Getting there early in medicine is always important. The sooner the diagnosis is obtained and, consequently, the sooner action can be taken to try to control the situation. At the moment, for Alzheimer’s disease, unfortunately, there are still no therapeutic weapons capable of successfully halting the advance of the clinical picture discovered before the symptoms become serious, that is, when there are still only the first signs of decay. However, on the research front, studies that try to anticipate the identification of neurodegenerative disease are growing, thanks to the identification of “spies” that can signal the first, imperceptible deficits of neuronal cells.
Alzheimer’s, ‘cleaning up’ the brain to fight the disease
at Federico Mereta
On this front, good news is coming from Australia. Research conducted by Australian National University experts coordinated by Nicolas cherbuim, director of the Research Center on Aging, Health and Wellness, points out that thanks to the analysis of a blood biomarker – the light chain neurofilament – combined with a cognitive test (Mini-Mental State Examination), several years before the onset of the clinical picture the risk of developing Alzheimer’s disease. All of this, and we are always in theory, without even having to be hospitalized. At the moment the results of these first studies are not yet published in a scientific journal, but only presented in a document from the same Australian university. And although interesting from a scientific point of view, a study of this type would have no repercussions on the sick.
Alzheimer’s, preserving memory with magnetic stimulation
The light chain neurofilament, that is the parameter sought with the blood test as the basis for this sort of “screening”, is in practice a signal of the well-being of neurons, since it identifies the presence of neuron cells at the end of their path of life. But it still has an important limitation: “The analysis of light chain neurofilaments is unfortunately very non-specific and indicates a state of neuronal suffering – he explains Massimo Tabaton, professor of Neurology at the University of Genoa. This means that in practice it can inform in general about the risk of developing a neurodegenerative disease and not Alzheimer’s disease in particular. There are other tests, used only in research, which may be more “powerful”: this is the case, for example, of the plasma dosage of Tau-phosphorylated or Beta42-amyloid. These are methods that are much more precise and more directly linked to the future development of Alzheimer’s disease ”. Let me be clear: we are still in the research phase and therefore these checks, in Italy, are carried out only for this purpose, without being available in clinical practice.
Alzheimer’s, preserving memory with magnetic stimulation
In short: Alzheimer’s leaves “traces” well before manifesting itself clinically. The results of the DIAN (Dominant Inherited Alzheimer Network) study on healthy subjects and young carriers of genetic mutations that cause and make onset the disease around the age of 50 say so: already twenty-five years before the clinical diagnosis, in the liquor, the liquid that bathes the spinal cord, a low level of beta-amyloid protein is observed. Three decades earlier, high levels of Tau proteins can be observed or amyloid can be identified thanks to Pet with specific tracers. “The real problem with this and other systems of potential early diagnosis is that to date there are no therapeutic interventions capable of substantially modifying the course of the disease identified early: the results of the first study on presymptomatic subjects with monoclonal antibodies have just appeared. substantially demonstrate the absence of a therapeutic effect between treated and untreated patients “, recalls Tabaton.
Alzheimer’s, dopamine is the key to diagnosis two years before the disease manifests
However, research continues in search of low-cost and non-invasive early diagnosis methodologies. And it’s not just about finding reliable markers in the blood. In fact, we are working to make the neuropsychology tests to be administered to people once they are 60-65 years old even more precise and simple investigations are also being developed that exploit the advantages offered by artificial intelligence. The group coordinated by Sandro Iannaccone, head of the Rehabilitation Unit for Cognitive-Motor Neurological Disorders of the IRCCS San Raffaele Hospital in Milan, together with Icelandic scholars, is working on an electroencephalogram whose results are immediately compared with those of about 5000 tests carried out on subjects with initial signs of disease. The exam takes five minutes and is non-invasive. Let me be clear: it is just an example of how in the future even in areas with a low population density and without large availability of diagnostic tools, it will be possible to recognize as soon as possible how much the “waste” is affecting the brain. And perhaps, thanks to increasingly specific drugs and other immune strategies, respond to prevent toxic substances from accumulating, turning into the fog that erases affects and memories.
Alzheimer’s, another tile on the (first and only) therapy
by Simone Valesini
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