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It has been found that a medical instrument known as a PIB-PET can detect amyloid-beta protein deposits. These deposits are linked with Alzheimer’s and many believe that they are the cause of Alzheimer’s. The deposits do predict who will develop the Alzheimer’s disease.

The findings are the result of a survey of over 100 studies which use the instrument, these confirm the sensitivity of the PIB-PET tool. It is a great leap forward as previous to this it was only possible to detect the deposits of Amyloid by autopsy.

Helpfully the study also helps to strengthen the evidence supporting the amyloid hypothesis. This is the theory that it is the accumulation of the amyloid-beta protein plaques within the brain which causes the disease to occur. There are several important pieces of evidence that tend to refute the amyloid theory, these are that amyloid deposits do not correlate with how strongly the disease shows itself, and they are also found within people who did not have any Alzheimer’s symptoms., and that drugs which remove this plaque from the brain have had poor results in helping Alzheimer’s sufferers.

Co-author Gil Rabinovici is quoted as saying “Our survey of PIB-PET studies, which looked cross-sectionally and longitudinally at people with normal cognitive performance, mild cognitive impairment and full-fledged Alzheimer’s disease, showed that amyloid deposits can be detected in a significant proportion of cognitively normal older adults, and that their presence is associated with Alzheimer’s-like brain atrophy and changes in brain activity,”. He is assistant professor of neurology in the UCSF Memory and Aging Center.

The study indicated that more elderly individuals with amyloid deposits were more likely to show the cognitive decline which is associated with Alzheimer’s than their “amyloid-negative” counterparts.

The results of this study were reported in the journal Behavioral Neurology (vol. 21, Issues 1-2, 2009), and it could explain why it is that patients with Alzheimer’s disease have not responded to promising experimental drugs that target amyloid, as it could be that the drugs need to be administered earlier to be effective. This is because the Amyloid deposits could be doing there damage silently to start with and by the time that symptoms are appearing the damage could already have been done. So this suggest that by having and using the PIB-PET tool to diagnose Alzheimer’s early it could mean that the drugs can be used to reduce the accumulation of Amyloid and ultimately stop someone from getting Alzheimer’s

The current crop of drugs (e.g. Aricept, Exelon and Razadyne) only target the symptoms they do not help with the underlying cause of the disease. While many treatments which are currently under development, focus on the amyloid deposits in an attempt to arrest further decline. However currently, these treatments have failed to provide useful results two phase III clinical trials with mild-to-moderate Alzheimer’s disease.

The PIB-PET instrument procedure involves injecting a tracer material called Pittsburgh compound B (PIB) into the brain by the bloodstream, then the brain is imaged with positron emission tomography (PET). The PIB compound will bind to amyloid-beta protein plaques, and send a signal which can then be detected by the PET scanner and shown as an image.

Unfortunately these technique are still very much in the early stages and are not ready to be used on individuals who do not suffer from the effects of Alzheimer’s, as the benefits of this treatment have not been demonstrated in clinical trials.

Tags: Alzheimer's by Matias
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Research has been pioneered at the University of Sunderland which shows that exposure to safe low levels of infra-red light can improve the cognitive functions of the brain. The current state of play with medical treatments for dementia is that they slow the deterioration of the brain, while this treatment could potentially reverse the effects of illnesses such as Alzheimer’s.

The infra-red would be delivered via a lightweight helmet at home for only 10 minutes per day. This new device was created by Dr. Gordon Dougal, who is a director of Virulite ( a medical research company). The idea originally came from his work with cold sores, where infrared was used to boost the cells with the body, which killed the cold sore virus.

The study itself was of middle-aged mice, they were exposed to infrared light for 6 minutes during the day for 10 days. This improved their performance in a three-dimensional maze.

Further research is being carried out in this area, it is funded by CELS, who support research and development in universities, companies and hospitals within the North East of England.

Bottom line: Study was done in mice, so very preliminary, but a human trial will be starting in Summer 2008.

Tags: Alzheimer's by Matias
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A new study has been published which documents an impressive improvement in Alzheimer’s disease by administering the drug Etanercept (trade name Enbrel). This follows from another study conducted in 2006 mentioned below.

The study identifies the importance of cytokines in the Alzheimer’s disease. One of these cytokines called tumor necrosis factor-alpha (TNF) is implicated. It is a critical component on the brains immune system. Its standard role is to regulate the transmission of impulse in the brain. However in Alzheimer’s patients there are elevated levels of TNF, and this interferes with the regulation. The authors of the paper postulated that reducing the level of TNF would reduce the symptoms of Alzheimer’s patients. So they gave patients an injection of an anti-TNF therapeutic drug called Etanercept.

The effects on the Alzheimer’s patient documented were dramatic and unprecedented; with improvements within minutes, following the injection of Etanercept to the spine. Previous to the dosage of the drug the patient could not perform simple mental addition, or recall more than 2 animals. 10 minutes after the dose of the drug, the patient was noticeably calmer, less frustrated and attentive. He knew the day of the week and month and that he was living California, he could name five animals, and his performance improved on arithmetic tests.

While the study discusses one patient, previous studies have indicated improvements also. A study done in 2006, called TNF-alpha Modulation for Treatment of Alzheimer’s Disease: A 6-Month Pilot Study showed significant improvement with treatment as measured by primary efficacy variables through the 6 months of the treatment.

However Etanercept may reduce the response of the immune system. The most common side effects of this drug are mild to moderate itching, swelling, pain and redness at the injection side. Also headache, dizziness , nasal and throat irritation may also occur. Look at the main site for Etanercept (Enbrel) for the full list.

Also one open question is what is causing the elevated levels of TNF? TNF may not be the root cause of the problem and if so the effect on the patient may only be temporary.

As Etanercept is already approved as a drug for rheumatoid arthritis it has passed through the regulatory hurdles which make the time to general availability so long. This means that this therapy could potentially be available in the very near future. Also the fact that this drug is still under patent would give Amgen and Wyetha a huge incentive to fund studies which would speed the progress of this to be an acceptable treatment for Alzheimer’s.

Tags: Alzheimer's by Matias
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One promising potential treatment for Alzheimer’s has been developing over the past few years. This is using a vaccine to reduce the level of beta-amyloid. Beta-amyloid is found to be in high quantities in patients with Alzheimer’s and is theorised to be the main cause of Alzheimer’s. This treatment trains the immune system to recognize and attack beta-amyloid. A compound by Elan named AN-1792 showed promising results in animal models of the disease, and initial human trials where also positive, however development has now stopped as 6% of patients had an averse immune response. The final report into AN-1792 can be found here The results indicated that the treatment reduced the effect of Alzheimer’s.

Elan is now working on a similar compound AAB-001 which they hope will cause a smaller immune response. They are entering into Phase 3 clinical trials. The results of the phase 2 trials will not be done until 2008, however the fact that Elan are going ahead with Phase 3 suggests that it is performing well in Phase 2.

AAB-001 is not the only compound out there, here is an extract from Elan’s fourth quarter report about other compounds which Elan (with partners) has in the pipeline:

Elan, in conjunction with its partners, is moving three compounds for mild to moderate AD through clinical trials: Bapineuzumab (AAB-001), ACC-001, and ELND-005. In distinct ways, these three compounds target A-beta peptide, which is presumed to be a key toxic mediator in the brain of Alzheimer’s patients.

With Bapineuzumab (AAB-001, a humanized monoclonal antibody against A-beta peptide), Elan and Wyeth plan to initiate global Phase 3 clinical trials by year-end, Phase 2 studies are ongoing (publicly available data anticipated mid-2008), and Phase 1 trials are underway with a subcutaneous formulation. ACC-001 (an active A-beta immunotherapeutic conjugate), also partnered with Wyeth, is progressing in Phase 2 studies in both Europe and the United States.

Next update on this treatment: 2008

Tags: Alzheimer's by Matias
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Alzheimer’s is another terrible age related disease, it causes a deterioration of mental abilities, including eventually the ability to take care of oneself on a daily basis, it may also involve personality changes. The risk of developing the disease doubles every 5 years past the age of 65, and some studies estimate that up to 50% of people 85 years and older have Alzheimer’s. But there are various steps you can take to reduce the risk getting Alzheimer’s.

• Engage in intellectually stimulating activities.
• Engage in social activity.
• Exercise regularly.
• Keep your cholesterol and homocysteine levels low.
• If your blood pressure is high, take measures to reduce it.
• If you have diabetes make sure it is controlled well.

For the research which led to these steps please go to the National Institute of Aging, the rest of this article will focus on the first point. There are many different methods to go about finding intellectually stimulating activities. Many people have already discovered the advantages of these types of activities, for example Brain Age, a set of numerical and analytical games for the Nintendo ds, has sold over 3 millions copies only 15 months after launch. Alternatively there are free sites which provide different challenges for you to master. One pointer from the studies is for there to be variety, and for novelty, for the greatest benefit. Here is a list of some activities to start you off:

1. Close your eyes and navigate to another rooms in your house by touch alone.
2. Use your other hand with your mouse
3. Enrol in a course at your local college, choose something you would never ordinarily do.
4. Learn your local neighbourhood, can you name all the streets within one mile?
5. Next time you go to the supermarket, add up all your purchases as you go along and see how closely you got the the total at checkout.
6. Star estimating numbers of objects as you go about your daily business, how many windows you can see.
7. Try and guess what people are thinking as you are walking around.
8. Go to epicurious and find a recipe you have never tried before and make it.
9. Learn to draw
10. Make a new list of 10 activities to do.

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