Brain & Spine Surgery
Alzheimer’s disease (AD) could be the next frontier for deep brain stimulation (DBS) therapy.
A small phase 1 pilot study showed that some patients with AD who received constant stimulation to the fornix — the principle outflow tract from the hippocampus — had increased hippocampal volume after 1 year.
There was also some evidence that this increased hippocampal volume correlated with cognitive benefit.
Two novel, noninvasive, and relatively simple eye tests show promise as potential screening tools for early Alzheimer’s disease (AD).
Preliminary results from 2 studies presented here at the Alzheimer’s Association International Conference (AAIC) 2014 show that beta-amyloid detected in the eyes significantly correlated with the burden of beta-amyloid in the brain, allowing investigators to accurately identify individuals with AD.
In the first study, researchers at the Commonwealth Scientific and Industrial Research Organization (CSIRO), Australia’s national science agency, used curcumin fluorescence imaging to highlight beta-amyloid in the retina and correlated these results using Pittsburgh compound B (PiB) positron emission tomography (PET) imaging findings in the brain.
Infants and toddlers with the Alzheimer’s disease-associated APOE4 genotype already showed distinctive patterns of brain structure relative to other young children, researchers said.
MRI scans carried out in 60 normally developing children, age 2 to 25 months, who carried the APOE epsilon-4 allele, showed smaller volumes of gray matter and and lower white matter myelin water fraction (MWF) compared with 102 children in the same age range whose APOE genes only include the epsilon-2 and/or epsilon-3 alleles, according to Sean C. L. Deoni, PhD, of Brown University in Providence, R.I., and colleagues.
“While our findings should be considered preliminary, this study demonstrates some of the earliest brain changes associated with the major genetic risk factor for late-onset Alzheimer’s disease,” the researchers wrote online in JAMA Neurology.
“Could a scoop of peanut butter and a ruler become that elusive test?”
If you treat the elderly, or any member of the growing number of families devastated by Alzheimer’s disease, you may be asked some version of that question, as posed by CBS News, in the coming weeks. You can thank media coverage of a study in the Oct. 15 issue of the Journal of Neurological Sciences titled “A Brief Olfactory Test for Alzheimer’s Disease.”
Here’s that brief olfactory test, as the CBS headline suggests: “A container of 14 g of peanut butter was opened, held medially at the bottom of a 30 cm ruler, and moved up 1 cm at a time during the participants’ exhale. Upon odor detection, the distance between the subject’s nostril and container was measured.”
The US Food and Drug Administration has approved an expanded indication for the rivastigmine transdermal system (Exelon Patch, Novartis Pharmaceuticals Corporation) to include patients with severe disease.
Approval of this new indication for the 13.3 mg/24h dose rivastigmine patch means it can be used across all stages of disease, making it the only transdermal therapy that can be used across all stages of disease, the company notes in a statement. The patch is already approved for patients with mild to moderate dementia of the Alzheimer’s type and for patients with mild to moderate dementia associated with Parkinson’s disease.
A new study adds to a growing body of evidence pointing to small-vessel cerebrovascular disease as an important contributor to Alzheimer’s disease (AD).
The study shows that increased total white matter hyperintensities (WMHs) as seen on MRI independently predicted AD diagnosis, as did the brain amyloid tracer Pittsburgh compound B (PIB) measured by positron emission tomography (PET).
This finding suggests that although amyloidosis is necessary for a diagnosis of AD, it may not be sufficient to cause dementia and that WMH may represent another important pathogenetic factor that contributes to dementia.
“This study, along with a whole line of research that is coming out right now, is clearly highlighting the importance of vascular disease in Alzheimer’s disease,” said author Adam M. Brickman, PhD, assistant professor of neuropsychology at Columbia University, New York.
Regular exercise reduces the development of painful diabetic neuropathy in animals—apparently related to increased expression of a protective substance called “heat shock protein” 72 (Hsp72), reports an experimental study in the February issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).
The observations add to previous studies suggesting that “progressive exercise training markedly decreased diabetes associated neuropathic pain,” write Yu-Wen Chen, PhD, of China Medical University, Taichung, Taiwan, and colleagues. The link to Hsp72 offers a clue as to how exercise can prevent or slow the development of neuropathy—a major complication of diabetes.
Exercise Reduces Diabetic Nerve Pain in Rats
Neuropathic pain is a common and difficult-to-treat type of pain related to nerve damage—most commonly caused by diabetes. Affecting about half of patients with diabetes, diabetic neuropathy causes symptoms such as numbness, tingling, or pain in the arms and legs.… [Continue Reading]
The number of people with Alzheimer’s disease is expected to triple in the next 40 years, according to a new study published in the February 6, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.
“This increase is due to an aging baby boom generation. It will place a huge burden on society, disabling more people who develop the disease, challenging their caregivers, and straining medical and social safety nets,” said co-author Jennifer Weuve, MPH, ScD, assistant professor of medicine, Rush Institute for Healthy Aging at Rush University Medical Center in Chicago. “Our study draws attention to an urgent need for more research, treatments and preventive strategies to reduce this epidemic.”
For the study, researchers analyzed information from 10,802 African-American and Caucasian people living in Chicago, ages 65 and older, between 1993 and 2011. Participants were interviewed and assessed for dementia every three years. Age, race and level of education were factored into the research.… [Continue Reading]
‘Brain pacemakers’ trialled as way of staving off memory loss from Alzheimer’s disease
IT HAS the makings of a science fiction movie: Zap someone’s brain with mild jolts of electricity to try to stave off the creeping memory loss of Alzheimer’s disease.
And it’s not easy. Holes are drilled into the patient’s skull so tiny wires can be implanted into just the right spot.
A dramatic shift is beginning in the disappointing struggle to find something to slow the damage of this epidemic: The first US experiments with “brain pacemakers” for Alzheimer’s are getting under way. Scientists are looking beyond drugs to implants in the hunt for much-needed new treatments.… [Continue Reading]
Three-fourths of patients with Alzheimer’s disease or frontal-lobe degeneration had MRI-detected biomarker levels that correlated with the diagnoses, suggesting MRI has potential as a screening tool for the conditions, investigators reported.
MRI-predicted values for total tau and β-amyloid ratio (tt/Aβ) in gray matter correctly pinpointed the diagnosis in 75% of patients with genetically or neuropathologically confirmed diagnoses, according to Corey McMillan, PhD, of the University of Pennsylvania in Philadelphia, and colleagues. Predicted values also had good correlation with actual tt/Aβ measured in cerebrospinal fluid (CSF), they said.
The findings are consistent with previous in vivo and autopsy studies of CSF tt/Aβ, the group reported in the Jan. 8 issue of Neurology.