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The purpose of this study is to test a new procedure to treat Alzheimer's disease. The procedure is called intermittent Deep Brain Stimulation (DBS) of the nucleus basalis of Meynert. There will be up to six participants enrolled at Wellstar MCG Memory Clinic. There will be another six participants similarly enrolled to act as a control group that does not receive DBS. This second group will document the course of progression of Alzheimer's disease under the normal standard of care. The main goal of the study is to determine if DBS can sustain or improve cognition in Alzheimer's disease for at least two years. Participant data, with identifying information removed, may be shared with online repositories for comparison with trials with similar subjects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intermittent deep brain stimulation of the nucleus basalis of Meynert | Experimental | Subjects will receive intermittent deep brain stimulation of the nucleus basalis of Meynert for 50 minutes each day. Assessments will be performed at onset, after four weeks of intervention, and each six months through two years. |
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| Control group | No Intervention | Subjects will have matching eligility criteria as those in the experimental arm, but will receive no intervention. Assessments will be performed at study onset, and each six months through two years after onset. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intermittent deep brain stimulation of the nucleus basalis of Meynert | Device | Subjects will receive intermittent deep brain stimulation of the nucleus basalis of Meynert for 50 minutes each day. |
| Measure | Description | Time Frame |
|---|---|---|
| Dementia Rating Scales | Subjects will be evaluated using the Clinical Dementia Rating Sum of Boxes scale. The investigators seeks for half of the intervention arm participants to have better (lower) or equal scale scores two years after intervention onset than they had at onset. This scale ranges from 0 to 18, and subjects will score from 2 to 6 at study entry. | Two years after intervention onset |
| Alzheimer's Disease Assessment Scale, Cognitive Subscale | The investigators seeks for scores on the Alzheimer's Disease Assessment Scale, Cognitive Subscale, to be equal or lower in half of the participants two years after the intervention begins compared to their value at study onset. This scale ranges from 0 to 85, and subjects at onset will likely have scores between 13 and 30. | Two years of intervention |
| Measure | Description | Time Frame |
|---|---|---|
| PET scans for beta amyloid | PET scans will be obtained at onset and annually through two years. The investigators seek for a reduction in the Standard Uptake Volume Ratio (SUVr) in the intervention arm compared to the control arm. SUVr is a ratio of image intensity in a reference region of the brain compared to the cerebral cortex. SUVr averages 1.22 in subjects diagnosed with Alzheimer's, and 1.0 in non-Alzheimer's controls. |
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Inclusion Criteria:
Age:65 minimum
Exclusion Criteria:
• clinical co-morbidity interfering with study (e.g. head trauma requiring medical treatment in the 2 years prior, brain tumor, subdural hematoma, or other clinically significant space-occupying lesion on brain CT or MRI), or other implant precluding high field MRI scans.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| David T Blake, PhD | Contact | 415-515-2659 | dblake@augusta.edu |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wellstar MCG Hospital, Neurology Memory Clinic | Recruiting | Augusta | Georgia | 30912 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37935282 | Background | Sasikumar S, Cohn M, Youm A, Duncan K, Boogers A, Strafella AP, Blake DT, Fasano A. Rethinking NBM DBS: Intermittent stimulation improves sustained attention in Parkinson's disease. Brain Stimul. 2023 Nov-Dec;16(6):1643-1645. doi: 10.1016/j.brs.2023.10.014. Epub 2023 Nov 5. No abstract available. | |
| 36939283 | Background |
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Subject data will be de-identified. Assessment outcomes and imaging results will be uploaded to open access websites for sharing such data like ADNI.
Data will be shared upon publication and will be available indefinitely.
Access will be open.
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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Six subjects will receive open label intermittent deep brain stimulation of the nucleus basalis of Meynert for 50 minutes daily. Six control subjects will document expected progression under normal standard of care.
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| Two years after study onset. |
| Anxiety scales | Subjects will receive a GAD-7 questionnaire at the same times as cognitive assessments. The investigators seek for reductions in the GAD-7 values in the intervention arm compared to the control arm. The GAD-7 scale ranges from 0 to 21, and higher scores indicate more anxiety. | Two years of intervention |
| Beta amyloid PET imaging, Centiloid scale. | PET scans will be obtained from particpants at onset and annually through two years. The investigators seek for a reduction in the Centiloid Scale in the intervention arm compared to the control arm. The Centiloid scale is 0CL on average in a 45 year old normal, and 100CL in a person with Alzheimer's dementia. | Two years of intervention |
| PHQ-9 questionaire | Participants will receive a PHQ-9 questionnaire at the same times as cognitive assessments. The investigators seek for reductions in this scale in the intervention arm compared to the control arm. The PHQ-9 depression scale has scores from 0 to 27, and higher scores indicate more depression. | Two years of intervention |
| Kumro J, Tripathi A, Lei Y, Sword J, Callahan P, Terry A, Lu XY, Kirov SA, Pillai A, Blake DT. Chronic basal forebrain activation improves spatial memory, boosts neurotrophin receptor expression, and lowers BACE1 and Abeta42 levels in the cerebral cortex in mice. Cereb Cortex. 2023 Jun 8;33(12):7627-7641. doi: 10.1093/cercor/bhad066. |
| 39924100 | Background | Pennington KR, Debs L, Chung S, Bava J, Garin CM, Vale FL, Bick SK, Englot DJ, Terry AV Jr, Constantinidis C, Blake DT. Basal forebrain activation improves working memory in senescent monkeys. Brain Stimul. 2025 Mar-Apr;18(2):185-194. doi: 10.1016/j.brs.2025.02.002. Epub 2025 Feb 7. |
| 28823679 | Background | Liu R, Crawford J, Callahan PM, Terry AV Jr, Constantinidis C, Blake DT. Intermittent Stimulation of the Nucleus Basalis of Meynert Improves Working Memory in Adult Monkeys. Curr Biol. 2017 Sep 11;27(17):2640-2646.e4. doi: 10.1016/j.cub.2017.07.021. Epub 2017 Aug 17. |
| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |