40 Hz Audio-Visual Stimulation Therapy for AD

A Clinical Trial Assessing the Efficacy of 40 Hz Auditory-Visual Stimulation for Patients With Alzheimer's Disease

This is a single-center, parallel-group, double-blind randomized controlled trial conducted at the First Affiliated Hospital of Xiamen University, enrolling 50 participants with Alzheimer's disease (AD)-derived mild cognitive impairment (MCI) or mild AD aged 50-80 years with ≥4 years of education. Subjects must meet diagnostic criteria per Chinese AD guidelines, show medial temporal lobe atrophy on baseline brain MRI, have a reliable caregiver, and be capable of completing all assessments. Exclusion criteria include severe visual/auditory impairment, non-AD dementia, recent neuromodulation therapy, uncontrolled severe systemic diseases, prominent psychiatric disorders, significant cerebral focal lesions on MRI, and other conditions precluding safe participation.

Eligible participants will be randomly assigned to either the 40 Hz audio-visual stimulation group or the placebo group. The intervention lasts 1 hour once daily for 12 weeks, with a total subject follow-up period of 36 weeks (12-week treatment + 24-week observational follow-up). The primary efficacy outcome is the change from baseline in the 11-item Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) at the end of treatment. Secondary outcomes include changes in Mini-Mental State Examination (MMSE) and ADCS-Activities of Daily Living (ADCS-ADL) scores across all follow-up visits. Exploratory biomarkers cover plasma Aβ42, Aβ40, Tau-217, gamma wave power on electroencephalography (EEG), and repeat Aβ-PET imaging (if previously performed). Cognitive, functional, emotional, EEG, and blood biomarker assessments will be conducted at scheduled time points. Safety monitoring focuses on intervention-related adverse events such as headache and dizziness, with detailed recording of onset, duration and accompanying symptoms.

Statistical analyses will use two-sided tests at α=0.05. Linear mixed models and repeated-measures ANOVA with ANCOVA adjustment for covariates will analyze the primary endpoint; appropriate parametric or nonparametric tests will be applied for secondary and exploratory outcomes. Baseline group balance will be compared via t-tests, Mann-Whitney U tests or chi-square tests. All data processing and statistical modeling will be performed using Python 3.11 and related analytical packages. The trial runs from July 2026 to December 2027.

Study Overview

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Fujian
      • Xiamen, Fujian, China, 361003
        • The First Affiliated Hospital of Xiamen University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria Subjects diagnosed with Alzheimer's disease-derived mild cognitive impairment (AD-MCI) or mild Alzheimer's dementia, diagnosed in accordance with Chinese Guidelines for the Diagnosis and Treatment of Alzheimer's Dementia (2020 Edition) and Chinese Expert Consensus on the Diagnosis and Treatment of AD-derived Mild Cognitive Impairment (2021).

Clinical Dementia Rating sum of boxes (CDR-SB) score ranges from 0.5 to 1. Age between 50 and 80 years old, with education ≥ 4 years, any biological sex. Able to cooperate with 12-week intervention and all scheduled assessments including cognitive scales, EEG, blood tests and brain imaging.

Subject or legal guardian provides written informed consent and agrees to comply with study procedures.

Baseline brain MRI with coronal hippocampal sequence shows medial temporal lobe atrophy (MTA) grade ≥2, highly suggestive of AD pathology.

Has a stable, reliable caregiver throughout the study period. Exclusion Criteria Severe visual impairment (uncorrected visual acuity <0.1, unable to detect flickering light) or severe hearing loss (pure tone audiometry ≥60 dB, cannot perceive 40 Hz auditory stimulation).

Cognitive decline caused by non-AD etiologies: vascular dementia, mixed dementia, dementia with Lewy bodies, Parkinson's disease dementia, frontotemporal dementia, Huntington's disease, cognitive impairment secondary to thyroid disorders, vitamin B12/folate deficiency, or other organic brain diseases.

Received other neuromodulation therapies (TMS, tDCS, etc.) within 3 months prior to screening or participated in other interventional cognitive trials recently.

Uncontrolled severe systemic diseases: advanced heart failure, arrhythmia, refractory hypertension, severe hepatic/renal dysfunction, active malignant tumors.

History of schizophrenia, mania or other severe psychiatric disorders; GDS ≥15 or HAMA ≥14 at screening; receiving antidepressant, anxiolytic or antipsychotic medication at screening.

Hachinski Ischemic Score (HIS) >4. Baseline MRI shows significant focal cerebral lesions: ≥2 infarcts >2 cm; infarcts in thalamus, hippocampus, entorhinal cortex or angular gyrus; Fazekas white matter hyperintensity grade ≥3.

Active HIV, syphilis, hepatitis B/C or other severe chronic infectious diseases.

Severe communication disorders or altered consciousness preventing completion of assessments or intervention.

Refusal of informed consent by legal guardian. Any other clinical condition judged by investigators to make the subject unsuitable for participation.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

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: 40 Hz Audio-Visual Stimulation Experimental Group

Non-invasive audio-visual neuromodulation device generating synchronized 40 Hz light flicker and sound stimulation. Subjects receive 1 session daily, 1 hour per session, for a total of 12 consecutive weeks. After intervention, 24 weeks of observational follow-up without stimulation is performed.

Placebo Comparator: Sham Audio-Visual Stimulation Placebo Control Group

Identical external device appearance with non-therapeutic low-frequency light and sound signals without 40 Hz gamma oscillation. Administration frequency, duration and operation process are completely consistent with the experimental group, once daily for 1 hour over 12 weeks, followed by 24 weeks of off-treatment follow-up.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Change from baseline in the 11-item Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog11) total score at Week 12 (end of intervention)
Time Frame: Baseline and Week 12 (12 weeks after randomization)
Baseline and Week 12 (12 weeks after randomization)

Secondary Outcome Measures

Outcome Measure
Time Frame
Change from baseline in ADCS-Activities of Daily Living (ADCS-ADL) total score
Time Frame: Baseline, Week 12, Week 36
Baseline, Week 12, Week 36

Other Outcome Measures

Outcome Measure
Time Frame
Changes in plasma Aβ42, Aβ40 and Tau-217 levels from baseline
Time Frame: Baseline, Week 12
Baseline, Week 12
Changes on Aβ-PET imaging (if baseline Aβ-PET was performed)
Time Frame: Baseline, Week 12 (only for subjects with baseline Aβ-PET scan)
Baseline, Week 12 (only for subjects with baseline Aβ-PET scan)
Changes in electroencephalography (EEG) gamma wave power from baseline
Time Frame: Baseline, Week 12, Week 36
Baseline, Week 12, Week 36

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

October 15, 2026

Primary Completion (Estimated)

May 31, 2027

Study Completion (Estimated)

December 31, 2027

Study Registration Dates

First Submitted

November 3, 2026

First Submitted That Met QC Criteria

November 3, 2026

First Posted (Actual)

November 9, 2026

Study Record Updates

Last Update Posted (Actual)

November 9, 2026

Last Update Submitted That Met QC Criteria

November 3, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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