Neurology Central

New study suggests the need for early detection of Alzheimer’s disease pathology

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According to a longitudinal study, researchers have suggested that anti-amyloid therapies would be most effective before individuals reach the threshold for preclinical Alzheimer’s disease (AD) – long before the first signs of memory problems appear.
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  1. While the observations are quite strong in identifying a link between amyloid and tau pathology, I would caution against the interpretation that we need to start anti-amyloid therapies in subjects with zero or low amyloid level. This would negate the observation that certain forms of the amyloid peptide do have a neuroprotective function. In a recent paper (Geerts Alzheimers Res Ther. 2018 Feb 2;10(1):14), we showed that this assumption is absolutely necessary to explain three clinical datasets. It also explains the lack of clinical benefit in recent studies with BACE inhibitors, despite substantial target engagement. Because of this dual property of beta-amyloid peptides, there is a large probability that removing beta-amyloid or inhibiting synthesis in low or zero amyloid subject would actually harm their cognitive functioning.

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