Encompassing more than half dozen subtypes, linked to at least four different protein aggregates and at least six distinct genes, frontotemporal dementia would seem like a researcher’s nightmare. And yet, its science is advancing so fast that they have never been more hopeful. Read Tom Fagan’s coverage of the 11th International Congress on FTD, held in Sydney, to catch up on the news.
Tufted astrocytes? Astrocytic plaques? These tau pathologies mark progressive supranuclear palsy and corticobasal degeneration, respectively. The science of these difficult-to-diagnose diseases may finally be taking off. Read Tom Fagan’s coverage of the first PSP & CBD International Research Symposium held in London. Learn how genetics are yielding clues toward pathways, and natural history cohorts and therapeutic trials are getting underway.
When the anti-Aβ protofibril antibody Ban2401 was first shown to reduce amyloid deposition in a Phase 2b clinical trial, researchers worried. Was its otherwise exciting cognitive benefit just an artifact of an imbalance of APOE4 carriers between the treatment and placebo groups, caused by regulatory changes during the trial? At the11th Clinical Trials on Alzheimer’s Disease conference, held October 24–27 in Barcelona, investigators allayed some of those concerns. Their subgroup analysis by APOE genotype indicated that the drug effect was likely real. An early look at biomarkers suggests they are adding up toward a treatment effect on Alzheimer’s pathophysiology.
Is Alzheimer’s more common, or different, in black Americans? Or do cerebrovascular risk factors account for much of that community's disproportionate dementia burden? There’s too little data to know, because minorities are underrepresented in observational and therapeutic studies on Alzheimer’s disease and related dementias. That may soon change. Researchers across the federally funded Alzheimer’s Disease Centers are being asked to step up recruitment and retention in culturally sensitive, community-building ways. A recent workshop at Washington University, St. Louis, saw lively debate of the issue, and those interested in studying minority recruitment can apply for a R24 grant dedicated to the topic. Read Gabrielle Strobel’s two-part report.
This year, the AAIC conference showcased a field that is doggedly inching toward an effective anti-amyloid therapy while at the same time branching out from its usual ways of doing things. The antibody BAN2401 showed promising Phase 2 data, making it the latest in a handful of such therapeutics shown to robustly remove brain amyloid. (Hint: Crank the dose.) A fifth antibody, crenezumab, might remove CSF Aβ oligomers, a long-elusive species the field finally appears able to measure. Other scientists showed progress on capturing the decades-long disease process in deeper ways. They include measuring brain amyloid by way of a blood test, detecting neurodegeneration by way of blood neurofilament light protein levels, imaging synapses and—last but not least—new tests that catch subtle subtle cognitive deficits many years prior to the overt forgetting that used to be called symptom onset. (Hint: tau.) Non-amyloid-centered research is growing apace, supporting large initiatives to study the cardiovascular components of dementia, metabolic underpinnings of sex differences in AD, innovative drug-delivery approaches using ultrasound, and tech-based ways to support research and patient care.