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Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by memory loss and multiple cognitive impairments. Given the recent failures of disease-modifying drugs, the current focus is in preventing synaptic damage that correlates with cognitive decline in AD patients. Transcranial Direct Current Stimulation (tDCS) is a safe, non-invasive, non-painful electrical stimulation of the brain which changes the resting membrane potential of neurons and allows neurons to fire easier, resulting in increasing the synaptic strength. When administered along with behavioral (language) therapy tDCS has resulted in improved language abilities in post-stroke and primary progressive aphasia (PPA). Previous studies have shown that tDCS over the left angular gyrus (AG) improves language associative learning in the elderly through changes in functional connectivity between the AG and the hippocampus. In addition, the investigators' studies in PPA have shown that anodal tDCS over the left inferior frontal gyrus (IFG) improves concurrently trained oral and written naming, and effects generalize to untrained items and tasks subserved by the same neural substrates. As synaptic strength becomes the target of new AD interventions, it becomes imperative to determine the use of tDCS as a therapeutic technique for AD. In the present study the investigators will compare the effects of tDCS over the AG—an area that is part of the default mode network (DMN) but also a language area, particularly important for supramodal semantic integration and event processing—in two predominant AD variants: the typical or amnesic variant AD, and the language-impaired (i.e. aphasic) variant AD, also described as logopenic variant PPA. The investigators aim to determine whether anodal high definition (HD)-tDCS over the left AG combined with verbal learning therapy will improve word list learning performance, as well as to identify the changes in functional connectivity and gamma-aminobutyric acid (GABA) using magnetic resonance imaging (MRI) and spectroscopy (MRS). Study results may help optimize future intervention in individuals with neurodegenerative disorders by providing treatment alternatives. A better understanding of the therapeutic and neuromodulatory effects of tDCS in AD will offer insight into means of impeding neurodegeneration that may improve patients' quality of life and augment therapies.
Alzheimer Disease, Early Onset
Anodal tDCS, Sham, Word list learning therapy
Johns Hopkins Hospital
Not yet recruiting
Johns Hopkins University
Published on BioPortfolio: 2019-10-16T10:39:36-0400
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Learning in which the subject must respond with one word or syllable when presented with another word or syllable.
Process in which individuals take the initiative, in diagnosing their learning needs, formulating learning goals, identifying resources for learning, choosing and implementing learning strategies and evaluating learning outcomes (Knowles, 1975)
Use of word stimulus to strengthen a response during learning.
Tests of the ability to hear and understand speech as determined by scoring the number of words in a word list repeated correctly.
The gradual expansion in complexity and meaning of symbols and sounds as perceived and interpreted by the individual through a maturational and learning process. Stages in development include babbling, cooing, word imitation with cognition, and use of short sentences.
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