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NCT Number: NCT07051239

Sleep Stimulation to Enhance Waste Clearance in the Brain

This study aims to examine whether multi-night closed-loop auditory stimulation (CLAS) during sleep can enhance waste clearance and memory consolidation in healthy adults and older adults with subjective cognitive decline or mild cognitive impairment who exhibit elevated brain amyloid levels identified through prior clinical screening. Specifically, the study investigates whether sleep stimulation increases the clearance of plasma biomarkers related to neurodegeneration, improves the brain's waste clearance system, and supports memory consolidation. Participants will undergo five nights each of CLAS and sham (no stimulation) interventions, with a washout period in between. They will also complete clinical assessments, including MRI scans, blood sample collection, and cognitive testing, and will keep track of subjective sleep quality, sleepiness, mood, and fatigue throughout the interventions.

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Key information

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

For the positive amyloid load group:

-Participants who meet the criteria of subjective cognitive decline or mild cognitive impairment (Clinical Dementia Rating < 2; Mini-Mental State Examination ≥ 21) and brain amyloid-beta (Aβ) accumulation confirmed by CSF or amyloid-PET, the inclusion age range is 55-80 years.

For healthy groups:

-Inclusion age range is 18-80 years.

Inclusion criteria

  • Proficiency in the French language (close to native level) to complete the neuropsychological evaluation and cognitive tests.
  • MRI compatibility: absence of metallic materials in the body (implants, vascular clips, certain types of orthopedic material, etc.), a pacemaker or other types of stimulators, cochlear implants, or any other electronic devices.

Exclusion criteria

  • Current or past psychiatric or neurological conditions (except for those directly associated with the patient group).
  • The presence of severe untreated sleep disorders.
  • The presence of irregular sleep-wake cycles (due to shiftwork or extreme chronotype).
  • The presence of moderate depression or high levels of anxiety.
  • Ongoing treatment with psychotropic medications (benzodiazepines, antidepressants).
  • Regular or excessive consumption of alcohol or caffeinated drinks.
  • Consumption of other psychoactive substances known to have an impact on the central nervous system.
  • Insufficient visual or auditory acuity to complete the assessments if uncorrected. Normal hearing is required for sound stimulation to be effective.
  • Claustrophobia that prevents undergoing brain imaging (MRI).
  • Pregnancy or currently breastfeeding

Treatment and study plan

Closed-loop acoustic stimulation

Other

At-home sleep will be monitored using an EEG headband. Non-awakening auditory stimuli will be delivered during non-rapid eye movement sleep (NREM), timed to the ascending phase of slow waves, using either active or control (sham) conditions.

Primary outcomes

  1. Plasma biomarkers

    Time frame: Blood samples will be collected the morning after each intervention phase. Interventions are separated by one week.

    Levels of plasma biomarkers associated with neurodegeneration and brain health will be compared between stimulation and sham interventions.

Secondary outcomes

  1. Glymphatic function

    Time frame: MRI scans will be performed the morning after each intervention phase. Interventions are separated by one week.

    Magnetic resonance imaging (MRI) derived measures will serve as proxies for glymphatic function and will be compared between stimulation and sham interventions.

  2. CLAS evoked responses

    Time frame: Each night of sleep during each intervention phase, whether receiving stimulation or sham.

    EEG responses locked to the acoustic stimulation will be examined (phase, amplitude, power, slow oscillations, spindle coupling) during stimulation and sham night recordings. Associations between APOE phenotype, age, amyloid accumulation, brain structure and function, baseline memory performance, sleep quality and responses to CLAS will be evaluated.

  3. Slow wave activity (SWA)

    Time frame: Each night of sleep during each intervention phase, whether receiving stimulation or sham.

    EEG SWA will be assessed during NREM sleep periods from each intervention (stimulation and sham)

  4. Sleep architecture

    Time frame: Each night of sleep during each intervention phase, whether receiving stimulation or sham.

    As measured with the EEG headband, macro- (e.g., duration, latency, distribution of sleep stages), and micro-architecture (slow waves, sleep spindles, rapid eye movements, arousals) differences between stimulation and sham conditions will be assessed.

  5. Change in memory performance

    Time frame: Before and after each intervention period. Interventions are separated by one week.

    Performance change in declarative memory tasks (cued-recall and recognition measures) will be evaluated.

  6. Encoding capacity

    Time frame: After each intervention phase. Interventions are separated by one week.

    Performance in a continuous mnemonic discrimination task (recognition and mnemonic discrimination measures) will be assessed after both stimulation and sham interventions.

  7. Alertness and sustained attention

    Time frame: The PVT task will be assessed before and after each intervention phase. Interventions are separated by one week.

    Performance (reaction times, lapses) in the psychomotor vigilance task (PVT).

  8. Subjective measures after sleep

    Time frame: Each morning throughout the intervention phase.

    As measured with morning questionnaires, subjective sleep quality, fatigue, sleepiness, mood, and affect, will be assessed every morning during each stimulation and sham intervention.

  9. Resting-state functional connectivity

    Time frame: MRI scans will be performed the morning after each intervention phase. Interventions are separated by one week.

    Changes in resting-state functional connectivity measured with fMRI will be compared between stimulation and sham interventions.

Study contacts

Contact information is provided by the study sponsor or research team.

Mélanie Strauss, MD, PhD

CONTACT

[email protected]

+32 2 555 55 39

Rebeca Sifuentes Ortega, PhD

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

Erasme University Hospital

Other

Collaborators

  • University of Amsterdam

Registry information

Official study title

Enhancing Waste Clearance Through Sleep Stimulation

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Jul 4, 2025
Registry last updated
Jul 9, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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