Health. Alzheimer’s Disease: Finally a Way to Detect It Earlier?

Alzheimer’s disease is the most common form of dementia, affecting almost a million people in France. The most common symptoms are memory loss and difficulty thinking, problem solving, and speaking.

Although the first signs most often appear after the age of 65, the disease develops 10 to 15 years before the first symptoms appear. When there is no cure, prompt diagnosis at an early stage would allow patients access to 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 look for protein buildup 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? That’s what researchers at Imperial College London suggest: using a standard MRI found in most hospitals.

To do this, they adapted an algorithm that is commonly used to classify 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 that indicate Alzheimer’s disease.

A 98% reliable test

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

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

“Waiting for a diagnosis can be a terrifying experience for patients and their families. If we could reduce the wait time, simplify the diagnostic process, and reduce some of the uncertainty, it would be very helpful. »

Existing medication

Another clue in the fight against the disease has been identified at Imperial College: drugs that are already being used to treat so-called attention deficit disorders.

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

To treat this pathology, so-called “noradrenargic” treatments are sometimes used, which include antidepressants and drugs used to treat hypertension.

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

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

Reduced symptoms

The scientists therefore searched for clinical trials published between 1980 and 2021 that used noradrenergic drugs such as atomoxetine or methylphenidate (Ritaline®, Concerta®, etc.) to improve symptoms in people with neurodegenerative diseases.

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

Eight other studies involving 425 people focused on behavior and neuropsychiatric symptoms such as agitation and apathy. There “the positive effect is significant”.

“Reassignment of noradrenergic drugs likely offers an effective treatment for general cognition and apathy in Alzheimer’s disease,” the researchers explain.

This explains that many studies remain to be carried out, particularly with regard to “the doses to be administered, the risks of interaction with other drugs …”.

Source: British Medical Journal.

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