Exercise as a primer for excitatory stimulation study in Vascular Cognitive Impairment No Dementia (EXPRESS-V)

What is this Study about?

This is a 5-week study evaluating the efficacy of combining exercise and transcranial direct current stimulation (tDCS) to enhance the effects on cognition in patients with vascular mild cognitive impairment.

What Will Happen in This Study?

Eligible participants will be randomized to one of four groups: exercise with tDCS or sham tDCS, or treatment as usual with tDCS or sham tDCS. If randomized to an exercise group, participants will undergo a 5-week exercise program at the University Health Network-Toronto Rehabilitation Institute (UHN-TRI).

The aim of the first 3 weeks will be to gradually increase exercise tolerance until participants are able to maintain moderate-intensity exercise for 30 minutes 5 days per week. The final 2 weeks of the study will combine exercise with tDCS or sham stimulation. Participants randomized to TU will receive active or sham tDCS at Sunnybrook.

Cognitive outcomes will be assessed at 4 time points and behavioural outcomes and blood biomarkers will be assessed at 3 time points: Baseline: prior to tDCS/sham intervention, Endpoint: at the end of the 5-week program, Follow-up: 4 weeks after the end of the program. Participants will also undergo neuroimaging (MRI) at baseline and endpoint

Who is Eligible to Participate in this Study?

Inclusion criteria:

1) ≥50 years of age

2) Females must be post-menopausal

3) Presence of cerebrovascular and/or cardiovascular risk factors or coronary artery disease

4) Fluent in English.

Exclusion:

1) History of stroke

2) Change in psychotropics within the last 4 weeks

3) Current benzodiazepine use

4) Metal implants

5) Significant neurological or psychiatric conditions based on clinician’s assessment (such as neurological conditions that would preclude participation in study activities, current major depressive disorder, bipolar disorder, schizophrenia)

6) Clinical diagnosis of dementia

7) Any medical contraindications to exercise

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