{"id":5290,"date":"2021-06-02T08:35:30","date_gmt":"2021-06-02T06:35:30","guid":{"rendered":"https:\/\/kompetenz-statt-demenz.dsgip.de\/?p=5290"},"modified":"2021-09-06T13:18:02","modified_gmt":"2021-09-06T11:18:02","slug":"clinical-trial-proves-potential-reversal-of-cognitive-decline-in-early-ad","status":"publish","type":"post","link":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/clinical-trial-proves-potential-reversal-of-cognitive-decline-in-early-ad\/","title":{"rendered":"Clinical trial proves potential reversal of cognitive decline in early Alzheimer&#8217;s disease"},"content":{"rendered":"<p><span data-contrast=\"auto\">It&#8217;s been a long road for Dr. Dale Bredesen in Alzheimer&#8217;s research: He worked for years as a scientist\u00a0and\u00a0studied\u00a0dying brain cells, fruit flies with &#8220;Alzflymer&#8221; and transgenic mice with &#8220;Mouzheimer&#8217;s.&#8221; But his applications for clinical trials that could demonstrate proof of efficacy of his research concepts in patients were first rejected in 2011 and again in 2018. Instead, he published treatment successes in his patients in 2014, 2016 and 2018. Finally, in 2019, he received approval to conduct a clinical trial,\u00a0which was then completed last year.\u00a0\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Now, the results are finally\u00a0in for this\u00a0\u2018special\u2019\u00a0study, which uses a fundamentally different approach and flips the clinical trial script: instead of prescribing a treatment, here the causes of Alzheimer&#8217;s and pre-Alzheimer&#8217;s that contribute to cognitive decline were first identified in each patient, and these were treated individually and thus targeted.\u00a0So,\u00a0in this study, deeper dives are made into the genetics and biochemistry of each patient to\u00a0generate\u00a0the optimal protocol for each. In this precision medicine study, Dr. Bredesen collaborated with three integrative medicine<\/span><span data-contrast=\"auto\"> physicians, Kat Toups, Ann Hathaway and Deborah Gordon. <\/span><\/p>\n<p><span data-contrast=\"auto\"><img decoding=\"async\" class=\"lazyload  wp-image-5303 alignright\" src=\"https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance.jpg\" data-orig-src=\"https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance.jpg\" alt=\"cognitive_performance\" width=\"504\" height=\"459\" srcset=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27504%27%20height%3D%27459%27%20viewBox%3D%270%200%20504%20459%27%3E%3Crect%20width%3D%27504%27%20height%3D%27459%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-srcset=\"https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance-200x182.jpg 200w, https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance-300x273.jpg 300w, https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance-400x364.jpg 400w, https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance-600x547.jpg 600w, https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance-768x700.jpg 768w, https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance-800x729.jpg 800w, https:\/\/kompetenz-statt-demenz.dsgip.de\/wp-content\/uploads\/2021\/06\/cognitive_performance.jpg 979w\" data-sizes=\"auto\" data-orig-sizes=\"(max-width: 504px) 100vw, 504px\" \/><\/span><\/p>\n<p><span data-contrast=\"auto\">To date, pharmacological approaches to treating Alzheimer&#8217;s have been almost uniformly unsuccessful, with over 400 failed<\/span><span data-contrast=\"auto\"> clinical trials. Unfortunately, the few small successes (e.g., memantine)<\/span><\/p>\n<p><span data-contrast=\"auto\">have not produced sustained improvements. For example, the\u00a0current\u00a0\u2019positive\u2019\u00a0trial\u00a0for the drug candidate\u00a0donanemab, a monoclonal antibody against beta-amyloid proteins, showed neither cognitive improvement nor stabilization of dementia, but only a reduction in the rate of progression by about one-third (see Figure).\u00a0\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">Thus, this\u00a0would be\u00a0a major\u00a0failure\u00a0of medical treatments\u00a0for\u00a0neurodegenerative diseases such as Alzheimer&#8217;s: in the U.S., it is currently estimated that about 45 million\u00a0people\u00a0will die from Alzheimer&#8217;s disease if effective treatment and prevention\u00a0will be\u00a0not developed. Against this backdrop, the results of this new clinical trial by Dr. Bredesen, published as a preprint in\u00a0medRxiv, a Yale-supported health sciences website, appear almost unprecedented (see figure).\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">The study design:\u00a0<\/span><\/b><span data-contrast=\"auto\">Dr. Bredesen&#8217;s study included 25 participants aged 50 to 76 years, all of whom were diagnosed with mild cognitive impairment (pre-Alzheimer&#8217;s) or early-stage dementia. Each patient was tested for existing risk factors such as inflammation, insulin\u00a0resistance, nutrient and hormone deficiencies, specific pathogens, exposure to (bio)toxins, and genetics, and then treated with a personalized protocol that continued for nine months. Treatment of the putative causes of cognitive decline with similar functional medical\u00a0approaches\u00a0have\u00a0already resulted in &#8220;case study&#8221; publications, but in contrast\u00a0to these, this is the first prospective clinical trial.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">The results:<\/span><\/b><span data-contrast=\"auto\">\u00a0Among the study participants, 21 (84%) improved significantly, one showed no change (4%), and three deteriorated (12%). Improvement was monitored using various cognitive testing procedures. Furthermore, imaging techniques such as MRI of the brain complemented the results of this cognitive test battery. They showed that brain shrinkage, which typically occurs in dementia, was prevented and thus paralleled the improvement in cognition.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">These extremely promising results demonstrate that identifying the factors that contribute to cognitive decline in each patient and treating them with a personalized protocol is an effective therapeutic approach for patients with pre-Alzheimer&#8217;s disease or early dementia. This small study continues to warrant a larger, randomized, controlled follow-up study, which is already underway. We will keep you updated on its progress to ensure that you continue to be well informed and on the cutting edge of clinical Alzheimer&#8217;s research!\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">For more information around the Bredesen protocol, also feel free to check out &#8216;Knowledge stops\u00a0Dementia&#8217;\u00a0<\/span><a href=\"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/therapists-treatments\/treatments\/recode-bredesen\/\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">here<\/span><\/a><span data-contrast=\"auto\">.\u00a0<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">Conclusion:\u00a0<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><b><span data-contrast=\"auto\">After the failure of all drug monotherapies in clinical trials, this prospective clinical trial of Dr. Bredesen&#8217;s multifactorial approach shows compelling results for the first time: 84% of patients experienced improvements in symptomatology, improved scores on cognitive tests, and increased gray matter volume on MRI. The results offer real hope for millions of patients with dementia or mild cognitive impairment, as well as those at risk for dementia due to a family history.\u00a0<\/span><\/b><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<p><span data-contrast=\"auto\">References<\/span><span data-ccp-props=\"{}\">\u00a0<\/span><\/p>\n<ol>\n<li><a href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/study\/NCT03883633\" target=\"_blank\" rel=\"noopener\"><span data-contrast=\"none\">https:\/\/clinicaltrials.gov\/ct2\/show\/study\/NCT03883633<\/span><\/a><span data-ccp-props=\"{&quot;134233279&quot;:true}\">\u00a0<\/span><\/li>\n<li><span data-contrast=\"auto\">MA\u00a0Mintun, AC Lo, CD\u00a0Evans,\u00a0Ph.D., AM Wessels, et al.\u00a0<\/span><span data-contrast=\"auto\">Donanemab\u00a0in Early Alzheimer\u2019s Disease\u00a0(2021). N\u00a0Engl\u00a0J Med; 384:1691-1704. DOI: 10.1056\/NEJMoa2100708<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true}\">\u00a0<\/span><\/li>\n<li><span data-contrast=\"auto\">K Toups, A Hathaway, D Gordon, H Chung, C Raji, A Boyd, BD. Hill, S Hausman-Cohen, M\u00a0Attarha, WJ\u00a0Chwa, M Jarrett, DE Bredesen (2021).\u00a0medRxiv\u00a0preprint May 11,\u00a02021\u00a0doi: https:\/\/doi.org\/10.1101\/2021.05.10.21256982<\/span><span data-ccp-props=\"{&quot;134233279&quot;:true}\">\u00a0<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>It&#8217;s been a long road for Dr. Dale Bredesen in Alzheimer&#8217;s research: He worked for years as a scientist\u00a0and\u00a0studied\u00a0dying brain cells, fruit flies with &#8220;Alzflymer&#8221; and transgenic mice with &#8220;Mouzheimer&#8217;s.&#8221; But his applications for clinical trials that could demonstrate proof of efficacy of his research concepts in patients were first rejected in 2011 and again in 2018. Instead, he published treatment successes in his patients in 2014, 2016 and 2018. Finally, in 2019, he received approval to conduct a clinical trial,\u00a0which was then completed last year.\u00a0\u00a0<\/p>\n","protected":false},"author":12,"featured_media":5497,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[90,62],"tags":[],"class_list":["post-5290","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-trial","category-forms-of-treatment"],"acf":[],"_links":{"self":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts\/5290","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/users\/12"}],"replies":[{"embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/comments?post=5290"}],"version-history":[{"count":5,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts\/5290\/revisions"}],"predecessor-version":[{"id":5320,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/posts\/5290\/revisions\/5320"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/media\/5497"}],"wp:attachment":[{"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/media?parent=5290"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/categories?post=5290"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kompetenz-statt-demenz.dsgip.de\/en\/wp-json\/wp\/v2\/tags?post=5290"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}