Behind The Research: Study Looks At Fighting Alzheimers Disease In A New Way
In the first preclinical study of its kind, Dr. Isabelle Aubert, senior scientist at the Sunnybrook Research Institute, and PhD student Kristiana Xhima used focused ultrasound to deliver a treatment deep inside the brain to help boost the health of brain cells affected by Alzheimers disease.
The study has been published in Science Advances.
According to the Public Health Agency of Canada, Alzheimers disease impacts 419,000 Canadians who are 65 years and older. Its estimated nine Canadians are diagnosed with dementia every hour.
Hallmarks of a brain with Alzheimers disease are plaques and tangles of toxic protein that develop and eventually prevent areas of the brain from producing nutrients and sending signals involved in the health of brain cells and communication. This causes brain cells to degenerate and die, which over time can affect how the brain functions. Most commonly, thinking, learning and memory are affected. Alzheimers disease has an impact on all aspects of a persons life.
Dr. Aubert and Kristiana Xhima share their insight and thoughts on their study.
What did your study find?
What does this mean for patients and their families?
How significant are these findings?
Kristiana Xhima: If were able to target Alzheimers disease early on, it could help with brain health in the long term. We can potentially protect these neurons early in the disease so that later on theyre healthier.
Final Stages Of Alzheimer’s
In the final stages, people may lose the ability to feed themselves, speak, recognize people and control bodily functions. Memory worsens and may become almost non-existent. Constant care is typically necessary. On average, those with Alzheimer’s live for 8 to 10 years after diagnosis, but this terminal disease can last for as long as 20 years.
Dementia: What Part Of The Brain Is Under Attack
Part 2 in our series on Dementia. Check out Part 1.
In the diagnosis list, dementia can be clearly stated or there may be other disorders highly linked to dementia, causing the resident to present with the same signs and symptoms. I want you to be able to recognize the types of dementia and the disorders linked to dementia so you can be adequately prepared to understand the residents needs and modify the treatment approach accordingly.
The Alzheimers Association recognizes these types of dementia:
- Alzheimers dementia: most common, 60-80% of known cases
- Vascular dementia: second most common, 10% of known cases
- Dementia with Lewy bodies
- Mixed dementia: commonly Alzheimers with Vascular dementia
- Frontotemporal dementia
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Hippocampal Asymmetry In Ad
Although hippocampus is structurally and functionally asymmetric, right vs. left hippocampal volume differences have received less research attention. In healthy adults there is hemispheric asymmetry of the whole hippocampus, with larger volume of the right one . There are also right vs. left differences in the layers thickness and volumes of different hippocampal subfields. For instance, Lister et al. identified asymmetries in neuronal numbers in rat CA1 and CA3/CA2 subfields, with the right hemisphere containing 21 and 6% fewer neurons, respectively .
Hippocampal volume asymmetry has been connected with cognitive functions and it has been suggested that hippocampal subfields analysis should be included in these correlation studies. For instance, Woolard and Heckers in a study of 110 healthy individuals of 32.3 ± 10.7 years of age demonstrated that the R > L asymmetry is limited to the anterior hippocampus and it is correlated with a measure of general cognitive functions . Moreover, they showed that the volume of anterior hippocampus correlates with the volumes of all four cortical lobes, whereas the posterior hippocampus volume was found strongly correlated with the volume of occipital cortex .
What Happens To The Brain In Alzheimer’s Disease
The healthy human brain contains tens of billions of neuronsspecialized cells that process and transmit information via electrical and chemical signals. They send messages between different parts of the brain, and from the brain to the muscles and organs of the body. Alzheimers disease disrupts this communication among neurons, resulting in loss of function and cell death.
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Dementia Symptoms And Areas Of The Brain
Knowing how different types of dementia affect the brain helps explain why someone with dementia might behave in a certain way.
Dementia and the brain
Until recently, seeing changes in the brain relied on studying the brain after the person had died. But modern brain scans may show areas of reduced activity or loss of brain tissue while the person is alive. Doctors can study these brain scans while also looking at the symptoms that the person is experiencing.
The most common types of dementia each start with shrinkage of brain tissue that may be restricted to certain parts of the brain.
Where To Go What To Eat
The question becomes what makes some cells vulnerable to Alzheimers pathology, while other cells appear to resist the destruction of the tau proteins for years.
The team at UCSF studied brain tissue from people who had died from different stages of Alzheimers disease.
In a brain region called the entorhinal cortex, located in the medial temporal lobe, which is one of the first areas attacked by Alzheimers, the researchers identified a certain subset of neurons that began to dissipate very early on in the disease. In the later course of the disease, researchers found that a similar group of neurons were also first to die when degeneration reached the brains superior frontal gyrus.
In both regions, these vulnerable cells were distinguished by a protein called RORB.
Our discovery of RORB for these selectively vulnerable cells gives us the opportunity to study in detail exactly why they succumb to tau pathology, and what could be done to make them more resilient, said researcher Kun Leng, of the Department of Neurology in the UCSF Weill Institute for Neurosciences.
Though it is not clear whether RORB itself causes vulnerability in some cells, it provides a new molecular handle for future studies to understand what makes these cells succumb to Alzheimers pathology.
Questions about Alzheimer’s disease or related disorders can be sent to Dana Territo, the Memory Whisperer, owner of Dana Territo Consulting, LLC, at .
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Is There Treatment Available
At present there is no cure for Alzheimer’s disease. However, one group of drugs called cholinergeric drugs appears to be providing some temporary improvement in cognitive functioning for some people with mild to moderate Alzheimer’s disease.
Drugs can also be prescribed for secondary symptoms such as restlessness or depression or to help the person with dementia sleep better.
Community support is available for the person with Alzheimer’s disease, their families and carers. This support can make a positive difference to managing dementia. Dementia Australia provides support, information and counselling for people affected by dementia. Dementia Australia also aims to provide up-to-date information about drug treatments.
For more information contact the National Dementia Helpline on 1800 100 500.
For a range of books and videos contact our Library.
For advice, common sense approaches and practical strategies on the issues most commonly raised about dementia, read our Help Sheets.
How Is Alzheimer’s Disease Diagnosed
There is currently no single test to identify Alzheimer’s disease. The diagnosis is made only after careful clinical consultation.
The clinical diagnosis might include:
- A detailed medical history
- Lumbar puncture for cerebral spinal fluid tests
- Medical imaging
These tests will help to eliminate other conditions with similar symptoms such as nutritional deficiencies or depression. After eliminating other causes, a clinical diagnosis of Alzheimer’s disease can be made with about 80% to 90% accuracy if the symptoms and signs are appropriate. The diagnosis can only be confirmed after death by examination of the brain tissue.
It is important to have an early and accurate diagnosis to determine whether a treatable condition other than Alzheimer’s disease, is causing the symptoms. If Alzheimer’s disease is diagnosed, medical treatment and other assistance can be discussed.
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Alzheimers Disease Vs Other Types Of Dementia
Dementia is an umbrella term for a range of conditions that involve a loss of cognitive functioning.
Alzheimers disease is the most common type of dementia. It involves plaques and tangles forming in the brain. Symptoms start gradually and are most likely to include a decline in cognitive function and language ability.
To receive a diagnosis of Alzheimers, a person will be experiencing memory loss, cognitive decline, or behavioral changes that are affecting their ability to function in their daily life.
Friends and family may notice the symptoms of dementia before the person themselves.
There is no single test for Alzheimers disease. If a doctor suspects the presence of the condition, they will ask the person and sometimes their family or caregivers about their symptoms, experiences, and medical history.
The doctor may also carry out the following tests:
- cognitive and memory tests, to assess the persons ability to think and remember
- neurological function tests, to test their balance, senses, and reflexes
- blood or urine tests
- a CT scan or MRI scan of the brain
- genetic testing
A number of assessment tools are available to assess cognitive function.
In some cases, genetic testing may be appropriate, as the symptoms of dementia can be related to an inherited condition such as Huntingtons disease.
Some forms of the APOE e4 gene are associated with a higher chance of developing Alzheimers disease.
What Causes Alzheimer Disease
Lots of research is being done to find out more about the causes of Alzheimer disease. There is no one reason why people get it. Older people are more likely to get it, and the risk increases the older the person gets. In other words, an 85-year-old is more likely to get it than a 65-year-old. And women are more likely to get it than men.
Researchers also think genes handed down from family members can make a person more likely to get Alzheimer disease. But that doesn’t mean everyone related to someone who has it will get the disease. Other things may make it more likely that someone will get the disease, such as high blood pressure, high cholesterol, Down syndrome, or having a head injury.
On the positive side, researchers believe exercise, a healthy diet, and taking steps to keep your mind active may help delay the start of Alzheimer disease.
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Why Looking At The Whole Hippocampus Is Not Enougha Critical Role For Anteroposterior Axis Subfield And Activation Analyses To Enhance Predictive Value Of Hippocampal Changes For Alzheimers Disease Diagnosis
- Centre for the Cellular Basis of Behaviour, Department of Neuroscience, Institute of Psychiatry, Kings College London, London, UK
The hippocampus is one of the earliest affected brain regions in Alzheimers disease and its dysfunction is believed to underlie the core feature of the disease-memory impairment. Given that hippocampal volume is one of the best AD biomarkers, our review focuses on distinct subfields within the hippocampus, pinpointing regions that might enhance the predictive value of current diagnostic methods. Our review presents how changes in hippocampal volume, shape, symmetry and activation are reflected by cognitive impairment and how they are linked with neurogenesis alterations. Moreover, we revisit the functional differentiation along the anteroposterior longitudinal axis of the hippocampus and discuss its relevance for AD diagnosis. Finally, we indicate that apart from hippocampal subfield volumetry, the characteristic pattern of hippocampal hyperactivation associated with seizures and neurogenesis changes is another promising candidate for an early AD biomarker that could become also a target for early interventions.
With an integrative perspective of molecular and cellular biology as well as neuroanatomy, our review focuses on the recent advancements in hippocampal analyses employing widely available magnetic resonance imaging scanners, and describes how it might impact on improved early AD diagnosis.
How Does Alzheimers Disease Affect The Brain
The brain typically shrinks to some degree in healthy aging but, surprisingly, does not lose neurons in large numbers. In Alzheimers disease, however, damage is widespread, as many neurons stop functioning, lose connections with other neurons, and die. Alzheimers disrupts processes vital to neurons and their networks, including communication, metabolism, and repair.
At first, Alzheimers disease typically destroys neurons and their connections in parts of the brain involved in memory, including the entorhinal cortex and hippocampus. It later affects areas in the cerebral cortex responsible for language, reasoning, and social behavior. Eventually, many other areas of the brain are damaged. Over time, a person with Alzheimers gradually loses his or her ability to live and function independently. Ultimately, the disease is fatal.
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Can Hippocampal Volume Differentiate Between Different Types Of Dementia
Several research studies have measured the hippocampal volume and looked at how it relates to other types of dementia. One possibility was that physicians could use the extent of atrophy in the hippocampal area to clearly identify what type of dementia was present.
For example, if Alzheimer’s disease was the only type of dementia that significantly affected the size of the hippocampus, this could be used to positively diagnose Alzheimer’s. However, multiple studies have shown that this measure is often not helpful in distinguishing most types of dementia.
One study published in the journal Neurodegenerative Diseases noted that a decreased size of the hippocampus occurred in vascular dementia.
A second study found that decreased hippocampal size was also correlated with frontotemporal dementia.
Scientists did discover a significant difference, however, when comparing Lewy body dementia with Alzheimer’s disease. Lewy body dementia shows far less atrophy of the hippocampal areas in the brain, which also coincides with less significant effects on memory, especially in the earlier stages of Lewy body dementia.
What Are The Warning Signs Of Alzheimers Disease
Watch this video play circle solid iconMemory Loss is Not a Normal Part of Aging
Alzheimers disease is not a normal part of aging. Memory problems are typically one of the first warning signs of Alzheimers disease and related dementias.
In addition to memory problems, someone with symptoms of Alzheimers disease may experience one or more of the following:
- Memory loss that disrupts daily life, such as getting lost in a familiar place or repeating questions.
- Trouble handling money and paying bills.
- Difficulty completing familiar tasks at home, at work or at leisure.
- Misplacing things and being unable to retrace steps to find them.
- Changes in mood, personality, or behavior.
Even if you or someone you know has several or even most of these signs, it doesnt mean its Alzheimers disease. Know the 10 warning signs .
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The Dementia Brain Tour
The brain is incredibly complex and this section of our site contains a lot of information about how the brain is thought to function. For more about how the brain works and the effects of dementia, see our set of videos below.
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What Are The Symptoms Of Alzheimers Disease
Symptoms of Alzheimers disease vary from person to person and worsen over time. Symptoms of the disease include:
- Memory loss. This is usually one of the first symptoms of Alzheimers disease.
- Putting objects in odd places
- Confusion about events, time and place
- Repeating questions
For more information on the stage of disease, click here.
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What Neurological Problems Are Involved In Dementia
For neurons to function well, be replaced with healthy cells, and avoid premature cell death, key biological processes must occur. People with Alzheimers disease experience changes that impair critical functions:
- Communication between nerve cells. Neurons exchange information through a chemical-electric charge that crosses a microscopic gap called a synapse. A single healthy neuron may have as many as 7,000 synaptic connections to other nerve cells2.
- Regeneration and repair. Neurons have the ability to be repaired and to adjust or change their synaptic connections based on the chemical and electrical messages they receive. A healthy brain can even generate new nerve cells by the process of neurogenesis. This ability to repair or change connections and generate new cells is vital to memory and learning2.
- Nutrient delivery and metabolism. Nerve cells need a steady supply of chemicals and nutrients to perform their functions and survive. Oxygen and glucose are critical to cell survival, and good circulation delivers these key nutrients while carrying away the waste products of energy metabolism2.
Youre Not Moving As Well As Usual
Difficulties with movement and performing physical activities in the right sequence can be an early sign of damage to the parietal lobe, which is related to motor skillsand this is one of the signs that Eva thinks she overlooked in her husband. Three years before his diagnosis, the couple began to participate in dragon-boat racing. Chow had always been a well-coordinated athlete and handyman, but during training he struggled to learn the basic stroke technique. The coach kept telling him, This is the way you do it. Steve didnt get it very well, and he was upset with the coach, says Eva.
Motor problems are also common with Lewy body dementia, but other neurodegenerative conditions, such as Parkinsons and multiple sclerosis, should be considered, as well.
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What Are The Signs And Symptoms Of Dementia
Many people associate dementia with memory loss. This is because memory problems are often one of the early symptoms of a dementia disorder, but they are not the only one. The symptoms of dementia can vary, depending on the type of dementia and what areas of the brain are affected. Symptoms may include:
- Memory loss, poor judgment, and confusion
- Changes in the ability to speak, understand, and express thoughts and/or words and to write and read
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money and paying bills
- Repeating questions
- Using unusual words to refer to familiar objects
- Taking longer to complete normal daily tasks
- Loss of interest in normal daily activities or events
- Hallucinations, delusions, and paranoia