Purpose

The investigators will evaluate the theory that Alzheimer's disease-related memory impairment derives from the inefficient orchestration of rhythmic activity at the level of large-scale cortical networks. The results as expected to elucidate AD-related pathophysiology and set groundwork for the development of drug-free interventions for improving memory in AD and related dementias.

Condition

Eligibility

Eligible Ages
Between 55 Years and 95 Years
Eligible Genders
All
Accepts Healthy Volunteers
Yes

Criteria

All subjects. Age 50-100 years. We will equally recruit subjects with respect to gender,
race, ethnicity, socioeconomic and other factors to allow the results of this research to
yield the greatest generalizability.

Mild AD dementia. Meets probable AD dementia NIA-AA criteria 86; MoCA 10-25 85;
performance on Uniform Data Set version 3 (UDS-3) delayed recall (Craft Story 21) and
recognition (Benson Complex Figure) memory worse than 1.5 SD for age and education; worse
than 1.5 SD for age and education in at least one other cognitive domain (e.g., language,
executive functioning) based on other tests in the UDS-3. A summary of the NIA-AA
criteria for AD dementia are that the patient has (1) dementia, such that cognitive or
behavioral symptoms (a) are interfering with the ability to function at work or usual
activities, (b) represent a decline from previous level of functioning, (c) are not
explained by delirium or major psychiatric disorder, (d) are detected and diagnosed, and
(e) involve a minimum of two domains including memory, executive function, visuospatial
abilities, language, and personality or behavior or comportment; (2) insidious onset; (3)
clear-cut history of worsening of cognition; (4) prominent cognitive deficits by history
and examination from either (a) an amnestic presentation or (b) a non-amnestic
presentation, which can be a language, visuospatial, or executive dysfunction
presentation; and lastly (5) no (a) substantial concomitant cerebrovascular disease, (b)
core features of Dementia with Lewy Bodies, (c) prominent features of behavioral variant
frontotemporal dementia (FTD), (d) prominent features of primary progressive aphasia, or
(e) evidence for another concurrent, active disorder or use of medication that could have
a substantial effect on cognition. All diagnoses are made by the BU ADRC clinical core
consensus and confirmed by Dr. Budson. The majority of patients will have a positive AD
biomarker, either from cerebrospinal fluid (CSF) or positron emission tomography (PET).
See also Additional Inclusion/Exclusion criteria below.

MCI due to AD. Meets MCI due to AD according to NIA-AA criteria 86; MoCA >18 85;
performance on Uniform Data Set version 3 (UDS-3) delayed recall (Craft Story 21) and
recognition (Benson Complex Figure) memory worse than 1.0 SD for age and education
adjusted norms. A summary of the NIA-AA criteria for MCI due to AD are that there is (1)
clinical concern reflecting a change in cognition reported by patient, informant, or
clinician; (2) objective impairment in one or more domains, typically including memory;
(3) preservation of independence in functional abilities; (4) not demented; (5) a rule
out of vascular, traumatic, and medical causes of cognitive decline; (6) evidence of
longitudinal decline in cognition, when feasible; (7) history consistent with AD genetic
factors, where relevant. All diagnoses are made by the BU ADRC clinical core consensus
and confirmed by Dr. Budson. The majority of patients will have a positive AD biomarker,
either from CSF or PET. See also Additional Inclusion/Exclusion criteria below.

Healthy controls. Healthy controls will also be recruited from the BU ADRC and will be
age, education, and gender matched to the AD patients. They will have a MoCA > 2585 and
performance within 1.0 SD for age and education adjusted norms on Uniform Data Set
version 3 (UDS-3). All "diagnoses" of healthy controls will be made by the BU ADRC
clinical core consensus and confirmed by Dr. Budson. The majority of healthy controls
will have a negative AD biomarker, either from CSF or PET. See also Additional
Inclusion/Exclusion criteria below.

All subjects. Current conditions allowed: mild depression and/or anxiety not requiring
hospitalization or medications other than what are listed below; hyperlipidemia;
hypercholesterolemia; hypertension; heart disease; asthma; gastroesophageal reflux
disease; edema; treated hypothyroidism; systemic vascular disease (but not stroke);
dermatological disorders; ophthalmologic disorders. Prior conditions excluded: stroke,
traumatic brain injury, other brain or systemic disorder that, in the opinion of Dr.
Budson, has produced a permanent alteration of cognition. Current medications allowed:
selective serotonin reuptake inhibitors; cholinesterase inhibitors (for the patients with
AD); statins; beta adrenergic blockers; bronchodilators; ace inhibitors; calcium channel
blockers; angiotensin II receptor blockers; other antihypertensive agents; histamine-2
receptor antagonists; proton-pump inhibitors; diuretics; thyroid medications; aspirin;
non-narcotic analgesics; antiplatelet agents; vitamins & minerals; topical medications;
eye drops.

Inclusion/exclusion criteria related to tasks, EEG and tACS. Subjects must have normal or
corrected-to-normal vision, color vision, nonpregnant, no metal implants in head, no
implanted electronic devices, no skin sensitivity, and no claustrophobia.

Additional exclusion criteria. Subjects will be excluded if they cannot understand the
informed consent or the experimental procedures. Subjects will be excluded if they have a
significant vision and/or hearing impairment which will prevent them from understanding
the informed consent and from completing the experimental procedures.

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Basic Science
Masking
Double (Participant, Outcomes Assessor)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
active stimulation
Memory performance data is collected during active brain stimulation and reported 1 year later
  • Device: High definition transcranial electrical current stimulation
    Low-intensity and safe, noninvasive application of electrical current to the human scalp with the goal of gradually modulating levels of neuronal excitability.
Sham Comparator
sham stimulation
Memory performance data is collected during sham brain stimulation and reported 1 year later
  • Device: High definition transcranial electrical current stimulation
    Low-intensity and safe, noninvasive application of electrical current to the human scalp with the goal of gradually modulating levels of neuronal excitability.

Recruiting Locations

677 Beacon St. Room 308
Boston, Massachusetts 02215
Contact:
Robert Reinhart, PhD
617-353-9481
rmgr@bu.edu

More Details

Status
Recruiting
Sponsor
Boston University Charles River Campus

Study Contact

Robert M. G. Reinhart, PhD
(617) 353-9481
rmgr@bu.edu

Detailed Description

The investigators hypothesize that AD-related memory impairments emerge from large-scale functional dysconnectivity, and by stimulating the brain noninvasively with extremely weak levels of electrical current, the investigators may be able to re-synchronize connectivity and stabilize or improve memory and cognitive function, measured behaviorally. The experimental intervention involves the application of low-intensity, high-definition, transcranial electrical current stimulation while subjects perform a variety of computer-based tasks that probe memory and cognitive function.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.