Alzheimer’s disease is the leading cause of dementia in the Italian population and over 600,000 people live with this condition. Currently, the few approved therapies to counter its evolution seem to be effective only in the very early stages of the disease, which is why neuroscience research plays a central role in identifying the pathological mechanisms underlying Alzheimer’s disease.
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From this premise the study, published in the Journal of Alzheimer’s Disease, of Laura Serra, of the Neuroimaging Laboratory of the Santa Lucia IRCCS in Rome, Marcello D’Amelio, Head of the Molecular Neuroscience Laboratory of Santa Lucia IRCCS and Full Professor of Human Physiology of the Campus Bio-Medico University, of Marco Bozzali, Associate Professor of Neurology of the University of Turin and of Mara Cercignani of Cardiff University.
The same team, within the integrated research platform between IRCCS Santa Lucia and Campus Bio-Medico University, coordinated by prof. D’Amelio, had identified in 2017 in the ventral tegmental area (VTA), linked to the production of dopamine, one of the first events in the course of disease development, through the use of experimental models.
“The VTA – explains D’Amelio – is represented by a very small area, which has about 600-700 thousand neurons, a small number compared to the more than 80 billion neurons that make up the human brain. Our study focused on the connections that are established between the VTA and the rest of the brain and how these, due to damage in the VTA, change over the course of the disease. The result, the fruit of years of research, has been the surprising ability that VTA lesions have in predicting the development of Alzheimer’s disease and the aim of this last work was to understand the time window that an analysis of the VTA is able to offer before the symptoms of the disease develop “.
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“The experimental setting – continues Serra – involved the use of functional neuroimaging and neuropsychological tests, two painless and non-invasive techniques with which we analyzed the activity of the VTA in 35 patients with mild cognitive impairment, an important risk factor for development of Alzheimer’s disease and other forms of dementia. We therefore monitored the evolution of the patients’ condition for 24 months, finding that, within the first two years of observation, in 16 of the 35 patients the mild cognitive disorder was converted in Alzheimer’s disease, and this conversion was anticipated by a significant reduction in the connectivity of the VTA to areas of the brain critical for the symptoms of the disease. In patients who did not develop the disease, however, the VTA maintained its function unaltered “.
Analyzing the results, the researchers were able to confirm that the reduction of VTA connections anticipates damage to other areas of the brain by about two years and the appearance of the first clinical symptoms, a time window within which it is possible to use drugs aimed at counteracting the evolution of the disease.
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“The person who realizes that he is showing the first symptoms of a cognitive disorder – suggests Carlo Caltagirone, neurologist, Scientific Director of the Santa Lucia IRCCS and co-author of the study – today has many tools that he can use to take care of his health. Alzheimer’s, according to the scientific evidence available today, the poor efficacy of drugs seems to be due to an excessively late use of therapies that are unable to stop degeneration in already compromised areas or to improve the clinical picture. This is why prevention and diagnosis are important. early, so as to be able to tackle the disease with all the weapons that neuroscience research offers “.
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Finally, this study confirmed the greater specificity of this method in accurately diagnosing Alzheimer’s disease, distinguishing it from other forms of dementia. In fact, patients with atrophy of the hippocampus, an area of the brain responsible for memory, but without a reduction in the activity of the VTA, did not develop Alzheimer’s disease, confirming previous studies that found in the synergistic presence of cerebral atrophy and disconnection of VTA. events related to the early presentation of clinical symptoms of the disease.
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