Evaluation of Cognitive State Using Neurosteer EEG System

Study Overview
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Brief Summary
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This is an observational study. Patients who fulfill all inclusion criteria and none of the exclusion criteria will be enrolled in the study, be neurologically evaluated and will go through EEG recordings while listening to an auditory cognitive assessment tool and preforming tasks. EEG recordings will be analyzed using proprietary computational analyses.

Detailed Description
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One of the major problems in the prevention and treatment of neurological disorders, is the lack of cost effective and reliable tools to assess neurodegeneration on a large scale at a very early stage. Although current imaging methods give a clear image of the brain atrophy involved in neurodegenerative disorders, there are deficiencies prohibiting their usage for prevention-scanning of large high-risk population such as high price, long set-up time and the need for trained personnel to conduct the test. An objective tool to asses the level of cognitive decline is therefore needed. Such a tool may be used to determine the level of cognitive decline independent of personal interpretation and/or variance between clinicians and provide consistency in assessment across patients and between medical facilities. The Neurosteer system provides objective neurological biomarkers using a wearable easy-to-use affordable system. The system facilitate the capture and interpretation of EEG data with only a single patch of electrodes, attached on the subject's forehead. Neurosteer examination includes completing auditory tasks while measuring brain activity with the device. The data is analyzed using machine learning methods to produce biomarkers, enabling a report of the patient's activity in real time and offline. The examination is easy to preform and can be conducted in every clinic or in patients' homes. In this study, clinical staff will identify potential subjects and will examine the eligibility of subject according to inclusion and exclusion criteria. Patients (or legal guardian) will sign the Informed Consent Form (ICF). Research staff will set up an assessment session using Neurosteer system. In this session the patient will listen to the auditory assessment battery and perform tasks. Level of cognition will be assessed by Neurosteer technology and statistical analysis will be performed to validate the results.

Official Title
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Evaluation of Cognitive State Using Neurosteer EEG System in Patients Suffering From Cognitive Decline

Conditions
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Cognitive Decline

Intervention / Treatment
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* Device: Neurosteer Aurora system


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women over the age of 45. MMSE score < 30. MMSE score ≥ 10. Patient is able to collaborate. No other cognitive comorbidity. No seizure event. Exclusion Criteria: Advanced stage of cognitive decline (MMSE < 10). Any verbal or non-verbal form of objection from patient or form patient's family member or significant other. Presence of several cognitive comorbidity. Damage to integrity of scalp and/or skull. Skin irritation in the facial and forehead area. Significant hearing impairments. History of drug abuse.

Ages Eligible for Study
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Minimum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>Patients who are assessed by the clinical staff using Mini-Mental State Exam (MMSE) | Device: Neurosteer Aurora system<br>* The system is composed of hardware and software modules that facilitate the capture and interpretation of electrophysiological data as well as enable viewing the processed data in real time and offline. An electrode patch is attached on the subject's forehead to capture the electrophysiological signal. The signal is sent via low energy Bluetooth to an EEG Monitor. The signal is then sent via Wi-Fi to the cloud where the data is stored on a HIPAA compliant server. Data analysis performed in the cloud transforms the electrophysiological signal into easily readable data of brain activity, which is accessible via any web interface.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation Between Cognition Level Changes as Evaluated by Current Clinical Tools (i.e. MMSE) and Brain Activity Features Extracted Using the Neurosteer Technology. | Cognition level changes will be evaluated by: Mini Mental State Examination (MMSE). A commonly used assessment tool that evaluates cognitive functioning and produces a total possible score of 30 points. Patients who score below 24 are typically suspected of cognitive decline. Neurosteer system (single channel EEG recording during cognitive auditory tasks). Using data analysis (a variant of the wavelet packet analysis and the best basis algorithm), the EEG signal is transformed into brain activity features (e.g. ST4, A0). Pearson correlation will be calculated between the mean activity of the EEG features and individual's MMSE score. | MMSE score will be taken from previous evaluation performed in the institute. Through study completion, brain activity features will be assessed using the Neurosteer EEG system, in an average of twice a week. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Usability and Tolerability of the Neurosteer System in the Elderly Population | Assessment will be conducted by questioning the subject after the test regarding tolerability to remain with the test equipment for the duration of the test and his ability to respond during the test. | 11 months | 
| Overall Brain Activity in Patients | Brain activity will be measured by the EEG test. Results will be included in statistical analysis that will take into consideration the brain activity as shown in the entire testing period, using power in the known frequency bands (Alpha - Theta). | 11 months | 
| Overall Response to Auditory Stimulation | Brain activity will be measured by the EEG test, and behavioral results will be measured as well using a clicker. Results will be included in statistical analysis that will take into consideration the brain activity using power in the known frequency bands (Alpha - Theta) as well as subject responses to the auditory stimulation as shown in the entire testing period, using known parameters such as reaction times, accuracy and hit rate. | 11 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cognition, Neurology, EEG, Neurosteer