The goal of this study is to assess the safety and feasibility of an oral fecal microbiota transplant (FMT) intervention for Alzheimer's disease (AD).
Studies suggests that microbes, including those derived from the gut, may play a role in the development or progression of AD. Gut microbiome composition among individuals with the Alzheimer's clinical syndrome is reduced in microbial diversity and shows compositional differences relative to control groups. Further, genera identified as more abundant in AD are associated with greater AD pathology while genera identified as less abundant in AD are associated with less AD pathology, as shown using CSF biomarkers. The goal of this study is to assess the safety and feasibility of an oral fecal microbiota transplant (FMT) intervention. * Primary Objective: To assess the safety and feasibility (recruitment, eligibility, enrollment, completion, and follow-up) of an oral FMT intervention in people with and without the Alzheimer's clinical syndrome. * Secondary Objective: To demonstrate the effects of FMT on the composition and function of the gut microbiota. To collect preliminary data in order to estimate sample size and other parameters for a larger study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
5
Double-encapsulated Fecal Microbiota Transplant Capsules
University of Wisconsin - Madison
Madison, Wisconsin, United States
Safety: Proportion of participants with treatment-related adverse events, serious adverse events, or adverse events of special interest.
Proportion of participants with treatment-related adverse events, serious adverse events, or adverse events of special interest. Adverse events, serious adverse events, or adverse events of special interest, will be evaluated following study procedures using AE and SAE forms, telephone and in person interview, and relevant medical records related to adverse events.
Time frame: 1 year
Feasibility: Participant recruitment rate
Number of weeks/months needed to meet study group numbers.
Time frame: 1 year
Feasibility: Eligibility
Proportion of individuals expressing interest who meet inclusion/exclusion criteria.
Time frame: 1 year
Feasibility: Procedures completed.
Proportion of participants able to complete procedures (including FMT) will be part of feasibility.
Time frame: 1 year
Feasibility: Retention
Proportion of participants that complete follow up.
Time frame: 1 year
Change in gut composition: Engraftment of fecal microbial transplant as assessed by 16S rRNA sequencing of recipient stool sample
In order to determine efficacy of fecal transplant, change in composition, i.e. microbial engraftment will be assessed by testing for newly detected operational taxonomic units (OTUs) in the gut microbiome of a participant post-FMT (which were present in the donor but undetected in the participant pre-FMT). This will be assessed via 16S rRNA seq of recipient stool samples pre- and post- FMT.
Time frame: baseline, 8 weeks, 24 weeks, 1 year
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Cognition: Change in Montreal Cognitive Assessment (MoCA) score
The Montreal Cognitive Assessment (MoCA) is a cognitive screening test used for detecting cognitive impairment. MoCA scores range between 0 and 30. Lower scores are indicative of impairment
Time frame: baseline and 1 year
Cognition: Change in results of Repeatable Battery for the Assessment of Neuropsychological Status
The Repeatable Battery for the Assessment of Neuropsychological Status consists of twelve subtests which give five scores, one for each of the five domains tested (immediate memory, visuospatial/constructional, language, attention, delayed memory). Raw scores on each domain are scaled to account for a person's age. Scaled scores are converted to percentiles which are used to determine a range of performance (impaired, borderline impaired, expected score, high average, superior) and overall cognitive status (impaired/not impaired).
Time frame: baseline and 1 year
Cognition: Change in the results of Trail Making Test Part A and Part B
The Trail Making Test is a neuropsychological test of visual attention and task switching. It consists of two parts, A and B. Participant is instructed to connect a set of 25 dots as quickly as possible while still maintaining accuracy. The test can provide information about visual search speed, scanning, speed of processing, mental flexibility, as well as executive functioning. Results for both TMT A and B are reported as the number of seconds required to complete the task; therefore, higher scores reveal greater impairment.
Time frame: baseline and 1 year
Metabolic/physiological measure: Change in the level of Hemoglobin A1C
Change in the level of Hemoglobin A1C will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in the level of fasting glucose
Change in the level of fasting glucose will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in the level of fasting insulin
Change in the level of fasting insulin will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in the level of C-reactive protein
Change in the level of C-reactive protein will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in the blood lipid profile
Change in the blood lipid profile will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in the blood pressure
Change in the blood pressure will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in body weight
Change in body weight will be assessed
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Metabolic/physiological measure: Change in the body composition by measuring body fat percentage
Change in the body composition by measuring body fat percentage
Time frame: baseline and 1 year
Change in insulin resistance indexed by the homeostatic model assessment-insulin resistance (HOMA-IR) method
Fasting glucose and fasting insulin will be used to calculate HOMA-IR.
Time frame: baseline, 8 weeks, 24 weeks, and 1 year
Change in physical activity as measured by Actigraphy watch
Actigraphy watch will be worn on the non-dominant wrist was used to record a participant's physical activity (total number of active minutes per day).
Time frame: baseline, 24 weeks, and 1 year
Change in Sleep as measured by Actigraphy watch
Actigraphy watch will be worn on the non-dominant wrist to estimate sleep duration.
Time frame: baseline, 24 weeks, and 1 year
Change in CSF biomarkers
Aβ42, Aβ42/Aβ40, phosphorylated tau, total tau, YKL-40
Time frame: baseline and 1 year
Change in serum/plasma metabolites on an average of one week pre and post FMT
Change in serum/plasma metabolites on an average of one week pre and post FMT
Time frame: baseline, week 8, week 24, and 1 year
Function: Change in total score on the Bristol Activities of Daily Living Scale
Change in total score on the Bristol Activities of Daily Living Scale. This is a tool used to measure functional ability (ability to independently carry out activities of daily living), and was developed for use with people with dementia. The minimum score is "0". The maximum score is "60". A lower score (better) indicates that a person is independent in their activities of daily living, and a higher score (worse) indicates that the individual is dependent on others.
Time frame: baseline and 1 year