The goal of this pilot prospective study is to evaluate the effect of tDCS on psychotic-like symptoms in patients with Lewy Body Dementia (LBD). The main questions it aims to answer are: * What is the effect of tDCS on neuropsychiatric symptoms, especially psychotic-like symptoms? * What is the impact of tDCS on caregiver burden? Researchers will compare active tDCS (2mA stimulation, anode on the left dorsolateral prefrontal cortex, cathode on the right fronto-orbital) to Sham tDCS (placebo stimulation, no intensity applied) to see if there is an effect on reducing psychotic-like symptoms and on caregiver burden. Participants will: * Undergo a stimulation phase consisting of 10 tDCS sessions of 20 minutes each, spread over 2 consecutive weeks (5 days with stimulation, 2 days without stimulation, 5 days with stimulation). * perform assessments at T0 (inclusion), T1 (at the end of the stimulation phase), and T2 (follow-up at 8 weeks post stimulation).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
30
2mA stimulation (anode on the left dorsolateral prefrontal cortex, cathode on the right fronto-orbital). 10 sessions of 20 minutes each, spread over 2 consecutive weeks (5 days with stimulation, 2 days without stimulation, 5 days with stimulation).
No intensity applied (anode on the left dorsolateral prefrontal cortex, cathode on the right fronto-orbital). 10 sessions of 20 minutes each, spread over 2 consecutive weeks (5 days with stimulation, 2 days without stimulation, 5 days with stimulation).
Clinical Research Unit-Memory Clinic / Centre de Gérontologie Clinique Rainier III / Princess Grace Hospital
Monaco, Monaco
RECRUITINGChange from Baseline in the composite score named "psychotic factor" at T1
"psychotic factor" corresponds to the sum of the subscores of psychotic-like symptoms from the Neuropsychiatric Inventory (NPI), namely Delusions, Hallucination, and Agitation/Aggression.
Time frame: Baseline, Week 2
Change from Baseline in the composite score named "psychotic factor" at T2
"psychotic factor" corresponds to the sum of the subscores of psychotic-like symptoms of the Neuropsychiatric Inventory (NPI), namely Delusions, Hallucination, and Agitation/Aggression.
Time frame: Baseline, Week 10
Change from Baseline in the Neuropsychiatric Inventory (NPI) total score
Neuropsychiatric Inventory (NPI), a scale that includes ten behavioral items (delusions, hallucinations, agitation, depression, anxiety, euphoria, apathy, disinhibition, irritability and aberrant motor behaviors) and two neurovegetative symptoms (sleep and appetite disorders). The evaluation was based on an interview with patients' primary caregivers. Both the frequency (/4) and the severity (/3) of each behavior were determined and a score was calculated by multiplying the frequency and the severity of each behavior observed.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the Neuropsychiatric Inventory (NPI) subscores
Neuropsychiatric Inventory (NPI) scale includes ten behavioral items (delusions, hallucinations, agitation, depression, anxiety, euphoria, apathy, disinhibition, irritability and aberrant motor behaviors) and two neurovegetative symptoms (sleep and appetite disorders). For each behavior the frequency (/4) and the severity (/3) were determined, corresponding to a subscore.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the Zarit scale score
The burden of the family caregiver was measured with the Zarit burden interview scale (completed by the caregiver). Composed of 22 questions on the physical, emotional and financial load felt. Total score /88.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the Trail Making Test (TMT) A&B performances
The TMT A\&B is a task requiring a subject to connect a sequence of 25 consecutive targets on a sheet of paper, in the shortest time possible without lifting the pen from the paper. Performances are time and number of errors
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the Quality of life questionnaire (Qol)
QoL was measured using the 13-item Quality of Life in Alzheimer's Disease (QOL-AD) scale (total score range 13-52; higher scores indicate better QOL). The QOL-AD scale uses a scale of 1-4 (poor, fair, good, or excellent) to rate a variety of life domains, including the patient's physical health, mood, relationships, activities, and ability to complete tasks
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the Mayo Clinic fluctuations scales score
The Mayo Fluctuations Scale is a four-item questionnaire assessing the common symptoms of cognitive fluctuation shown to significantly differentiate Lewy Body Dementia from Alzheimer disease. These four items are daytime drowsiness, daytime sleepiness, disorganised thought and staring spell. Total score /4.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the percentage of errors during an "antisaccades" paradigm
Eye movements were recorded and analyzed with an eye-tracking device.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the saccades latency (in ms) during an "antisaccades" paradigm
Eye movements were recorded and analyzed with an eye-tracking device.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the mean variation of latency times (in ms) during voluntary saccades
Eye movements are recorded and analyzed with an eye-tracking device. Mean measurement is calculated from several saccades latency recorded during voluntary saccades paradigm
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the frequency of square waves-jerks during horizontal eye movements paradigm
Eye movements are recorded and analyzed with an eye-tracking device. Presence, absence, frequency (number/minute) of square wave-jerks are recorded.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the frequency of fixations impairments during eye movements paradigm
Eye movements are recorded and analyzed with an eye-tracking device. Presence, absence, frequency of nystagmus, flutters or other fixations impairments
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the saccades main velocity during oculomotor paradigms
This concerns saccades Main velocity (in °/sec) during vertical and horizontal paradigms. Eye movements were recorded and analyzed with an eye-tracking device.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the saccades gain during oculomotor paradigms
This concerns saccades Gain (gaze accuracy) during vertical and horizontal paradigms. Gain range 0-1. Eye movements were recorded and analyzed with an eye-tracking device.
Time frame: Baseline, Week 2, Week 10
Change from Baseline in the saccades latency during oculomotor paradigms
This concerns saccades Latency (in ms) during vertical and horizontal paradigms. Eye movements were recorded and analyzed with an eye-tracking device.
Time frame: Baseline, Week 2, Week 10
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