Feb. 6
— By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - Dramatic new scans show brain cells
quickly and steadily disappearing in patients with Alzheimer's
disease, an international team of researchers reported on
Thursday.
They used magnetic resonance imaging, also known as MRI, to chart
a 5 percent annual loss of brain cells in Alzheimer's patients -- up
to 10 percent in key memory areas.
In contrast, healthy volunteers monitored in the study lost less
than 1 percent of their brain cells a year.
"For the first time, you can see Alzheimer's disease progressing
in living patients," said Paul Thompson, an assistant professor of
neurology at the University of California Los Angeles school of
medicine, who led the study.
"We were stunned to see a spreading wave of tissue loss.
Initially confined to memory areas, this loss moved across the brain
like a lava flow, destroying more and more tissue as the disease
progressed."
Writing in the Journal of Neuroscience, the researchers said
their findings would help doctors check to see if treatments are
helping, and perhaps help chart the course of the disease.
Alzheimer's is assessed using standard tests of a patient's
behavior and performance, rather than any physical evidence.
This will probably continue to be the case, said Dr. Sid Gilman,
director of the Alzheimer's center at the University of
Michigan.
"The diagnosis of Alzheimer's disease really depends upon
demonstration of cognitive dysfunction," Gilman said in a telephone
interview.
"No amount of PET scanning or MRI scanning will make the
diagnosis. There are anecdotal stories of people dying who had
scored normal on tests of cognitive function a few weeks before and
upon death the brain can show definitive signs of Alzheimer's."
CHARTING FUTURE TREATMENT
However, such a test would be extremely useful in charting future
treatments, Gilman said.
"Currently all we have is symptomatic treatment," he said. "We
have no treatment that stops the progression."
But, he added, researchers are working on ways to stop the
now-incurable disease, such as vaccinations that might stop the
buildup of toxic proteins in the brain.
"We are on the verge of some very exciting discoveries in
Alzheimer's disease, so that a biomarker that told us the disease
itself was not progressing would be extremely important," Gilman
said.
For their study, Thompson and colleagues at UCLA, in Britain and
in Australia scanned the brains of 12 Alzheimer's patients and 14
healthy volunteers. MRI gives a finer image of bodily structures
than x-rays.
"They got a scan every three months," Thompson said in a
telephone interview.
They were able to put together time-lapse images, which can be
seen on the Internet at
http://www.loni.ucla.edu/~thompson/AD_4D/dynamic.html.
On average, the Alzheimer's patients lost 5.3 percent of their
brain cells each year. In memory regions they lost up to 10
percent.
"Memory systems go first and then the frontal areas involved in
inhibition and self-control and later areas involved in emotion,"
Thompson said.
"Another feature is that some parts of the brain are completely
spared. One example is the visual area. Why it is, is a
mystery."
Thompson hopes the method could not only be used to compare
treatments for Alzheimer's, but perhaps to see if exercise and
mental exercise could prevent or delay Alzheimer's in people at a
high risk of the disease.
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