temporal cortex to improve working memory in people living with dementia.
Forward digit span
A set of numbers will be presented one after another and you will be asked to recall them in the same order after a brief maintence period. Accuracy and reaction time will be measured
Reverse digit span
A set of digits will be presented and you must recall the digits in reverse order. Accuracy and reaction time will be measured
Sentence span
You will be presented with a set of sentences one after another. You are tasked with remembering the last word of each sentence. Then after a brief maintence period, you will be asked to repeat the last word of each sentence in the order the sentences were presented in. Accuracy and reaction time will be measured
Grocery list task
You will be presented with a set of grocery items one after another. After a brief maintence period, you will be asked to repeat the items in the same order they were presented in. Accuracy and reaction time will be measured
Frontotemporal EEG connectivity (imaginary component of coherence)
The investigators will measure changes in the level of connectivity between the frontal and temporal cortex during working memory through electroencephalography (EEG). This metric indicates the level of communication between brain areas.
Prefrontal theta-gamma coupling (modulation index)
Theta-gamma coupling in the prefrontal cortex (involved in coordinating the order of items stored in working memory) during working memory will be extracted from electroencephalography (EEG) recorded during working memory maintenance.
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