AMCI - Amnestic Mild Cognitive ImpairmentPBM-CogConnectNCT07287527
Effects of Photobiomodularion on Brain Connectivity and Cognitive Function in Cognitive Impairment
A study testing Active transcranial Photobiomodulation and Cognitive Rehabilitation in people with AMCI - Amnestic Mild Cognitive Impairment, run by Uskudar University at 2 sites in Turkey (Türkiye).
Trial summary
The goal of this clinical trial is to learn if transcranial photobiomodulation (t-PBM), a light-based brain therapy, can help improve memory and cognitive skills in older adults with amnestic mild cognitive impairment (aMCI). Read more about this study
- Who is it for?
- Ages 55 years and older
- Conditions the study is for
- AMCI - Amnestic Mild Cognitive Impairment
- What is being tested?
- Active transcranial Photobiomodulation and Cognitive Rehabilitation
- Type of treatment
- Medical device, Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- 2 sitesTurkey (Türkiye)
- Study dates
- 30 Mar 2024to Oct 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 55 years or older
- Diagnosis of amnestic Mild Cognitive Impairment (aMCI)
Who cannot join
- Presence of a neurological disorder
- Presence of a severe psychiatric disorder
- Having a pacemaker or other implanted medical device that is not MRI-compatible
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)2 sites, 2 recruiting
- Recruiting
NPIstanbul Brain Hospital
Istanbul
Shams Farhad, PhD, +90 5528566917, shams.farhad@uskudar.edu.tr
- Recruiting
Uskudar University, Faculty of Medicine
Istnabul
shams.farhad@uskudar.edu.tr Farhad, PhD candidate, +905528566917, shams.farhad@uskudar.edu.tr
About this study
Official title: The Effects of Transcranial Photobiomodulation (t-PBM) on Cognitive Performance and Functional Brain Connectivity in Patients With Mild Cognitive Impairment and the Role of Genetic Factors
The goal of this clinical trial is to learn if transcranial photobiomodulation (t-PBM), a light-based brain therapy, can help improve memory and cognitive skills in older adults with amnestic mild cognitive impairment (aMCI). This condition involves memory problems that are greater than normal aging and may increase the chance of developing Alzheimer's disease.
The main questions this study aims to answer are:
Read more
- Does t-PBM, when used together with cognitive training, improve memory and cognitive skills?
- Does t-PBM change how certain brain areas communicate with each other, especially in the default mode network (DMN)?
Researchers will compare:
t-PBM plus cognitive training to sham (inactive) t-PBM plus the same cognitive training to see if the active light treatment leads to better cognitive improvement and healthier brain activity.
Participants will:
- Provide a blood sample so the research team can create a genetic profile;
- Complete cognitive tests before and after the 4-week program;
- Meet with a dietitian before and after the program so the research team can make sure diet stays consistent and does not influence brain results;
- Have a brain fMRI scan before and after treatment to measure brain connectivity changes;
- Take part in eight sessions of cognitive training;
- Receive either active t-PBM or sham t-PBM during these sessions.
Read the detailed description
Amnestic mild cognitive impairment (aMCI) is associated with early disruptions in large-scale brain networks, including the default mode network (DMN), which often shows inefficient or abnormally high connectivity in individuals at increased risk for Alzheimer's disease. Human studies examining the impact of transcranial photobiomodulation (t-PBM) on DMN connectivity and cognitive performance in aMCI remain limited, and few controlled trials have assessed Group × Time interaction effects. This study was designed to address this gap by evaluating whether t-PBM produces measurable changes in resting-state functional connectivity and cognitive outcomes when combined with cognitive rehabilitation.
The trial uses a randomized, sham-controlled, pretest-posttest design. Participants with aMCI were randomly assigned to receive either active t-PBM paired with a cognitive rehabilitation program or sham t-PBM with the same cognitive rehabilitation. The intervention was delivered across eight sessions. Cognitive assessments and resting-state fMRI scans were conducted before the first session and after the final session to evaluate changes in cognitive performance and DMN connectivity. The experimental model allows for the direct evaluation of treatment-related neural changes while accounting for natural variation and practice effects.
To minimize confounding factors, dietary stability was monitored. All participants completed a dietitian visit at baseline and follow-up to document eating habits and reduce the influence of diet-related changes on cognitive or imaging outcomes. In addition, peripheral venous blood samples were collected at baseline for genetic analysis. Genotyping targeted APOE alleles (rs429358, rs7412) and the COMT Val158Met (rs4680) polymorphism. DNA extraction followed silica membrane-based protocols, and allelic discrimination was performed using TaqMan-based real-time PCR. Quality assurance included blinded laboratory processing, random duplicates, call rate thresholds (>95%), and Hardy-Weinberg equilibrium criteria. These genetic data were incorporated into exploratory models to examine whether genotype moderated baseline brain connectivity or response to the intervention.
Neuroimaging was conducted using a GE SIGNA Hero 3.0 Tesla MRI system. High-resolution T1-weighted structural images were acquired using an axial MPRAGE sequence (TR = 2745 ms, TE = 3.01 ms, TI = 1020 ms, flip angle = 8°, 1 mm slice thickness, voxel size 0.44 × 0.44 × 1 mm, 225 slices). Resting-state functional MRI data were collected using an axial multiband echo-planar imaging sequence (TR = 2000 ms, TE = 22 ms, flip angle = 20°, voxel size 3.125 × 3.125 × 3 mm, 45 slices, matrix 64 × 64, 200 volumes; approximately 6 minutes 40 seconds). Participants were instructed to remain still, keep their eyes closed, and avoid focused mental activity during the scan. These data enable reliable estimation of DMN functional connectivity before and after the intervention.
The study integrates cognitive rehabilitation outcomes, functional neuroimaging, dietary monitoring, and genetic profiling to explore neurobiological and behavioral effects of t-PBM in aMCI. By evaluating network-level changes and potential individual differences in treatment response, the trial aims to improve understanding of whether t-PBM can serve as a network-targeted adjunctive intervention for individuals with early cognitive impairment.
- Being tested
- Active transcranial Photobiomodulation, sham transcranial Photobiomodulation, Cognitive Rehabilitation
- Keywords
- t-PBM, aMCI, fMRI, Cognitive Rehabilitation, functional connectivity, APOE, COMT
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Active transcranial PhotobiomodulationDevice
The active intervention consists of transcranial photobiomodulation (t-PBM) delivered while the device is placed on the participant's head and operating at gamma-frequency. The device provides active near-infrared light output throughout the 20-minute session. Active intervention is administered for a total of 8 sessions.
sham transcranial PhotobiomodulationDevice
The sham intervention uses the same transcranial photobiomodulation (t-PBM) device and head placement as the active intervention; however, no therapeutic near-infrared light output is delivered. The device's external indicators remain active to mimic real stimulation and maintain participant blinding. Each session lasts 20 minutes. The sham intervention is administered for a total of 8 sessions.
Cognitive RehabilitationBehavioural
The cognitive rehabilitation program consists of 8 sessions, each lasting 20 minutes, delivered simultaneously with either active or sham transcranial photobiomodulation (t-PBM). The program is a pen-and-paper-based cognitive exercise protocol targeting attention, memory, executive functions, and language. Each session includes structured tasks with predefined difficulty levels. Task difficulty increases progressively by 0.5 points from Session 1 onward, ensuring gradual cognitive challenge and adaptation across all eight sessions. The rehabilitation protocol is identical for both study arms.
| Study group | Role | What they receive |
|---|---|---|
| Intervention Arm: Active Treatment | Experimental | Participants in this arm will receive active transcranial photobiomodulation delivered at gamma frequency while simultaneously participating in a structured cognitive rehabilitation session. The photobiomodulation device will be placed on the participant's head and will operate continuously for 20 minutes during each session. Cognitive rehabilitation tasks will be administered throughout the stimulation period to enhance cognitive engagement. This combined intervention will be applied across all scheduled treatment sessions. Receives: Device: Active transcranial Photobiomodulation; Behavioral: Cognitive Rehabilitation |
| Control Arm: Sham/Placebo | Sham comparator | Participants in this arm will receive sham transcranial photobiomodulation while completing the same cognitive rehabilitation session provided to the experimental group. The device will be placed on the participant's head and will appear to operate normally; however, no active light output will be delivered. Each session lasts 20 minutes, during which participants complete standardized cognitive rehabilitation tasks. Session frequency, duration, and rehabilitation procedures are identical to the experimental arm to maintain blinding and ensure comparable conditions. Receives: Device: sham transcranial Photobiomodulation; Behavioral: Cognitive Rehabilitation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in Default Mode Network (DMN) Functional Connectivity Measured by Resting-State fMRI
Measured: Baseline and after completion of the 8-session intervention (approximately 4 weeks)
Change in Montreal Cognitive Assessment (MoCA) Total Score
Baseline and post-intervention cognitive performance will be compared using the Montreal Cognitive Assessment (MoCA), a standardized cognitive screening instrument.
Score range: 0 to 30 points (higher scores indicate better cognitive performance).
Measured: From baseline to post-intervention assessment following 8 sessions
Secondary outcomes (1)
Genotype-Based Comparison of Treatment Outcomes
This outcome measure evaluates group-based comparisons of treatment-related changes in cognitive performance and brain functional connectivity across COMT and APOE genotype groups following transcranial photobiomodulation, as a single composite comparison outcome.
Genetic profile (grouping variable):
COMT Val158Met polymorphism and APOE genotype (ε2, ε3, ε4 alleles), determined by genotyping analysis from peripheral blood samples; unit: genotype category (COMT: Val/Val, Val/Met, Met/Met; APOE: ε2 carrier, ε3/ε3, ε4 carrier).
Cognitive performance measure:
Montreal Cognitive Assessment (MoCA) total score; measurement tool: standardized MoCA test; unit: change in total score from baseline (points; range 0-30).
Brain connectivity measure:
Default Mode Network (DMN) functional connectivity; measurement tool: resting-state fMRI-based functional connectivity analysis using Pearson correlation of BOLD time series; unit: change in connectivity strength from baseline.
Measured: Baseline genetic assessment and post-intervention outcomes after completion of 8 sessions
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Dec 2025
- Study start30 Mar 2024
- Primary completion31 Dec 2025 (estimated)
- Study completionOct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for AMCI - Amnestic Mild Cognitive ImpairmentStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Uskudar University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Baris Metin, Uskudar University
- Investigators
- Baris Metin, Prof. Dr., Principal investigator, Uskudar University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07287527
- Sponsor's protocol ID
- UUBAYP-2024-003
- Acronym
- PBM-CogConnect
- Status last verified
- Dec 2025
- First submitted
- 19 Nov 2025
- Last updated
- 17 Dec 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No: De-identified individual participant data (IPD), including genetic, neuroimaging, and cognitive assessment data, will not be shared outside the primary research team due to ethical, legal, and institutional restrictions related to participant privacy and data protection.
Publications
Chan AS, Lee TL, Hamblin MR, Cheung MC. Photobiomodulation Enhances Memory Processing in Older Adults with Mild Cognitive Impairment: A Functional Near-Infrared Spectroscopy Study. J Alzheimers Dis. 2021;83(4):1471-1480. doi: 10.3233/JAD-201600.
PubMed 33998541
Study at a glance
From the registry record, last updated by the sponsor on 17 Dec 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Transcranial Photobiomodulation (t-PBM) on Cognitive Performance and Functional Brain Connectivity in Patients With Mild Cognitive Impairment and the Role of Genetic Factors
- ClinicalTrials.gov ID
- NCT07287527
- Acronym / sponsor ID
- PBM-CogConnect / UUBAYP-2024-003
- Keywords
- t-PBM, aMCI, fMRI, Cognitive Rehabilitation, functional connectivity, APOE, COMT
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Uskudar UniversityUniversity, hospital or other
- Study start
- 30 Mar 2024 (actual)
- Primary completion
- 31 Dec 2025 (estimated)
- Study completion
- Oct 2026 (estimated)
- First posted
- 17 Dec 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this clinical trial is to learn if transcranial photobiomodulation (t-PBM), a light-based brain therapy, can help improve memory and cognitive skills in older adults with amnestic mild cognitive impairment (aMCI). This condition involves memory problems that are greater than normal aging and may increase the chance of developing Alzheimer's disease.
The main questions this study aims to answer are:
- Does t-PBM, when used together with cognitive training, improve memory and cognitive skills?
- Does t-PBM change how certain brain areas communicate with each other, especially in the default mode network (DMN)?
Researchers will compare:
t-PBM plus cognitive training to sham (inactive) t-PBM plus the same cognitive training to see if the active light treatment leads to better cognitive improvement and healthier brain activity.
Participants will:
- Provide a blood sample so the research team can create a genetic profile;
- Complete cognitive tests before and after the 4-week program;
- Meet with a dietitian before and after the program so the research team can make sure diet stays consistent and does not influence brain results;
- Have a brain fMRI scan before and after treatment to measure brain connectivity changes;
- Take part in eight sessions of cognitive training;
- Receive either active t-PBM or sham t-PBM during these sessions.
Detailed description
Amnestic mild cognitive impairment (aMCI) is associated with early disruptions in large-scale brain networks, including the default mode network (DMN), which often shows inefficient or abnormally high connectivity in individuals at increased risk for Alzheimer's disease. Human studies examining the impact of transcranial photobiomodulation (t-PBM) on DMN connectivity and cognitive performance in aMCI remain limited, and few controlled trials have assessed Group × Time interaction effects. This study was designed to address this gap by evaluating whether t-PBM produces measurable changes in resting-state functional connectivity and cognitive outcomes when combined with cognitive rehabilitation.
The trial uses a randomized, sham-controlled, pretest-posttest design. Participants with aMCI were randomly assigned to receive either active t-PBM paired with a cognitive rehabilitation program or sham t-PBM with the same cognitive rehabilitation. The intervention was delivered across eight sessions. Cognitive assessments and resting-state fMRI scans were conducted before the first session and after the final session to evaluate changes in cognitive performance and DMN connectivity. The experimental model allows for the direct evaluation of treatment-related neural changes while accounting for natural variation and practice effects.
To minimize confounding factors, dietary stability was monitored. All participants completed a dietitian visit at baseline and follow-up to document eating habits and reduce the influence of diet-related changes on cognitive or imaging outcomes. In addition, peripheral venous blood samples were collected at baseline for genetic analysis. Genotyping targeted APOE alleles (rs429358, rs7412) and the COMT Val158Met (rs4680) polymorphism. DNA extraction followed silica membrane-based protocols, and allelic discrimination was performed using TaqMan-based real-time PCR. Quality assurance included blinded laboratory processing, random duplicates, call rate thresholds (>95%), and Hardy-Weinberg equilibrium criteria. These genetic data were incorporated into exploratory models to examine whether genotype moderated baseline brain connectivity or response to the intervention.
Neuroimaging was conducted using a GE SIGNA Hero 3.0 Tesla MRI system. High-resolution T1-weighted structural images were acquired using an axial MPRAGE sequence (TR = 2745 ms, TE = 3.01 ms, TI = 1020 ms, flip angle = 8°, 1 mm slice thickness, voxel size 0.44 × 0.44 × 1 mm, 225 slices). Resting-state functional MRI data were collected using an axial multiband echo-planar imaging sequence (TR = 2000 ms, TE = 22 ms, flip angle = 20°, voxel size 3.125 × 3.125 × 3 mm, 45 slices, matrix 64 × 64, 200 volumes; approximately 6 minutes 40 seconds). Participants were instructed to remain still, keep their eyes closed, and avoid focused mental activity during the scan. These data enable reliable estimation of DMN functional connectivity before and after the intervention.
The study integrates cognitive rehabilitation outcomes, functional neuroimaging, dietary monitoring, and genetic profiling to explore neurobiological and behavioral effects of t-PBM in aMCI. By evaluating network-level changes and potential individual differences in treatment response, the trial aims to improve understanding of whether t-PBM can serve as a network-targeted adjunctive intervention for individuals with early cognitive impairment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Intervention Arm: Active Treatment | Experimental | Device: Active transcranial Photobiomodulation, Behavioral: Cognitive RehabilitationParticipants in this arm will receive active transcranial photobiomodulation delivered at gamma frequency while simultaneously participating in a structured cognitive rehabilitation session. The photobiomodulation device will be placed on the participant's head and will operate continuously for 20 minutes during each session. Cognitive rehabilitation tasks will be administered throughout the stimulation period to enhance cognitive engagement. This combined intervention will be applied across all scheduled treatment sessions. |
| Control Arm: Sham/Placebo | Sham comparator | Device: sham transcranial Photobiomodulation, Behavioral: Cognitive RehabilitationParticipants in this arm will receive sham transcranial photobiomodulation while completing the same cognitive rehabilitation session provided to the experimental group. The device will be placed on the participant's head and will appear to operate normally; however, no active light output will be delivered. Each session lasts 20 minutes, during which participants complete standardized cognitive rehabilitation tasks. Session frequency, duration, and rehabilitation procedures are identical to the experimental arm to maintain blinding and ensure comparable conditions. |
Who may qualify
- Ages
- 55 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Age 55 years or older
- Diagnosis of amnestic Mild Cognitive Impairment (aMCI)
Key exclusion criteria (3 listed)
- Presence of a neurological disorder
- Presence of a severe psychiatric disorder
- Having a pacemaker or other implanted medical device that is not MRI-compatible
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Active transcranial PhotobiomodulationThe active intervention consists of transcranial photobiomodulation (t-PBM) delivered while the device is placed on the participant's head and operating at gamma-frequency. The device provides active near-infrared light output throughout the 20-minute session. Active intervention is administered for a total of 8 sessions. | Device | Intervention Arm: Active Treatment |
| sham transcranial PhotobiomodulationThe sham intervention uses the same transcranial photobiomodulation (t-PBM) device and head placement as the active intervention; however, no therapeutic near-infrared light output is delivered. The device's external indicators remain active to mimic real stimulation and maintain participant blinding. Each session lasts 20 minutes. The sham intervention is administered for a total of 8 sessions. | Device | Control Arm: Sham/Placebo |
| Cognitive RehabilitationThe cognitive rehabilitation program consists of 8 sessions, each lasting 20 minutes, delivered simultaneously with either active or sham transcranial photobiomodulation (t-PBM). The program is a pen-and-paper-based cognitive exercise protocol targeting attention, memory, executive functions, and language. Each session includes structured tasks with predefined difficulty levels. Task difficulty increases progressively by 0.5 points from Session 1 onward, ensuring gradual cognitive challenge and adaptation across all eight sessions. The rehabilitation protocol is identical for both study arms. | Behavioural | Control Arm: Sham/Placebo, Intervention Arm: Active Treatment |
Primary outcome
Change in Default Mode Network (DMN) Functional Connectivity Measured by Resting-State fMRI
Time frame: Baseline and after completion of the 8-session intervention (approximately 4 weeks)
Change in Montreal Cognitive Assessment (MoCA) Total Score
Time frame: From baseline to post-intervention assessment following 8 sessions
Baseline and post-intervention cognitive performance will be compared using the Montreal Cognitive Assessment (MoCA), a standardized cognitive screening instrument. Score range: 0 to 30 points (higher scores indicate better cognitive performance).
1 secondary outcome
Genotype-Based Comparison of Treatment Outcomes
Time frame: Baseline genetic assessment and post-intervention outcomes after completion of 8 sessions
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Dec 2025.
- Background: PubMed 33998541Chan AS, Lee TL, Hamblin MR, Cheung MC. Photobiomodulation Enhances Memory Processing in Older Adults with Mild Cognitive Impairment: A Functional Near-Infrared Spectroscopy Study. J Alzheimers Dis. 2021;83(4):1471-1480. doi: 10.3233/JAD-201600.
- Individual participant dataSharing planned: No. De-identified individual participant data (IPD), including genetic, neuroimaging, and cognitive assessment data, will not be shared outside the primary research team due to ethical, legal, and institutional restrictions related to participant privacy and data protection.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Baris Metin, Prof. Dr. principal investigator
Uskudar University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Active transcranial Photobiomodulation and Cognitive Rehabilitation in people with AMCI - Amnestic Mild Cognitive Impairment, run by Uskudar University at 2 sites in Turkey (Türkiye).
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 3 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: looking for participants now, as of the sponsor's last update on 17 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Shams Farhad, PhD (+905528566917, shams.farhad@uskudar.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Default Mode Network (DMN) Functional Connectivity Measured by Resting-State fMRI (time frame: Baseline and after completion of the 8-session intervention (approximately 4 weeks)). The study lists 2 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 NCT07287527, 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 17 Dec 2025.