Understanding Brain Mechanisms Involved in Autobiographical Memory

Alzheimer Disease Clinical Trial

Official title:

Understanding Brain Mechanisms Involved in Autobiographical Memory Using High-density Electroencephalography and Transcranial Alternating Current Stimulation

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05710549
• Other study ID #: 2021-01388
• Status: Recruiting
• Phase: N/A
• Start date: April 25, 2022
• Est. completion date: August 2025

Study information

• Verified date: November 2023
• Source: University of Geneva, Switzerland
• Contact: Lucie Bréchet, PhD
• Phone: +41 22 379 08 52
• Email: lucie.brechet[@]unige.ch
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The overall objective of this project is to characterize the spatiotemporal dynamics of brain oscillations underpinning autobiographical memory (ABM) and the modulation of the memory network using non-invasive brain stimulation.

Description:

Accumulating evidence suggests that activity in distributed networks supporting ABM is altered even decades before the expected onset of clinical symptoms in Alzheimer's disease (AD). Robust network alterations associated with age-related memory and cognitive decline have been linked to abnormal oscillatory brain rhythmic activity and functional dysconnectivity. However, the detailed neural mechanisms are still poorly understood. The investigators propose to precisely characterize the underlying neurophysiological mechanisms that lead to behavioral and cognitive disturbances in ABM of MCI patients. Specifically, hdEEG will be used to characterize the sources and spatiotemporal dynamics of the neuronal activity involved in the ABM network of 40 mild cognitive impairment (MCI) patients and compare it to 40 age-matched, older healthy participants and 40 healthy young participants. The investigators will then apply non-invasive brain stimulation in the form of transcranial alternating current stimulation (tACS) to gain novel insights into the causal role of brain oscillations in the ABM network of MCI patients.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 120
• Est. completion date: August 2025
• Est. primary completion date: August 2025
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 85 Years

Eligibility

Inclusion Criteria:

Cognitively-Unimpaired Younger and Older Adults

• Age 18 to 35 years old (younger adults)

• Age 55+ years old (older adults)

• without any cognitive impairment (based on the Montreal Cognitive Assessment: MoCA)

• willing and capable to give informed consent for participation in the study after it has been thoroughly explained able

• willing to comply with all study requirements informed consent form was signed

Mild Cognitive Impairment (MCI) patients

• Age 55+ years old

• Clinical Diagnosis of MCI

• Confirmation of diagnosis will be made by the study MD based on a holistic consideration of the participant's cognitive evaluation and history

• Mini-Mental State Examination (MMSE) = 18 (Mild AD = 21)

• CDR = .5

• Demonstration or history of autobiographical memory impairments

• On a stable dose of medications for memory loss including cholinesterase inhibitors (e.g. donepezil, rivastigmine) or memantine as defined as 6 consecutive weeks of treatment at an unchanging dose

• Minimum of completed 8th-grade education

• willing and capable to give informed consent for participation in the study after it has been thoroughly explained - note that to ensure this in the case of the MCI participants, a cut-off of MOCA score >18 will be applied

• able and willing to comply with all study requirements informed consent form was signed

Exclusion Criteria:

Cognitively-Unimpaired Younger and Older Adults

• any cognitive impairment captured by the Montreal Cognitive Assessment (MoCA) - score < 26

• major psychiatric co-morbidity including major depressive disorder, schizophrenia, or psychosis

• blindness or other disabilities that prevent task performance

• Contraindication for undergoing MRI

• Any metal in the brain or skull (excluding dental fillings) or elsewhere in the body unless cleared by the responsible covering MD (e.g. MRI compatible joint replacement)

Mild Cognitive Impairment (MCI) patients

• Age < 55 years old

• Any current diagnosis of a major psychiatric disorder (e.g., schizophrenia, bipolar disorder, major depressive disorder)

• Other than MCI, any history of other progressive or genetic neurologic disorder (e.g. Parkinson's disease, multiple sclerosis, tubular sclerosis) or acquired neurological disease (e.g. stroke, traumatic brain injury, tumor), including intracranial lesions

• History of head trauma resulting in prolonged loss of consciousness

• Current history of poorly controlled headaches including chronic medication for migraine prevention

• History of fainting spells of unknown or undetermined etiology that might constitute seizures

• History of seizures, diagnosis of epilepsy, or immediate (1st-degree relative) family history of epilepsy with the exception of a single seizure of benign etiology (e.g. febrile seizures) in the judgment of a board-certified neurologist

• Any unstable medical condition or chronic (particularly) uncontrolled medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.) or study complication

• contraindications to tACS, as recorded on a standardized screening questionnaire, which include a reported seizure within the past two years, use of neuroactive drugs, self-reported presence of specific implanted medical devices (e.g., deep brain stimulator, medication infusion pump, cochlear implant, pacemaker, etc.), or the presence of any active dermatological condition, such as eczema, on the scalp

• Contraindication for undergoing MRI or receiving tACS

• Any metal in the brain or skull (excluding dental fillings) or elsewhere in the body unless cleared by the responsible covering MD (e.g. MRI compatible joint replacement)

• Any devices such as a pacemaker, medication pump, nerve stimulator, TENS unit, ventriculoperitoneal shunt unless cleared by the responsible covering MD

Related Conditions & MeSH terms

• Alzheimer Disease
• Cognitive Dysfunction
• Memory Disorders
• Memory Loss
• Mild Cognitive Impairment

Intervention

Device:
• high-density electroencephalography (hdEEG)
EEG will be recorded with a 257-channel EEG system (Geodesic Sensor Net, MegStim). An EEG net is applied at once on the head with evenly spaced sensors that provide full scalp coverage, including the cheek, Ag/Ag-Cl electrodes that are interconnected by thin rubber bands and contain small sponges soaked with saline water that touches the participant's scalp surface directly. Net application takes about 10 min to derive impedances to <30 kOhms. EEG is recorded with 1 kHz and band-pass filtered between 0.1-200 Hz. Vertex electrode Cz is used as an acquisition reference.
• Transcranial alternating current stimulation (tACS)
tACS will be delivered by a battery-driven current stimulator Starstim SS32 (Neuroelectrics) through surface Ag/AgCl electrodes placed into holes of a neoprene cap corresponding to the international 10/20 EEG system. Gel (Parker Lab, Inc.) will be applied to optimize signal conductivity and lower impedance.

Locations

Country	Name	City	State
Switzerland	University of Geneva, Campus Biotech	Geneva

Sponsors (1)

Lead Sponsor	Collaborator
Prof. Christoph M. Michel

Country where clinical trial is conducted

Switzerland, 

References & Publications (3)

Brechet L, Brunet D, Birot G, Gruetter R, Michel CM, Jorge J. Capturing the spatiotemporal dynamics of self-generated, task-initiated thoughts with EEG and fMRI. Neuroimage. 2019 Jul 1;194:82-92. doi: 10.1016/j.neuroimage.2019.03.029. Epub 2019 Mar 19. — View Citation

Michel CM, He B. EEG source localization. Handb Clin Neurol. 2019;160:85-101. doi: 10.1016/B978-0-444-64032-1.00006-0. — View Citation

Roehri N, Brechet L, Seeber M, Pascual-Leone A, Michel CM. Phase-Amplitude Coupling and Phase Synchronization Between Medial Temporal, Frontal and Posterior Brain Regions Support Episodic Autobiographical Memory Recall. Brain Topogr. 2022 Mar;35(2):191-206. doi: 10.1007/s10548-022-00890-4. Epub 2022 Jan 26. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Spatiotemporal dynamic changes measured with electroencephalography (hdEEG)	Changes in spatiotemporal dynamics in different frequency bands (theta, alpha, beta, gamma) will be assessed with hdEEG	up to 30 minutes
Primary	Cognitive Assessment	The Montreal Cognitive Assessment (MOCA) will be administered to characterize the cognitive status	baseline