Transcranial Magnetic Stimulation to Slow Down Cognitive Decline in Alzheimer's Disease
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: repetitive transcranial magnetic stimulation, sham repetitive transcranial magnetic stimulation.
- Кому может быть актуально
- Состояния в реестре: Alzheimer Disease, Alzheimer Disease, Early Onset. Базовые параметры: 50 лет — 85 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Нидерланды
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Transcranial Magnetic Stimulation (TMS) to Slow Down Cognitive Decline in Alzheimer's Disease (AD): TMSLA - a Monocentric Randomized Controlled Trial.
Обзор
New amyloid-targeting drugs for Alzheimer's disease (AD) offer minimal or unclear efficacy and often cause adverse events, highlighting the need for new therapies. In recent years, repetitive transcranial magnetic stimulation (rTMS) has shown increasing success. A recent randomized, double-blind, sham-controlled, phase 2 demonstrated promising results from a 24-week rTMS treatment protocol targeting the precuneus. This brain region is considered a main hub of the human brain connectome and a prominent area of AD pathology. The results showed stable cognitive performance and increased brain activity in the treatment group, whereas the sham group worsened. A replication study is planned to further investigate the working mechanism of precuneus-rTMS in AD and to improve understanding of its therapeutic potential.
Вмешательства
- Устройство repetitive transcranial magnetic stimulation
20 Hz repetitive transcranial magnetic stimulation targeted at the precuneus - Устройство sham repetitive transcranial magnetic stimulation
20 Hz sham repetitive transcranial magnetic stimulation targeted at the precuneus
Первичные конечные точки
- CDR - Sum of Boxes [Срок оценки: from enrollment to 3 month follow-up]
Вторичные конечные точки (12)
- Magnetoencephalography (MEG): Spectral analysis [Срок оценки: from baseline to week 24 (post-treatment)]
- Cerebrospinal fluid (CSF) biomarkers [Срок оценки: from baseline to week 24 (post-treatment)]
- Neuropsychological evaluation: Trail Making Test [Срок оценки: from baseline to week 24 (post-treatment)]
- Amsterdam instrumental activities of daily living questionnaire (AmsterdamiADL); [Срок оценки: baseline to 3 month follow-up]
- Mini mental state examination (MMSE) [Срок оценки: baseline to 3-month follow up.]
- Neuropsychiatric Inventory Questionnaire (NPI-Q) [Срок оценки: baseline to 3 month follow up]
- Quick Inventory of Depressive Symptomatology (QIDS) [Срок оценки: baseline to 3-month follow up]
- Magnetoencephalography (MEG): Corrected Amplitude Envelope Correlation (AEC-c) [Срок оценки: From baseline to week 24 (post-treatment)]
- Magnetoencephalography (MEG): Phase Lag Index (PLI) [Срок оценки: baseline to week 24 (post-treatment)]
- Magnetoencephalography (MEG): Joint Permutation Entropy (JPE) [Срок оценки: baseline to week 24 (post-treatment)]
- Neuropsychological evaluation: Verbal Fluency Test [Срок оценки: baseline to week 24 (post-treatment)]
- Neuropsychological evaluation: Visual Association Test (VAT) [Срок оценки: baseline to week 24 (post-treatment)]
Критерии участия
Критерии включения
- Biomarker-supported Alzheimer's disease (abnormal CSF p-tau/Aβ42 ratio of > 0.023 or amyloid PET positive).
- Between 50 and 85 years old.
- Clinical Dementia Rating (CDR) score of 0.5 or 1.
- Mini-Mental State Examination (MMSE) score between 18 and 27.
- Presence of a caregiver.
Критерии исключения
- Medical history of neurodegenerative diseases other than AD, stroke, or epilepsy.
- Severe psychiatric dysregulation, hampering successful study participation and leading to possible cognitive impairment. Eligibility for participation will be based on clinical evaluation by an expert neurologist and/or psychiatrist.
- Extensive cerebrovascular damage on MRI classified as Fazekas level 2 or 3. Patients with abnormalities classified as Fazekas level 3 are excluded. For Fazekas level 2, patient's eligibility for participation will be evaluated by an expert neurologist.
- Presence of metal in the head or cranial/thoracic implants, including cochlear implants.
- Cholinesterase inhibitors with unstable dosage in the last 2 months.
- Extreme claustrophobia or metallic objects in or on the body, preventing MRI and MEG examination.
- Previous rTMS treatment (for blinding reasons).
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Двойное слепое
- Основная цель
- Лечение
Центры проведения
Нидерланды · 1 центр
- Amsterdam UMC — Amsterdam
Публикации
- Koch G, Casula EP, Bonni S, Borghi I, Assogna M, Minei M, Pellicciari MC, Motta C, D'Acunto A, Porrazzini F, Maiella M, Ferrari C, Caltagirone C, Santarnecchi E, Bozzali M, Martorana A. Precuneus magnetic stimulation for Alzheimer's disease: a randomized, sham-controlled trial. Brain. 2022 Nov 21;145(11):3776-3786. doi: 10.1093/brain/awac285. PMID 36281767
Идентификаторы
NCT: NCT07036328 · 2024.0870