Network-Level Mechanisms for Preclinical Alzheimer's Disease Development

NCT ID: NCT03461861

Last Updated: 2023-07-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-04-11

Study Completion Date

2021-03-31

Brief Summary

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The purpose of this project is to test the hypothesis that AGB101 low dose levetiracetam extended release formulation can reduce abnormal hyperfunctional activity in the hippocampus in normal, healthy adults. The investigators will compare the functional connectivity results after taking AGB101 or placebo.

Detailed Description

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In this study the investigators want to find out whether the use of a perturbation, such as AGB101 low dose of levetiracetam extended release formulation, in healthy adults can reduce abnormal hippocampal network activity. The investigators also want to study whether this low dose of LEV can improve memory function.

Generic levetiracetam is a type of drug called an anti-epileptic or anti-seizure medication. It is FDA approved worldwide for adults and children as young as one month with seizures. It is a generic drug used in long-term epilepsy treatment. It is relatively safe and has an acceptable side-effect profile.

AGB101 has been developed as a novel extended release formulation of low dose levetiracetam (below clinically marketed doses for epilepsy) for slowing the progression of amnestic mild cognitive impairment.

It is known that age and the APOE 4 gene are important risk factors for late-onset Alzheimer's disease. Further studies have shown that cognitively normal, older adults have more hyperfunctional brain network activity, increased alpha beta accumulation, decreased memory function, and decreased brain volume, which is consistent with Alzheimer's disease patterns.

Conditions

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APOE 4

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This is a randomized, double-blind, placebo-controlled crossover study in which a low dose of AGB101 (220mg QD) or placebo will be administered to 50 healthy 55-75-year-old subjects, with the order of treatments counterbalanced in a within-subject crossover design.
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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AGB101 220 mg, then Placebo

AGB101 220 mg/day capsule, once daily dosing for 2 weeks. After a 4 week washout, to be followed by Placebo, given as a capsule, once daily dosing for 2 weeks.

Group Type EXPERIMENTAL

AGB101 220 mg

Intervention Type DRUG

AGB101 oral dose of 220 mg/day capsule, given as once-daily dosing.

Placebo

Intervention Type OTHER

Placebo, oral capsule given once-daily.

Placebo, then AGB101 220 mg

Placebo, given as a capsule, once daily for 2 weeks. After a 4 week washout, to be followed by AGB101 220 mg/day capsule, once daily dosing for 2 weeks.

Group Type EXPERIMENTAL

AGB101 220 mg

Intervention Type DRUG

AGB101 oral dose of 220 mg/day capsule, given as once-daily dosing.

Placebo

Intervention Type OTHER

Placebo, oral capsule given once-daily.

Interventions

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AGB101 220 mg

AGB101 oral dose of 220 mg/day capsule, given as once-daily dosing.

Intervention Type DRUG

Placebo

Placebo, oral capsule given once-daily.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Fluent in English
* At least eight (8) years of education
* Geriatric Depression Scale (GDS) (62) score \< 6
* Hachinski Ischemic Score ≤ 4
* Normal general cognitive function as well as 1) normal memory function, documented by MOCA score of 23 or greater, and a RBANS Delayed Memory Index score of 85 or greater.

Exclusion Criteria

* Neurological disease, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or a history of significant head trauma or known structural brain abnormalities
* Major psychiatric disease or chronic unstable medical conditions
* History of drug abuse
* History of alcohol abuse (4 or greater drinks per day on average)
* Unable to complete MRI scans (no Pacemaker/Defibrillator)
* Known clinically significant abnormalities in B12 or thyroid function tests
* End Stage Renal Disease (ESRD)
* Hemodialysis (HD)
Minimum Eligible Age

55 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

Medical College of Wisconsin

OTHER

Sponsor Role lead

Responsible Party

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Yang Wang

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yang Wang, PhD

Role: PRINCIPAL_INVESTIGATOR

The Medical College of Wisconsin

Locations

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Froedtert & The Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Reiman EM, Chen K, Alexander GE, Caselli RJ, Bandy D, Osborne D, Saunders AM, Hardy J. Functional brain abnormalities in young adults at genetic risk for late-onset Alzheimer's dementia. Proc Natl Acad Sci U S A. 2004 Jan 6;101(1):284-9. doi: 10.1073/pnas.2635903100. Epub 2003 Dec 19.

Reference Type BACKGROUND
PMID: 14688411 (View on PubMed)

Filippini N, MacIntosh BJ, Hough MG, Goodwin GM, Frisoni GB, Smith SM, Matthews PM, Beckmann CF, Mackay CE. Distinct patterns of brain activity in young carriers of the APOE-epsilon4 allele. Proc Natl Acad Sci U S A. 2009 Apr 28;106(17):7209-14. doi: 10.1073/pnas.0811879106. Epub 2009 Apr 8.

Reference Type BACKGROUND
PMID: 19357304 (View on PubMed)

Sheline YI, Raichle ME, Snyder AZ, Morris JC, Head D, Wang S, Mintun MA. Amyloid plaques disrupt resting state default mode network connectivity in cognitively normal elderly. Biol Psychiatry. 2010 Mar 15;67(6):584-7. doi: 10.1016/j.biopsych.2009.08.024. Epub 2009 Oct 14.

Reference Type BACKGROUND
PMID: 19833321 (View on PubMed)

Li W, Antuono PG, Xie C, Chen G, Jones JL, Ward BD, Singh SP, Franczak MB, Goveas JS, Li SJ. Aberrant functional connectivity in Papez circuit correlates with memory performance in cognitively intact middle-aged APOE4 carriers. Cortex. 2014 Aug;57:167-76. doi: 10.1016/j.cortex.2014.04.006. Epub 2014 Apr 30.

Reference Type BACKGROUND
PMID: 24905971 (View on PubMed)

Sheline YI, Morris JC, Snyder AZ, Price JL, Yan Z, D'Angelo G, Liu C, Dixit S, Benzinger T, Fagan A, Goate A, Mintun MA. APOE4 allele disrupts resting state fMRI connectivity in the absence of amyloid plaques or decreased CSF Abeta42. J Neurosci. 2010 Dec 15;30(50):17035-40. doi: 10.1523/JNEUROSCI.3987-10.2010.

Reference Type BACKGROUND
PMID: 21159973 (View on PubMed)

Koh MT, Haberman RP, Foti S, McCown TJ, Gallagher M. Treatment strategies targeting excess hippocampal activity benefit aged rats with cognitive impairment. Neuropsychopharmacology. 2010 Mar;35(4):1016-25. doi: 10.1038/npp.2009.207. Epub 2009 Dec 23.

Reference Type BACKGROUND
PMID: 20032967 (View on PubMed)

Sanchez PE, Zhu L, Verret L, Vossel KA, Orr AG, Cirrito JR, Devidze N, Ho K, Yu GQ, Palop JJ, Mucke L. Levetiracetam suppresses neuronal network dysfunction and reverses synaptic and cognitive deficits in an Alzheimer's disease model. Proc Natl Acad Sci U S A. 2012 Oct 16;109(42):E2895-903. doi: 10.1073/pnas.1121081109. Epub 2012 Aug 6.

Reference Type BACKGROUND
PMID: 22869752 (View on PubMed)

Devi L, Ohno M. Effects of levetiracetam, an antiepileptic drug, on memory impairments associated with aging and Alzheimer's disease in mice. Neurobiol Learn Mem. 2013 May;102:7-11. doi: 10.1016/j.nlm.2013.02.001. Epub 2013 Feb 13.

Reference Type BACKGROUND
PMID: 23416036 (View on PubMed)

Bakker A, Krauss GL, Albert MS, Speck CL, Jones LR, Stark CE, Yassa MA, Bassett SS, Shelton AL, Gallagher M. Reduction of hippocampal hyperactivity improves cognition in amnestic mild cognitive impairment. Neuron. 2012 May 10;74(3):467-74. doi: 10.1016/j.neuron.2012.03.023.

Reference Type BACKGROUND
PMID: 22578498 (View on PubMed)

Vossel KA, Beagle AJ, Rabinovici GD, Shu H, Lee SE, Naasan G, Hegde M, Cornes SB, Henry ML, Nelson AB, Seeley WW, Geschwind MD, Gorno-Tempini ML, Shih T, Kirsch HE, Garcia PA, Miller BL, Mucke L. Seizures and epileptiform activity in the early stages of Alzheimer disease. JAMA Neurol. 2013 Sep 1;70(9):1158-66. doi: 10.1001/jamaneurol.2013.136.

Reference Type BACKGROUND
PMID: 23835471 (View on PubMed)

Palop JJ, Chin J, Roberson ED, Wang J, Thwin MT, Bien-Ly N, Yoo J, Ho KO, Yu GQ, Kreitzer A, Finkbeiner S, Noebels JL, Mucke L. Aberrant excitatory neuronal activity and compensatory remodeling of inhibitory hippocampal circuits in mouse models of Alzheimer's disease. Neuron. 2007 Sep 6;55(5):697-711. doi: 10.1016/j.neuron.2007.07.025.

Reference Type BACKGROUND
PMID: 17785178 (View on PubMed)

Tuminello ER, Han SD. The apolipoprotein e antagonistic pleiotropy hypothesis: review and recommendations. Int J Alzheimers Dis. 2011 Feb 24;2011:726197. doi: 10.4061/2011/726197.

Reference Type BACKGROUND
PMID: 21423560 (View on PubMed)

Dickerson BC, Salat DH, Bates JF, Atiya M, Killiany RJ, Greve DN, Dale AM, Stern CE, Blacker D, Albert MS, Sperling RA. Medial temporal lobe function and structure in mild cognitive impairment. Ann Neurol. 2004 Jul;56(1):27-35. doi: 10.1002/ana.20163.

Reference Type BACKGROUND
PMID: 15236399 (View on PubMed)

Mohajeri MH, Saini K, Schultz JG, Wollmer MA, Hock C, Nitsch RM. Passive immunization against beta-amyloid peptide protects central nervous system (CNS) neurons from increased vulnerability associated with an Alzheimer's disease-causing mutation. J Biol Chem. 2002 Sep 6;277(36):33012-7. doi: 10.1074/jbc.M203193200. Epub 2002 Jun 14.

Reference Type BACKGROUND
PMID: 12068009 (View on PubMed)

Tampellini D, Capetillo-Zarate E, Dumont M, Huang Z, Yu F, Lin MT, Gouras GK. Effects of synaptic modulation on beta-amyloid, synaptophysin, and memory performance in Alzheimer's disease transgenic mice. J Neurosci. 2010 Oct 27;30(43):14299-304. doi: 10.1523/JNEUROSCI.3383-10.2010.

Reference Type BACKGROUND
PMID: 20980585 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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R21AG056882-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

PRO00031146

Identifier Type: -

Identifier Source: org_study_id

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