Alzheimer’s disease scientists say a brain-boosting device could slow memory loss

The only one approved treatments for Alzheimer’s disease are medications with limited effectiveness and a risk of serious, sometimes fatal side effects. That’s why scientists are looking for therapies that can stop the disease, especially if drugs aren’t involved.

One experimental therapy may slow the progression of symptoms, a small preliminary study suggests. Using a transcranial magnetic stimulation (TMS) The device, which is widely used to safely treat depression and other mental health conditions, allowed researchers to target a key brain network involved in storing memories and typically hit hard by the disease, according to the report. was presented Thursday at the Clinical Trials in Alzheimer’s Meeting in Madrid.

Researchers found that when the device was targeted at the right spot in the brain, it could slow the development of symptoms, such as memory loss, compared to inactive treatment.

In Alzheimer’s, nerve cells in the brain at some point begin to malfunction, leading to the debilitating symptoms of memory loss. Previous research has shown that the accumulation of two abnormal proteins, beta-amyloid and tau, damages neurons’ ability to form new connections and maintain existing connections, said Dr. Giacomo Koch, professor of human physiology at the University of Ferrara and one of the co-founders of Sinaptica, the Cambridge, Massachusetts-based company currently developing the therapy.

“The goal is to restore the connections between neurons by improving activity in certain areas relevant to the disease,” Koch said in a Zoom interview with NBC News. “This therapy is like training for the neurons.”

The idea is that just as exercise strengthens muscles, the electrical signals generated by the TMS can increase the ability of neurons to make connections with each other.

About 6.9 million people in the US have Alzheimer’s disease. According to the Alzheimer’s Association, this number could rise to 13.8 million by 2060.

The new study, a Phase 2 clinical trial, involved 32 volunteers with Alzheimer’s disease, aged 56 to 88 at the start of the study, who were followed for 52 weeks. Sixteen of the participants who received the treatment were women.

Initially, the researchers determined the exact spot in the brain’s default mode network, which is involved in storing memories of life events, that would benefit most from electrical stimulation by using TMS to “ping” different sites. When the right spot was activated by the electricity, a signal spread through the network, like the ripples you see when a stone is thrown into a body of water.

Then, 18 of the volunteers received weekly 20-minute sessions with the TMS, while 14 received so-called sham treatments, where participants were treated as if they were receiving TMS therapy, but without the device turned on, to rule out the placebo. effect. The TMS device was crucial to the study because it allowed electrical signals to be generated in the brain without any sensation.

“It would be almost impossible to use electric current because it would be very painful,” Koch said. “In this case, we can use very powerful magnetic fields, which are very well tolerated and safe, to induce strong electrical currents in the brain.”

Side effects were fairly rare and included mild headache, skin discomfort and neck pain.

When the two groups were compared using standard cognitive tests, researchers found that symptoms worsened 44% more slowly in the patients who received EMS therapy.

To put that in perspective, two of the newer drugs, lecanemab And donanemabThey have been shown to slightly slow the decline of memory and thinking skills – by 27.1% and 22.3% respectively. The treatments consist of infusions of monoclonal antibodies, given every two or four weeks, and are expensive: $26,500 to $32,000 per patient per year. Both are associated with an increased risk of diabetes swelling of the brain and microbleeds.

Furthermore, during the one-year TMS study, participants who received the experimental treatment showed little decline in their ability to perform activities of daily living. “That is not only important for the patient, but also for healthcare providers,” says Koch.

Koch and his colleagues are currently planning a phase 3 trial, which would be required for Food and Drug Administration approval.

Dr. Irina Skylar-Scott, a cognitive neurologist and clinical assistant professor at Stanford University’s Center for Memory Disorders, said the procedure in the study shows promise. “As a field, we are all excited about new mechanisms and new pathophysiological targets.”

However, there are significant limitations to the study. The trial size is small and concerns only one location.

“The next step is to conduct a multicenter Phase 3 trial to see if this pays off,” said Skylar-Scott, who was not involved in the study. “If it works, it will be very exciting.”

The findings are “very, very preliminary,” said Dr. Lawrence Honig, professor of neurology at Columbia University Irving Medical Center. “At first glance, if you look at the numbers, it did better than the dummy treatment in a number of areas – that’s good. But as with any investigation, the devil is in the details.”

This is a small, single-center study, Honig said. “A multicenter study would offer a little more hope of generalizability,” he added, meaning it could apply to a broader group of people. Honig was not part of the new study.

Honig would also like to see a future study include measurements of biomarkers, such as blood tests and brain scans, to determine whether there are actually improvements in the disease, for example through reductions in tau and/or amyloid in the brain, along with reducing symptoms.

As for what he would tell his patients: “Based on these results, you can’t say much about the usefulness of these treatments.”

The idea behind the new research “is very cool,” although limited by the small number of patients, said Dr. Ryan Darby, assistant professor of neurology and director of the frontotemporal dementia clinic at Vanderbilt University Medical Center.

Another problem: It’s not yet clear whether this method is something other centers can easily adopt, said Darby, who was not part of the TMS study. “But I think the results are exciting and worth pursuing.”