Unlocking Alzheimer's Mysteries

Animalicious Cow writes "A shunt implanted in the skull of a patient with Alzheimer's could be the first treatment that actually fixes what's broken in the brain rather than simply masking symptoms of the debilitating disease."

Comments

Unlocking...

[gregh76]

...what?

hm

[TaraByte]

it gives a new meaning to brain-drain.

Shunt

[PD]

Sort of like a brain bypass? har har

Seriously, the article talks about a protein that is the cause of the degeneration of brain cells. That's news to me. When was this protein discovered, and does anyone know of other ways of fixing the problem that people are working on? This is pretty cool. I think we might be on the verge of curing many diseases - alzheimers, thyroid imbalances, diabetes. But probably not the common cold though.

Re:Shunt

[AssFace]

must have been prior to '95 because I know all through while I was in college they were teaching it in neuroscience.

it is similar in many ways (but slower) to the prions that Mad Cow disease involves.

Ceribro-dialysis

[wowbagger]

This makes me wonder if you couldn't do something along the lines of hemodialysis - slowly feed in a synthetic ceribro-spinal fluid, and then drain off the contaminated CSF.

Any doctors in the house?

Re:Ceribro-dialysis

[brianjcain]

Sounds good to me. But it'd probably be called "encephalo-dialysis," right?

Re:Ceribro-dialysis

[Muhammar]

1) cerebro-

2) injecting anything into brain through catheter would cause HUGE risk of infecion.

They just milk the brain. The system is closed (outlet into stomach) for the reason 2)

There is another disease where this approach works: hemochromatosis.
Genetic defect in hemochromatosis patients causes iron overabsorbtion, which would gradualy kill them. Bleeding these patients regularly saves their lives.

http://www.cdc.gov/nccdphp/dnpa/hemochromatosis/

Now they even allow hemochromatosis patient blood to be donated to bloodbanks.

Re:Ceribro-dialysis

[Op911]

I'd have to express a hefty degree of skepticism about the purported mechanism of this kind of device in treating Alzheimer's disease. As mentioned in the article shunts are successfully used in a condition known as hydrocephalus to reduce abnormal CSF pressure in the brain which can certainly cause a dementia-like picture that can mimic Alzheimer's disease. Alzheimer's disease isn't just caused by evil humors... we don't know the actual pathophysiology yet and are only beginning to work it out by analyzing the debris in the aftermath of the biochemical accident that takes place. These theories of increased tau and beta amyloid deposition cascading into decreased CSF production and creating more deposition are certainly possible but they are just that - theories, and are not the primary avenues of research in Alzheimer's disease today either.

More important to address is the implication in the Wired article that there was a benefit in this treatment from the trial they mention. (1) This trial was not an randomized controlled trial powered to determine efficacy or lack thereof but rather a trial to determine safety. (2) There was only a trend to benefit that was not statistically significant. (3) Most importantly the treatment group had 3 patients excluded from the analysis for various reasons and were not included in the final analysis. In other words, the statistical analysis performed was not an intention-to-treat analysis which is the gold standard we use in looking at the validity of the result of a trial. Were an intention to treat analysis performed there very well might have been no benefit seen. The editorial in the journal where the original trial was published expressed skepticism, although it also encouraged the researcher to continue with their work and pursue a larger trial with more patients to better assess benefit.

In other words, this treatment is barely in alpha-testing and the follow-up trial to be performed by the Eunoe people will determine if it will see the light of day.

Having said that this trial is a breath of fresh air from the ongoing pursuit of cholinesterase inhibitor medications and it would be a major breakthrough it it works. I'm just not going to hold my breath.

Re:interesting

[PD]

Except that it's wrong. New brain cells can form in adult brains.

Yikes

[barakn]

I found myself wondering how the CSF was transported all the way from the brain to the peritoneum, and then I saw the diagram of the tube that runs underneath the skin.

"Wow, grandpa, you're ripped. Look at that vein in your pectoral muscle.... wait, that's not a vein! Gross!"

I hope they perfect the anti-amyloid vaccines.

Re: Yikes

[Bowling Moses]

Not going to happen. Vaccines work against viruses; Alzheimers disease is thought to be caused by the formation and accumulation of amyloid plaques between neurons. The amyloid plaque itself is a great big gamish of improperly folded proteins. Alzheimer's patients can't properly dispose of them, or perhaps the systems that do dispose of them are overtaxed and the problem is in why they form in such size (I don't work on Alzheimer's--the 2nd one's just a guess). A couple other diseases have at some stage a buildup of misfolded proteins; Amyotrophic lateral sclerosis (ALS) aka "Lou Gehrig's Disease" is one such example, multiple sclerosis is another.

Re: Yikes

[barakn]

Perhaps you should have looked at the second page of the article. It briefly mentions the trial of a vaccine against amyloid. Unfortunately some people died, but the treatment may still be helping the other recipients in the study. Your characterization of a vaccine is incomplete. They also work against bacteria (Anthrax, Botulism, Cholera, Tetanus, etc.) and have been employed against cancer (with limited results to date). Antisera are commonly used against toxins from Black Widows, snakes, etc.. And work continues on vaccines against some of the eukaryotic diseases like malaria. Vaccines have a great medical potential that has only been partially realized.

Re: Yikes

[Bowling Moses]

Hmm...I followed that link on the 2nd page, and sure enough, you're correct. Never really thought about it that way--when you vaccinate against a virus, you use "killed" virus or artificially synthesized virus protein coat to provoke an immune response. The same approach could work for other things as well. For bacteria or a eukaryotic pathogen I imagine you'd pick something it expresses in quantity on the cell membrane or something it excretes; for antivenoms I think the case currently is different. Some are still made by injecting some poor critter with ever increasing doses of the toxin, making it produce antibodies against it. There's a somewhat newer approach where (insert favorite organism here) is transfected with DNA to produce human antibodies that are specific to only one portion of the venom; antiserum made this way is less likely to cause anaphylactic shock as it contains a only single type of human antibody. Developing a vaccine against toxins is intriguing, just take a nonfunctional part of one of the toxin proteins and use that to provoke an immune response, yes?

grandpa simpson

[Minn_Kota_Marine]

I have a son about your age.

Fascinating idea...

[dacarr]

Considering that the jury is apparently still out on aluminum contributing or causing alzheimer's disease, this is an interesting concept.

Better Symptomatic Treatment

[E. T. Alveron]

I disagree with the author's claim that this "fixes what's broken" in an alzheimer's patient.

From what I can tell, the shunt drains excess cerebrospinal fluid, which prevents (harmful) protein deposition. However it doesn't restore a healthy equilibrium of CSF production and consumption.

Re:Better Symptomatic Treatment

[p7]

The article does say that the shunt increases CSF production, by filtering out the offending proteins and sending them to the peritoneum. Obviously the article lacks some details of the process. For one it starts off saying that the shunt drains CSF from the brain a drop every minute. It then mentions how this process will increase CSF replenishment. My guess is that these drips are less than the increased CSF that removing the proteins provide.

sounds good

[brmic]

though i usually resent brain surgery, cause long term effects are usually disregarded in the excitement of the moment (Moniz's and Degas' lobotomy being a prime example) and the joy over apparent short term effects, this seems a minor problem with morbus Alzheimer. Still, the treatment at best will stop the accumulation of plaque in the brain, not restore the "original" state. The major problem with this is imho, that any successful temporary cure of symptoms will draw money from research into causes of m. alzheimer and effective preventive methods. Then again, this seems to be what we do all along, finding a fix and moving on, and look what we've come to.

Re:sounds good

[c.emmertfoster]

though i usually resent brain surgery

Yes, every time I recieve brain surgery I also harbor bad feelings...?

What's the verdict, Doc?

[Anonymous Coward]

Doctor: I have two pieces of very bad news for you.

Patient: What's the first bit of bad news, Doc?

Doctor: I'm afraid you have terminal cancer.

Patient: Ok, so what's the other bad news?

Doctor: I'm sorry to say that you have Alzheimer's disease.

Patient: Heck, that's not so bad. At least I don't have cancer.

I came out here...

[AragornSonOfArathorn]

I came out here to post something, but I forgot what it was....