A research team led by scientists from the University of Washington School of Medicine assembled the most detailed chronology of the long-term human brain slowly falling into full Alzheimer's disease. This breakthrough research result was published on July 11 in the "English Journal of Medicine" (NEJM).

As part of an international research collaboration of the Dominant Genetic Alzheimer's Network (DIAN), scientists from the University of Washington and elsewhere have conducted a variety of Alzheimer's disease in 128 subjects from a family of genetically susceptible diseases Markers were evaluated before symptoms occurred. Individuals in the study have a 50% chance of inheriting one of the three mutations that must cause Alzheimer's disease, often at a very young age.

Using the medical records of the parents of the subjects to estimate the age of onset of symptoms for the study participants, the scientists assembled a schedule of brain changes that led to the characteristic memory loss and cognitive decline of Alzheimer's disease. The earliest changes in the participants' age 25 years before the onset of the disease can be detected, and the level of cerebrospinal fluid, a key component of Alzheimer's disease plaque, can be detected.

The lead author of the article, Dr. Randall Bateman, a well-known neurology professor at Washington University School of Medicine in St. Louis, said: "A series of changes have begun to occur in patients or families decades before the onset of Alzheimer's symptoms. We learn more about the origin of Alzheimer ’s disease planning preventive treatment, and the value of the Alzheimer ’s timeline for conducting successful drug experiments will be incalculable. ”

For example, Bateman said, the new data showed that plaques were visible in brain scans 15 years before memory problems became apparent. DIAN researchers plan to give treatment to clear or prevent plaque formation at this early stage of the disease process, and monitor the subjects to see if they can not only prevent or reduce plaque, but also enable other Alzheimer ’s in the study Biomarkers have been improved.

Mainly funded by the National Institutes of Health (NIH), the DIAN collaboration is investigating the rare, familial form of Alzheimer ’s disease, which can cause the affected person to develop symptoms between the ages of 30 and 40, more often than usual The delayed form of Alzheimer's disease that occurs after the age of 65 is decades earlier.

Dr. Laurie Ryan, Director of the Clinical Trials Program at the National Institute of Aging, NIH, said: "These exciting findings confirm for the first time our long-standing suspicion that the disease begins many years before the first signs of cognitive decline or memory loss. Although DIAN participants are at risk for this rare genetic form of disease, the insights gained from the research will give us an excellent understanding of late-onset Alzheimer's disease. "

Because these genetic forms of Alzheimer's disease individuals are widely distributed geographically, few extensive studies are completed in one center. To this end, Dr. John C. Morris, the chief researcher of DIAN and a famous neurology professor at the University of Washington, and his research team formed a network four years ago.

"Without the joint collaboration and contributions of our DIAN collaborators across research institutions in the US, UK and Australia, it is impossible to collect these new research results," Morris said.

Other findings from the new study include:

• 15 years before the onset of Alzheimer's disease symptoms, the level of cerebrospinal fluid tau, a structural protein in brain cells, increases.

• Atrophy of key brain structures can be identified 15 years before symptoms

• Decreased glucose utilization in the brain and a specific form of memory impairment can be detected 10 years before the symptoms

The researchers also tested participants from the DIAN family who did not have any mutations that would cause hereditary Alzheimer's disease.

Bateman said: "In family members without mutations in Alzheimer's disease, we did not detect changes in test biomarkers. Among family members without mutations, the normality of Alzheimer's biomarkers is surprising. "

Bateman is leading DIAN participants in Alzheimer's disease prevention and treatment trials. He and his colleagues hope to start the experiment this year.

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