Komal Bavaskar, D Y Patil University
Alzheimer’s disease affects around 5.8 million Americans aged 65 and over. 80% of those surveyed are 75 or older. In India, more than 4 million people are affected by this disease. Alzheimer’s disease is thought to affect between 60% and 70% of the approximately 50 million individuals globally who have dementia.
What is Alzheimer’s?
Alzheimer’s disease is a degenerative neurologic illness that involves brain shrinkage (atrophy) and cell death. It is the most prevalent form of dementia, which is defined as a progressive decrease in a person’s cognitive, behavior, and social abilities that impairs their capacity to operate independently. Alzheimer’s disease (AD) is the main cause of dementia globally. Early signs include short-term memory loss, a deterioration in problem-solving, difficulty finding words, and issues with spatial navigation. An estimated 10-22% of Alzheimer’s patients have seizures, while the remaining 22-54% have quiet epileptic activity.
Patients with quiet epileptic activity in their brains have a faster decrease in cognitive function. The researcher intended to test levetiracetam, an anti-seizure drug authorized by the FDA in 1999 and previously shown to be effective in Alzheimer’s disease models. Levetiracetam, which is now accessible as a generic, costs around $70 per year. This is a medication used to treat epilepsy. In the trial, we utilized it on Alzheimer’s patients who showed signs of silent epileptic activity, which is seizure-like brain activity without the associated physical convulsions.
How was the recent study conducted?
In this study, 54 patients who suffer from moderate Alzheimer’s symptoms were examined who exhibited silent epileptic activity. They were monitored overnight using an electroencephalogram (EEG), and to measure magnetic waves, an hour-long magnetoencephalogram (MEG) was utilized. MEG can detect epileptic activity that EEG does not have because it looks at different brain cell populations.
Of the patients selected for the study, 34 patients were eligible to participate, with nearly 40% having epileptic activity and the remaining without epileptic activity (before the screening, patients who were on anti-seizure drugs for pre-existing seizure disorders were excluded). These patients were subsequently separated into two groups, with one getting a placebo for four weeks, followed by four weeks without therapy, and then a levetiracetam dosage.
The dose used in this trial was 125 mg twice a day, which is far lower than the normal dose used to treat epilepsy. The second group received the same treatment in reverse order. The researchers assessed the patient’s problem-solving abilities, reasoning abilities, word recall, and navigation skills. For example, by using a driving simulator on a computer monitor, they made participants learn to walk on a street through a virtual city.
Findings from the study:
The researchers discovered that patients treated with levetiracetam improved their cognitive performance, but when the patients were separated into those with and without silent epileptic activity, the patients with silent epileptic activity showed progress from being on the drug. Epileptic variation is a subtype of Alzheimer’s disease that is extremely prevalent, affecting around 60% of individuals. Levetiracetam improves the complications in patients with this kind of Alzheimer’s disease.
When doctors diagnose Alzheimer’s patients, they usually don’t test for silent seizures, so the results of the study may prompt them to consider whether the patient is potentially experiencing epileptic activity. Doctors don’t test for silent seizures in patients this may lead them to examine if the patient is potentially suffering epileptic activity. Some clinical characteristics suggest that Alzheimer’s patients are more prone to have quiet epileptic activity. The primary one is being under the age of 65 when symptoms first appear. Researchers claim that the medication appeared to assist younger individuals even when they did not exhibit identifiable epileptic activity.
Significance of the study:
Patients in the research were already receiving presently authorized Alzheimer’s medicines, and the results show that levetiracetam improves cognitive performance more than existing therapies alone. Future research will be required to determine whether using the medication on a long-term basis can reduce disease development.
The goal of this study was to check for cognitive improvement throughout the short term of therapy. There are additional trials underway to determine if the medicine may help delay the illness course over long periods, adding that future UCLA research will focus on enrolling a more diverse study group and evaluating different anti-seizure drugs.
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Reference:
- Vossel, K., Ranasinghe, K. G., Beagle, A. J., La, A., Ah Pook, K., Castro, M., Mizuiri, D., Honma, S. M., Venkateswaran, N., Koestler, M., Zhang, W., Mucke, L., Howell, M. J., Possin, K. L., Kramer, J. H., Boxer, A. L., Miller, B. L., Nagarajan, S. S., & Kirsch, H. E. (2021). Effect of levetiracetam on cognition in patients with Alzheimer’s disease with and without epileptiform activity: A randomized clinical trial. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2021.3310
Author info:
Komal Bavaskar is a student currently pursuing M.Sc in Biotechnology. She is a resourceful person with a positive and proactive attitude when faced with diversity. She is interested in the research field and is a very dedicated worker who sets realistic goals. Komal strives to do the best she can for whatever task is presented to her.
Published articles:
- https://bioxone.in/news/worldnews/understanding-the-concept-of-membrane-channels/
- https://bioxone.in/news/worldnews/first-interchangeable-biosimilar-insulin-for-diabetic-patients/
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- Cell Senescence in Type II Diabetes: Therapeutic Potential
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