“reversible” Alzheimer's Disease?
Peter, F., Susanne, J., Margareta, H., Silvia, W., Wolfgang, K., Thomas, L. and Heinz, T.K. (2011), “REVERSIBLE” ALZHEIMER'S DISEASE?. Journal of the American Geriatrics Society, 59: 1137-1138. https://doi.org/10.1111/j.1532-5415.2011.03437.x
View Original Source →Abstract
A molecular basis for memory failure in Alzheimer's disease (AD) has been recently hypothesized, in which a significant role is attributed to small, soluble oligomers of amyloid β-peptide (Aβ). Aβ oligomeric ligands (also known as ADDLs) are known to be potent inhibitors of hippocampal long-term potentiation, which is a paradigm for synaptic plasticity, and have been linked to synapse loss and reversible memory failure in transgenic mouse AD models. If such oligomers were to build up in human brain, their neurological impact could provide the missing link that accounts for the poor correlation between AD dementia and amyloid plaques. This article, using antibodies raised against synthetic Aβ oligomers, verifies the predicted accumulation of soluble oligomers in AD frontal cortex. Oligomers in AD reach levels up to 70-fold over control brains. Brain-derived and synthetic oligomers show structural equivalence with respect to mass, isoelectric point, and recognition by conformation-sensitive antibodies. Both oligomers, moreover, exhibit the same striking patterns of attachment to cultured hippocampal neurons, binding on dendrite surfaces in small clusters with ligand-like specificity. Binding assays using solubilized membranes show oligomers to be high-affinity ligands for a small number of nonabundant proteins. Current results confirm the prediction that soluble oligomeric Aβ ligands are intrinsic to AD pathology, and validate their use in new approaches to therapeutic AD drugs and vaccines.
Case Details
Disease Location
Brain (alzheimer's)
Personal Characteristics
Started at 76 -year-old, male, mmse of 28. Follow-up at 78.5 -year-old, again at 81.1 -year-old, and again at 83.6. Lifestyle changes included, walking, hiking, mountaineering, taking photos, making movies, lecturing, but has continued gardening, meeting people, and reading.
Clinical Characteristics
At 78.5, significant decline in episodic memory, MRI showed medial temporal lobe atrophy. Fdg-PET showed typical ad pattern, leading to diagnosis at 81.1, mild improvement on memory tests--attributed to antidementia medication, mesial temporal lobe atrophy was more pronounced during this follow-up at 83.6, episodic memory scores remained stable, mmse was 27, no decrease on any neuropsych measures for 60 months. Fdg-PET showed even more pronounced ad pattern
Remission Characteristics
Ad was no longer diagnosed at 83..6 because of the lack of cognitive decline over 5 years, and lack of decline of episodic memory
Treatment & Mechanisms
Proposed Remission Mechanisms
Lifestyle changes (active lifestyles)
Clinical Treatment
Donepezil 5mg