2023-09-24 07:50:00
The hunt for memory Shock waves as a secret recipe once morest Alzheimer’s?
By Daniela Halm September 24, 2023, 9:50 a.m. Listen to article
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In Germany, around 1.8 million people live with a diagnosis of dementia, a disease that is still not curable. But research into new therapies is in full swing: shock wave therapy is said to be able to slow down the progression of Alzheimer’s disease.
Five years ago, Hans-Jürgen experienced his first typical symptoms. He had difficulty finding the right words and had difficulty orienting himself. The now 82-year-old received the diagnosis: “Alzheimer’s disease”.
His partner Gabriele accidentally heard regarding shock wave therapy that is supposed to help those affected by dementia. This is how she came into contact with the Bonn University Hospital. Here, Alzheimer’s patients are treated with so-called transcranial pulse stimulation (TPS) with the aim of stopping the disease. Hans-Jürgen’s condition even improved following using this shock wave therapy. He reports that he feels much clearer in his head followingwards. His partner also sees positive changes following the treatment. The word-finding problems are still there, but significantly less. “And he’s reading once more.”
Stop Alzheimer’s with pulse waves
During shock wave therapy, the patient’s head is first measured precisely. Pulse waves are then passed through the skull. They stimulate the brain regions affected by Alzheimer’s up to a depth of eight centimeters. “These ultra-short shock waves can penetrate the bone and, for example, cause cellular changes in the brain. We naturally hope that this will have a positive influence on changes in Alzheimer’s disease, and we are testing this very carefully,” explains Professor Ullrich Wüllner. He is a neurologist and director of the clinic for neurodegenerative diseases at the University Hospital of Bonn.
Wüllner sees potential in pulse wave treatment: “We have actually observed a stable course in regarding two thirds of our patients over the past few months. This means that mental performance, as measured in neuropsychological tests, is not getting worse.”
Large studies are still missing
Wüllner has treated 50 patients so far, but there are still no large studies that prove the positive effect. The therapy is used for people with mild to moderate dementia and can be carried out on an outpatient basis. It must be repeated every six weeks to avoid worsening. Health insurance companies do not cover the costs of the treatment because its effectiveness has not yet been scientifically proven.
Shock wave therapy cannot cure Alzheimer’s, but stopping dementia would be progress: “If you look at the dynamics of Alzheimer’s disease, it would be a big deal if you might tell those affected that we can treat the disease at a certain level stabilize,” says Wüllner.
Antibodies slow down mental decline
Most of the pharmaceutical industry’s research initiatives rely on antibodies once morest the protein deposits that occur in Alzheimer’s disease and which disrupt the function of nerve cells in the brain. Promising candidates include lecanemab or donanemab, which appear to be particularly effective in the early stages of Alzheimer’s disease. They are intended to remove the harmful protein deposits in the brain that form there over a period of years and thus slow down the progression of Alzheimer’s. This was confirmed in current clinical studies: a large part of the deposits were removed from the brain and in some cases the progression of the disease was significantly reduced.
The antibody donanemab was able to slow down the decline in cognitive abilities by around a third in those less severely affected. However, some people who were treated with antibodies experienced serious side effects such as brain swelling or cerebral hemorrhage. Isolated deaths are also said to be related to the antibodies. “The antibodies do not have the same effect on everyone affected, the correct pre-selection, possibly also the combination of different antibodies, still needs to be investigated,” says Wüllner. The goal is more personalized medicine that can be tailored to individual sufferers.
Treat illness earlier
The antibody lecanemab was approved in the USA at the beginning of the year, but approval is still pending in the EU. Donanemab is currently not available as a drug. There have been repeated setbacks in the search for Alzheimer’s drugs because it is a very complex disease. The diagnosis of dementia must be made much earlier in order to achieve good treatment results, says Wüllner. When the first symptoms of Alzheimer’s appear, the disease has already been active in the body for decades. Not only did deposits form in the brain, but secondary changes such as inflammatory reactions were also triggered.
“The studies show that antibody therapy must begin as early as possible, ideally in a presymptomatic stage,” says Wüllner. The current start of treatment is probably too late. “The earlier protein accumulations and deposits in the brain can be eliminated, the cheaper it seems to be and the better the side effect profile would probably be,” suspects Wüllner.
The number of those affected is increasing
Whether antibodies or shock wave therapy, there is still no cure in sight, but early diagnosis and targeted therapies might significantly improve the lives of many people affected by Alzheimer’s in the future. The number of people suffering from dementia is increasing: according to estimates, it might rise from 1.8 million to 2.8 million people in Germany by 2050.
Everyday life has already become easier for Hans-Jürgen and his partner. Since he started shockwave therapy a year ago, his orientation has improved once more. For Gabriele, it’s a positive change: “I don’t always have to be so on guard, I’m more relaxed and, let’s say, you’re more confident once more.”
The full names of Hans-Jürgen and Gabriele are known to the editorial team.
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