- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05232877
Effects of t-DCS and Cognitive Training on Apathy in Elderly With Minor Neurocognitive Impairment (FAME3)
Effects of t-DCS Combined With Concurrent Cognitive Training on Apathy in Elderly Subjects With Minor Neurocognitive Impairment
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique using a low intensity electric current to modify cortical excitability. There is growing interest for tDCS for psychiatric illnesses, notably for depression.
Apathy is a pervasive neuropsychiatric symptom characterized by a reduction in goal-directed behavior and activity that persists over time and causes identifiable functional impairment. tDCS could be a promising new area for non-pharmacological treatment of apathy.
The aim of this study is to evaluate the effects of repeated sessions of tDCS combined with simultaneous cognitive training on apathy in older people with minor neurocognitive disorders. For this, 30 apathetic subjects with minor neurocognitive disorders will be included and randomized between two groups. The intervention group will follow sessions of tDCS combined with a simultaneous cognitive training on tablet. The control group will follow cognitive training with a combined sham tDCS. Intervention will last for 4-week with 3 sessions per week (12 sessions). Stimulation will be performed with Startim 20 (Neuroelectrics®) which is approved by the European Union as a Class IIa medical device and meeting European safety standards. Stimulation will last for 20 minutes and the dorsolateral prefrontal cortex (F3) will be targeted. For the intervention group, the electric current will be 2mA. Assessments will be done at baseline, just after the end of intervention and 3 months after intervention. Apathy, daily functional motor behaviors, cognitive functions and fatigue will be assessed with clinician assessment, self-administered questionnaires, ambulatory actigraphy and cognitive tests. The assessments and the intervention will be done by different people. Study will be a double-blind randomized controlled trial.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Nice, France, 06000
- Centre Memoire Ressources et Recherche, CHU de Nice
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 65 years
- Subject consulting in one of the investigating centers
- Clinical diagnosis of Minor Neurocognitive Disorder according to DSM 5 criteria (APA, 2013)
- Apathetic syndrome defined according to the Diagnostic Criteria for Apathy (Miller & al., 2021)
- Subject who can read and write French
- Subjects who are beneficiaries of a social security plan
- Signature of free and informed consent
Exclusion Criteria:
- Current clinical diagnosis of a depressive episode characterized by DSM 5 criteria (APA, 2013)
- Known diagnosis of schizophrenia, bipolar disorder, substance abuse or dependence
- Significant sensory or motor impairment
- Subject under guardianship, conservatorship, or conservatorship
- Active smoking or smoking cessation of less than one year
- Contraindications to the practice of tDCS: history of intracranial hypertension, neurosurgery, metallic implant at the cephalic level, pacemaker
- Unbalanced epilepsy
- Severe somatic disease not stabilized
- Previous use of tDCS (problem of maintaining the integrity of the blinding procedure)
- Scalp skin disease
- Concurrent participation in another drug research study or any other study that may interfere with study results
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: tDCS combined with simultaneous cognitive training
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The intervention group will follow sessions of tDCS combined with a simultaneous cognitive training on tablet
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Sham Comparator: cognitive training with a combined sham tDCS
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The control group will follow cognitive training with a combined sham tDCS.
Intervention will last for 4-week with 3 sessions per week (12 sessions).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Apathy Inventory (Robert et al., 2002), clinician version
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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The Apathy Inventory scored from 0 (No problem) to 4 (major problem) the 3 dimensions of apathy: the emotional blunting, the loss of initiative and the loss of interest.
A higher total score indicates a greater severity.
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Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment of neuropsychiatric symptoms
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Clinician assess behavioral symptoms and scored the severity from 0 to 3.
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Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of the global cognitive functioning
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Mini mental state examination (MMSE): test for asses the global cognitive functioning Unit of measure: score Scored from 0 to 30. A lower score indicate lower performance in global cognitive functioning. |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Assessment of cognitive functions with FAB
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Frontal assessment battery (FAB): test for asses global executive functions Unit of measure: score Scored from 0 to 18. A lower score indicate lower performance in global executive functions. |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Assessment of episodic memory
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Grober and Bruschke test : test for asses episodic memory Unit of measure: score Scored from 0 to 48. A lower score indicate lower performance in episodic memory |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Assessment of attention and mental flexibilty
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Trail Making test A_b: test for attention and mental flexibilty Unit of measure: time to realize the test A longer time indicate a lower performance in attention and mental flexibility. |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of working memory
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Empan de chiffres: test for asses working memory Unit of measure: score A lower score indicate a lower performance in working memory |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of verbal fluency
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Fluency test: test for asses verbal fluency Unit of measure: number of words produced by the participant into 60 seconds A lower score indicate a lower performance. |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of language
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Test de "dénomination d'image": test for asses language Unit of measure: score A lower score indicate a lower performance. |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of fatigue with Multidimensional fatigue inventory (MFI)
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Multidimensional fatigue inventory (MFI): 20-item self-report questionnaire for measuring five dimensions of fatigue. Each subscale contains four items, which are scored on a five-point Likert-scale. Scores range from 4 (absence of fatigue) to 20 (maximum fatigue) for each subscale. Unit of measure: score |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of fatigue with 15-sec Sustained maximal handgrip contraction
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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15-sec Sustained maximal handgrip contraction: The decrease in force during the 15-s was used as the indicator of fatigability. Measure: performance for the test: The decrease in force during the 15-s was used as the indicator of fatigability. It was computed as the difference between the area under constant curve equal to the maximal grip force and the area under the force-time curve of 15-s |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of daily physical activity
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Actigraphy: assessment of time physical activity of light, moderate and vigorous intensity and sedentary time in daily life in minute and % of daily activity.
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Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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Assessment of tDCS adverse effects questionnaire
Time Frame: Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
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tDCS adverse effects questionnaire: questionnaire for asses the tDCS adverse effects. It is a 11-item scale. Each item corresponds to an adverse effect. Each item is scored from 1 (absence of the adverse effect) to 4 (severe). If the adverse effect is present (score>1) the clinician scored if this is related to tdCS from 0 (none) to 5 (definite). A higher score indicate more adverse effects. Unit of measure: score |
Changes from baseline severity of apathy at 4 weeks and 18 weeks are assessed (12 weeks after the end of intervention)
|
Collaborators and Investigators
Investigators
- Principal Investigator: Eric ETTORE, MD, Nice University 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
- 21-PP-15
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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