Gamma Sensory Stimulation at 40Hz for a 6‐month Period Reduces White Matter Atrophy in Alzheimer’s Disease Patients

Abstract

AbstractBackgroundAlthough white matter atrophy is observed in normal aging, it is more pronounced in Alzheimer’s Disease (AD) patients. Recently, advanced magnetic resonance imaging (MRI) provided more detailed information which linked changes in white matter to elevated risk and progression of AD. White matter degeneration, myelin loss, and oligodendrocyte damage in AD patients suggest that white matter can be a mechanistically important target in AD patients. Recently, clinical benefits of 40Hz gamma sensory stimulation have been demonstrated in AD patients. Here, we studied the effects of 40Hz gamma sensory stimulation on white matter in patients with clinical presentation of AD spectrum and compared our results to historical data.MethodThe data presented here is from Overture study (NCT03556280) and the Alzheimer's Disease Neuroimaging Initiative (ADNI1) database. Overture study data included treatment group participants who received 1‐hour daily 40Hz gamma auditory‐visual stimulation at home for a 6‐month period and placebo group. Analysis between the groups suggested a difference in white matter atrophy favoring the treatment group. To compare our treatment group with a larger control group, we studied ADNI1. We included a subset of each population so that baseline distributions (age, MMSE, white matter volume) are matched and had Month 6 MRI data. The resulting populations contained N=16 participants from Overture study and N=64 participants from ADNI1. Overture study structural MRI were acquired using 1.5 Tesla MRI and cerebral white matter segmentation was performed using FreeSurfer as it was done in ADNI1. Age, MMSE, white matter volume adjusted least‐square means method is used to assess the percentage changes in white matter volume within 6‐month period.ResultThe Overture study treatment group participants exhibited 0.38±0.82 percentage increase (volume in % of total intracranial volume) and ADNI1 study participants exhibited ‐2.45±0.40 percentage decrease in white matter volume after 6‐month period (p<0.004).ConclusionOur results suggest that 40Hz gamma sensory stimulation therapy for 6‐month period may reduce white matter atrophy, protect axons, and possibly prevent myelin and oligodendrocyte damage in AD patients. Given the crucial role of white matter connecting expansive brain regions, preventing or reducing its atrophy may diminish AD disease progression.