Alzheimer Disease
Conditions
Brief summary
This study tests the effects of the Neuro RX Gamma synchronous and asynchronous devices on the cognitive and behavioral functioning of subjects with moderate-to-severe Alzheimer's Disease. The Neuro RX Gamma is non-invasive and delivers near-infrared energy to the brain in daily treatment sessions at home. An optional substudy will involve the use of the Electroencephalogram (EEG) to assess the effect of the treatment devices on the electrical activity of the brain compared to sham.
Detailed description
The Neuro RX Gamma system is a headset which emits pulsed near-infrared energy synchronously or asynchronously through diodes placed on the scalp and inside a nostril. A potential participant will undergo screening procedures to confirm eligibility to participate in the study, followed by randomization procedure to one of the study groups - treatment synchronized, treatment asynchronized or sham (placebo). A dedicated caregiver will apply the device to the subject for 20 minute daily sessions at home, 6 days a week for a total of 12 weeks. The subject and caregiver will be required to return to the clinic for follow-up assessments after 3, 6 and 12 weeks of treatment. Participants will have the choice of opting into a substudy involving the collection of rest EEG recordings during the baseline and weeks 3, 6 and 12 visits. 60 patients will be enrolled in 2 clinical sites in Ontario, Canada.
Interventions
DEVICENeuro RX Gamma synchronous
Twenty minute treatment, six days per week for 12 weeks
DEVICESham
Twenty minutes, six days per week for 12 weeks with sham device
DEVICENeuro RX Gamma asynchronous
Twenty minutes, six days per week for 12 weeks with sham device
Sponsors
Vielight Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age is greater than or equal to 50 years old * Meets the criteria for probable Alzheimer's disease of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) * If receiving ongoing cholinesterase inhibitor therapy and/or memantine, must be on a stable dosage for at least the prior 3 months * Mini Mental State Examination (MMSE) score between 0-20 at screening assessment * Severe Impairment Battery score at baseline of ≤90 * Outpatient with a reliable caregiver willing to commit to study visits and procedures
Exclusion criteria
* Current psychiatric or other neurologic disease * Any history of stroke, seizures, light sensitivity (polymorphous light eruption, solar urticaria, persistent light reactivity) or Lyme disease, including those taking photosensitizing medication * Currently undergoing light therapy treatment * Increased skin sensitivity at the treatment site including active herpes simplex in the treatment area, history of keloid formation, or history of retinoid use in the past month * Pregnant or lactating or planning to become pregnant * Any issues with ambulation, vision, or hearing which could, in the opinion of the investigator, interfere with their ability to complete assessments * Does not speak English at a level necessary for the completion of the assessments. * Currently participating in another clinical research study involving an investigational product. * Has participated in a drug or device study within the last 30 days. * Any condition, such as agitation/aggression, that in the opinion of the investigator would cause the patient to be unable to comply with study procedures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in the Severe Impairment Battery (SIB) score - An assessment of Severe Dementia in the elderly. | Baseline to Week 12 | The SIB evaluates cognitive abilities in severely impaired individuals. This scale covers social interaction, memory, orientation, language, attention, praxis, visuospatial ability, construction and orientation to name. There are 40 items and the SIB score ranges from 0-100. Individuals who score less than 63 on the SIB are rated as very severely impaired. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Device safety according to the number of device-related adverse events | Baseline to Week 12 | Subjects will be monitored for clinical evidence of device-related adverse events throughout the study. |
| Change in the Severe Impairment Battery score - An assessment of Severe Dementia in the elderly. | Baseline to Week 3 | The SIB evaluates cognitive abilities in severely impaired individuals. This scale covers social interaction, memory, orientation, language, attention, praxis, visuospatial ability, construction and orientation to name. There are 40 items and the SIB score ranges from 0-100. Individuals who score less than 63 on the SIB are rated as very severely impaired. |
| Change in the Alzheimer's Disease Cooperative Study - Activities of Daily Living for Severe Alzheimer's Disease (ADL SAD) score | Baseline to Week 3 | The ADL SAD assesses the performance of activities of daily living by patients with Alzheimer's disease. The assessment includes 19 questions. The score for each question ranges as follows: questions 1 - 5, 0 - 15; questions 6 - 8, 0 - 13; questions 9 - 12, 0 - 12; questions 13 - 15, 0 - 10 and questions 16 - 19, 0 - 4. Subscales will be summed to compute the total score. The total score ranges from 0 - 54 with higher scores indicating less functional impairment and greater competence. |
| Change in the Alzheimer's Disease Cooperative Study - Clinical Global Impression of Change (ADCS CGIC) score. | Baseline to Week 3 | The ADCS CGIC gives the Clinician's assessment of the patient's response to the treatment. It is intended to be used as a measure of clinically meaningful change. The ADCS-CGIC focuses on clinicians' observations of change in the patient's cognitive, functional, and behavioral performance since the beginning of a trial. It relies on both direct examination of the patient and interview of the caregiver. Scored as marked/moderate/minimal improvement or worsening or no change. |
| Change in the Electroencephalogram's (EEG) overall power spectral density | Baseline to Week 12 | The EEG recordings will give insight into the effect on the neural activity of the brain of the Neuro RX Gamma synchronized and Neuro RX Gamma asynchronized compared to sham. |
| Change in the Neuropsychiatric Inventory (NPI) score which assesses behavioral changes in neurologic illnesses based on a standardized caregiver interview. | Baseline to Week 3 | The NPI assesses the frequency, severity and level of distress caused by 12 common dementia-related behaviors (delusions, hallucinations, agitation/aggression, depression/dysphoria, anxiety, elation/euphoria, apathy/indifference, disinhibition, irritability/lability, aberrant motor behavior, sleep and appetite/eating). |
Other
| Measure | Time frame | Description |
|---|---|---|
| Caregiver reported treatment compliance | 12 weeks | Caregivers will document treatment sessions in a logbook to monitor compliance. |
Countries
Canada
Outcome results
None listed