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Deep Brain Stimulation for Alzheimer's Disease

Not Applicable
Conditions
Alzheimer Disease
Dementia, Alzheimer Type
Deep Brain Stimulation
Interventions
Drug: Best medical treatment for Alzheimer's disease
Device: Deep brain stimulation
Registration Number
NCT03959124
Lead Sponsor
Buddhist Tzu Chi General Hospital
Brief Summary

Background: Deep brain stimulation (DBS) is used to modulate the activity of dysfunctional brain circuits. The safety and preliminary efficacy of nucleus basalis of Meynert (NBM)-DBS in Alzheimer's disease (AD) is proved in a recent phase 1 clinical trial, yet, the mechanism still unknown.

Objective: 1. To compare the brain structure and functional circuits between a) AD patients with optimal drug treatment (ODT) plus NBM-DBS, b) AD with ODT and c) normal age-and sex-matched control. 2. To evaluate the clinical effectiveness of NBM-DBS in AD patients 60-75 year-old. 3. To evaluate the abnormal functional circuitry response to acute and chronic NBM-DBS in AD.

Methods: A total of 30 subjects (10 subjects of AD with ODT plus NBM-DBS; 10 subjects of AD with ODT and 10 subjects of normal age-and sex-matched subjects) will be enrolled in this prospective, with normal control, Phase II study. Study tools will include clinical rating batteries, structure and functional imaging of magnetic resonance (MR) and positron emission tomography (PET), and electroencephalogram (EEG).

Expected Results: NBM-DBS will be proved to be an safe and effective treatment modality in AD patients 60-75 year-old. Through multi-modal images and EEG analysis, the possible action mechanisms of NBM-DBS on memory circuit will be discussed. The study results may shed a light on this helpless neurodegenerative disease of dementia.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria

For groups (AD with/ without DBS)

  1. Confirmed Alzheimer's dementia diagnosis
  2. Regular medications taking for at least 3 months
  3. Clinical Dementia Rating: 0.5 - 2
  4. Mini Mental Status Examination: ≦ 26
  5. Amyloid PET: positive
  6. Informed consent signed by patients or families

For normal control group

  1. No cognitive impairment (Mini Mental Status Examination)
  2. Amyloid PET: negative
  3. Informed consent signed by patients and families
Exclusion Criteria

For groups (AD with/ without DBS)

  1. Structural lesions identified by Magnetic resonance imaging (ex: stroke, brain surgery)
  2. Other neurodegenerative/ neuropsychiatric diseases
  3. Systemic medical diseases with cognitive impairment (ex: anemia, thyroid disease)
  4. Can't have regular follow-up visit

For normal control group

  1. Structural lesions identified by Magnetic resonance imaging (ex: stroke, brain surgery)
  2. Dementia/ neurodegenerative/ neuropsychiatric diseases
  3. Systemic medical diseases with cognitive impairment (ex: anemia, thyroid disease)
  4. Can't have regular follow-up visit

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
AD without DBSBest medical treatment for Alzheimer's diseaseAlzheimer's disease subjects with optimal medication therapy and without DBS treatment
AD with DBSDeep brain stimulationAlzheimer's disease subjects with optimal medication therapy and with DBS treatment
AD with DBSBest medical treatment for Alzheimer's diseaseAlzheimer's disease subjects with optimal medication therapy and with DBS treatment
Primary Outcome Measures
NameTimeMethod
Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog)One year

Change from baseline in Alzheimer's Disease Assessment Scale-cognitive subscale; Total scores range from 0-70. Higher scores (≥ 18) indicate worse cognitive function. It consists of 11 tasks measuring the disturbances of memory, language, praxis, attention and other cognitive abilities.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Buddhist Tzu Chi General Hospital

🇨🇳

Hualien City, Taiwan

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