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A Closer Look

Posted on April 25, 2019

In the first study of its kind, imaging that detects Alzheimer’s-related brain “plaques” has been shown to significantly influence the treatment of patients living with dementia and mild cognitive impairment.

The study showed the benefits of positron emission tomography, or PET, scans in the identification of amyloid plaques in the brain and how these plaques could be managed.

The technique, known as amyloid PET imaging, provided more insight for researchers on how to medically manage Alzheimer’s disease, including using medications and counseling, for almost two-thirds of participants in the study.

Amyloid PET imaging also changed the  for cognitive impairment in more than a third of the study participants.

The study, which consisted of more than 11,000 Medicare participants, was published on April 2, 2019, in the Journal of the American Medical Association. It included researchers from the American College of Radiology, the Alzheimer’s Association, UC San Francisco, Brown University School of Public Health, Virginia Commonwealth University School of Public Health, Washington University School of Medicine in St. Louis, UC Davis School of Medicine, and the Kaiser Permanente Division of Research.

The researchers hope their findings could mean improvements in care and zeroing in on the causes of cognitive decline for some individuals.

They also hope that their findings make amyloid PET imaging more broadly accessible and a standard in diagnosing Alzheimer’s disease.

Alzheimer’s disease is a progressive brain disorder that causes a decline in both memory and cognitive function. The deterioration caused by the disease means those who live with the condition are eventually unable to take care of themselves or perform simple tasks.

While the average age of onset for Alzheimer’s disease is the mid-60s, some people with the condition develop symptoms as young as the 30s in a situation known as early-onset Alzheimer’s. While men and women both get the disease, women have a 50 percent greater chance of developing the condition than men.

In addition to memory loss and cognitive decline, other symptoms of the condition include confusion, mood swings and personality changes, the inability to care for oneself, and loss of speech.

Alzheimer’s disease is named after Dr. Alois Alzheimer, a German psychiatrist and neuropathologist. In 1906, Dr. Alzheimer analyzed changes in the brain tissue of a woman who had died of an unusual mental illness that caused symptoms such as memory loss, difficulty speaking and language problems, and erratic behavior. 

After the patient’s death, Alzheimer studied her brain and found abnormal clumps and tangles.These clumps and tangles are known as amyloid plaques and tau protein.

Amyloid plaques and tau protein tangles in the brain are a hallmark of Alzheimer’s disease. These elements can interfere with how the brain transmits messages.

Additionally, another mark of Alzheimer’s disease is the loss of connections between the neurons in the brain.

“Neurons are essential to the brain and the body; they allow the brain to transmit messages to other parts of the body, including muscles and organs,” said Dr. Joel Singer, a New York personal cell physician.

Although Alzheimer’s disease research has advanced significantly since the disease was discovered in 1906, checking for amyloid plaques meant postmortem analysis of brain tissue until very recently. With the use of amyloid PET, physicians can now detect plaques with a brain scan in living patients.

“The ability to accurately diagnose patients means more targeted treatments and better outcomes,” Singer said.

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