Innovative approach combines non-invasive brain stimulation, cognitive exercises

TORONTO, May 1, 2014 /CNW/ - The Centre for Addiction and Mental Health (CAMH) has been awarded the largest-ever grant for Alzheimer's disease prevention in Canada, for a study which will apply recent advances in brain science to clinical treatment. The announcement was made by Prime Minister Stephen Harper in Montreal today.

"We're intervening at an earlier stage among people who do not have Alzheimer's dementia but are at high risk of developing it," says Dr. Benoit H. Mulsant, CAMH Physician-in-Chief and lead investigator of the study. "Our approach will stimulate neurons in the brain and strengthen cognitive skills, which we hope will prevent the brain damage associated with Alzheimer's, and prevent or delay the diagnosis."

Thanks to unprecedented support from the Brain Canada Chagnon Fund of almost $10 million over five years, the research team will be studying a combination of a painless brain stimulation treatment, called transcranial Direct Current Stimulation (tDCS), with memory and problem solving exercises, known as cognitive remediation.

"The treatments we currently have for Alzheimer's dementia are usually initiated when the patient is diagnosed, at which point the brain is already damaged," says Dr. Mulsant, "so the treatments don't work very well."

Two groups of people known to be at high risk of developing Alzheimer's will be included in the study: 250 older adults with clinical depression who have been successfully treated with antidepressants, and 125 with mild cognitive impairment (MCI), which is a noticeable decline in memory and thinking abilities. Individuals will be randomly assigned to receive this intervention, or a sham or placebo intervention and their outcomes will be compared for up to five years.

The study is called PACt-MD (Preventing Alzheimer's dementia with Cognitive remediation plus tDCS in MCI and Depression). PACt-MD will draw participants from five major Toronto hospitals. In addition to CAMH, Baycrest, St. Michael's Hospital, Sunnybrook Health Sciences Centre and the University Health Network are collaborating.

"We believe that this intervention will be more beneficial than the comparison placebo group in acutely improving cognition and then slowing down its decline over time, and in preventing the onset of Alzheimer's dementia," says Dr. Tarek Rajji, Chief of Geriatric Psychiatry at CAMH, one of the co-lead investigators of PACt-MD at CAMH with Dr. Bruce G. Pollock, Vice President, Research.

In 2011, 747,000 Canadians were living with dementia, and this number is projected to increase to 1.4 million by 2031. There are a number of risk factors that can lead to dementia, but not all can be targeted in prevention efforts. Major depression has been identified as the second most promising target for studies that try to prevent Alzheimer's, after lack of physical activity.

PACt-MD also involves a series of lab-based tests involving genetics and brain imaging to study both genetic factors as well as brain changes associated with the intervention.

If this combination approach is beneficial in older persons with either mild cognitive impairment or depression, then it can be further tested in the general population or in other populations at high risk for Alzheimer's disease, notes Dr. Mulsant.

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, and one of the world's leading research centres in its field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit www.camh.ca.

SOURCE Centre for Addiction and Mental Health