Dr. Dennis Selkoe and Dr. Reisa Sperling lead the Center for Alzheimer's Research and Treatment.

Alzheimer’s disease robs us of our most precious possessions — our memories.  And, like a robbery in the middle of the night, the theft can take place without us realizing it. Dr. Dennis Selkoe, Co-Director, Center for Neurologic Diseases at Brigham and Women’s Hospital (BWH), and Dr. Reisa Sperling, Director of the BWH Center for Alzheimer’s Research and Treatment, recently shared their insights into the latest medical research on Alzheimer’s disease at a lecture sponsored by the McCourt Foundation.

“Current therapies often provide patients with some symptomatic relief for a short period of time, however, none of these treatments slows the progression of Alzheimer’s disease,” says Dr. Sperling. “With nearly 10,000 U.S. baby boomers turning 65 each day, the search for new Alzheimer disease treatments has intensified.”

Finding an effective treatment begins with understanding the biology of Alzheimer’s disease. “We know that there are two brain abnormalities present in patients with Alzheimer’s disease, both of which can recently be seen on brain imaging:  plaques (made up of beta amyloid protein), and neurofibrillary tangles (made up of tau protein),” says Dr. Selkoe.

Most research, according to Dr. Selkoe, has focused on the role of beta amyloid, which has been demonstrated to cause forgetfulness in preclinical studies. Beta amyloid plaques are thought to cause memory problems by interfering with brain activity that occurs in the synapses, the space between nerve cells that allows transmission of information.

Using advanced brain imaging techniques, Dr. Sperling’s research has confirmed that the accumulation of beta amyloid in the brain begins years before diagnosis — before patients even realize what is happening. Further study of these patients finds that their brains are not working normally even at the pre-symptomatic stage.

Dr. Sperling is convinced that earlier treatment, prior to the development of symptoms, is key to helping people with Alzheimer’s disease. This approach, she emphasizes, is consistent with how we’ve made progress with other diseases. She notes that by reducing cholesterol before people develop heart disease, we’ve been able to dramatically reduce cardiac deaths.

“We hope that starting treatment much earlier in the disease, before symptoms are present, as well as treating for a longer period of time, will slow cognitive decline and ultimately prevent Alzheimer’s dementia.”

Earlier this year, Dr. Sperling and her colleagues at the Center for Alzheimer Research and Treatment (CART) at BWH announced they will be leading a study of an amyloid-clearing drug in older people thought to be in the pre-symptomatic stage of Alzheimer’s disease.  The Anti-Amyloid Treatment in Asymptomatic Alzheimer’s disease (A4) trial will study 1000 people, ages 70-85, whose brain scans show amyloid accumulation but who are not experiencing clinical symptoms of the disease.  The patients will be given an experimental amyloid-clearing drug and followed for three years. The trial will take place at 50 sites in the U.S., Canada, and Australia, including BWH.

To learn more about Alzheimer’s disease research:

– Jamie R.

 

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