- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03880240
Gamma Induction for Alzheimer's Disease
Gamma Induction for Amyloid Clearance in Alzheimer's Disease
Alzheimer's Disease (AD) is characterized by amyloid-β (Aβ) plaque buildup and phosphorylated tau (p-tau) in the brain, as well as widespread neurodegeneration. Amyloid-β and tau are proteins that build up in the brain that may contribute to memory problems. The evidence suggests that both amyloid and tau play a critical role in AD and interventions that reliably and safely decrease the intracerebral burden of amyloid or tau could potentially be of marked clinical importance. Currently, therapeutic options are very limited and while there are pharmacologic interventions that transiently improve cognitive function, there are no treatments that alter disease progression.
The purpose of this study is to see if multiple daily sessions of non-invasive brain stimulation can affect brain activity to decrease the amount of amyloid and tau in people with AD as compared to Sham (placebo) stimulation. The type of brain stimulation that will be used is called transcranial alternating current stimulation (tACS). This study will investigate different doses of tACS (2-4 weeks) and assess safety. The hope is that tACS will decrease the amount of amyloid and tau and improve memory and thinking in people with AD.
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
- Name: Stacey Monsell
- Phone Number: 617-667-9088
- Email: smonsell@bidmc.harvard.edu
Study Contact Backup
- Name: Julianne Reilly
- Email: jrreilly@mgh.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Recruiting
- Beth Israel Deaconess Medical Center
-
Contact:
- Stacey Monsell
- Phone Number: 617-667-9088
- Email: smonsell@bidmc.harvard.edu
-
Principal Investigator:
- Emiliano Santarnecchi, PhD, PsyD
-
Principal Investigator:
- Lorella Battelli, PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Clinical Diagnosis of early to moderate AD*
- Mini Mental State Examination (MMSE) ≥ 18
- Clinical Dementia Rating (CDR) ≥ 0.5
Demonstration or history of memory impairments.
- Confirmation of diagnosis will be made by the study MD based on a holistic consideration of the participant's cognitive evaluation and history.
- Amyloid positive PET imaging
- At least 45 years old
- On a stable dose of medications for memory loss including cholinesterase inhibitors (e.g. donepezil, rivastigmine or memantine) as defined as 6 consecutive weeks of treatment at an unchanging dose
- Minimum of completed 8th grade education
- No history of intellectual disability
Exclusion Criteria:
- Current history of poorly controlled migraines including chronic medication for migraine prevention
Current or past history of any neurological disorder other than dementia, such as epilepsy, stroke (cortical stroke), progressive neurologic disease (e.g. multiple sclerosis) or intracranial brain lesions; and history of previous neurosurgery or head trauma that resulted in residual neurologic impairment.
- Non-cortical disease such as confluence white matter changes (including lacunar infarcts < 1cm) and asymptomatic, subacute, cerebellar infarcts may be included upon review of a medically responsible neurologist.
- Past or current history of major depression, bipolar disorder or psychotic disorders, or any other major psychiatric condition.
- Contraindication for undergoing MRI or receiving TMS or tACS,
- >50 mSv of radiation exposure for research within the past year (PET imaging exclusion)
- History of fainting spells of unknown or undetermined etiology that might constitute seizures.
- History of seizures, diagnosis of epilepsy, history of abnormal (epileptiform) EEG or immediate (1st degree relative) family history of epilepsy; with the exception of a single seizure of benign etiology (e.g. febrile seizure) in the judgment of the investigator.
- Chronic (particularly) uncontrolled medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.).
- Metal implants (excluding dental fillings) or devices such as pacemaker, medication pump, nerve stimulator, TENS unit, ventriculo-peritoneal shunt, cochlear implant, unless cleared by the study MD.
- Substance abuse or dependence within the past six months.
- Medications will be reviewed by the responsible MD and a decision about inclusion will be made based on the following: The patient's past medical history, drug dose, history of recent medication changes or duration of treatment, and combination of CNS active drugs.
- All female participants that are pre-menopausal will be required to have a pregnancy test; any participant who is pregnant or breastfeeding will not be enrolled in the study.
- Subjects who, in the investigator's opinion, might not be suitable for the study
- A hair style or head dress that prevents electrode contact with the scalp or would interfere with the stimulation (for example: thick braids, hair weave, afro, wig)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 2 weeks of daily tACS sessions
10 daily (Monday-Friday) 1-hour sessions of tACS stimulation
|
tACS is a non-invasive way of stimulating the brain externally using weak electric currents.
Electrodes are placed into a cap that you wear on your head.
A weak electrical current travels back and forth through the electrodes to your head.
tACS will be applied at a frequency of 40Hz and targeting the area of maximal tracer uptake on amyloid PET imaging using an individualized multielectrode design to maximize the induced electrical current to the target region.
Other Names:
|
Experimental: 4 weeks of daily tACS sessions
20 daily (Monday-Friday) 1-hour sessions of tACS stimulation
|
tACS is a non-invasive way of stimulating the brain externally using weak electric currents.
Electrodes are placed into a cap that you wear on your head.
A weak electrical current travels back and forth through the electrodes to your head.
tACS will be applied at a frequency of 40Hz and targeting the area of maximal tracer uptake on amyloid PET imaging using an individualized multielectrode design to maximize the induced electrical current to the target region.
Other Names:
|
Experimental: 4 weeks of twice daily tACS sessions
20 days (Monday-Friday) of 1-hour sessions of tACS twice per day
|
tACS is a non-invasive way of stimulating the brain externally using weak electric currents.
Electrodes are placed into a cap that you wear on your head.
A weak electrical current travels back and forth through the electrodes to your head.
tACS will be applied at a frequency of 40Hz and targeting the area of maximal tracer uptake on amyloid PET imaging using an individualized multielectrode design to maximize the induced electrical current to the target region.
Other Names:
|
Sham Comparator: 2/4 weeks of Sham tACS sessions
10/20 days (Monday-Friday) of 1-hour sessions of tACS once/twice per day
|
Placebo Control, simulation of transcranial alternating current stimulation without receiving any stimulation
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
PET amyloid burden
Time Frame: up to 16 weeks
|
Changes in the amyloid load observed via PET imaging will be evaluated by comparing PET data acquired before and after the tACS sessions
|
up to 16 weeks
|
PET tau deposition
Time Frame: up to 16 weeks
|
Changes in the tau deposition observed via PET imaging will be evaluated by comparing PET data acquired before and after the tACS sessions
|
up to 16 weeks
|
Incidence of Treatment-Emergent Adverse Events
Time Frame: up to 16 weeks
|
Adverse Events as a result of tACS stimulation will be reported
|
up to 16 weeks
|
Change in Gamma activity
Time Frame: up to 16 weeks
|
Changes in oscillatory activity in the EEG gamma band will be evaluated before and after the tACS sessions.
|
up to 16 weeks
|
Alzheimer's Disease Assessment Scale -Cog Score
Time Frame: up to 16 weeks
|
Change in ADAS-Cog score will be reported, to document a potential clinical benefit of tACS. The scale ranges from a total score of 0-70 with higher score indicating greater cognitive impairment. The ADAS-Cog has a total scoring range of 0-70, with the score based on the number of errors made in each of the 11 following items: word recall task, commands, constructional praxis, naming task, ideational praxis, orientation, word recognition, remembering word recognition test instructions, comprehension of spoken language, word-finding difficulty in spontaneous speech, and spoken language ability. Subscale scores are not reported, only the total score. |
up to 16 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Follow-up Amyloid PET burden
Time Frame: up to 16 weeks
|
Changes in the amyloid load observed via PET imaging at follow-up visits.
|
up to 16 weeks
|
Follow-up Cognitive Evaluation
Time Frame: up to 16 weeks
|
Changes in Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) score at follow-up visits The ADAS-Cog has a total scoring range of 0-70, with the score based on the number of errors made in each of the 11 following items: word recall task, commands, constructional praxis, naming task, ideational praxis, orientation, word recognition, remembering word recognition test instructions, comprehension of spoken language, word-finding difficulty in spontaneous speech, and spoken language ability. Subscale scores are not reported, only the total score. The scale ranges from a total score of 0-70 with higher score indicating greater cognitive impairment. |
up to 16 weeks
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Emiliano Santarnecchi, PhD, Massachusetts General Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2019P000092
- R01AG060981 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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