TMS in Preclinical and Prodromal AD: Modulation of Brain Networks and Memory
Alzheimer Disease, Mild Cognitive Impairment, Aging
About this trial
This is an interventional treatment trial for Alzheimer Disease
Eligibility Criteria
Inclusion Criteria:
- Between the ages of 60-85
- All participants will be native English speakers
- Willing and able to consent to the protocol and undergo imaging and neuropsychological testing at the specified time points
- Participants with aMCI will be asked to bring a study partner to all visits
- Only patients with very mild or mild cognitive impairment (CDR 0.5 or CDR 1) will be included in the prodromal AD cohort
Exclusion Criteria:
- History of head trauma involving loss of consciousness or alteration in consciousness
- Another major neurologic or psychiatric condition
- Known presence of a structural brain lesion (e.g. tumor, cortical infarct)
- Any contraindication to MRI, such as presence of pacemakers, aneurysm clips, artificial heart valves, ear implants, metal fragments, or foreign objects in the eyes, skin, or body
- Longstanding premorbid history (i.e. longer than 10 years) of alcohol or substance abuse with continuous abuse up to and including the time that the symptoms leading to clinical presentation developed
- Any significant systemic illness or unstable medical condition which could lead to difficulty complying with the study protocol.
- Unwilling to return for follow-up, undergo neuropsychological testing, TMS, and MR imaging
Sites / Locations
- Massachuetts General HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Sham Comparator
Active stimulation
Sham stimulation
Active rTMS will be administered with a MagPro X100 stimulator (MagVenture, Denmark), using a 70 mm figure-of-eight liquid cooled coil capable of doing active or sham stimulation (e.g. the Cool B70 coil or the Cool B65 A/P coil). Active rTMS will be delivered at 80% of a patient's active motor threshold. rTMS will be administered in an excitatory iTBS pattern. Stimulation parameters will remain well within established safety guidelines (Rossi et al. 2009).
SHAM stimulation will also be administered with a MagPro X100 stimulator (MagVenture, Denmark), using a 70 mm figure-of-eight liquid cooled coil capable of doing active or sham stimulation (e.g. the Cool B70 coil or the Cool B65 A/P coil). SHAM rTMS will be delivered at 80% of a patient's active motor threshold. SHAM stimulation will be delivered to the exact same cortical targets as active rTMS. While no electromagnetic stimulation will be delivered during SHAM, the sounds will approximate active stimulation and skin electrodes will approximate the sensation of active rTMS. Inclusion of a sham condition in this protocol is critical to measure whether or not the stimulation is improving memory performance, or whether practice effects or other non-specific effects are responsible for any changes in memory which may be observed.