NCT05292222

Brief Summary

Alzheimer's disease (AD) is a progressive neurodegenerative condition affecting 6.2 million individuals in the United States, resulting in an annual cost of care of $305 billion. AD is functionally characterized by progressive degeneration of large-scale brain networks (LSBNs), including the default mode network (DMN) presumably from the deposition of amyloid plaques and neurofibrillary tangles. Available FDA-approved medications for AD such as donepezil and memantine offer limited benefit and modest impact on quality of life. In combination with resting state functional MRI (rs-fMRI), transcranial magnetic stimulation (TMS) with intermittent theta burst stimulation (iTBS) offers a non-invasive alternative to pharmacotherapy in persons with AD. We propose a pilot trial using rs-fMRI to target dysfunctional LSBNs in early stage AD.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
15

participants targeted

Target at below P25 for not_applicable alzheimer-disease

Timeline
Completed

Started Jun 2022

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

March 14, 2022

Completed
9 days until next milestone

First Posted

Study publicly available on registry

March 23, 2022

Completed
3 months until next milestone

Study Start

First participant enrolled

June 17, 2022

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 7, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 7, 2023

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

January 7, 2025

Completed
Last Updated

January 7, 2025

Status Verified

November 1, 2023

Enrollment Period

1.4 years

First QC Date

March 14, 2022

Results QC Date

November 27, 2024

Last Update Submit

December 17, 2024

Conditions

Keywords

transmagnetic stimulationfunctional MRI guided Theta Burst StimulationEarly Stage

Outcome Measures

Primary Outcomes (1)

  • Change in Connectivity Measure of the TGd Parcellations.

    Assessed by calculating the difference and standard deviation between follow-up and baseline of number of abnormal connections of the TGd parcellation. Range: 0-378. There are 378 possible connections of the parcellation. Higher values indicate more abnormal connections of the TGd parcellation pre and post-treatment. The change in the number of abnormal connections of the parcellation is reported.

    9 weeks

Study Arms (1)

Intermittent theta burst stimulation

EXPERIMENTAL

All subjects will receive treatment with intermittent theta burst stimulation (iTBS). There will be a total of 5 treatments over a 2-week period. All subjects will receive iTBS to the right TGd region. TBS treatment will also be provided for two additional sites within the large-scale brain networks (LSBNs) that is found to contain the greatest number of connectivity anomalies. Total participation will be 10-12 weeks.

Device: Intermittent theta burst stimulation

Interventions

MagVenture TMS Therapy with theta burst stimulation. Resting motor threshold: 80%; Number of pulses per session: 1200 pulses; Inter-train interval: 8 seconds; Pulse frequency in burst: 50 Hertz

Also known as: Transmagnetic stimulation, MagVenture
Intermittent theta burst stimulation

Eligibility Criteria

Age40 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Established diagnosis of Mild Cognitive Impairment (MCI)/mild AD
  • Evidence for Central Nervous System (CNS) amyloidosis (e.g., Amyloid positron emission tomography (PET) or cerebrospinal fluid (CSF) biomarkers consistent with AD)
  • Prior brain imaging performed
  • Mini-Mental State Examination (MMSE) \>24
  • Clinical Dementia Rating (CDR) Scale 0.5-1
  • Stable dose of cholinesterase inhibitors and memantine for at least one month
  • Subjects are between 40-90 years of age

You may not qualify if:

  • Non-AD dementia including, but not limited to, Lewy body dementia, frontotemporal dementia, vascular dementia, Jakob-Creutzfeldt disease, etc.
  • Inability to tolerate rs-fMRI
  • Contraindication of rs-fMRI due to implants or metal
  • Seizure disorder

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

HealthPartners Neuroscience Center

Saint Paul, Minnesota, 55130, United States

Location

Related Publications (1)

  • Kashyap B, Hanson LR, Gustafson SK, Barclay T, Howe CM, Sherman SJ, Hungs M, Rosenbloom MH. Open label pilot of personalized, neuroimaging-guided theta burst stimulation in early-stage Alzheimer's disease. Front Neurosci. 2024 Dec 9;18:1492428. doi: 10.3389/fnins.2024.1492428. eCollection 2024.

MeSH Terms

Conditions

Alzheimer Disease

Condition Hierarchy (Ancestors)

DementiaBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesTauopathiesNeurodegenerative DiseasesNeurocognitive DisordersMental Disorders

Results Point of Contact

Title
Bhavani Kashyap, MBBS, PhD
Organization
HealthPartners Institute

Study Officials

  • Bhavani Kashyap, MBBS, PhD

    HealthPartners Institute

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 14, 2022

First Posted

March 23, 2022

Study Start

June 17, 2022

Primary Completion

November 7, 2023

Study Completion

November 7, 2023

Last Updated

January 7, 2025

Results First Posted

January 7, 2025

Record last verified: 2023-11

Data Sharing

IPD Sharing
Will not share

No identifiable data will be shared with other researchers.

Locations