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Dementia

Clinical trial of Alzheimer’s drug underway

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A clinical trial of a new drug candidate for Alzheimer’s disease has begun. 

The drug has been developed at University College London (UCL), in partnership with pharmaceutical company Eisai, and participants are now being screened at UCLH. 

Participants in the trial, conducted at the UCLH Leonard Wolfson Experimental Neurology Centre, will have the rare inherited form of Alzheimer’s disease.

The drug being looked at – known as E2814 – will target tau protein found in the brain, known to be responsible for disease progression. It is the first time a treatment targeting tau is being trialled in people with the inherited form of Alzheimer’s disease.

The trial is being carried out by the Dominantly Inherited Alzheimer Network Trials Unit (DIAN-TU), an international collaboration sponsored by Washington University School of Medicine to test new experimental therapies for Alzheimer’s. 

E2814 is the first drug to be tested for their DIAN-TU tau study.

DIAN-TU’s chief investigator in the UK is Dr Cath Mummery, consultant neurologist at the National Hospital for Neurology and Neurosurgery (NHNN) and head of clinical trials at the UCL Dementia Research Centre in the UCL Queen Square Institute of Neurology.

People who inherit mutations that cause Alzheimer’s disease almost invariably develop the cognitive impairments of the disease at an earlier and more predictable age, often developing symptoms around the same age their parents did – in their 50s, 40s and even 30s.

The DIAN-TU tau next-generation program will evaluate three anti-tau drugs in clinical studies and has selected E2814 as the first investigational anti-tau drug. The clinical study aims to determine whether these drugs can slow or stop the progress of Alzheimer’s disease.

Dr Mummery said: “As we’ve learned more about Alzheimer’s, we understand that tau plays a critical role in disease progression alongside amyloid; this is the first anti-tau treatment we will study in these families with genetic forms of Alzheimer’s disease and this important work advances the field towards our goal of discovering an effective treatment for this devastating disease.

“What is gratifying is that this is an example of collaboration between UCLH and UCL, with the candidate drug developed at the Dementia Research Centre and now entering clinical trials at UCLH.”

If it is shown to be effective in the DIAN-TU trial, E2814 may be beneficial for people with the more common, sporadic forms of Alzheimer’s disease in the older population by, at least, slowing further progression of the disease.

Dementia

Classical music and Alzheimer’s – could it improve memory?

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Could classical music improve memory in people with Alzheimer’s disease and other cognitive impairment?

A three-year study – The Mozart Effect and Memory in patients with cognitive impairment – will assess that exact topic, with music anecdotally being said to have benefit on those living with such conditions. 

The project, from the Cognitive Neurolab at the Universitat Oberta de Catalunya (UOC), will investigate whether music can be used to facilitate or enhance learning in those with mild cognitive impairment (MCI) or mild Alzheimer’s disease (AD).

It will also look at which aspects of music are key in establishing a cognitive benefit, so which kinds of music – relaxing or vitalising – and what times are most useful; for example, in the phase in which we learn new information or in that in which we retrieve information we have previously learned.

Previous studies have indicated that exposure to music can increase performance in learning and attention-related tasks, but this will look at the most effective kind for memory.

“The majority of these studies were on healthy people and we don’t know if music could be a complementary tool for cognitively stimulating those with memory deficits,” says Dr Marco Calabria, leading the project.

“These neurodegenerative diseases are characterised by difficulties in forming new memories, and music could be one way of helping to consolidate new learning.”

The study will involve patients from both Barcelona’s Hospital de Sant Pau and from SINGULAR Musica & Alzheimer, a centre in Barcelona specialising in the rehabilitation and cognitive stimulation of people with Alzheimer’s through music. 

In the study’s first phase, participants will carry out memory-related tasks with classical music in the background. They will have to memorise unknown faces and remember them afterwards. 

Dr Calabria explains that classical music is being used because “it’s a kind of music that is characterised by being both relaxing and vitalizing, and has proven to be the most effective in giving memory a boost. 

“What’s more, the fact that it has no lyrics means there is less of the interference that verbal information can cause with regard to the content that participants will have to learn in the memory tasks.” 

In phase two, researchers will use music familiar to participants to see whether the fact they like it could deliver emotional, and therefore memory-related, benefits. 

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Brain injury

‘We want to be part of the solution – for Bill and future generations’

Dr Judith Gates speaks to NR Times about this weekend’s football match organised by Head for Change, which will be the first ever to involve no heading of the ball

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The first football match which involves no heading of the ball will help raise awareness and stimulate conversation about the impact of head injury in sport, its organisers have said. 

The 11-a-side match, involving 25 former professional footballers, has been hailed as an experiment as researchers try to discover whether the game can function without heading, in light of ever-growing research which links football to neurodegenerative disease.

It is organised by Head for Change, the organisation helping to drive forward calls for changes to player safety, and will only allow headers in the penalty box for the first half and then restrict all heading during the second half. 

It will be held at Spennymoor Town Football Club, in County Durham, on Sunday at 3pm. 

The event forms part of the “legacy” for former Spennymoor Town and Middlesbrough defender Bill Gates, who has sports-related dementia, and whose wife Dr Judith Gates is co-founder and chair of Head for Change. 

Dr Judith Gates

“When Bill received his diagnosis in 2017, we made two promises to him,” Dr Gates tells NR Times. 

“One was to optimise his life and do all we could to make his life as good as we could as a dad, grandad and great grandad, and the second was for his legacy, to do everything we could to be part of the solution for future generations of footballers and their families not to have to face this.

“The purpose of this match is to raise awareness of the dangers of heading the ball and to provide alternative discussion with purpose. It’s an experiment to see what the game will look like. 

“To be clear, Head for Change is not suggesting heading should be banned, that is a decision for football’s governing authorities, not for us. 

“But we want people to realise the impact. Bill was a Titan to me in his 20s, fit and indestructible, so if this disease can do this to him, it can happen to anyone.”

The match has attracted widespread media attention and comes after an array of stark academic findings, including the research from Professor Willie Stewart that footballers are up to five times more likely to suffer from dementia than the general population. 

“Part of why I co-founded Head for Change was to be part of the solution,” says Dr Gates. 

“We’re extremely aware that there is a lot of bashing going on and everyone is saying it’s someone else’s fault, but lessons must be learnt from the past. 

“For too long we have been assured that our brain was safe in our skull, but we are increasingly understanding how the brain works and how it can be damaged through contact sports. Education will continue to play a very important role in what happens going forward.”

The match itself – which will also be raising money for The Solan Connor Fawcett Cancer Trust – will be held at Spennymoor Town’s stadium, The Brewery Field. 

The town is where Dr Gates grew up and met her husband, and in a quirk of fate, Spennymoor Town’s chief executive Brad Groves used to work for Bill as a warehouseman when Bill owned a chain of sports stores. 

The club, alongside those playing in the match, have been hugely supportive of their ambitions, says Dr Gates. 

“We’ve been amazed at the extent to which they have stepped up, Spennymoor have been phenomenal. Brad has been so kind in offering whatever he can do to help. We are hugely appreciative,” she says. 

“The players taking part are excited to be part of it, they may not be able to use one of their many footballing skills but they can use the rest of them. 

“Spennymoor is a small town with a big heart and we are so pleased to be able to hold this match, and particularly here, at Bill’s first club.”

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Dementia

EEG test could increase early diagnosis of Alzheimer’s

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Fastball EEG data for alzheimers

A simple but revolutionary approach to early Alzheimer’s diagnosis is being pioneered, in a breakthrough that could pave the way for improved outcomes for individuals who develop the disease in the future.

The research uses a new method to passively measure brain activity. It involves participants looking at a series of flashing images on a computer over two minutes, whilst their brain waves are measured using an EEG cap.

New research on this, published today on World Alzheimer’s Day, shows that the technique is highly effective at picking up small, subtle changes in brain waves which occur when a person remembers an image. 

Crucially, the technique is completely passive, meaning the person doing the test doesn’t need to understand the task or respond, and may not even be aware of their memory response.

The team behind the ‘Fastball EEG’ technology – led by psychologists at the University of Bath and funded by the dementia charity BRACE – say the approach is cheap, portable and relies on pre-existing technology already available in hospitals, making it easily scalable. 

They are now beginning to use Fastball EEG in a study of the earliest stages of Alzheimer’s disease in collaboration with the Research Institute for the Care of Older People (RICE) and the Bristol Brain Centre at Southmead Hospital.

Alzheimer’s is the underlying cause of approximately 60 per cent of dementia, with an estimated prevalence rate in Europe and North America of 5 to 7 per cent of the population. Estimates suggest the disease costs the UK economy around £26 billion a year, with costs expected to rise as an ageing population will see numbers increasing.

Alzheimer’s disease is currently diagnosed using a combination of subjective and objective reports of cognitive decline, often involving memory tests administered in a clinic. 

These tests are prone to various biases, including assessment anxiety, but also require verbal and written communication abilities which make them ineffective for certain people.

By knowing more about people’s disease at an earlier stage, drugs can be prescribed earlier when they may be more effective, such as the recently-approved Aducanumab, the first disease modifying treatment for Alzheimer’s disease. 

Lifestyle interventions can also be implemented to help slow disease progression. Current diagnosis for Alzheimer’s typically occurs late in the progression of the disease.

In the near future, the researchers hope that Fastball EEG could help lower the age of diagnosis by up to five years. Longer-term, they say it may offer opportunities to expand this further. They liken their future aspirations for its application to current screening tools used to test for high blood pressure in middle age.

Lead researcher and cognitive neuroscientist Dr George Stothart, of the Department of Psychology at the University of Bath, explains: “Fastball offers a genuinely novel way of measuring how our brain is functioning. 

“The person being assessed doesn’t need to understand the test, or even respond, they simply watch a screen of flashing images and by the way we manipulate the images that appear we can learn an enormous amount about what their brain is, or is not, able to do.

“The tests we currently use to diagnose Alzheimer’s miss the first 20 years of the disease, which means we are missing huge opportunities to help people.

“For decades now we have had tools in scientific research that have been able to probe how the brain is working, but we have never made the leap to a viable clinical tool for the objective assessment of cognition. We hope that Fastball may be that leap.

“We are at a really exciting stage in its development. We are testing the tool in earlier and earlier stages of Alzheimer’s and expanding the type of brain function it can measure, to include language and visual processing. 

“This will help us to not only understand Alzheimer’s but also the many other less common forms of dementia.

“Ultimately the Holy Grail of a tool like this would be a dementia screening tool used in middle age for everyone, regardless of symptoms, in the same way we test for high blood pressure. We are a long way from that, but this is a step towards that goal.”

Mark Poarch, chief executive of BRACE, added: “We were delighted to be able to fund Dr Stothart’s research, which clearly has exciting potential. 

“It could result in an early diagnostic tool with benefit for innumerable people and help turn the tide against dementia. More generally, we have seen in the last year what happens when the world ploughs resources into medical research to find a vaccine for a dangerous virus, and we now need to give dementia researchers the resources they need to achieve comparable breakthroughs.”

Dr Stothart and colleagues will soon start work on a significant £100,000 longitudinal study of early dementia funded by the Academy of Medical Sciences. The study will involve testing patients with Mild Cognitive Impairment using the new Fastball tool.

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