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PACt-MD: Preventing Alzheimer’s dementia with cognitive remediation plus transcranial direct current stimulation in mild cognitive impairment and depression

Depression is identified as one of the six potentially modifiable risks for both cognitive decline and Alzheimer’s disease (AD) by the National Institutes of Health. Unfortunately, at the time AD and related disorders such as mild cognitive impairment (MCI) are diagnosed, the brain has already sustained substantial insult that limits the efficacy of current treatments. As a result, research focusing on additional preventive interventions is beneficial.

There are no pharmacological or nonpharmacological interventions that have demonstrated efficacy at reducing or delaying the development of AD in those with MCI. Thus, this high-risk, untreated population represents an excellent and urgent target for a novel preventive intervention. The main aim of PACt-MD is to study the efficacy of a preventive intervention for AD in high-risk groups of individuals with MCI and major depressive disorder. The intervention is a combination of cognitive remediation and noninvasive brain stimulation known as transcranial direct current stimulation.

Working in collaboration with the Centre for Addiction and Mental Health, Baycrest Health Sciences, University Health Network and St. Michael’s Hospital, this multisite project will enrol and evaluate patients in the largest-ever grant-funded study for AD prevention in Canada, with the hope of improving the lives of people living with depression and MCI. The primary aims are to prevent long-term cognitive decline and prevent the incidence of dementia in patients with MCI. The secondary aim is to assess whether cognitive remediation coupled with transcranial direct current stimulation improves cognition acutely. Further exploratory aims will assess the moderating effects of several biomarkers on these therapeutic effects.​