Alzheimer’s: Can Flickering Lights and Sound Slow Decline?

A team of researchers is exploring a novel approach to slowing the progression of Alzheimer’s disease: flickering lights and sound. The non-invasive technique, spearheaded by biomedical engineer Annabelle Singer at Georgia Institute of Technology and Emory University, aims to stimulate brain activity and potentially improve cognitive function in patients.

Singer’s work centers on understanding how neural activity patterns change in the brains of Alzheimer’s patients and leveraging that knowledge to develop targeted brain stimulation. Unlike traditional pharmaceutical approaches, which have invested billions in drug therapies, Singer’s method utilizes a device resembling ski goggles and headphones to deliver precisely timed flickering lights and sounds.

“We are taking a really different approach to Alzheimer’s,” Singer explained. “We’ve determined how neural activity that is essential for memory fails in Alzheimer’s disease. We’re then using that information to develop brain stimulation that could improve brain health.”

The device emits flickering lights at a rate approximately five times faster than a typical strobe light, accompanied by rapid clicking or beeping sounds. This sensory stimulation is designed to “decode” memory processes in Alzheimer’s patients and pinpoint how disruptions in neural activity contribute to memory impairment. Early trials have shown promising results, suggesting the technique can slow cognitive decline and reduce brain volume loss in areas crucial for memory.

A feasibility study found that an hour a day of 40 Hz flickering light and sound showed potential to slow cognitive decline. “Both those things are really promising,” Singer said. “We don’t know that People can reverse the memory impairment that’s already there. Instead, what we’re going for is to slow the continuing decline.”

Singer’s interest in this unconventional approach stems from a skepticism towards the potential side effects and limited efficacy of many Alzheimer’s medications. She shifted her focus to exploring alternative methods that could address the underlying neural mechanisms of the disease. “The majority of research on Alzheimer’s disease focuses on the molecular scale — how proteins accumulate or go wrong,” she said. “We’re asking, how do neurons behave electrically to generate memory and how do those patterns change in Alzheimer’s patients?”

Currently, a Phase 3 double-blind clinical trial, involving nearly 700 patients across 70 locations in the United States, is underway. The study is being led by Cognito Therapeutics, a medtech company specializing in wearable devices. Singer serves as a scientific advisor to Cognito, but does not directly lead the trial.

The potential impact of this research is significant, given the growing prevalence of Alzheimer’s disease. More than 7 million Americans age 65 or older currently live with the disease, a number projected to nearly double to 13.8 million by 2060, according to projections. Worldwide, some 57 million people are living with dementia, with Alzheimer’s being the most common form.

While pharmaceutical companies have recently gained FDA approval for new medications like lecanemab and donanemab, some doctors have expressed reservations about their modest benefits and potential risks, including life-threatening swelling or bleeding in the brain. These therapies also come with a hefty price tag of around $30,000 a year, making them inaccessible to many.

Singer’s approach offers a potentially more accessible and less invasive alternative. The initial proof-of-concept study, conducted in collaboration with James Lah, director of the Cognitive Neurology Program at Emory University, evaluated 10 patients with mild cognitive impairment. The results indicated beneficial changes in both patients’ spinal fluid and brain-wave tests (EEGs) after exposure to the flickering lights and sound.

“We saw some really interesting changes in the patterns of electrical connectivity in patients after being exposed to this flicker,” Lah said. “The whole notion of using external stimulation to modify brain activity is fascinating. It’s just cool.”

Singer’s journey into this field began with a long-held fascination with lights and sound, stemming from her teenage years and involvement in theater. While she initially considered a career in set design, she ultimately pursued biomedical engineering, driven by a desire to understand the underlying mechanisms of memory and cognition.

A pivotal moment came during her time at UCSF Fein Memory and Aging Center, where she witnessed firsthand the limitations of existing treatments for Alzheimer’s patients. “It was a really educational experience for me,” Singer recalled, “because I saw both how sophisticated all their work was. At the same time, they had almost nothing to offer their patients.”

This realization fueled her determination to explore new avenues for treating the disease. Her research builds upon decades of established science demonstrating the impact of flickering lights on neural activity, but she innovated by combining light and sound at a specific frequency (40 Hz) to target the hippocampus, a brain region essential for memory.

While the feasibility study reported some headaches as a side effect, testing on individuals with seizure disorders revealed that the flickering lights did not trigger seizures, and even showed a decrease in subclinical seizure activity. Further research is ongoing to understand this phenomenon.

Singer believes her approach addresses a critical gap in Alzheimer’s treatment by focusing on the fundamental neural processes underlying learning and memory impairment. “One of the things that we’re really excited about is how accessible this potential intervention is,” she said, referring to the potential for a wearable device. “If we have a very safe, low-risk intervention, then I think that changes the equation.”

The results of the ongoing Phase 3 clinical trial are expected later this year, and will be crucial in determining the future of this innovative treatment approach.