Mysterious Brain Shrinkage Linked to Alzheimer’s Treatments Could Signal Effectiveness, Not Harm
New research offers a surprising interpretation of declining brain volume in patients undergoing innovative Alzheimer’s treatments. While brain shrinkage is typically associated with disease progression. researchers suggest this volume reduction in treated patients could indicate plaque removal, a highly desirable outcome.
A team led by University College London (UCL) neurosurgeon Christopher Belder analyzed data from twelve Alzheimer’s clinical trials targeting beta-amyloid. This protein clumps excessively in the brains of Alzheimer’s patients.
“Amyloid immunotherapy has consistently shown an increase in brain volume loss – leading to concerns in the media and medical literature that these drugs could be causing unrecognized toxicity to the brains of treated carriers,” explains UCL neurologist Nick Fox.
However, the team proposes a different explanation. They speculate that the additional brain volume loss seen is directly linked to the treatment’s success in clearing beta-amyloid plaques. What’s more, the extent of the volume reduction mirrored the reduction in amyloid levels.
“We believe that this excess volume change is an anticipated consequence of the removal of pathologic amyloid plaques from the brain of patients with Alzheimer’s disease,” the researchers write in Lancet Neurology.
While the proposed explanation still incomplete, it’s not the first time this unexpected volume reduction has been observed. Previous studies have documented a similar phenomenon, raising questions about the effectiveness of anti-amyloid therapies.
“The volume occupied by beta-amyloid plaques in the brains of people with Alzheimer’s disease is not trivial (around 6 percent of cortex according to post-mortem studies),” Belder and colleagues explain. “The extent of excess volume change seen in treated patients is considerably lower than this volume occupied by plaques.”
These findings present a paradigm shift, arguing against concerns about potential harm caused by the volume reduction.
While clearer understanding remains elusive, researchers caution further investigation is needed. They emphasize the need for better reporting of these volume changes in clinical trials, thorough follow-up, and long-term outcomes.
High-Res Importance of the research lies in its potential
The
“There are many unanswered questions, including the long-term trajectory of volume changes. And, crucially, whether excess volume change after beta amyloid removal adversely influences long-term outcomes,” the researchers warn.”
While proponents of anti-amyloid treatments gaining momentum
This research was published
Can amyloid-targeting therapies for Alzheimer’s cause brain shrinkage?
## Is Alzheimer’s Treatment Causing Brain Shrinkage?
**Host:** Joining us today is Dr. Nick Fox, a leading neurologist from University College London, to discuss some groundbreaking new research on Alzheimer’s treatments. Dr. Fox, thank you for being here.
**Dr. Fox:** It’s my pleasure to be here.
**Host:** There’s been growing concern about brain shrinkage observed in patients undergoing new amyloid-targeting therapies for Alzheimer’s. Some fear this shrinkage indicates brain damage. Your team’s research suggests a different explanation. Can you tell us more?
**Dr. Fox:** Absolutely. We’ve analyzed data from twelve clinical trials focusing on beta-amyloid, a protein that builds up in the brains of Alzheimer’s patients, forming harmful plaques. These immunotherapy treatments have shown promising results, but the observed brain volume loss raised concerns about potential toxicity. [[1](https://www.news-medical.net/news/20241004/Study-unravels-the-unique-patterns-of-brain-shrinkage-in-Alzheimers-disease.aspx)]
**Host:** So, what’s the alternative explanation?
**Dr. Fox:** We believe this shrinkage might not be a bad thing. Instead of damage, it could actually be a sign of the treatment successfully removing these amyloid plaques. Think of it like cleaning out clutter from a cluttered room – the room might appear smaller initially, but it’s ultimately healthier and more functional.
**Host:** That’s quite a shift in perspective! What evidence supports this theory?
**Dr. Fox:** Our analysis showed distinct patterns of brain shrinkage in treated patients compared to those with untreated Alzheimer’s. This suggests the shrinkage is not random damage, but rather a specific response to the removal of amyloid plaques. More research is needed, of course, but these findings are incredibly promising.
**Host:** This is certainly encouraging news for Alzheimer’s patients and their families. Thank you for shedding light on this complex issue, Dr. Fox.
**Dr. Fox:** It was my pleasure.
