AzTrials
AzTrials

Dementia With Lewy Bodies (DLB)REACT-DLBNCT07846189

Rhythmic Entrainment and Alertness in Lewy Body Dementia

A study testing Rhythmic Auditory Cueing in people with Dementia With Lewy Bodies (DLB) and Lewy Body Dementia (LBD), run by Johns Hopkins University.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

This study will examine how people with dementia with Lewy bodies (DLB) or mild cognitive impairment with Lewy bodies respond to rhythmic auditory cues, and whether changes in alertness affect ability to synchronize movements to a rhythm. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Rhythmic Auditory Cueing
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
No sites listed yet
Study dates
30 Nov 2026to 31 Jul 2027
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 years or older
  • Diagnosis of probable dementia with Lewy bodies (DLB) or mild cognitive impairment with Lewy bodies (MCI-LB) based on established clinical diagnostic criteria
  • Fluent in English
  • Able to attend with a study partner who can complete care-partner-reported cognitive fluctuation measures
  • Clinical Dementia Rating (CDR) global score of 0.5-1.0
  • Adequate upper-limb motor function, defined as Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III finger-tapping item (3.4) score ≤2 on at least one hand and ability to sustain rhythmic tapping for at least 10 seconds at approximately 1-3 Hz during a brief practice trial
  • Adequate hearing, corrected if necessary, to perceive rhythmic auditory cues
  • Stable on all medications for at least 30 days before enrollment

Who cannot join

  • Age younger than 18 years
  • CDR global score ≥2.0
  • Severe upper-limb impairment, defined as MDS-UPDRS Part III finger-tapping item (3.4) score ≥3 in the dominant hand, or inability to produce more than 10 consecutive taps at ≥1 Hz despite instruction/practice
  • Other neurological, musculoskeletal, or sensory conditions that preclude safe or reliable task participation

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

Kyurim Kang, PhD contact

410-614-5671

kkang19@jhmi.edu

Alexander Pantelyat, MD contact

4105023290

apantel1@jhmi.edu

About this study

Official title: Rhythmic Entrainment and Alertness Co-modulating Test in Dementia With Lewy Bodies (REACT-DLB): Pilot Study

This study will examine how people with dementia with Lewy bodies (DLB) or mild cognitive impairment with Lewy bodies respond to rhythmic auditory cues, and whether changes in alertness affect ability to synchronize movements to a rhythm.

Participants will complete a single study visit that includes finger-tapping tasks performed with and without rhythmic auditory cues at different tempos. Brain activity will be recorded using electroencephalography (EEG), and tapping performance will be measured. Participants and the participant's study partners will also provide repeated ratings of alertness during the visit.

The study aims to identify brain and behavioral measures of rhythmic synchronization and determine whether these measures change depending on a participant's level of alertness. The findings will help guide the development of future rhythm-based interventions for people with DLB.

Read the detailed description

REACT-DLB is a single-session, within-participant mechanistic study designed to characterize neural and behavioral responses to rhythmic auditory cueing in individuals with probable dementia with Lewy bodies (DLB) or mild cognitive impairment with Lewy bodies. The target enrollment is 30 participants with a Clinical Dementia Rating (CDR) global score of 0.5-1.0, with balanced recruitment across CDR 0.5 and 1.0 when feasible.

Participants will first complete a self-paced finger-tapping trial to determine the participant's preferred tapping tempo. Participants will then complete six auditory-cued tapping trials at three tempo conditions: preferred tempo, 20% slower than preferred tempo, and 20% faster than preferred tempo. The tempo conditions will be presented in randomized order. EEG and finger-tapping responses will be recorded during the task.

The primary neural measure of rhythmic entrainment is beta-band event-related desynchronization (β-ERD), and the primary behavioral measure is inter-tap-interval coefficient of variation (ITI-CV). Exploratory measures include delta/theta inter-trial phase coherence (ITPC), mean asynchrony between taps and auditory cues, and continuation drift.

To evaluate whether momentary alertness influences rhythmic entrainment, participants and care partners will provide repeated Visual Analogue Scale ratings of alertness between tapping blocks, and brief eyes-open resting-state EEG recordings will be collected. The EEG theta/alpha ratio will be used as a neural index of alertness. Clinician- and care-partner-reported measures of cognitive fluctuation will also be collected. Analyses will examine whether alertness measures are associated with differences in neural and behavioral rhythmic entrainment.

For participants taking levodopa, study testing will be scheduled during the participant's best clinically defined ON state when applicable. If a clear best ON state cannot be identified, testing will occur within approximately one hour of medication administration. Participants not taking levodopa will be tested in the participant's usual clinically stable medication state.

The active finger-tapping component lasts approximately 13 minutes. Including rest periods and alertness assessments, the tapping-related portion is expected to take approximately 20-25 minutes. The entire study visit, including consent, questionnaires, EEG setup and recording, tapping tasks, and breaks, is expected to last approximately 90-120 minutes.

Being tested
Rhythmic Auditory Cueing
Keywords
rhythmic auditory stimulation, rhythmic entrainment, auditory-motor synchronization, electroencephalography (EEG), alertness, cognitive fluctuations
Medical subject headings
Lewy Body Disease

What participants receive

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

  • Rhythmic Auditory CueingBehavioural

    Participants will perform finger-tapping tasks while listening to rhythmic auditory cues presented at three tempo conditions: preferred tempo, 20% slower, and 20% faster. Each cued condition will be repeated twice in randomized order.

Study groups in NCT07846189
Study groupRoleWhat they receive
Auditory-Cued Finger TappingExperimentalParticipants will complete a single-session finger-tapping protocol. After a 1-minute self-paced tapping trial to determine preferred tempo, participants will complete six 2-minute auditory-cued tapping trials at three tempo conditions: preferred tempo, 20% slower, and 20% faster, with each condition repeated twice in randomized order. EEG and tapping responses will be recorded during the task, and alertness will be assessed between tapping blocks.
Receives: Behavioral: Rhythmic Auditory Cueing

What is being measured

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

  1. Beta-band event-related desynchronization (β-ERD) during auditory-cued finger tapping

    Beta-band event-related desynchronization (β-ERD; 13-30 Hz) will be derived from task-related EEG recorded during auditory-cued finger tapping. β-ERD is an EEG measure of sensorimotor activation and auditory-motor coupling during rhythmic movement. β-ERD will be compared across the three auditory cueing tempo conditions: preferred tempo, 20% slower than preferred tempo, and 20% faster than preferred tempo. Collected at a single study visit; during six 2-minute auditory-cued finger-tapping trials.

    Measured: Day 1, during each of six 2-minute auditory-cued finger-tapping trials

  2. Inter-tap interval coefficient of variation (ITI-CV) during auditory-cued finger tapping

    Inter-tap interval coefficient of variation (ITI-CV) will be calculated from the timing of consecutive finger taps during auditory-cued finger tapping. ITI-CV measures variability in tapping intervals and serves as an index of motor-timing precision and rhythmic consistency, with lower values indicating more consistent tapping. ITI-CV will be compared across the three auditory cueing tempo conditions: preferred tempo, 20% slower than preferred tempo, and 20% faster than preferred tempo. Collected at a single study visit; during six 2-minute auditory-cued finger-tapping trials.

    Measured: Day 1, during each of six 2-minute auditory-cued finger-tapping trials

Secondary outcomes (3)
  1. EEG Alertness Index as assessed by theta/alpha ratio (TAR)

    The EEG Alertness Index will be calculated as the frontal theta/posterior alpha ratio (TAR) from eyes-open resting-state EEG recordings collected between finger-tapping blocks. TAR is an EEG marker of cortical arousal, with higher TAR indicating lower alertness. TAR will be examined in relation to neural and behavioral rhythmic entrainment across auditory cueing conditions. Collected at a single study visit; during 2-minute eyes-open resting-state EEG recordings collected between tapping blocks

    Measured: Day 1, during each 2-minute eyes-open resting-state EEG recording collected between finger-tapping blocks

  2. Participant-reported alertness as assessed by Visual Analogue Scale (VAS)

    Participants will provide repeated Visual Analogue Scale ratings of their momentary alertness between finger-tapping blocks. These ratings will be used to characterize within-session variation in alertness and examine its relationship with neural and behavioral measures of rhythmic entrainment. Scale 1-10 lower score better. Collected at a single study visit; assessed between tapping blocks.

    Measured: Day 1, immediately after each of six 2-minute auditory-cued finger-tapping trials

  3. Care-partner-reported participant alertness as assessed by Visual Analogue Scale (VAS)

    Care partners will provide repeated Visual Analogue Scale ratings of the participant's momentary alertness between finger-tapping blocks. These ratings will provide an additional measure of within-session alertness variation and will be examined in relation to neural and behavioral measures of rhythmic entrainment. Scale 1-10 lower score better. Collected at a single study visit; assessed between tapping blocks.

    Measured: Day 1, immediately after each of six 2-minute auditory-cued finger-tapping trials

Timeline

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

  1. First posted29 Sep 2026
  2. Study start30 Nov 2026 (estimated)
  3. Primary completion31 Jul 2027 (estimated)
  4. Study completion31 Jul 2027 (estimated)

Resources

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
Basic science
Allocation
Not applicable
Intervention model
Single group
Model description
All participants complete the same single-session, within-subject protocol. Following a self-paced finger-tapping trial, participants complete six auditory-cued tapping trials across three tempo conditions (preferred tempo, 20% slower, and 20% faster), with each condition repeated twice in randomized order.
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07846189
Sponsor's protocol ID
IRB00582709
Other IDs
U24AG084436
Acronym
REACT-DLB
Status last verified
Oct 2026
First submitted
18 Sep 2026
Last updated
9 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Baik K, Jung JH, Jeong SH, Chung SJ, Yoo HS, Lee PH, Sohn YH, Kang SW, Ye BS. Implication of EEG theta/alpha and theta/beta ratio in Alzheimer's and Lewy body disease. Sci Rep. 2022 Nov 4;12(1):18706. doi: 10.1038/s41598-022-21951-5.

    PubMed 36333386
  • Pantelyat A, Dayanim G, Kang K, Turk B, Pagkatipunan R, Huenergard SK, Mears A, Bang J. Rhythmic auditory cueing in atypical parkinsonism: A pilot study. Front Neurol. 2022 Oct 28;13:1018206. doi: 10.3389/fneur.2022.1018206. eCollection 2022.

    PubMed 36388209
  • Stylianou M, Murphy N, Peraza LR, Graziadio S, Cromarty R, Killen A, O' Brien JT, Thomas AJ, LeBeau FEN, Taylor JP. Quantitative electroencephalography as a marker of cognitive fluctuations in dementia with Lewy bodies and an aid to differential diagnosis. Clin Neurophysiol. 2018 Jun;129(6):1209-1220. doi: 10.1016/j.clinph.2018.03.013. Epub 2018 Apr 3.

    PubMed 29656189
  • Donaghy PC, Carrarini C, Ferreira D, Habich A, Aarsland D, Babiloni C, Bayram E, Kane JP, Lewis SJ, Pilotto A, Thomas AJ, Bonanni L; Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment Lewy Body Dementias Prodromal Working Group. Research diagnostic criteria for mild cognitive impairment with Lewy bodies: A systematic review and meta-analysis. Alzheimers Dement. 2023 Jul;19(7):3186-3202. doi: 10.1002/alz.13105. Epub 2023 Apr 24.

    PubMed 37096339
  • McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, Aarsland D, Galvin J, Attems J, Ballard CG, Bayston A, Beach TG, Blanc F, Bohnen N, Bonanni L, Bras J, Brundin P, Burn D, Chen-Plotkin A, Duda JE, El-Agnaf O, Feldman H, Ferman TJ, Ffytche D, Fujishiro H, Galasko D, Goldman JG, Gomperts SN, Graff-Radford NR, Honig LS, Iranzo A, Kantarci K, Kaufer D, Kukull W, Lee VMY, Leverenz JB, Lewis S, Lippa C, Lunde A, Masellis M, Masliah E, McLean P, Mollenhauer B, Montine TJ, Moreno E, Mori E, Murray M, O'Brien JT, Orimo S, Postuma RB, Ramaswamy S, Ross OA, Salmon DP, Singleton A, Taylor A, Thomas A, Tiraboschi P, Toledo JB, Trojanowski JQ, Tsuang D, Walker Z, Yamada M, Kosaka K. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017 Jul 4;89(1):88-100. doi: 10.1212/WNL.0000000000004058. Epub 2017 Jun 7.

    PubMed 28592453
  • D'Antonio F, Kane JPM, Ibanez A, Lewis SJG, Camicioli R, Wang H, Yu Y, Zhang J, Ji Y, Borda MG, Kandadai RM, Babiloni C, Bonanni L, Ikeda M, Boeve BF, Leverenz JB, Aarsland D; ISTAART Lewy body dementias Consortia Working Group. Dementia with Lewy bodies research consortia: A global perspective from the ISTAART Lewy Body Dementias Professional Interest Area working group. Alzheimers Dement (Amst). 2021 Sep 14;13(1):e12235. doi: 10.1002/dad2.12235. eCollection 2021.

    PubMed 34541289
  • Rahimi J, Kovacs GG. Prevalence of mixed pathologies in the aging brain. Alzheimers Res Ther. 2014 Nov 21;6(9):82. doi: 10.1186/s13195-014-0082-1. eCollection 2014.

    PubMed 25419243
  • Mueller C, Ballard C, Corbett A, Aarsland D. The prognosis of dementia with Lewy bodies. Lancet Neurol. 2017 May;16(5):390-398. doi: 10.1016/S1474-4422(17)30074-1. Epub 2017 Mar 22.

    PubMed 28342649

Questions about this trial

What is this clinical trial studying?

A study testing Rhythmic Auditory Cueing in people with Dementia With Lewy Bodies (DLB) and Lewy Body Dementia (LBD), run by Johns Hopkins University.

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 8 inclusion and 4 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: opening soon, as of the sponsor's last update on 9 Oct 2026. 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?

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 Kyurim Kang, PhD (410-614-5671, kkang19@jhmi.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Beta-band event-related desynchronization (β-ERD) during auditory-cued finger tapping (time frame: Day 1, during each of six 2-minute auditory-cued finger-tapping trials). 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 NCT07846189, which also lists 8 linked publications.

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 9 Oct 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in