ClinicalTrials.gg
RecruitingNCT06821568TDCS4MCRUpdated Jul 16, 2026

Home-Based Brain Stimulation for Motoric Cognitive Risk Syndrome

An interventional study of Personalized Transcranial Direct Current Stimulation (tDCS) and Active-Sham in Alzheimer Disease and Related Dementias, Cognition and Mobility Disability, sponsored by Hebrew SeniorLife. Recruiting at 2 sites in 2 countries. Open to participants aged 65 Years to 90 Years. Per ClinicalTrials.gov, last updated 2026-07-16.

Sponsored by Hebrew SeniorLife · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Sep 2025; still recruiting 1 year 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
128
Allocation
Randomized
Ages
65 Years to 90 Years
Sex
All
01

Study summary

The objective of this study is to determine the effects of a 6-month, home-based personalized transcranial direct current stimulation (tDCS) intervention targeting the left dorsolateral prefrontal cortex on cognitive function, dual task standing and walking, and other metrics of mobility in older adults with motoric cognitive risk syndrome (MCR).

Read the detailed description

In older adults, motoric cognitive risk (MCR) is a pre-dementia transition state between "normal" aging and dementia. MCR is associated with impaired function within several brain networks that causes numerous symptoms including loss of memory, the ability to complete complex mental tasks, and the capacity to control one's walking and thus avoid falling and fall-related injuries. This study seeks to assess the short-term and long-term use of an investigational device called a transcranial direct current stimulation (tDCS).

tDCS is a noninvasive technology that enables selective modulation of brain network function, to provide multi-symptom relief to older adults with MCR. By using state-of-the-art technology to 1) utilize a personalized tDCS intervention via an established optimization approach using individual brain MRIs, and 2) complete stimulation in a home-based setting, this study is expected to result in the development of tDCS interventions that have maximal impact on daily life function within this population.

In this study, investigators will conduct a 9-month sham-controlled, double-blinded, multi-site trial in 128 older adults aged 65-90 years old with MCR. All enrolled participants will complete an open-label 2-week, 10-session tDCS intervention. During the open-label phase of the study, all participants will receive active tDCS. Then, participants will be randomly assigned into either the tDCS arm that receives five weekly tDCS sessions for 6 months, or a combination arm of five weekly tDCS sessions for 3 months before or after five weekly sessions of sham for 3 months. Sham treatment is similar to the study tDCS treatment, but omits the key therapeutic element of the treatment being studied. Participants in the combination arm will not know whether they are receiving tDCS or sham during the first or second 3-month period. Enrolled participants will complete assessments relating to cognition, mood, balance, and memory at baseline, after the 2-week open-label phase, after 3 and 6 months of tDCS, and again 3 months later. Once a week, participants will also complete a gait (walking) assessment at home. MRI scans will be performed at baseline, after completing 3 months of tDCS, and after completing 6 months of tDCS.

02

Conditions studied

  • Alzheimer Disease and Related Dementias
  • Cognition
  • Mobility Disability

Keywords

  • Anatomy
  • Anxiety
  • Atrophic
  • Behavioral
  • Brain
  • Brain Region
  • Cephalic
  • Cognitive
  • Communities
  • Dementia
  • Development
  • Dose
  • Double-Blind Method
  • Electric Stimulation
  • Enrollment
  • Evaluation
  • Exhibits
  • Exposure to
  • Frequencies
  • Future
  • Gait
  • Gait Speed
  • Genetic Crossing Over
  • Home
  • Impaired Cognition
  • Individual
  • Intervention
  • Intervention Studies
  • Magnetic Resonance Imaging
  • Measurable
  • Measures
  • Mood
  • Motor
  • Multi-Institutional Clinical Trial
  • Neuronal Plasticity
  • Outcome
  • Participant
  • Performance
  • Phase
  • Pilot Projects
  • Prefrontal Cortex
  • Randomized
  • Randomized Controlled Clinical Trials
  • Research
  • Resolution
  • Rest
  • Risk
  • Series
  • Site
  • Structure
  • Testing
  • Therapeutic
  • Time
  • Syndrome
  • Walking
  • Work
  • Arm
  • cerebral atrophy
  • Clinically relevant
  • cognitive task
  • Cost
  • Dementia Risk
  • Design
  • Executive Function
  • functional improvement
  • functional near infrared spectroscopy
  • Gray Matter
  • high risk
  • home test
  • improved
  • insight
  • late life
  • mental function
  • neural network
  • neuroimaging
  • noninvasive brain stimulation
  • normal aging
  • older adult
  • older men
  • older women
  • open label
  • primary endpoint
  • response
  • secondary outcome
  • smartphone application
  • transcranial direct current stimulation
  • trial design
  • walking speed
  • Alzheimer's Disease
03

In context

Alzheimer Disease

3,965 studies on the registry are indexed under Alzheimer Disease; 926 are open to participants now.

This study's planned enrollment of 128 is above the median of 70 across 3,019 interventional studies indexed under Alzheimer Disease.

Browse Alzheimer Disease studies →

Lead sponsor

Hebrew SeniorLife is the lead sponsor of 38 studies on the registry; 7 are open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 2 (40%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
65 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Men and women
  • Age 65-90 years
  • Subjective cognitive complaints as defined by a 'Yes' response to "Do you feel that you have more problems with memory than most?" or a 'No' response to "is your mind as clear as it used to be?"
  • (MoCA) score ≥21
  • Slow gait speed as measured by averaging two 4-Meter walks and defined as a usual walking speed one standard deviation below age and sex-adjusted means.
  • Absence of significant disability as defined by the ability to walk over the instrumented gait mat unassisted (e.g., able to walk without any walking aids for at least 2 minutes non-stop) and preserved activities of daily living as defined by a score of less than 9 on the Functional Activities Questionnaire.
  • Identification of an eligible informant
  • Identification of a willing and able tDCS-administrator; i.e., a study partner to lead the administration of home-based transcranial direct current stimulation (tDCS)
  • Access to reliable WiFi in the participant's home

Exclusion criteria

Exclusion Criteria:

  • Formal education less than the 8th grade
  • Previous physician diagnosis of dementia
  • Any current diagnosis of a major psychiatric disorder (e.g., schizophrenia, bipolar disorder, major depressive disorder)
  • Evidence of moderate-to-severe depressive symptoms defined by a score of ≥9 on the 15-item Geriatric Depression Scale
  • History of head trauma resulting in prolonged loss of consciousness
  • History of fainting spells of unknown or undetermined etiology that might constitute seizures
  • History of seizures, diagnosis of epilepsy, or immediate (first-degree relative) family history of epilepsy except for a single seizure of benign etiology (e.g. febrile seizures) in the judgment of a board-certified neurologist
  • Hospitalization within the past three months due to acute illness, or as the result of a musculoskeletal injury significantly affecting gait or balance
  • Any unstable medical condition or chronic (particularly) uncontrolled medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.) or study complication
  • Substance use disorders within the past six months
  • A hairstyle or headdress that prevents electrode contact with the scalp or would interfere with the stimulation (for example thick braids, hair weave, afro, wig)
  • Chronic vertigo
  • Myocardial infarction within the past 6 months
  • Active cancer for which chemo-/radiation therapy is being received
  • Legal blindness
  • Visual hallucinations (history or self-report)
  • Pacemaker
  • to MRI or tDCS, including unprovoked seizure within the past two years, risk of ferromagnetic objects anywhere in the body, self-reported presence of specific implanted medical devices (e.g., deep brain stimulator, medication infusion pump, cochlear implant, pacemaker, etc.), the presence of any active dermatological condition, such as eczema, on the scalp, etc. as outlined by current recommendations for noninvasive brain stimulation endorsed by the International Federation for Clinical Neurophysiology.
  • History of REM sleep behavior disorder (RBD), often an early sign of Parkinson's disease
  • Medications and medical history will be reviewed by the responsible covering physician and a decision about inclusion will be made based on the participant's past medical history, drug dose, history of recent medication changes or duration of treatment, and combination with other CNS active drugs.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

MMSE and MoCA

Short tests of memory and thinking, each scored out of 30. Lower scores suggest more difficulty; criteria give a range, either to include people with memory problems or to leave them out.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
128 participants (estimated)

Study arms

  • Experimental
    Personalized Transcranial Direct Current Stimulation (tDCS)

    After an initial open-label 2-week home-based transcranial direct current stimulation (tDCS) intervention, participants will receive 5 weekly home-based tDCS sessions for 6 months. Baseline MRIs will enable personalization of tDCS via current flow modeling for optimization to each participant with the goal of generating an average electric field of 0.25 V/m within their identified left dlPFC. The direct current delivered by any one electrode will not exceed 2.0 mA and the total amount of current from all electrodes will not exceed 4 mA. Each 20-minute session will begin and end with a 60-second ramp up/down of current amplitude to maximize comfort.

    Other: Personalized Transcranial Direct Current Stimulation (tDCS)

  • Active comparator
    Combination Arm; Sham Plus Personalized Transcranial Direct Current Stimulation (tDCS)

    After an initial open-label 2-week home-based transcranial direct current stimulation (tDCS) intervention, participants will receive a combination arm of five weekly tDCS sessions for 3 months before or after five weekly sessions of sham for 3 months. The investigators will use an active sham in which very low-level currents (0.5 mA total) will be transferred between electrodes in close proximity on the scalp throughout the entire 20-minute session. This intervention will be optimized to each participant to deliver currents designed to not significantly influence their cortical tissue, but still mimic the cutaneous sensations induced by tDCS. Participants in the combination arm will not know whether they are receiving tDCS or sham during the first or second 3-month period.

    Other: Personalized Transcranial Direct Current Stimulation (tDCS) · Other: Active-Sham

Interventions

  • OtherPersonalized Transcranial Direct Current Stimulation (tDCS)

    Home-based transcranial direct current stimulation (tDCS) tailored to target the left dlPFC.

  • OtherActive-Sham

    Stimulation administered in very low-level currents (0.5 mA total) designed to not significantly influence cortical tissue, but still mimic the cutaneous sensations induced by tDCS.

06

What researchers measure

Primary outcomes

  1. Dual task cost to gait speed

    This metric assesses the degree to which performing a secondary cognitive task diminishes the control of gait.

    Time frame: Pre-randomization baseline; within three days of completing the initial open-label tDCS intervention; Month 3, Month 6; Month 9.

Secondary outcomes

  1. Executive function composite score

    This metric is derived from the CANTAB computerized test battery and reflects age-, sex-, and education-based z-scores on numerous cognitive functions associated with executive function.

    Time frame: Baseline, within three days of completing initial open-label tDCS intervention, Month 3, Month 6, & Month 9.

  2. Dual task gait speed

    This metric assesses the ability to walk and perform a cognitive task at the same time and predicts cognitive decline and the development of dementia.

    Time frame: Baseline, within three days of completing initial open-label tDCS intervention, Month 3, Month 6, & Month 9.

  3. Preferred gait speed

    This metric assesses the preferred gait speed over the course of 4 meters.

    Time frame: Baseline, within three days of completing initial open-label tDCS intervention, Month 3, Month 6, & Month 9.

  4. The change in left prefrontal deoxygenated hemoglobin between standing and dual task walking

    This metric is measured using functional near-infrared spectroscopy (fNIRS) and reflects one aspect of brain activation induced by performing the task of dual task walking and preferred speed.

    Time frame: Baseline, within three days of completing initial open-label tDCS intervention, Month 3, Month 6, & Month 9.

  5. The change in left prefrontal deoxygenated hemoglobin between standing and usual walking

    This metric is measured using functional near-infrared spectroscopy (fNIRS) and reflects one aspect of brain activation induced by performing the task of usual walking and preferred speed.

    Time frame: Baseline, within three days of completing initial open-label tDCS intervention, Month 3, Month 6, & Month 9.

  6. Left dorsolateral prefrontal cortex (dlPFC) gray matter volume

    This metric quantifies the volume of gray matter within the left dorsolateral prefrontal cortex (the brain target-of-interest for the tDCS intervention).

    Time frame: Baseline, Month 3, & Month 6

  7. Left dorsolateral prefrontal cortex (dlPFC) functional connectivity

    This metric quantifies the strength of functional connectivity between the left dorsolateral prefrontal cortex (the brain target-of-interest for the tDCS intervention) and the rest of the brain.

    Time frame: Baseline, Month 3, & Month 6

  8. 7-day accelerometry-based physical activity

    This metric assesses the quantity and quality of habitual, real-world physical activity.

    Time frame: Baseline, within three days of completing initial open-label tDCS intervention, Month 3, Month 6, & Month 9.

07

Study locations

2 of 2 sites recruiting
08

References and documents

Individual participant data

Plan to share: Yes — De-identified demographic, cognitive, motor, clinical, gait kinematics, free-living accelerometry, functional near infrared spectroscopy (fNIRS), MRI, and trial compliance and safety data

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Sharing of clinical trial data (participant level and summary level data, raw and processed) is expected at the time of publication of the primary results or within 9 months of database lock, whichever comes first. At minimum, per HSL's Record Management, Retention, Disposition and Destruction Policy, all data will be retained for at least seven years after project completion or the sponsored award agreement end date as stipulated in its terms and conditions.

Access criteria: De-identified data and all metadata will be archived within the Marcus Institute Data Archiving Service (MIDAS), a publicly accessible website built on the CKAN (Comprehensive Knowledge Archive Network) open-source data management platform. The MIDAS system is maintained and hosted by Hebrew SeniorLife. Access to scientific data will be controlled prior to publication of the primary results or for 9 months following database lock, whichever comes first. During this period, the project PI will maintain and chair a standing subcommittee of the project investigators which will review each request. Upon majority approval of a request, access to the data may be granted in secure fashion. After this period, archived data will be accessible by investigators without need of approval by the study team. Moreover, investigators who wish to access data will not need to be affiliated with HSL. Data containing patient identifiers or related sensitive fields will be archived on HSL private servers.

Data sharing details ↗ · www.marcusinstituteforaging.org

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Sep 2025 (actual). Primary completion is estimated for Mar 2029, 42 months after the start.

Of 882 non-industry interventional studies with no phase under Alzheimer Disease, half reached primary completion within 30 months of starting (the median), counting those still running; a quarter within 15 and three quarters within 51. This study's planned 42 months is above that.

Counting every sponsor, half of 959 studies reached it within 29 months; a quarter within 15 and three quarters within 51.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 5, 2025
First posted
Feb 12, 2025
StartActual
Sep 2, 2025
Primary completionEst.
Mar 2029
CompletionEst.
Jun 2029
Last update
Jul 16, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06821568
Lead sponsor
Hebrew SeniorLife
Collaborators
National Institute on Aging (NIA), Tel Aviv Medical Center
Responsible party
Brad Manor (Associate Scientist, Hebrew SeniorLife) — Principal investigator
First posted
Feb 12, 2025
Start date
Sep 2, 2025
Primary completion
Mar 2029 (estimated)
Completion
Jun 2029 (estimated)
Last update
Jul 16, 2026

Study contacts

Katie Baldyga, BA
Contact
Kathrynbaldyga@hsl.harvard.edu
617-971-5380
Juhi Salecha, MS
Contact
JuhiSalecha@hsl.harvard.edu
617-971-5398
Brad Manor, PhD
principal investigator · Hebrew SeniorLife
Jeff Hausdorff, PhD
principal investigator · Tel-Aviv Sourasky Medical Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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