Scientists have developed a technique that allows them to watch the spread
of Alzheimer's disease through the brains of living patients "like a flow
of lava," as one researcher put it.
The technique, described today in The Journal of Neuroscience, may help
pharmaceutical companies evaluate the effectiveness of Alzheimer's drugs
and aid in the early identification of people who are at highest risk for
developing the disease.
In the technique, a computer analyzes single brain scans taken over time and generates three-dimensional videos.
"People have used imaging before, but the studies have really been like
taking Polaroid pictures at the ballet," said Dr. Paul Thompson, assistant
professor of neurology at the University of California at Los Angeles and
the lead author of the report.
"This is the first study to chart the dynamic spread of Alzheimer's in the brain."
The videos were based on the analysis of subtle changes in the MRI scans
of 12 patients with Alzheimer's, compared with those of 14 elderly people
without the disease. The videos depict the average loss of brain cells in
different brain areas for the Alzheimer's patients.
Researchers have long known through autopsy studies that Alzheimer's patients
show the progressive death of nerve cells in many areas of the brain.
But in the videos, the damage can be seen moving from structures involved
with memory to brain areas involved in emotion and in the control of behavior.
Other regions of the brain -- sensory centers responsible for vision and
touch, for example -- remained untouched, Thompson said, calling them "islands
of cells in all this devastating sequence of loss."
The researchers found the loss of brain tissue progressed at a rate of
4 percent to 5 percent each year in Alzheimer's patients. In healthy brains,
about 0.5 percent is lost each year in aging.
Dr. Thomas Chase, chief of experimental therapeutics at the National Institute
of Neurological Disorders and Stroke and an expert on Alzheimer's treatment,
said the new technique "adds to our understanding of the time course that
unfolds in an Alzheimer's brain."
The ability to see the disease progressing over time in the whole brain
might in the future help scientists separate subtypes of Alzheimer's, Chase
said.
But he added, "The real question, is, `Does this advance our ability to
deal with Alzheimer's, to understand precisely what the disease is and to
discover more effective therapies?' "
Dr. Antonio Convit, a research scientist at the Nathan S. Kline Institute
for Psychiatric Research, said the technique might be used to tell who, among
people who show on psychological tests early signs of mental impairment characteristic
of Alzheimer's, will develop the disease.