An interventional study of Abbott St Jude Medical Infinity™ in Mild Cognitive Impairment (MCI), Mild Cognitive Impairment (MCI) Amnestic and Mild Cognitive Impairment (MCI) Due to Alzheimer's Disease, sponsored by University of Texas Southwestern Medical Center. Not yet recruiting. Open to participants aged 60 Years to 85 Years. Per ClinicalTrials.gov, last updated 2026-10-21.
Sponsored by University of Texas Southwestern Medical Center · Not applicable, Interventional, and Treatment
This trial is a 12-month safety and feasibility study, enrolling up to six participants. These participants will serve as their own controls, structured in multiple parts that follow an initial short-term stereo electroencephalography (SEEG) mapping period.
During this trial we aim to demonstrate the safety of acute and chronic network-guided stimulation in Mild Cognitive Impairment by evaluating adverse effects, tolerability, and feasibility during both the short- term SEEG mapping phase and subsequent permanent DBS therapy.
In addition to safety measures, therapeutic results as follows are to be tested for: (1) Develop patient-specific stimulation parameters for the treatment of MCI, as well as develop and test memory state classifiers by enrolling six individuals to undergo intracranial mapping (SEEG). We will use targeted memory tasks to generate neural data needed for state distinctions, and conduct a systematic parameter search to identify and develop optimal settings for each patient. (2) Assess efficacy of open loop stimulation by delivering a fixed open loop protocol based on the parameters discovered earlier, while SEEG electrodes remain in place, and testing the efficacy of the trained classifier to detect favorable brain states. (3) Evaluate chronic DBS therapy by implanting a permanent system in participants who show an acute beneficial response to assess long term outcomes. (4) Assess therapeutic outcomes and refine protocols by measuring reductions in memory-related impairment.
The above findings will guide further refinement of the device and protocol.
This is a 12-month, within-subject safety and feasibility study evaluating network-guided deep brain stimulation (DBS) for Mild Cognitive Impairment (MCI), enrolling up to six participants who serve as their own controls. The protocol proceeds through a screening phase, a short-term intracranial mapping period using stereo-electroencephalography (SEEG), permanent DBS implantation, an open-label programming phase, a double-blind discontinuation phase, and long-term follow-up.
Screening and Presurgical Baseline (up to 16 weeks before implantation). Eligible participants undergo a thorough standardized neuropsychological evaluation, including demographic and medical/psychiatric history, physical and mental status exams, vital signs, laboratory testing, and medication review (with specific attention to anti-amyloid monoclonal antibody therapy, which must be paused at least 12 weeks before surgery).
Participants undergo CT and 3T MRI imaging (structural, diffusion tractography, and resting-state functional sequences) for surgical planning. A presurgical baseline visit within 1-4 weeks of surgery repeats key labs, adds cardiac risk assessment (EKG, anesthesiology evaluation), confirms surgical clearance, and administers neuropsychological battery assessing processing speed, working memory, executive function, verbal and visual memory, and language.
SEEG Implantation and Inpatient Mapping (Day 0-7). Using standard stereotactic technique and ROSA planning software, 12 intracranial electrode trajectories (six per hemisphere) are placed targeting the anterior and posterior hippocampus, anterior and posterior cingulate cortex, anterior insula, and orbitofrontal cortex. Electrodes are measured using the NeuroPort recording system (Blackrock Microsystems, FDA-cleared under 510(k) K09095), sampling approximately 160 contacts at 2 kHz. All participants are monitored by the clinical staff, and maintained on antibiotics during admission.
Three experiments are conducted during the inpatient stay:
DBS Implantation (Day 7 ± 3 days). Participants meeting criteria proceed to explant of the SEEG electrodes and implantation of two permanent DBS leads (one per hemisphere, at sites selected from mapping data) along with a subcutaneous pulse generator, performed under general anesthesia with standard perioperative antibiotic prophylaxis. A post-procedure CT confirms absence of complications (e.g. hemorrhage) before discharge.
Postoperative Visits and Device Activation (Day 14 and Day 21). A one-week post-operative visit assesses wound healing and neurological status, with weekly follow-up thereafter for monitoring purposes. Approximately two weeks post-implant, device activation occurs using the rank-ordered parameter sets derived from inpatient testing. Predefined stopping/delay criteria apply (e.g., ≥4-point MoCA worsening confirmed at 48 hours, ≥10-point MADRS increase, or new suicidality), triggering deferral and biweekly reassessment until baseline status is re-established.
Open-Label Phase (Months 1-8). Programming is individualized based on inpatient-derived parameters, with amplitude titrated to balance benefit and side effects. Periodic visits track mood, cognition, and function (GAD-7, MADRS, C-SSRS, MoCA, ECog, CDR, CGI-S, HVLT-R), and the same stopping rules apply if worsening is observed on two consecutive visits, prompting stimulation cessation and supportive care.
Double-Blind Discontinuation (Weeks 33-45). All participants, regardless of open-label response, enter a blinded discontinuation period of up to 12 weeks to further characterize effects.
Long-Term Follow-Up. Participants are followed annually after completion of the blinded discontinuation phase to monitor device safety and intended clinical outcomes.
Across all phases, primary objectives are to characterize the safety, tolerability, and feasibility of acute (SEEG-based) and chronic (DBS) network-guided stimulation in MCI. Secondary objectives include developing patient-specific stimulation parameters and memory-state classifiers, testing open-loop stimulation efficacy, and evaluating longer-term cognitive and functional outcomes to inform refinement of the stimulation protocol and device.
3,930 studies on the registry are indexed under Cognitive Dysfunction; 1,114 are open to participants now.
This study's planned enrollment of 6 is below the median of 64 across 2,855 interventional studies indexed under Cognitive Dysfunction.
Browse Cognitive Dysfunction studies →University of Texas Southwestern Medical Center is the lead sponsor of 1,009 studies on the registry; 201 are open to participants now.
Of its 138 completed or terminated interventional studies of FDA-regulated products, 105 (76%) have results posted.
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Exclusion Criteria:
Any clinical impression reflective of disease pathologies indicated by the list below is exclusionary
Eligibility Note:
Participants will be excluded if the investigator determines that cognitive impairment is primarily attributable to vascular cognitive impairment, Lewy body disease, frontotemporal degeneration, Parkinson's disease, traumatic brain injury, delirium, unstable psychiatric illness, medication effects, substance use, or another non-AD neurologic or systemic condition.
A prior or concurrent diagnosis of Alzheimer's disease is permitted only if the participant is clinically at the MCI / mild neurocognitive disorder stage, rather than dementia stage. In other words, participants with "MCI due to Alzheimer's disease," "prodromal Alzheimer's disease," or "early Alzheimer's disease" may be included if functional independence is preserved.
Subjects will be deactivated (stimulation no longer occurs) from stimulation with the Abbott St Jude Medical Infinity™. Weekly assessments on primary memory measures will occur.
Device: Abbott St Jude Medical Infinity™
Subjects will continue stimulation (stimulation occurs) with the Abbott St Jude Medical Infinity™ based on parameters developed in the inpatient stay. Weekly assessments on primary memory measures will occur.
Device: Abbott St Jude Medical Infinity™
Subjects will be deactivated (stimulation no longer occurs) from stimulation/ continue stimulation with the Abbott St Jude Medical Infinity™. Weekly assessments on primary memory measures will occur.
Demonstrate device safety
Description: The primary objective is to demonstrate safety of acute and chronic network guided stimulation for Mild Cognitive Impairment (MCI). This is determined if participants with the Deep Brain Stimulation Device demonstrate no significant device related serious adverse events (SAE). Device safety will be measured by number of reported SAE's in years 2 through 4.
Time frame: 4 years
RCI - ECog
The Everyday Cognition Scale (ECog) measures the ability to perform everyday tasks that demand memory, language, visuospatial abilities, planning, organization, and divided attention. The ECog consists of a global and domain scores for each of the previously described categories, and is scored as follows: 1= better or no change compared to 10 years earlier, 2= questionable/occasionally worse compared to 10 years earlier, 3= consistently a little worse compared to 10 years earlier, 4= consistently much worse compared to 10 years earlier. Thus, the lower the overall score is on this measure at both the global and domain score level, the better one is performing with respect to their cognition. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - ECog
The Everyday Cognition Scale (ECog) measures the ability to perform everyday tasks that demand memory, language, visuospatial abilities, planning, organization, and divided attention. The ECog consists of a global and domain scores for each of the previously described categories, and is scored as follows: 1= better or no change compared to 10 years earlier, 2= questionable/occasionally worse compared to 10 years earlier, 3= consistently a little worse compared to 10 years earlier, 4= consistently much worse compared to 10 years earlier. Thus, the lower the overall score is on this measure at both the global and domain score level, the better one is performing with respect to their cognition. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - GAD-7
General Anxiety Disorder-7 ( (GAD-7). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The GAD-7 is a seven-item self-report instrument for screening, diagnosis, and severity assessment of anxiety disorders. The GAD-7 total score for the seven items ranges from 0 to 21: 0-4 Minimal anxiety; 5-9 Mild anxiety; 10-14 Moderate anxiety; 15-21 Severe anxiety. • Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. • Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - GAD-7
General Anxiety Disorder-7 ( (GAD-7). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The GAD-7 is a seven-item self-report instrument for screening, diagnosis, and severity assessment of anxiety disorders. The GAD-7 total score for the seven items ranges from 0 to 21: 0-4 Minimal anxiety; 5-9 Mild anxiety; 10-14 Moderate anxiety; 15-21 Severe anxiety. • Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. • Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - NPI-Q
Neuropsychiatric Inventory Questionnaire (NPI-Q). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The neuropsychiatric inventory questionnaire score, which includes 12 items that assesses a broad range of psychiatric disturbances associated with: (1) delusions; (2) hallucinations; (3) agitation or aggression; (4) depression or dysphoria; (5) anxiety; (6) elation or euphoria; (7) apathy or indifference; (8) disinhibition; (9) irritability or lability; (10) motor disturbance; (11) nighttime behaviors; and (12) appetite and eating, is scored by severity (1-3), and distress to caregiver (0-5), then added together (range 0-8) with a higher score indicating greater severity. • Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. • Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96
Time frame: Week 35-39 (3-6 weeks post-intervention)]
RCI - NPI-Q
Neuropsychiatric Inventory Questionnaire (NPI-Q). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The neuropsychiatric inventory questionnaire score, which includes 12 items that assesses a broad range of psychiatric disturbances associated with: (1) delusions; (2) hallucinations; (3) agitation or aggression; (4) depression or dysphoria; (5) anxiety; (6) elation or euphoria; (7) apathy or indifference; (8) disinhibition; (9) irritability or lability; (10) motor disturbance; (11) nighttime behaviors; and (12) appetite and eating, is scored by severity (1-3), and distress to caregiver (0-5), then added together (range 0-8) with a higher score indicating greater severity. • Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. • Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - CGI-S
Clinical Global Impression Severity Scale (CGI-S). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Clinical Global Impression - Improvement scale (CGI-I) is a 7-point (1-7) scale that requires the clinician to assess how the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention with the higher scores indicating higher symptom severity. • Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. • Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - CGI-S
Clinical Global Impression Severity Scale (CGI-S). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Clinical Global Impression - Improvement scale (CGI-I) is a 7-point (1-7) scale that requires the clinician to assess how the patient's illness has improved or worsened relative to a baseline state at the beginning of the intervention with the higher scores indicating higher symptom severity. • Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. • Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - CDR
Global Clinical Dementia Rating (CDR). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Clinical Dementia Rating Global Score (CDR-GS) assesses the overall severity of cognitive and functional impairment across six domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care. Global scores range from 0 to 3, with higher scores indicating greater impairment. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - CDR
Global Clinical Dementia Rating (CDR). Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Clinical Dementia Rating Global Score (CDR-GS) assesses the overall severity of cognitive and functional impairment across six domains: memory, orientation, judgment and problem solving, community affairs, home and hobbies, and personal care. Global scores range from 0 to 3, with higher scores indicating greater impairment. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - MADRS
Montgomery-Åsberg Depression Rating Scale (MADRS) Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Montgomery-Asberg Depression Rating Scale (MADRS) is a 10-item clinician-rated scale used to measure the severity of depressive episodes and monitor patient progress during treatment. Each item yields a score of 0 to 6; the overall score thus ranges from 0 to 60.\[4\] Higher MADRS score indicates more severe depression. Usual cutoff points are: 0 to 6: normal /symptom absent; 7 to 19: mild depression; 20 to 34: moderate depression 35 to 60: severe depression. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - MADRS
Montgomery-Åsberg Depression Rating Scale (MADRS) Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Montgomery-Asberg Depression Rating Scale (MADRS) is a 10-item clinician-rated scale used to measure the severity of depressive episodes and monitor patient progress during treatment. Each item yields a score of 0 to 6; the overall score thus ranges from 0 to 60.\[4\] Higher MADRS score indicates more severe depression. Usual cutoff points are: 0 to 6: normal /symptom absent; 7 to 19: mild depression; 20 to 34: moderate depression 35 to 60: severe depression. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - C-SSRS
Columbia-Suicide Severity Rating Scale (C-SSRS) Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a brief, evidence-based tool used to screen for suicide risk, measure the severity of suicidal ideation, and track suicidal behavior. Screening versions typically group responses into general clinical risk categories: • No Risk / Score 0: No ideation or behavior reported. • Low Risk (e.g., Categories 1-2): Wish to be dead or non-specific active thoughts. • Moderate Risk (e.g., Category 3 or interrupted/aborted) Method without plan • High Risk (e.g., Categories 4-5, actual attempts, detailed plan): Active intent/plan. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - C-SSRS
Columbia-Suicide Severity Rating Scale (C-SSRS) Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a brief, evidence-based tool used to screen for suicide risk, measure the severity of suicidal ideation, and track suicidal behavior. Screening versions typically group responses into general clinical risk categories: • No Risk / Score 0: No ideation or behavior reported. • Low Risk (e.g., Categories 1-2): Wish to be dead or non-specific active thoughts. • Moderate Risk (e.g., Category 3 or interrupted/aborted) Method without plan • High Risk (e.g., Categories 4-5, actual attempts, detailed plan): Active intent/plan. * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
RCI - MoCA
Montreal Cognitive Assessment (MoCA) Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Montreal Cognitive Assessment (MoCA) is a quick 30-point test used by health professionals to screen adults for mild memory and thinking problems. MoCA Normal and Mild cognitive impairment score ranges were derived from the JAGS 2005 MoCA Validation study where MoCA MCI score ranges were defined by Petersons' Criteria. The moderate and severe groups were arbitrary defined by default as: Normal Cognitive performance 26 and above; Mild impairment 18-25; Moderate impairment 10-17; Severe impairment 0-9 * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 35-39 (3-6 weeks post-intervention)
RCI - MoCA
Montreal Cognitive Assessment (MoCA) Participant's primary memory and cognitive measures Reliable Change Index (RCI) in either direction. The Montreal Cognitive Assessment (MoCA) is a quick 30-point test used by health professionals to screen adults for mild memory and thinking problems. MoCA Normal and Mild cognitive impairment score ranges were derived from the JAGS 2005 MoCA Validation study where MoCA MCI score ranges were defined by Petersons' Criteria. The moderate and severe groups were arbitrary defined by default as: Normal Cognitive performance 26 and above; Mild impairment 18-25; Moderate impairment 10-17; Severe impairment 0-9 * Responders are defined as those having a reliable improvement, based on the Reliable Change Index (RCI) of ≥1.96 (p\<0.05) on the primary memory and cognitive measures relative to baseline. * Non-responders are defined as those who fail to achieve an RCI of ≥ 1.96.
Time frame: Week 41-44 (9-12 weeks post-intervention)
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