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Alzheimer DementiaPhase 2LeADNCT03875638

Treating Hyperexcitability in AD With Levetiracetam

A Phase 2 study testing Levetiracetam in people with Alzheimer Dementia and Alzheimer Disease, run by Beth Israel Deaconess Medical Center at 1 site in United States.

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 aim of this study is to explore the relationship between cortical hyperexcitability, abnormalities of brain network function, and cognitive dysfunction in human patients with AD and whether administration of the antiepileptic medication levetiracetam (LEV) normalizes these measures and improves cognition. Read more about this study

Who is it for?
Ages 50 to 90 yearsHealthy volunteers can take part
What is being tested?
Levetiracetam
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
58 participants
Where
1 siteUnited States
Study dates
22 Aug 2019to 16 Feb 2026
Phase
Phase 2
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 50 to 90 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Inclusion Criteria for the Subjects with early Alzheimer's Disease (AD)
  • Age 50-90 years old.
  • On a stable dose of medications for memory loss including cholinesterase inhibitors (for example: donepezil, rivastigmine or memantine) as defined by 4 consecutive weeks of treatment at an unchanging dose
  • Meeting the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable AD.
  • Mini Mental State Examination (MMSE) ≥ 20.
  • Positive amyloid status (as defined by cerebral spinal fluid biomarkers or amyloid positron emission tomography (PET) study.
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  • Clinician Dementia Rating (CDR) of 0.5-1.0.
  • Age 50-90 years old.
  • Normal neurologic exam
  • Mini Mental State Examination (MMSE) > 28
  • Clinician Dementia Rating (CDR) of 0

Who cannot join

  • Diagnosis of epilepsy, or immediate (1st degree relative) family history epilepsy with the exception of a single seizure of benign etiology (e.g. febrile seizures) in the judgment of a board-certified neurologist. Evidence of epileptiform discharges and electroencephalogram (EEG) abnormalities will be included;
  • Current or past history of any neurological disorder other than dementia, such as epilepsy, stroke (cortical stroke), progressive neurologic disease (e.g. multiple sclerosis) or intracranial brain lesions; and history of previous neurosurgery or head trauma that resulted in residual neurologic impairment. Non-cortical disease such as scattered white matter changes (including lacunar infarcts < 1 cm) and asymptomatic, subacute, cerebellar infarcts may be included upon review of a medically responsible neurologist. However, subjects with significant vascular disease, as defined by a score greater than 2 on the age-related white matter changes (ARWMC) scale, will be excluded.
  • Any current diagnosis of a major psychiatric disorder (e.g., schizophrenia, bipolar disorder) with the exception of depression. As co-morbidity of anxiety / depression in AD is high, anxiety / depression will not be an automatic exclusion. However, the study physician will assess any subject with a Geriatric Depression Score (GDS) score of 9 or above, and will exclude subjects with a past history of multiple psychiatric hospitalizations or suicide attempts, or current active suicidality.
  • Evidence of significant kidney impairment as defined as an estimated glomerular filtration rate (eGFR) <30
  • Medications will be reviewed by the responsible covering physician and a decision about inclusion will be made based on the participant's past medical history, drug dose, history of recent medication changes or duration of treatment, and combination with other central nervous system active drugs. Current use of an antiepileptic drug will be an absolute exclusion.
  • History of seizures, diagnosis of epilepsy, or immediate (1st degree relative) family history epilepsy with the exception of a single seizure of benign etiology (e.g. febrile seizures) in the judgment of a board-certified neurologist.
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  • Current or past history of any neurological disorder, such as epilepsy, stroke (cortical stroke), progressive neurologic disease (e.g. multiple sclerosis) or intracranial brain lesions; and history of previous neurosurgery or head trauma that resulted in residual neurologic impairment.
  • Any current diagnosis of a major psychiatric disorder (e.g., schizophrenia, bipolar disorder, major depressive disorder).
  • Abnormal Neurologic or Cognitive exam
  • Use of medications that could alter cortical excitability, as determined by the investigators.
  • Exclusion Criteria for All Subjects regarding magnetic resonance imaging (MRI) and transcranial magnetic stimulation (TMS)
  • History of head trauma resulting in prolonged loss of consciousness.
  • Current history of poorly controlled headaches including chronic medication for migraine prevention.
  • History of fainting spells of unknown or undetermined etiology that might constitute seizures.
  • Chronic (particularly) uncontrolled medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.).
  • Any metal in the brain or skull (excluding dental fillings) or elsewhere in the body unless cleared by the responsible covering MD (e.g. MRI compatible joint replacement).
  • Any devices such as pacemaker, medication pump, nerve stimulator, ventriculo-peritoneal shunt unless cleared by the responsible covering physician.
  • Substance use disorders within the past six months.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

Other trials in United States

About this study

Official title: Treating Hyperexcitability in Alzheimer's Disease With Levetiracetam to Improve Brain Function and Cognition

The aim of this study is to explore the relationship between cortical hyperexcitability, abnormalities of brain network function, and cognitive dysfunction in human patients with AD and whether administration of the antiepileptic medication levetiracetam (LEV) normalizes these measures and improves cognition.

Read the detailed description

This is a randomized, placebo-controlled crossover study. Participants with early Alzheimer's Disease (AD) will be tested in a double-blind crossover design with placebo, low-dose levetiracetam (LEV) 125 mg twice daily or high-dose LEV 500mg twice daily. These results will be contrasted with results from a demographically similar control group who will undergo baseline testing only, without any intervention, to establish a comparison norm for the AD group.

Each subject will undergo four screening and baseline visits consisting of a baseline neurological, medical, and cognitive evaluation. If amyloid status is unknown in AD patients, the participant will have an amyloid PET scan. Additional baseline measures include: a high density electroencephalogram (EEG); a 24 hour ambulatory EEG; functional magnetic resonance imaging (fMRI); neuropsychological testing; and transcranial magnetic stimulation with electromyogram (EMG) and EEG measures to assess cortical excitability. AD participants will be randomized to one of six possible groups that consists of a varying order of 3 treatment periods (LEV 125 mg, LEV 500 mg and placebo). The group assignments will be counterbalanced across subjects. Each treatment period will last for 4 weeks with a 4 week washout between treatments. All participants will be assessed prior to initiation of a treatment period (with the initial assessment occurring as part of the baseline assessment) and at the end of each treatment period. The following measures will be repeated as done at baseline at these time points: fMRI; neuropsychological testing; and TMS-EMG-EEG. AD participants will be enrolled for approximately 5 months.

Being tested
Levetiracetam, Placebo oral capsule
Keywords
Mild Alzheimer's Disease, Early Alzheimer's Disease
Medical subject headings
Alzheimer Disease, Cognitive Dysfunction

What participants receive

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

  • LevetiracetamDrug

    Levetiracetam is an antiepileptic medication that has been shown to reduced network cortical hyperexcitability

  • Placebo oral capsuleDrug

    The placebo is a capsule that is identical in appearance to the levetiracetam

Study groups in NCT03875638
Study groupRoleWhat they receive
Early Alzheimer's Disease Group Low DoseExperimentalSubjects with Alzheimer's Disease will undergo a four-week treatment period consisting of low-dose levetiracetam (125 mg twice daily)
Receives: Drug: Levetiracetam
Early Alzheimer's Disease Group High DoseExperimentalSubjects with Alzheimer's Disease will undergo a four-week treatment period consisting of high-dose levetiracetam (500mg twice daily).
Receives: Drug: Levetiracetam
Early Alzheimer's Disease Group PlaceboPlacebo comparatorSubjects with Alzheimer's Disease will undergo a four-week treatment period consisting of placebo twice daily.
Receives: Drug: Placebo oral capsule
Healthy Control GroupNo interventionA group of demographically similar subjects without Alzheimer's Disease will undergo baseline testing only, without any intervention

What is being measured

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

  1. Neuropsychological Test Battery (NTB)

    Our primary cognitive outcome measure will be the mean z-score change relative to baseline on the NTB

    Measured: From enrollment until the end of the treatment periods at 5 months

  2. Transcranial magnetic stimulation (TMS) resting motor threshold

    Our primary TMS electrophysiological outcome measure of cerebral cortical excitability will be the change in the TMS resting input-output curve inflection point

    Measured: From enrollment until the end of the treatment periods at 5 months

  3. Transcranial magnetic stimulation (TMS)-evoked electroencephalogram (EEG) hypersynchrony

    Our primary electrophysiological measure of cerebral network excitability will be TMS-evoked EEG hypersynchrony with stimulation of parietal cortex

    Measured: From enrollment until the end of the treatment periods at 5 months

  4. Resting-state electroencephalogram (EEG) beta band power

    Our primary electrophysiological measure of local network function will be resting-state EEG power in the beta band

    Measured: From enrollment until the end of the treatment periods at 5 months

  5. Resting-state electroencephalogram (EEG) beta band connectivity

    Our primary electrophysiological measure of brain network interactions will be resting-state EEG functional connectivity in the beta band

    Measured: From enrollment until the end of the treatment periods at 5 months

  6. Default-mode network resting-state functional magnetic resonance imaging (fMRI) functional connectivity

    Our primary imaging measure of integrity of macroscopic brain networks will be mean resting-state fMRI functional connectivity within the default-mode network

    Measured: From enrollment until the end of the treatment periods at 5 months

  7. Change in motor evoked potential (MEP) amplitude

    Our primary transcranial magnetic stimulation (TMS) measure of plasticity in cortical excitability will be the change in MEP amplitude 10 minutes after intermittent theta-burst stimulation

    Measured: From enrollment until the end of the treatment periods at 5 months

  8. Change in beta power after theta-burst stimulation

    Our primary transcranial magnetic stimulation (TMS) measure of plasticity in cortical oscillations will be change in resting-state electroencephalogram (EEG) beta power after theta-burst stimulation

    Measured: From enrollment until the end of the treatment periods at 5 months

Timeline

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

  1. First posted15 Mar 2019
  2. Study start22 Aug 2019
  3. Primary completion16 Feb 2026
  4. Study completion16 Feb 2026

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Participants will be tested in a double-blind crossover design with twice daily, low-dose levetiracetam (125 mg twice daily) or high-dose levetiracetam (500mg twice daily) or placebo. Each dose and placebo will be administered for a four week period.The order of interventions will be counterbalanced across subjects, with randomization occurring in blocks of 6. There will be a 4 week washout period between each treatment period.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
58 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03875638
Sponsor's protocol ID
2019P000091
Acronym
LeAD
Status last verified
Apr 2026
First submitted
13 Mar 2019
Last updated
7 Apr 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Ozdemir RA, Passera B, Fried PJ, Press D, Shaughnessy LW, Buss S, Shafi MM. Neurophysiological signatures of default mode network dysfunction and cognitive decline in Alzheimer's disease. Sci Adv. 2025 Nov 28;11(48):eadt8991. doi: 10.1126/sciadv.adt8991. Epub 2025 Nov 28.

    PubMed 41313764
  • Hagan B, Buss SS, Fried PJ, Shafi MM, Turk KW, Xie KY, Frank B, Passera B, Ozdemir RA, Budson AE. Evaluating Alzheimer's disease with the TMS-EEG perturbation complexity index. Neurosci Conscious. 2026 Jan 21;2026(1):niaf062. doi: 10.1093/nc/niaf062. eCollection 2026.

    PubMed 41574278

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Levetiracetam in people with Alzheimer Dementia and Alzheimer Disease, run by Beth Israel Deaconess Medical Center at 1 site in United States.

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 11 inclusion and 18 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 7 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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?

Neuropsychological Test Battery (NTB) (time frame: From enrollment until the end of the treatment periods at 5 months). The study lists 8 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 NCT03875638, which also lists 2 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 7 Apr 2026.

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