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Alzheimer DiseaseActiGliANCT06224920

Activity of Cerebral Networks, Amyloid and Microglia in Aging and Alzheimer's Disease

An observational study of Alzheimer Disease and Corticobasal Syndrome, run by Ludwig-Maximilians - University of Munich.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The temporal sequence of microglial activation, changes in functional and structural connectivity and the progression of neurocognitive deficits has not been conclusively clarified. Read more about this study

Who is it for?
Ages 55 to 80 years
Conditions the study is for
Alzheimer Disease, Corticobasal Syndrome
What is being tested?
magnetic resonance imaging, electroencephalography and blood and CSF biomarker
Type of treatment
Injection or infusion
How many people
140 participants
Where
No sites listed yet
Study dates
1 Jan 2017to 1 Jan 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 55 to 80 years
  • All sexes
  • Adult, Older adult

Study population: recruitment of participants via the outpatient clinics of Department of Psychiatry and Psychotherapy, Department of Neurology and Institute of Stroke and Dementia Research (LMU hospital)

Who may be able to join

  • Informed consent for the additional examinations, written declaration of consent
  • Constant pharmacotherapy in a period of one week before the MRI/EEG/PET examination

Who cannot join

  • Existence of legal guardianship/restricted capacity to consent
  • Other severe concomitant psychiatric illnesses, e.g. schizophrenia, bipolar affective disorder
  • Clinically relevant depressive symptoms (Beck Depression Inventory, BDI, score > 17/GDS > 5)
  • Acute suicidal tendencies
  • Drug, medication or alcohol abuse at the time of the study
  • Severe traumatic brain injury (> 2nd degree TBI) in the medical history or 1st degree within the last 3 months.
Show all 14Show fewer
  • Evidence of structural damage to the basal ganglia or brainstem
  • Severe neurological diseases (such as disc prolapse in the last 6 months, sensory, motor or autonomic polyneuropathies)
  • Severe internal diseases (such as manifest arterial hypertension, severe heart disease, pacemaker, respiratory insufficiency)
  • Any electronic implants (e.g. pacemakers) or other MRI and/or PET contraindications
  • Malignant diseases of any kind in the last 5 years, severe active infectious diseases, chronic and systemic skin diseases
  • Bone diseases (such as Paget's disease, osteoporosis with spontaneous fractures, recent fractures)
  • Other circumstances which, in the opinion of the investigator, speak against the patient's participation in this study
  • Occupational or other radiation exposure >15 mSv/a

About this study

Official title: Aktivität Von Zerebralen Netzwerken, Amyloid Und Mikroglia Bei Alterung Und Alzheimer-Krankheit

The temporal sequence of microglial activation, changes in functional and structural connectivity and the progression of neurocognitive deficits has not been conclusively clarified. To date, there have been no studies of the topographical and pathogenetic relationship between microglial activation and network degeneration. The main aim of the present study is to investigate the relationships between functional, structural MRI connectivity and microglial activation at different stages of AD in a multimodal approach. Genetic predisposition and biomarkers in blood and cerebrospinal fluid will also be taken into account in order to close the explanatory gap in pathogenesis between the known molecular pathological changes and their effects at system level in an integrative approach.

Read the detailed description

The main aim of the present study is to investigate correlations between functional and structural MRI connectivity and microglial activation in PET at different stages of AD. Some previous studies have described that especially the brain regions affected by AD-related alterations show increased microglial activity. How these relationships known at the anatomical level relate to changes in functional connectivity is still largely unclear. The multimodal analysis of functional connectivity in the resting networks and the investigation of inflammatory effects using microglia PET may be able to reveal previously unknown neuropathological connections between different stages of AD. Since a direct toxicity effect of Aβ on surrounding neurons can also be assumed, the topography of fibrillar Aβ deposits is also recorded using PET. To date, there are no studies investigating changes in functional and structural connectivity with microglia-associated inflammatory changes and Aβ at different disease stages.

  1. evaluation of the correlation of microglial activation determined in PET with the degeneration of functional networks depending on the stage of the disease.
  2. Is microglial activation or Aβ deposition the cause of changes in functional networks?
  3. What is the overlap between microglia- and Aβ-induced network degeneration (modulation of synaptic pruning vs. neurotoxic effect of ß-amyloid)
  4. How reliable is functional connectivity as a biomarker for AD stratification at different disease stages?
  5. What is the temporal and topographical spread of AD pathologies along the hub regions of the resting networks and can a pattern of spread indicative of a specific molecular mechanism be identified?
  6. Does the extent (quantitative and regional) of microglial activation correlate with existing amyloid and tau deposits, as well as network changes? How does microglial activation change in relation to the progression of tau deposits?
  7. correlation of inflammatory changes in a multimodal comparison with changes in structural connectivity, metabolic alterations, biomarker abnormalities and changes at the neurotransmitter level.
  8. Is there an image morphologic correlate of soluble TREM2 receptor concentration in cerebrospinal fluid at different disease stages?
  9. What role does oxidative stress (glutathione changes) play in the pathogenesis of AD and is there a connection to other disease-related changes at the multimodal level?
  10. are there certain correlations between genetic factors (especially carriers vs. non-carriers of apolipoprotein E, APOE, risk allele ε4 as the strongest genetic risk factor of sporadic AD) and structural or functional connectivity changes depending on the disease stage that can be derived from the multimodal data analysis? a. What is the temporal relationship between microglial activation and Aβ deposits or functional and structural network alterations?
Being tested
magnetic resonance imaging, electroencephalography, blood and CSF biomarker, positron emission tomography, neuropsychological test
Keywords
Alzheimer´s disease, corticobasal degeneration, microglial activation, neuroinflammation, amyloid, tau protein
Medical subject headings
Alzheimer Disease, Corticobasal Degeneration, Neuroinflammatory Diseases, Frontotemporal Dementia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • magnetic resonance imagingDiagnostic test

    MRI data acquisition was performed on a 3 Tesla MRI scanner with parallel transmission and reception technology (Skyra Magnetom, Siemens Healthcare, Erlangen, Germany). Imaging is performed with a maximum gradient strength of 45mT/m and a maximum slew rate of 200 T/m/s and a 64-element head coil.

  • electroencephalographyOther

    Also called eeg

    A 20-channel resting EEG (Brain Products, Gilching, Germany) is recorded as part of routine clinical diagnostics in the Department of Psychiatry and Psychotherapy at the LMU to rule out focal neurophysiological pathologies. Within the scope of the present study, an extended examination will be carried out, which includes a 64-channel EEG, including a passive visual paradigm. After completion of the clinical evaluation, the neurophysiological changes in resting activity will be scientifically analyzed in comparison to the MRI and PET data.

  • blood and CSF biomarkerDiagnostic test

    Aβ1-42 and 1-40, total tau protein and phosphorylated tau protein 181 (p-Tau), apolipoprotein E (APOE), soluble TREM2 protein, neurofilament light chain and glial fibrillary protein (GFAP) will be determined.

  • positron emission tomographyDiagnostic test

    Also called PET

    According to an established and standardized protocol, PET scans are performed with the TSPO receptor ligand [18F]-GE-180, [18F]flutemetamol for assessment of fibrillar Aβ 162 accumulation and the Tau ligand [18F]-PI-2620. In brief, [18F]GE-180 TSPO PET images (mean dose: 177 ± 17 MBq) with an emission window of 60-80 min after injection will be acquired to measure the activation of glial cells. [18F]Flutemetamol Aβ PET images (average dose: 182 ± 11 MBq) are acquired with an emission window of 90-110 min after injection to assess fibrillar Aβ accumulation. Dynamic [18F]PI-2620 tau PET (average dose: 186 ± 14 MBq) with an emission window of 0-60 minutes after injection are performed for quantification of tau aggregation. Static images of the late phase (20-40 min) are reconstructed. These images are used for further processing and analysis.

  • neuropsychological testDiagnostic test

    Trained psychologists at the Memory Clinic of the LMU Hospital administered the CDR, CERAD-NB and Mini-Mental State Examination (MMSE). The CERAD-NB battery was used to generate a total score for the six subscales: semantic fluency (animals/60 s), modified Boston naming test, lexical items, construction practice, lexical items retrieval, and lexical items discrimination, with higher scores indicating better performance.

Study groups in NCT06224920
Study groupRoleWhat they receive
Alzheimer´s disease spectrumMCI-AD patients Evidence of minor cognitive impairment with essentially preserved everyday competence and evidence of reduced Aβ42 concentration in the cerebrospinal fluid. Score in the CERAD word list 1.5 SD below the normal range. Patients with AD-dementia Evidence of pronounced cognitive impairment and relevant impairment of everyday life and evidence of reduced Aβ42 concentration in the cerebrospinal fluid (diagnostic criteria (NIA-AA fulfilled)).
Receives: Diagnostic Test: magnetic resonance imaging; Other: electroencephalography; Diagnostic Test: blood and CSF biomarker; Diagnostic Test: positron emission tomography; Diagnostic Test: neuropsychological test
corticobasal syndrome due to probable 4 repeat taupathyEvidence of the typical clinical picture of an atypical Parkinson's syndrome with onset of symptoms > 1 year. No evidence of reduced Aβ42 concentration in the cerebrospinal fluid. Fulfillment of the revised Armstrong criteria for probable CBS or the Movement Disorder's Society criteria for suggestive/possible PSP-CBS.
Receives: Diagnostic Test: magnetic resonance imaging; Other: electroencephalography; Diagnostic Test: blood and CSF biomarker; Diagnostic Test: positron emission tomography; Diagnostic Test: neuropsychological test
subjective congnitive declineSubjective memory impairment, with age-appropriate unremarkable neurocognitive test battery (CERAD) and no evidence of reduced Aβ42 concentration or increased total tau or phospho-tau concentration in the cerebrospinal fluid. Subjective cognitive deterioration over a period of 6 months to 5 years.
Receives: Diagnostic Test: magnetic resonance imaging; Other: electroencephalography; Diagnostic Test: blood and CSF biomarker; Diagnostic Test: positron emission tomography; Diagnostic Test: neuropsychological test

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. association of cerebral connectivity with microglia activation patterns

    association between functional/structural connectivity and TSPO SUVR

    Measured: until 06/2024

  2. Individual regional associations between Aβ-, tau- and neurodegeneration with microglial activation

    association of regional amyloid and tau with microglial activation (measured by TSPO-PET)

    Measured: until 06/2024

  3. validation of blood-based biomarkers in the differentiation of AD, SCI and CBS cases

    comparison of AD-related biomarkers (pTau181, Abeta1-42/1-40), plasma apolipoprotein E and inflammatory biomarkers (GFAP, NfL)

    Measured: until 06/2024

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jan 2024
  2. Study start1 Jan 2017
  3. Primary completion1 Jan 2024
  4. Study completion1 Jan 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
140 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06224920
Sponsor's protocol ID
17-755 and 17-569
Acronym
ActiGliA
Status last verified
Jul 2025
First submitted
16 Jan 2024
Last updated
4 Jul 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Ochsner M, Brendel M, Franzmeier N, Trappmann L, Zaganjori M, Ersoezlue E, Kurz C, Haeckert J, Utecht J, Schirge PM, Papazov B, Pogarell O, Janowitz D, Buerger K, Ewers M, Palleis C, Weidinger E, Biechele G, Schuster S, Finze A, Eckenweber F, Rupprecht R, Rominger A, Goldhardt O, Grimmer T, Keeser D, Stoecklein S, Dietrich O, Bartenstein P, Levin J, Hoglinger G, Perneczky R, Rauchmann BS. Microglial dynamics associate with the spatial pattern of tau deposition in early Alzheimer's disease. Alzheimers Res Ther. 2026 Oct 12;18(1):232. doi: 10.1186/s13195-026-02230-1.

    PubMed 42875788

Questions about this trial

What is this clinical trial studying?

An observational study of Alzheimer Disease and Corticobasal Syndrome, run by Ludwig-Maximilians - University of Munich.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

association of cerebral connectivity with microglia activation patterns (time frame: until 06/2024). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06224920, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jul 2025; AzTrials last refreshed its copy on 7 Nov 2026.

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