Health.  Alzheimer's disease: new test, new treatments, a turning point in the fight?

Health. Alzheimer’s disease: new test, new treatments, a turning point in the fight?

Alzheimer’s disease is the most common form of dementia, affecting nearly one million people in France. The most common symptoms are memory loss and difficulties with thinking, problem solving and language.

Although the first signs most often appear after the age of 65, the disease develops 10 to 15 years before the appearance of the first symptoms. If there is no cure, rapid diagnosis at an early stage would allow patients to access therapies to manage the signs of the disease and plan for the future.

Today, doctors use a range of tests to diagnose the disease, including cognitive tests and brain scans. The scans are used to check for protein deposits in the brain and shrinkage of the hippocampus, the area of ​​the brain linked to memory. All these tests can take several weeks…

What if one exam was enough? This is what researchers at Imperial College London are proposing: using a standard MRI found in most hospitals.

To do this, they adapted an algorithm usually used in the classification of cancerous tumors to the brain.

They divided the brain into 115 regions and assigned 660 different characteristics, such as size, shape and texture, to assess each region. They then trained the algorithm to identify changes predictive of Alzheimer’s disease.

A 98% reliable test

By testing their tool on healthy subjects and patients with dementia, they found a prediction efficiency rate of… 98%! This system was also able to distinguish between early and advanced stages of the disease with 79% accuracy.

“Currently, no other simple and widely available method can predict Alzheimer’s disease with this level of accuracy, so our research is an important step forward,” says Professor Eric Aboagye, from the Department of Surgery and Cancer Imperial College, lead author of this study.

“Waiting for a diagnosis can be a horrifying experience for patients and their families. If we could reduce the wait time, simplify the diagnostic process and reduce some of the uncertainty, that would help a lot. »

Existing drugs

Another lead in the fight against the disease has been identified at Imperial College: drugs already used to treat what is known as attention disorders.

Attention Deficit/Hyperactivity Disorder, or ADHD, is characterized by attention deficit, impulsiveness and sometimes hyperactivity leading to social or academic difficulties.

To treat this pathology, so-called “noradrenargic” treatments – which include antidepressants and drugs for the management of high blood pressure – are sometimes used.

The London researchers noticed that these drugs target norepinephrine, a neurotransmitter essential to many cognitive processes such as attention, learning or memory.

However, at the onset of Alzheimer’s disease, “a noradrenergic disturbance occurs contributing to the typical cognitive symptoms of the disease”, launch the researchers.

Reduced symptoms

Of which, the scientists therefore looked for clinical trials published between 1980 and 2021 in which noradrenergic drugs, such as atomoxetine or methylphenidate (Ritaline®, Concerta®, etc.) had been used to potentially improve symptoms in people with the disease. of neurodegenerative diseases.

And they found it. Among them, 10 works involving 1,300 patients were interested in their impact on global cognition: orientation, attention, memory, fluidity… “This showed a slight but significant positive effect”, advance the authors.

Eight other studies, involving 425 people, focused on behavior and neuropsychiatric symptoms like agitation and apathy. There, “the positive effect was significant”.

“The reassignment of noradrenergic drugs is likely to offer an effective treatment in Alzheimer’s disease for general cognition and apathy,” explain the researchers.

Which explain that there are still many studies to be conducted, particularly with regard to “the doses to be administered, the risks of interaction with other drugs…”.

Source: “British Medical Journal”.

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