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N/A N=63 Randomized Quadruple-blind Treatment

Scalp Application of LED Therapy to Improve Thinking and Memory in Veterans With Gulf War Illness

Gulf War Veterans Illness · Neurobehavioral Manifestations · Memory Disorders

Enrolled (actual)
63
Serious AEs
0.0%
Results posted
Jan 2020
Primary outcome: Primary: Digit Span Forwards — 8.7; 9.22; 8.33; 9.36 units on a scale — p=<0.01

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Real LED Treatment (Device); Sham LED Treatment (Device)
Age
Adult, Older Adult · 38+ yrs
Sex
All
Sponsor
VA Office of Research and Development
Primary completion
Aug 2018

Outcome Measures

OutcomeResultp-value
PRIMARY
Digit Span Forwards
8.7; 9.22; 8.33; 9.36; 9.11; 9.8 <0.01 sig
PRIMARY
Digit Span Backwards
5.78; 6.39; 7.21; 7.73; 6.94; 7 0.88
PRIMARY
Digit Span Total Forward + Backwards
14.48; 15.61; 15.54; 15.86; 16.06; 16.79 0.81
PRIMARY
Trails Condition 2
34.56; 39.61; 34.5; 37.59; 34; 33.26 0.23
PRIMARY
Trails Condition 4
87.72; 97.74; 88.83; 79.63; 80.61; 89.68 <0.12
PRIMARY
Stroop Inhibition (Trial 3)
60.8; 60.83; 59.54; 57.81; 56.33; 60.63 <0.52
PRIMARY
Stroop Inhibition/Switching
72.04; 68.22; 68.5; 62.46; 72.44; 59 <0.27
PRIMARY
California Verbal Learning Test -II (CVLT-II) Total Trials 1-5
45.48; 41.09; 47.96; 46.05; 50; 50.42 <0.37
PRIMARY
CVLT-II, Short Delay Free Recall
9.52; 8.13; 10.38; 9.5; 10.9; 10.74 <0.36
PRIMARY
CVLT-II, Short Delay Cued Recall
11; 10.22; 12.04; 10.82; 12.56; 11.84 <0.46
PRIMARY
CVLT-II Long Delay Free Recall
10; 8.49; 11; 9.82; 11.4; 10.21 <0.84
PRIMARY
CVLT-II Long Delay Cued Recall
11; 9.83; 11.9; 10.96; 12.56; 11.48 <0.93
PRIMARY
Conner's Continuous Performance Test II (CPT) False Alarms
30.48; 24.14; 26.16; 18.32; 26.72; 17.22 <0.85
PRIMARY
CPT Correct Detections, Reaction Time (RT)
477.41; 464.62; 476.38; 470.82; 457.02; 467.5 <0.26
PRIMARY
Conner's Continuous Performance Test II (CPT), D'
1.84; -0.67; 0.499; -.836; 0.24; -1.13 <0.45
PRIMARY
Rey Osterrieth Complex Figure Test (ROCFT); Immediate Recall
16.16; 14.87; 20.56; 18.14; 22.22; 18.658 <0.46
PRIMARY
ROCFT, Delayed Recall
15.75; 14.28; 18.96; 17.5; 21.64; 19 <0.64
SECONDARY
Beck Depression Inventory (BDI)
19.72; 15.17; 18.91; 11.95; 17.06; 13.05 <0.82
SECONDARY
PCL-Civilian Survey
48.83; 40.30; 42.04; 35.43; 42.5; 36.32 <0.43
SECONDARY
Visual Analog Pain Rating
3.48; 3.59; 3.06; 2.73; 3.14; 2.4 <0.15
SECONDARY
Short Form McGill Pain Questionnaire
9.58; 10.74; 11.38; 9; 9.67; 8.63 .08
SECONDARY
Pittsburgh Sleep Quality Index (PSQI)
10.12; 8.39; 9.54; 7.64; 9.11; 7.05 <0.7
SECONDARY
Karolinska Sleepiness Scale
5.08; 4.35; 4.58; 4.27; 5.33; 3.53 <0.48
SECONDARY
Short Form-36V Plus (PCS)
-.85; -.83; -1.06; -.76; -.91; -.61 <0.02 sig
SECONDARY
Short Form-36V Plus (MCS)
-.64; -.20; -.53; -.078; -.50; -.34 <0.36
SECONDARY
Multidimensional Fatigue Inventory (MFI), General Score
14.08; 11.83; 13.9; 12.68; 14.44; 11.74 <0.82
SECONDARY
Multidimensional Fatigue Inventory, Physical Score
11.32; 11.57; 11.5; 10.73; 11.83; 11 <0.2
SECONDARY
Multidimensional Fatigue Inventory, Reduced Activity Score
11.52; 10.48; 11.21; 11.05; 11.6; 9.47 <0.71
SECONDARY
Multidimensional Fatigue Inventory, Reduced Motivation Activity
10.44; 9.78; 10.67; 9.96; 11.28; 10.32 <0.85
SECONDARY
Multidimensional Fatigue Inventory, Mental Fatigue
14.24; 12.83; 13.71; 12.5; 13.72; 13.05 <0.44

Summary

The purpose of this study is to learn if an experimental treatment can help thinking ability, and memory in Veterans with Gulf War Veterans Illnesses (GWVI). The experimental treatment uses light-emitting diodes (LEDs), that are applied outside the skull, to the head using a helmet that is lined with near-infrared diodes. LEDs are also placed in the nostrils (one red diode; and one near-infrared diode), near-infrared photons to the olfactory bulbs located on the orbito-frontal cortex. There are connections between the olfactory bulbs and the hippocampus. A treatment takes about 30 minutes. The participants receive a series of LED treatments which take place as outpatient visits at the VA Boston Healthcare System, Jamaica Plain Campus. The FDA considers the helmet LED device used here, to be a non-significant risk device. The diodes in the device placed in the nose are low-risk devices, within the FDA Category of General Wellness. In addition, a single, 90 mW near-infrared (NIR) LED was placed on each ear. The LEDs do not produce heat.

Eligibility Criteria

Inclusion Criteria

Participants were recruited from the participants in a Department of Defense (DoD) study of a longitudinal cohort of Gulf War Veterans who returned from their deployment in 1991 through Ft. Devens, MA. This cohort has been followed at multiple time points since the end of war (Proctor et al., 1998), and through the VA Informatics and Computing Infrastructure (VINCI)/Corporate Data Warehouse (CDW) database, with approval from NDS. The San Francisco VA Medical Center (SF VAMC) was a second site on the study (35 Veterans were run in Boston; 12 were run in San Francisco on the same protocol.)

Those recruited from the VINCI/CDW database, resided within a 25 mile radius of the Boston VA Healthcare System (VABHS) or 25 miles of the SF VA Medical Center (VAMC). The Institutional Review Board at the VA BHS and the SF VAMC (University of California, San Francisco) approved the study. In accordance with the Declaration of Helsinki, Informed Consent and HIPAA authorization was obtained from all participants.

Participants answered 'Yes' to the following questions: 1) Difficulty concentrating; and/or 2) Difficulty remembering recent information.

  • Must be a Veteran deployed in 1990-1991 Gulf War, in the Kuwait Theatre
  • Meets criteria for GWVI as defined by "Symptom Questions used to identify Gulf War Illness by Kansas Case Definition, and Chronic Multisymptom Illness by Fukuda Case Definition" (Steele, 2000; Fukuda et al., 1998). Participants must have the presence of 1 or more chronic symptoms (lasting >6 months) from at least 2 of 3 symptom categories from Fukuda et al., (1998): 1) musculoskeletal (muscle pain, or joint pain, stiffness); 2) mood-cognition 3) fatigue.
  • Ages 38 - 65 years
  • Must be physically able to travel to the VA Boston Healthcare System, Jamaica Plain or San Francisco VA Medical Center, for Neuropsychological testing and transcranial LED treatments
  • Must meet screening criteria from the Eligibility Screening:

The following Neuropsychological (NP) tests were administered at Screening: Trail Making Test A & B (Reynolds, 2002); Controlled Oral Word Association Test (COWAT (FAS); Spreen & Benton, 1977; Benton and Hamsher, 1989); California Verbal Learning Test - II (Delis et al., 2000); Color-Word Interference Test (Stroop; Delis, Kaplan, Kramer, 2001). Additional screening tests included: Short Form McGill Pain Questionnaire (Melzac, 1984); Overall VAS current pain rating (0-10); and the PTSD Checklist- Civilian (PCL-C, Weathers et al., 1994).

Participants were required to score at least 2 SD below the standardized norm (age, education, gender) on at least 1 NP screening test or 1 SD below the standardized norm on at least 2 NP screening tests. The Word Reading Subtest from the Wide Range Achievement Test-4 (Wilkinson and Robertson, 2006) was used to estimate premorbid level of cognitive functioning. The SD for each participant on each NP screening test was adjusted by his/her estimated premorbid cognitive level.

The Test of Memory Malingering (TOMM, 1996) was administered. Participants who failed Trial 2, or Trial 1 and 2 were excluded from the study. If a participant failed Trial 1, but did not fail Trial 2, he/she was not excluded if he/she showed evidence of poor learning on other NP screening tests such as the CVLT (Schroeder et al., 2013, Arch Clin Neuropsych) Participants were required to have a level of pain 7/10 or less on the VAS and less than 38/50 on the McGill pain questionnaires at screening, as pain has been shown to influence cognition (Moriarty et al., 2011, Review).

Exclusion Criteria

  • Presence of a neurodegenerative disease such as ALS, Parkinson's, Dementia
  • Presence of a life-threatening disease such as cancer
  • Presence of a severe mental disorder such as schizophrenia, or bipolar depression (not associated with PTSD)
  • Current substance abuse or active treatment within last 6 months
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01782378). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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