At the turn of the last century, Dr. Alois Alzheimer
experimented on the brains of dead patients who had experienced a
mysterious decline in intellectual ability.

Alzheimer was the first to look deeply into the absentmindedness
that was known to most people as a trait of the elderly and part of
the natural aging process.

He found that what these people were experiencing was not a
simple case of forgetfulness. Alzheimer discovered abnormal
proteins in their brains, which he described as the cause of a
biological disease.

Since then, Alzheimer’s disease, named for the pioneering
researcher, has become increasingly diagnosed among people
primarily older than 60. Because more people are living longer in
life, there are growing numbers of patients living with
Alzheimer’s, said Norman Foster, a neurologist at the
University Hospital. Foster is involved in a groundbreaking
national study aimed at diagnosing the disease using brain scanning
techniques rather than behavioral diagnosis.

Alzheimer’s is becoming a serious health problem because
most afflicted patients cannot care for themselves. Although there
are many treatments that slow the progression of the disease,
Alzheimer’s is difficult to diagnose and symptoms are
irreversible, Foster said.

Traditional methods used to diagnose Alzheimer’s are based
on assessing a patient’s behavioral symptoms. These symptoms
usually include memory loss and absentmindedness. The diagnosis is
often ambiguous because these symptoms are common in many brain
diseases that cause dementia, said Judy Heidebrink, a clinical
neurology professor who is also involved in the brain scanning
study.

Dementia is the deterioration of mental capabilities such as
memory, concentration, and judgment.

Even mentally healthy people may exhibit these symptoms. Because
of this problem with diagnosing Alzheimer’s, it is difficult
to treat affected patients with disease-specific drugs early enough
to be effective, Heidebrink added.

To help develop better ways to diagnose Alzheimer’s, which
is deteriorating the minds of an estimated four million Americans,
the University has become part of the Alzheimer’s Disease
Neuroimaging Initiative.

“We think we have some drugs that can prevent the
progression of Alzheimer’s and we have so many possibilities.
We have to test them,” Foster said.

“The ultimate goal is to be able to do so efficiently.
 This is kind of a first step toward being able to do a better
job.”

ADNI, a $60 million initiative, will develop and use
brain-scanning techniques to find biological, rather than only
behavioral, changes that occur with Alzheimer’s disease and
other forms of dementia.

“There is good evidence that things go wrong in the brains
of people who have Alzheimer’s several years before they have
significant impairment,” said Foster, who is the team leader
of the campus ADNI site.

Biological and chemical changes will be found in the study.
These changes will be designated as universal markers
characteristic of Alzheimer’s and will be used to diagnose
the disease precisely on a case-by-case basis, Foster added.

In 2002, the University released the first conclusive study
showing that a PET scanner, a medical “camera”
traditionally used for diagnosing heart disease and cancer
patients, can help to distinguish Alzheimer’s from other
forms of brain disease.

Most types of neuroimaging that are commonly used in research
and diagnosis, such as MRI scanning, produce images of the anatomy
of a tissue sample. They show changes in tissue that have already
occurred, such as the formation of a tumor, but provide no
information about the activity of the tissue, said Bob Koeppe, a
professor of radiology who is involved in ADNI.

PET scans produce images that contain critical information about
the functioning of live tissue. This kind of information is
critical in treating Alzheimer’s because it will allow
doctors to treat tissue that is being affected before it is
damaged, Koeppe added.

The University will be leading the ADNI’s PET Quality and
Analysis Data Coordinating Center, which will both develop PET
scanning methods to be used at other ADNI sites and also analyze
PET scans that will be made in hospitals nationwide.

In a PET scan image, the brain appears as a pattern of colored
spots. These spots correspond to areas of high and low brain
activity and reveal information about which parts of the brain are
most affected by Alzheimer’s.

Scans can be comparatively analyzed to normal brain images and
to images of brains affected by different neurological diseases to
determine biological symptoms typical of each disease and create
better standards for diagnosing dementia, Foster said.

The University will also contribute to the project clinically by
serving as a recruitment site that, starting in April 2005, will
find people between the ages of 55 and 90 to participate in the
study.  

The research participants, either cognitively normal or
suffering different forms of dementia, will be followed for up to
three years.  Similar sites will be set up nationally and in
Canada.

ADNI is a $60 million collaboration between government agencies,
universities and pharmaceutical companies.

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