Improvement of Memory in Mild Cognitive Impairment
Improvement of Memory in Mild Cognitive Impairment (MCI) Using Transcranial Alternating Current Stimulation (tACS) Guided by EEG and MRI: a Randomized, Sham-controlled, Parallel-arm, Double-blind Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Lucie Bréchet, PhD
- Phone Number: +41 22 379 08 52
- Email: lucie.brechet@unige.ch
Study Locations
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Geneva, Switzerland, 1202
- Recruiting
- University of Geneva, Campus Biotech
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Contact:
- Lucie Bréchet, PhD
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Principal Investigator:
- Lucie Bréchet, PhD
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Sub-Investigator:
- Paul G Unschuld, PhD
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Mild Cognitive Impairment (MCI) patients
- age ≥ 55 years old
- clinical diagnosis of mild cognitive impairment (MCI) based on a comprehensive clinical assessment and standard neuropsychological examination including tests of language, visuospatial thinking, executive functions, and memory
- confirmation of diagnosis will be made by Prof. Paul Unschuld, the study MD, based on a participant's cognitive evaluation and history
- understanding of the informed consent
- able and willing to comply with all study requirements
- informed consent form was signed
- women of childbearing potential (WOCBP) must perform a pregnancy test during screening
Caregiver
- minimum 21 years of age
- self-reported computer/tablet proficiency
- willingness to learn how to use tACS
- availability during the study period to administer tACS to the participant
- informed consent form was signed
- women of childbearing potential (WOCBP) must perform a pregnancy test during screening
Exclusion Criteria:
Mild Cognitive Impairment (MCI) patients
- age < 55 years old
- any current diagnosis of a psychiatric disorder (e.g., schizophrenia, bipolar disorder, depressive disorder)
- other than MCI, any history of other progressive or genetic neurologic disorder (e.g., Parkinson's disease, multiple sclerosis, tubular sclerosis) or acquired neurological disease (e.g., stroke, traumatic brain injury, tumor), including intracranial lesions
- history of head trauma resulting in prolonged loss of consciousness
- current history of poorly controlled headaches including chronic medication for migraine prevention
- history of fainting spells of unknown or undetermined etiology that might constitute seizures
- history of seizures, diagnosis of epilepsy
- any unstable medical condition or chronic uncontrolled medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.)
- contraindication for undergoing MRI or receiving tACS
- any metal in the brain or skull (excluding dental fillings) or elsewhere in the body unless cleared by the responsible covering MD (e.g., MRI compatible joint replacement)
- any skin problems, such as dermatitis, psoriasis, or eczema
- any electrically, magnetically, or mechanically activated implanted devices such as a pacemaker, intracranial electrodes, implanted defibrillators, medication pumps, nerve stimulators, vascular clips, or any other prosthesis in the brain
- any serious life-threatening disease such as congestive heart failure, pulmonary obstructive chronic disease, or active neoplasia
- pregnant women
- adults lacking capacity for consent
Caregiver
- insufficient understanding of study procedures
- poor eyesight, severe arthritis in the hands, pain, deformity or other condition that interferes with successful administration of tACS
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Transcranial alternating current stimulation (tACS)
The randomized, sham-controlled, parallel-arm, double-blind clinical trial will include 4 weeks of daily, home-based stimulation sessions.
MCI patients will be randomly assigned to the active or sham group.
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tACS will be delivered by a battery-driven current stimulator Starstim SS32 (Neuroelectrics) through surface Ag/AgCl electrodes placed into holes of a neoprene cap corresponding to the international 10/20 EEG system.
Gel (Parker Lab, Inc.) will be applied to optimize signal conductivity and lower impedance.
Two tACS (active and sham) conditions will be applied in randomized order.
40 Hz tACS will be delivered to different brain areas of the memory network.
We will employ a multielectrode montage based on electric field modeling using the individual MRI to optimally reach the target areas.
The maximum injected current per electrode is 2mA and the overall maximal current is 4mA to generate an average electric field of 0.25 V/m.
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Experimental: neurophysiological (hdEEG)
At the baseline and after 4 weeks, MCI patients will be evaluated in the laboratory using hdEEG.
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EEG will be recorded with a 257-channel EEG system.
An EEG net is applied at once on the head with evenly spaced sensors that provide full scalp coverage, including the cheek.
The net contains Ag/Ag-Cl electrodes that are interconnected by thin rubber bands and contain small sponges soaked with saline water that touch the participant's scalp surface directly.
Net application takes about 10 min to derive to impedances of <30 kOhms.
EEG is recorded with 1 kHz and band-pass filtered between DC-200 Hz.
Vertex electrode Cz is used as an acquisition reference.
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Experimental: clinical measures (MoCA)
At the baseline and after 4 weeks, MCI patients will be evaluated in the laboratory using MoCA.
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Clinical Evaluation and Cognitive Assessment - to characterize the level of dementia and changes in cognitive status measured at the baseline and after 4 weeks of gamma/sham tACS intervention, and in a follow-up 3 months after the stimulation using MoCA.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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cognitive status measured by Montreal Cognitive Assessment (MoCA)
Time Frame: baseline, after 4 weeks
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The primary objective is to characterize cognitive status at baseline and after 4 weeks of the home-based stimulation intervention.
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baseline, after 4 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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modulation of gamma activity assessed with high-density EEG
Time Frame: baseline, after 4 weeks,
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The secondary objective is to assess with hdEEG any changes in gamma power at baseline and after 4 weeks of the home-based stimulation intervention.
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baseline, after 4 weeks,
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Lucie Bréchet, PhD, University of Geneva (UNIGE)
- Study Chair: Paul G Unschuld, PhD, Geneva University Hospitals (HUG)
Publications and helpful links
General Publications
- Benussi A, Cantoni V, Grassi M, Brechet L, Michel CM, Datta A, Thomas C, Gazzina S, Cotelli MS, Bianchi M, Premi E, Gadola Y, Cotelli M, Pengo M, Perrone F, Scolaro M, Archetti S, Solje E, Padovani A, Pascual-Leone A, Borroni B. Increasing Brain Gamma Activity Improves Episodic Memory and Restores Cholinergic Dysfunction in Alzheimer's Disease. Ann Neurol. 2022 Aug;92(2):322-334. doi: 10.1002/ana.26411. Epub 2022 Jun 6.
- Brechet L, Brunet D, Birot G, Gruetter R, Michel CM, Jorge J. Capturing the spatiotemporal dynamics of self-generated, task-initiated thoughts with EEG and fMRI. Neuroimage. 2019 Jul 1;194:82-92. doi: 10.1016/j.neuroimage.2019.03.029. Epub 2019 Mar 19.
- Brechet L, Michel CM, Schacter DL, Pascual-Leone A. Improving autobiographical memory in Alzheimer's disease by transcranial alternating current stimulation. Curr Opin Behav Sci. 2021 Aug;40:64-71. doi: 10.1016/j.cobeha.2021.01.003. Epub 2021 Feb 14.
- Brechet L, Yu W, Biagi MC, Ruffini G, Gagnon M, Manor B, Pascual-Leone A. Patient-Tailored, Home-Based Non-invasive Brain Stimulation for Memory Deficits in Dementia Due to Alzheimer's Disease. Front Neurol. 2021 May 20;12:598135. doi: 10.3389/fneur.2021.598135. eCollection 2021.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2021-D0055
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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