MORE THAN A CENTURY AGO, Alois Alzheimer, a German psychiatrist, first identified the neurodegenerative brain condition that came to be known as Alzheimer’s disease.
Finding ways to diagnose and treat this devastating disease has frustrated scientists and clinicians ever since.
Now the long and hard-fought campaign against Alzheimer’s has reached a potentially significant milestone: the launch of the first clinical trials to test whether new drug treatments given before dementia can prevent the disease.
The trial is being conducted by the Dominantly Inherited Alzheimer’s Network Trial Unit (DIAN-TU), led by principal investigator Randall J. Bateman, MD, the Charles F. and Joanne Knight Distinguished Professor of Neurology at Washington University School of Medicine.
Steps on the journey
School of Medicine researchers have made many key contributions along the journey to the new DIAN-TU trial.
The late Leonard Berg, MD, the founding director of the university’s Knight Alzheimer’s Disease Research Center, and current director John C. Morris, MD, were among the first to assert and prove that Alzheimer’s harms patients’ brains for many years prior to dementia onset and memory loss.
Washington University scientists have led the quest for new treatments and for biological markers that can identify people who seem normal but whose brains are actively being damaged by presymptomatic Alzheimer’s disease.
Researchers have characterized disease markers in cerebrospinal fluid and have tested neuroimaging techniques for detecting Alzheimer’s, making it possible to diagnose the disease much earlier.
A long, slow descent
Rare, inherited forms of Alzheimer’s are particularly devastating — striking much earlier in life than sporadic forms of the disease — with symptoms becoming apparent in some mutation carriers in their 30s or 40s. Children who inherit one of the mutations typically show signs of Alzheimer’s at about the same age as their parents.
To expand researchers’ opportunities to work with these families, Morris founded the Dominantly Inherited Alzheimer’s Network (DIAN) in 2008. This global network generated a pool of qualified volunteers and forged a research partnership determined to understand forms of Alzheimer’s caused by genetic mutations.
With the help of DIAN family members, researchers created a detailed timeline of the brain’s long, slow descent into Alzheimer’s dementia, showing, for example, that brain plaques can be detected 15 years prior to symptoms. These plaques are made mostly of amyloid beta. This protein, which abnormally accumulates in the brain of people with Alzheimer’s, is thought to play a role in brain cell damage and death.