4Hz Transcranial Alternating Current Stimulation for Patients With Mild Alzheimer's Disease

Xuanwu Hospital, Beijing40 enrolled

Overview

The goal of this study is to explore the efficacy and safety of 4Hz transcranial alternating current stimulation (tACS) in patients with mild Alzheimer's disease (AD). The study will recruit 40 individuals with mild AD, and the participants will be randomized to either a 4 Hz tACS group or a sham stimulation group. Both groups will undergo 30 one-hour sessions across 3 weeks (21 days). At the end of the intervention and 3-month follow-up, all subjects will repeat the baseline assessments.

Background: Recently, transcranial alternating current stimulation (tACS), which could interact with ongoing neuronal activity, has emerged as a potentially effective and promising treatment for Alzheimer's disease (AD), and the 4Hz frequency was suggested to improve working memory Methods: The proposed study is a double-blinded, randomized controlled trial that will include 40 individuals with mild AD, and the participants will be randomized to either a 4Hz tACS group or a sham stimulation group. Both groups will undergo 30 one-hour sessions in 3 weeks (21 days). The outcome measures will be assessed at baseline, end of intervention and 3 months after the first session. Primary outcome is global cognitive function, assessed by the 11-item cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog), and the second outcomes include changes in other neuropsychological assessments, structural MRI, resting electroencephalogram (EEG) and simultaneous EEG-functional MRI (fMRI).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Alzheimer Disease

Interventions

transcranial alternating current stimulationDEVICE

The alternating current is administered through medical grade conductive pads that are produced specifically for the Nexalin technology. The pads are places on the forehead and behind each ear, and are connected to the Nexalin device with thin cables. Intervention will be implemented with a tACS device with 4Hz frequency and a peak-to-peak amplitude of 15mA, 30 one-hour sessions in 3 weeks (21 days).

sham stimulationDEVICE

Electrodes will also be put on patient's forehead and behind each ear. The sham stimulator has the exactly same appearance with the true stimulator. Participants and operators cannot determine whether the stimulator is true based on its appearance or patients' feelings. However, when the device is started, no current flows through the electrodes. Participants in this controlled group will also receive sham stimulations with 30 one-hour sessions in 21 days.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Subjects with informed consent; 2. 45-75 years of age; 3. At least 6 years of education; 4. AD according to the National Institute on Aging and the Alzheimer's Association (NIA-AA) guidelines; 5. Clinical Dementia Rating Scale (CDR)=1.0; 6. Positive findings in amyloid PET imaging or amyloid protein levels in CSF; 7. On a stable dose of cholinesterase inhibitors (e.g. donepezil or rivastigmine) as defined as 6 consecutive weeks of treatment at an unchanging dose, and without any intentions to modify the dosage during the observation period. Exclusion Criteria: 1. Current or past history of any neurological disorder other than dementia, such as epilepsy, stroke, progressive neurologic disease (e.g. multiple sclerosis), poorly controlled migraines or intracranial brain lesions; and history of previous neurosurgery or head trauma that resulted in residual neurologic impairment; 2. Contraindication for undergoing MRI or receiving tACS; 3. Eczema or sensitive skin; 4. Familial AD; 5. Depression or other psychiatric disorders; 6. Abnormal brain structural magnetic resonance imaging (MRI) scan, including hydrocephalus, stroke, structural lesions, etc. that would potentially confound the outcome; 7. Severe cardiovascular/pulmonary disorders; 8. Other conditions, in the investigator's opinion, might not be suitable for the study.

Locations (1)

Xuanwu Hospital, Capital Medical University

Beijing, China

Outcomes

Primary Outcomes

Change in Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog, 11-items version)

ADAS-cog 11 scale ranges from 0 to 70, and higher value represents a worse outcome. This study will use ADAS-cog to assess changes in the global cognitive function after intervention.

Time frame: up to 21 days (end of intervention)

Secondary Outcomes

Change in Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-cog, 11-items version).

ADAS-cog 11 scale ranges from 0 to 70, and higher value represents a worse outcome. This study will use ADAS-cog to assess changes in the global cognitive function after intervention.

Time frame: 3 months

Change in brain volume and white matter integrity

Structural MRI will be used to measure brain volume and white matter integrity.

Time frame: up to 21 days (end of intervention), 3 months

Change in brain connectivity

Functional MRI and resting-state EEG will be used to measure brain connectivity.

Time frame: up to 21 days (end of intervention), 3 months

Change in Mini-mental State Examination

Mini-mental State Examination (MMSE) will be used to evaluate the general cognitive function. MMSE ranges from 0 to 30, and higher value represents a better outcome.

Time frame: up to 21 days (end of intervention), 3 months

Change in Montreal Cognitive Assessment

Montreal Cognitive Assessment (MoCA) will be used to evaluate the general cognitive function. MoCA ranges from 0 to 30, and higher value represents a better outcome.

Time frame: up to 21 days (end of intervention), 3 months

Data from ClinicalTrials.gov

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