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%
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 behaviour
and performance, rather than any physical evidence.
This will probably continue to be the case, said Dr. Sid Gilman,
director of the Alzheimer's centre 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
if you click here.
On average, the Alzheimer's patients lost 5.3% of their brain cells each
year. In memory regions they lost up to 10%.
"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.
Source: Reuters