Can Alzheimer’s Disease Be Slowed by Flickering Lights and Sound?

That’s the central question for Annabelle Singer, an associate professor and biomedical engineer at Georgia Institute of Technology and Emory University.

In her lab at Tech’s campus in Atlanta, Singer aims to deepen our understanding of brain activity patterns and how these change in Alzheimer’s patients. Building upon that, she’s focused on creating new therapeutic methods for the disease.

“We’re taking a really different approach to Alzheimer’s,” she explains. “We’ve found out how crucial neural activity for memory becomes disrupted in Alzheimer’s. We’re using that insight to devise brain stimulation methods that might enhance brain health.”

While major pharmaceutical companies have invested billions into drug therapies, Singer is pursuing an entirely different path. Her method involves a device resembling ski goggles and headphones.

The goggles emit flickering lights at a speed about five times quicker than typical strobe lights, while the headphones introduce a rapid clicking and beeping noise. Through this approach, Singer seeks to decode memory functions in Alzheimer’s patients, using light and sound to investigate how deficiencies in neural activity contribute to memory issues.

This non-invasive sensory stimulation has shown early promise in both preclinical and feasibility studies. Initial tests revealed that flickering lights and sounds at 40 Hz for just an hour a day could actually curb cognitive decline and the loss of brain volume in memory-critical regions.

“Both findings are really promising,” she remarks. “We don’t know if we can reverse existing memory impairment, but our goal is to slow the ongoing decline.”

Singer has long criticized traditional Alzheimer’s medications for their serious potential side effects and less-than-stellar efficacy. She wanted to explore alternatives.

“Most research on Alzheimer’s tends to zero in on the molecular level—like how proteins misfold or accumulate,” she notes. “We’re curious about how neurons electrically function to generate memory and how these patterns shift in Alzheimer’s patients.”

A Phase 3 double-blind clinical trial is currently underway, involving nearly 700 patients across 70 locations in the United States. This study, spearheaded by Cognito Therapeutics, a medtech firm focused on wearable tech, has Singer serving as a scientific adviser on their board.

“The hope,” she states, “is to observe that people receiving this stimulation experience slower or no decline in cognitive function compared to untreated individuals.”

The clinical trial’s completion is expected later this year.

More than 7 million Americans aged 65 and older live with Alzheimer’s disease, a number projected to nearly double to 13.8 million by 2060 unless medical breakthroughs occur. Globally, roughly 57 million people have some form of dementia, with Alzheimer’s being the most prevalent, according to the World Health Organization.

Given the aging population, the urgency for improved treatments is pushing research forward around the globe.

In recent years, the U.S. Food and Drug Administration hastened approvals for new medications like lecanemab and donanemab. However, some doctors remain skeptical about whether the modest improvements observed in trials justify the risks, especially when these drugs can cause severe side effects like brain swelling or bleeding.

Lecanemab reportedly slowed cognitive decline by 27% over 18 months compared to those not on the drug, while donanemab users with mild cognitive issues showed about a 35% reduced risk of disease progression.

The steep cost of around $30,000 per year for these therapies has raised concerns about their accessibility for many patients.

Continuing research in next-generation treatments is active, with organizations like the Mayo Clinic suggesting that future Alzheimer’s therapies might involve a mix of various medications.

Nearby Singer’s lab, James Lah serves as the director of the Cognitive Neurology Program at Emory University and is an associate professor of neurology. He worked with Singer on an earlier proof-of-concept study a few years back, assessing 10 patients with mild cognitive impairment who engaged in the flickering lights and sound trials for an hour daily over eight weeks.

“This was the inaugural human trial of this technology,” he explains.

The results indicated that the flickering had positive outcomes, as evidenced by both spinal fluid tests and electroencephalograms (EEGs) of the participants.

“We observed some intriguing changes in how electrical connectivity patterns evolved in patients post-stimulation,” Lah mentions.

This research has laid the foundation for the ongoing Phase 3 trial, which he finds incredibly interesting, although he isn’t a principal investigator.

A Love of Lights and Sound

Since her teenage years, Singer has had an affinity for lights and sound.

Growing up in Boxborough, Massachusetts, a small town about 25 miles northwest of Boston, she initially intended to work in theater, focusing on set design.

Her high school lacked a robotics team or advanced engineering programs, but it did have a theater. Singer was drawn to the stage, not through acting, but through the magic of lighting and sound working together.

“The magic of theater comes from the sets, lights, and sounds,” she reflects. “It creates an entirely new world, and I love that. I still do.”

Eventually, she pursued a career in biomedical engineering, attending Wesleyan University, with further studies at the University of California, San Francisco, and post-doctoral work at MIT.

About 20 years ago, her path shifted while she was observing rounds at the UCSF Fein Memory and Aging Center, where she witnessed the detailed testing Alzheimer’s patients underwent.

“It was a profoundly educational experience,” Singer recalls. “I saw how complex the work was, yet they had little to offer their patients.”

This lack of viable treatment options left a lasting impression. “I thought, ‘Wow, there’s a significant gap in addressing Alzheimer’s,’” she says. “I wanted to help fill that gap.”

Her passion for light and sound has now come full circle, shaping her innovative method to aid millions affected by Alzheimer’s.

“In theater, it was about controlling audience perception,” she explains. “In neuroscience, it’s about guiding how an individual experiences something, allowing us to measure their reactions.”

Her work is founded on years of established research demonstrating that flickering lights can stimulate neural activity in visual areas of the brain. Yet, she points out, the visual cortex isn’t the target in Alzheimer’s research, necessitating further innovation.

“Ultimately, we discovered that combined light and sound at 40 Hz could penetrate the hippocampus, a critical memory area,” she notes.

During feasibility tests, the most common side effect was headaches. In trials with those who have seizure disorders, rather than triggering seizures, the flickering lights appeared to reduce subclinical seizure activity. Her research into the underlying reasons for this continues.

For patients with Alzheimer’s, she acknowledges the critical role of drug research, but adds, “To me, it hasn’t adequately tackled how we address memory and learning impairments.”

“We’re really excited about how accessible this potential intervention could be,” she says, referring to the goggles. “If we have a low-risk option, that could really change things.”

Only time will reveal if her research withstands scrutiny through the ongoing clinical trial.

Lah, the Emory neurologist, is intrigued by what he’s seen thus far.

“The concept of using external stimuli to alter brain activity is captivating,” Lah states. “It’s just fascinating. Some things genuinely are.”