what if, adni 2 follow up

WHAT IF
the theory is that alzheimers disease is caused by the accumulation
of a sticky gooey substance called beta amyloid that attaches itself
to the brain and as a result the brain nerve cells die and what the end
result is
alzhiemers disease
thats the theory that is about to be finally tested in a clinical trial in
columbia
why columbia and not the us

in columbia there is an extended family of over 300 people who
get full blown alzhiemers disease in their mid 40s
they have a genetic mutation that predisposes them to get the
disease

there are people here in the us that have the same mutation but they
are not in the same family and in the same area of the country
like the family is in columbia

the new drug being tested is called crenezumab
its an injectible drug that induces the body or it is an anitbody that
attaches itself to this goey sticky beta amyloid and starts to remove
it from the brain

instead of giving it to people who have full blown alzhiemers
the drug will be given to people who dont have any symptoms yet
but who most certainly will get the disease within 10 years

if the beta amyloid gets removed as its produced and these people
who are destined to get alzheimers dont get alzheimers then the
theory that the beta amyloid is the cause of alzheimers disease
is proven and we then will have the first real medicine that can be
used to prevent alzheimers disease from occurring

thats the treatment america and the world is waiting for
i know if it was available and it works i would be first in line
to volunteer to get it
similar drugs as ive mentioned before though do not work as
well in patients like me who carry the apoe 4 gentotype
so if it works it may not work as well in me and others who
carry this genotype

could we have a cure or preventative treatment coming soon
the goal is a cure by 2025
i of course dont have that much time to wait

ADNI 2 FOLLOW UP
yesterday i went for my one year follow up for the adni 2 study
alzheimers disease neuroimaging  intiative phase 2
i had tons of blood drawn in special tubes that are sent off to
the adni central location i think in uc san diego

i had a neuropsychological exam done again
yes the torture test
this was a little shorter yesterday as it was only an hour long
next year i have the lengthy one done of 2-21/2 hours
dont look forward to that one

i had another neurological exam done by a neurologist and
a lot of questions were asked about how i was doing

my wife she also has to go with me
they ask her lots of questions about me and she
has to fill out a lengthy questionnaire on how im doing
she was real good this time and didnt get faintified

then finally i had a special volumetric mri of the brain done without
contrast that also takes extra views of the area of the brain
where alzheimers usually starts
this volume of this area will be measured and any subtle
changes in its size will be detected on this mri
this mri although read locally will be sent to the research central
area i think again at uc san diego to be officially read for the study

as a part of the deal i dont get the results of these studies

however when i take the neuropsych exam i know personally how
i am doing
i still have short term memory problems that are noticeable when
i take the test and have been persistent
they do correlate with things i notice but others dont notice
in my everyday life
none of this interferes with what i am doing now but
would have interfered with my practice of medicine

this does seem stable however and has not really worsened in a
year and a half since i had my first neuropsych exam done

my wife she and i did a video for the alzheimers research center
they did over 4-5 hours of filming and made a 5 minute video

ive reviewed it and although its hard to watch for me i know
that its a good video that hopefully will encourage people to get
evaluated  if they are having symptoms or to volunteer for an alzheimers
research study

i should be able to post it on my blog and it also will be available
on the azheimers research centers website and possibly other
national websites soon

i will post where it can be viewed when its available

the organicgreen doctor

scans, post video, post visit, workup

SCANS
tried to post a beta amyloid pet scan of a patient with
mild cognitive impairment yesterday on facebook
that would not post so im posting it here

the red stuff is not suppose to be there
this is actually from a patient with alzheimers disease
but a patient with mild cognitive impairment who has
advanced some will look similar to this

that red stuff is beta amyloid
thats what is thought to be the cause or the end result
of whatever is causing alzheimers disease

if we can stop this deposition of the beta amyloid in the
brain or remove it early with meds or a vaccine then we
will be getting somewhere in the prevention and cure and
treatment of the big A

this is a glucose metabolism  pet scan

the red stuff in this scan is suppose to be there
its radioactively labelled glucose
the more the merrier
in mild cognitive impairment its reduced
and in the big A its even reduced more
the brain cells that are damaged cant metabolize
glucose well so they start dying

the other scan that is done is the volumetric mri


on the right is a normal beta amyloid with a normal
volumetric mri (vmri)
on the left is the abnormal beta amyloid with the red stuff
and just below this is an abnormal volumetric mri
with increase size to the ventricles in the middle that looks
like a bird in flight and the decrease in the hippocampal area
on the under surface of the brain
-the hallmarks of early alzheimers disease or mild cognitive impairment

these then are the three scans that i am aware of that are used
in working up alzheirmers disease or cognitive problems
the beta amyloid scan is only available in research centers but will
be available elsewhere in the next two years if the fda approves it

the volumetric mri and the glucose metabolism pet scan can be done
at many radiological centers now

hope this is helpful to those of you that have asked about them

POST VIDEO
taping the video was fun
dang sure was a lot of retakes
hate to see what it would be like to do a movie
the video staff taped an interview with me then with the doctor
i see doing an office visit with me then with the research director
doing an intake interview with me and then with the testing person
doing part of the neuropsychological testing (asked them to do
the part that i could do correctly)
this is will eventually be on their new updated website
will post it when its all completed

POST VISIT
am sure they hate to see doctors as patients
know i hate being one
theres no changes in my medications and will do
a follow up in 6 months
not much to report

WORKUP
a close relative of mine has decided to undergo an evaluation
mainly as a baseline for future reference
the relative took the article that was written about my situation
to the doctors visit
she is now having an evaluation done that sounds like its everything
that should be done to evaluate someone

this is probably a good idea since
the relative is probably at a higher risk than most people because of
our shared genetic history
remember most cases of alzheimers ARE NOT genetic
it just happens that it probably is in our families genes

the earlier this is picked up
the earlier medication and preventative stuff can be done (we all should
be doing those things anyway)
the medications can delay things for awhile
it gives us time with our families
and in my case i savour each day
which i may not have been doing if i didnt know

good luck with the evaluation

the organicgreen doctor