Effect of Deep Transcranial Magnetic Stimulation (dTMS) on Cognition in Older Adults With Subjective Cognitive Decline (SCD)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- 入组人数
- 30
- 试验地点
- 2
- 主要终点
- Percentage of scheduled treatment sessions that are attended by study participants
研究概览
简要总结
Deep transcranial magnetic stimulation (dTMS) is a brain stimulation technique that involves generating a brief magnetic field in a coil that is placed on the scalp. The magnetic field passes through the skull and induces a weak electrical current in the brain that briefly activates neural circuits at the stimulation site. The Brainsway dTMS H7-Coil is able to target an area of the brain that has been shown in studies to be linked to greater resilience to cognitive decline. In this study, the investigators will combine dTMS with cognitive training in older adults with subjective cognitive decline (SCD) and examine the effect of this treatment on memory, other cognitive abilities, and mood. In addition, the investigators will examine the combined effects of dTMS and cognitive training on brain activity as measured using electroencephalography (EEG).
Approximately 30 older adults from ages 55 to 70 with SCD and a positive family history of Alzheimer's disease will be enrolled in this study.
详细描述
This study will examine the effects of combining cognitive remediation with neurostimulation using deep transcranial magnetic stimulation (dTMS) and the H7-coil to target the anterior cingulate cortex (ACC) in older adults at risk for developing Alzheimer's disease (AD). Thirty older adults with subjective cognitive decline (SCD) and a family history of AD will participate in a single-site randomized double-blind sham-controlled cross-over trial of dTMS of the ACC in conjunction with active cognitive remediation for both sham and dTMS interventions. The primary goal of the study is to establish the feasibility of dTMS and cognitive training as a means to improve cognitive abilities in SCD. Secondary goals are to obtain preliminary evidence of improvement in executive function and memory abilities following dTMS and cognitive training. This trial is a first step towards developing effective neurostimulation protocols to reduce cognitive decline in older adults at risk for developing AD.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Double (Participant, Investigator)
入排标准
- 年龄范围
- 55 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •have a family history of late onset sporadic Alzheimer's disease (AD) as defined by having a first degree relative, living or deceased, with a probable or confirmed diagnosis of AD
- •have subjective memory decline and concern about memory changes
- •score 26 or higher on the Montreal Cognitive Assessment (MoCA)
- •are willing to provide informed consent
- •are able to follow the treatment schedule
- •are stable on medications for 2 months and are not expected to change medication during the entire study period (if they are taking medications)
- •have a satisfactory safety screening questionnaire for TMS
- •have an informant/study partner who is able to complete study questionnaires regarding the participant
排除标准
- •have a metal plate in their head, except in the mouth (such as an ear implant, implanted brain stimulators, aneurysm clips)
- •have known increased pressure or a history of increased pressure in their brain, which may increase their risk for having seizures
- •have a cardiac pacemaker
- •have an implanted medication pump
- •have a central venous line
- •have a significant heart condition
- •have current depression or a history of any psychotic disorder, bipolar disorder, eating disorder, obsessive compulsive disorder, post-traumatic stress disorder, or dementia other than AD
- •have a history of substance abuse in the last 6 months
- •have a history of stroke or other brain lesions
- •have a personal history of epilepsy
- •have a family history of epilepsy
- •are a pregnant or breast-feeding woman
- •have a history of abnormal MRI of the brain
- •have significant hearing loss requiring use of hearing aids
- •have untreated hypo- or hyper-thyroidism
- •have TMS contraindications
- •have unstable medical condition(s)
- •regularly use benzodiazepines or other hypnotics within 2 weeks of randomization
结局指标
主要结局
Percentage of scheduled treatment sessions that are attended by study participants
时间窗: 19 weeks
There are in total 20 sessions of dTMS intervention and 20 sessions of sham stimulation.
次要结局
- Change in baseline in scores on the Geriatric Anxiety Inventory (GAI).(19 weeks)
- Change in baseline in scores on the Neuropsychiatric Inventory Questionnaire (NPI-Q)(19 weeks)
- Change in baseline memory performance on a neuropsychological battery(19 weeks)
- Change in executive function performance on a neuropsychological battery(19 weeks)
- Change in baseline in scores on the Geriatric Depression Scale (GDS).(19 weeks)
- Change in slow wave and resting state activity(17 weeks)
研究者
Linda Mah, MD
Clinician Scientist
Rotman Research Institute at Baycrest