Alzheimer's Disease Clinical Trial
Official title:
Effect of Deep Brain Stimulation of the Hypothalamus/ Fornix on Memory Impairment in Patients With Alzheimer's Disease
Alzheimer's Disease (AD) is the most common cause of dementia for which no treatment has
shown consistent efficacy to stop or slow down the disease. Recent report of enhancement of
memory abilities by bilateral chronic deep brain stimulation (DBS) of the fornix in the
hypothalamus suggests that neuromodulation of circuits involved in memory processes may have
therapeutic implications in AD patients with memory decline.
The primary objectives of this prospective, non-controlled, pilot study are to evaluate the
feasibility and safety of DBS in AD patients with mild cognitive and memory impairment, and
to evaluate the efficacy of DBS to slow down or stabilize this decline. Five patients with
AD (DSM IV) diagnosed less than two years, with mild cognitive decline (MMSE 20-24), and
specific impairment of episodic memory will be included in a 2-year period. The evaluation
criteria for feasibility will be the proportion of patients undergoing the procedure,
chronic stimulation and evaluation process without adverse event (AE). Efficacy will be
evaluated using numerous cognitive and memory testing. Changes in behavioral and mood
scales, and changes in hypothalamic functions (clinical, biological and hormonal assessment)
will evaluate safety and tolerance. Clinical, neuro-psychological, biological and imaging
assessment will be performed 3 and one month before and 3, 6, 12 and 24 months after
surgery. Bilateral electrodes (Medtronic 3389) will be implanted, by MR-guided frame-based
stereotaxy, in the hypothalamic part of the fornix, and then connected to the generator
(Kinetra, Medtronic). Chronic high-frequency stimulation will be delivered immediately after
surgery.
The investigators expect to slow down, or to stabilize the spontaneous decline of MMSE and
ADAS scores after 6, 12 and 24 months of stimulation. In case of efficacy, DBS might offer
to AD patient the possibility to slow down/stabilize their symptoms, which no other
treatment can currently offer, and to increase their quality of life.
n/a
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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