An effective treatment for Alzheimer's disease

Alzheimer's disease reduces the number of nerve cells in the brain, causing it to shrink. Nerve cells can't be replaced naturally, and no cure has yet been discovered, therefore this is irreversible. Alzheimer's disease also leads to a decrease in the number of neurotransmitters, particularly acetylcholine, therefore transmission of neural messages is decreased. The disease leads to deterioration of brain function, resulting in memory loss, reduced language skills and behavioural and emotional problems.

Alzheimer's disease can be treated with acetylcholinesterase inhibitors, although they aren't very effective and most people get little benefit from them.¹ A couple of years ago the first steps were made to investigate the usage of a new drug in the treatment of Alzheimer's disease. Etanercept is an inhibitor that regulates the transmission of signals between neurons in the brain. It regulates the function of a protein called TNF-alpha that is usually involved in inflammation.² A number of investigations have related excess TNF-alpha to the progression of Alzheimer's disease, as it seems to also act as a neural transmitter in the human body.²

Etanercept has previously been used in the effective relief of pain, through perispinal administration (injection around the spine, but not into the spinal column).² This indicated that etanercept crosses the blood-brain membrane barrier, and suggested that the veins around the spine can be used to transport drugs to the spine and the brain.

In a case study, two patients were treated with perispinal etanercept.² The first patient had impairments in attention, linguistic processing, and memory. After treatment with a non-effective drug, he had become effectively mute before his treatment regime was changed to include perispinal etanercept. The patient's speech, as well as his movement, increased significantly after treatment, with the greatest improvement seen in the week after treatment.

The second patient was an 80 year-old who had a history of increasing word-finding difficulty, and worsening memory and handwriting. Even just 8 minutes after treatment with etanercept, the patient showed improvement, being able to recite the days of the week backwards, something he was incapable of doing before treatment. His conversational ability, attention span, and forgetfulness all improved in the weeks post-treatment, with the greatest effect being seen in the first week.

Since the greatest effect was observed one week after etanercept treatment, weekly treatments might be the most effective. Although this study has limitations, it adds to the range of treatments available to treat Alzheimer's disease.


¹ http://hcd2.bupa.co.uk/fact_sheets/html/alzheimers_disease.html
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² Tolbinick E and Gross H. Rapid improvement in verbal fluency and aphasia following perispinal etanercept in Alzheimer's disease. BMC Neurology 8:27 (2008)

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