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Participants received either full-pressure ECP (150-300 mmHg) or sham (25 mmHg): 3-5 weekly one-hour sessions for 35 treatments, then twice-weekly through six months. Assessments occurred at baseline and weeks 6, 12, 18, 24, 36, and 52. Primary endpoints included ADCS-ADL, ADAS-cog-14, and VADAS-cog.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Full-pressure ECP significantly improved ADCS-ADL scores versus sham (mean change 2.57 vs. -0.49; p=0.036) and VADAS-cog scores (9.95 vs. 5.22; p=0.005) at 12-24 weeks. Benefits persisted through 52 weeks despite treatment cessation at 6 months. No serious device-related adverse events occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Full-pressure ECP therapy significantly improved cognition and ADL compared to sham treatment in early AD. ECP represents a novel therapeutic approach warranting further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15333175261451918","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T19:02:14Z","timestamp":1778785334000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of Clinically Diagnosed Alzheimer\u2019s Disease by External Counterpulsation A Randomized Clinical Trial"],"prefix":"10.1177","volume":"41","author":[{"given":"Jack E.","family":"Juni","sequence":"first","affiliation":[{"name":"Medical Device Development, Renew Research, LLC, Farmington Hills, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey M.","family":"Burns","sequence":"additional","affiliation":[{"name":"University of Kansas Alzheimer's Disease Center, University of Kansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H.","family":"Salat","sequence":"additional","affiliation":[{"name":"MGH\/MIT\/HMS Athinoula A. 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