Effects of Electrical Stimulation on Verbal Learning in Typical and Atypical Alzheimer's Disease

Launched by JOHNS HOPKINS UNIVERSITY · Oct 8, 2019

Keywords

ClinConnect Summary

This clinical trial is exploring how a type of brain stimulation called Transcranial Direct Current Stimulation (tDCS) can help improve verbal learning in people with Alzheimer's disease. Specifically, the researchers want to see if using tDCS, combined with language exercises, can enhance the ability to learn and recall words in two groups of participants: those with typical Alzheimer's disease characterized by memory loss and those with a less common form that primarily affects language skills. The study will also look at how this stimulation affects brain connections and the levels of certain brain chemicals.

To participate, individuals must be between 45 and 85 years old, right-handed, and proficient in English, with at least a high school education. They need to have a specific diagnosis related to Alzheimer's disease that can be confirmed through tests. Participants can expect to engage in language learning tasks while receiving either active or sham (inactive) stimulation. This study aims not only to find new treatment options but also to understand who might benefit most from this approach, ultimately aiming to improve the quality of life for both patients and their caregivers.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• For the aphasic/atypical AD participants:
• • Must be between 45-85 years of age.
• • Must be right-handed.
• • Must be proficient in English.
• • Must have a minimum of high-school education.
• • Must be diagnosed as logopenic variant Primary Progressive Aphasia (PPA) with Alzheimer's Disease (AD) biomarkers. Other possible diagnosis for the 'aphasic AD' variant would be Mild Cognitive Impairment (MCI) or 'possible AD' according to 2011 guidelines with AD biomarkers (CSF or positron emission tomography (PET) amyloid-beta or fluorodeoxyglucose (FDG)-positron emission tomography (PET) with unihemispheric atrophy).
• • Participants will be diagnosed from PPA and early dementias clinics at Johns Hopkins University or other specialized centers in US using current consensus criteria. Diagnosis will be based on neuropsychological testing, language testing (most commonly the Western Aphasia Battery), MRI and clinical assessment. The investigators will also use two new variant classification tests the investigators have developed at the lab which discriminate PPA variants with great accuracy (above 80%): a spelling test and a speech production test (i.e.,Cookie Theft picture description task).
• For the amnesic/typical AD participants:
• • Must be between 45-85 years of age.
• • Must be right-handed.
• • Must be proficient in English.
• • Must have a minimum of high-school education.
• • Must be diagnosed with 'probable AD' in specialized diagnostic centers with neuropsychological (e.g., RAVLT) and AD biomarkers according to 2011 guidelines.
• • The investigators will also perform extensive testing in the investigators' test battery including the Mnemonic Similarity Test (MST) that discriminates and measures the most salient hippocampal deficit-pattern separation (PS).
• Exclusion Criteria:
• • People with previous neurological disease including vascular dementia (e.g., stroke, developmental dyslexia, dysgraphia or attentional deficit).
• • People with hearing loss (\> 25 decibel, using audiometric hearing screen).
• • People with uncorrected visual acuity loss.
• • People with advanced dementia or severe language impairments (MMSE \< 15, or Montreal Cognitive Assessment \<10, or language Frontotemporal Dementia-specific Clinical Dementia Rating (FTD-CDR) = 3).
• • Left handed individuals.
• • People with pre-existing psychiatric disorders such as behavioral disturbances, severe depression, or schizophrenia that do not allow these people to comply or follow the study schedule and requirements such as repeated evaluation and therapy.
• Exclusion Criteria for MRI Participation:
• • People with severe claustrophobia.
• • People with cardiac pacemakers or ferromagnetic implants.
• • Pregnant women.