Author: Jean-Claude Muller, 穆卓Executive Editor at BtoBioInnovation,   jcm@btobioinnovation.com

More on Alzheimer’s Disease Treatment

A recent paper entitled “Why so many clinical trials of therapies for Alzheimer’s disease fail?” published in the November 25, 2017 issue of The Lancet comes to a striking conclusion.  

Roy Anderson et al from the Imperial College of London are analyzing, through a possible framework model of transition of individuals between healthy and disease states embedded in a clinical trial simulation, how the progression of Alzheimer’s disease evolves.

Their key conclusions are two-fold:

First, the variability in measurements of endpoints between individuals implies that even with a good therapy efficacy, it would be difficult to identify a treatment slowing disease progression with a clinical trial of only 5 years’ duration. The simulation indicates that a 20% therapy efficacy could not even be identified after ten years of treatment; a 40% efficacy might show up at year 10; a 60% efficacy could only become significant after 7.5 years and even an 80% therapy efficacy might only be borderline visible in a 5 years’ clinical trial.

Second, the article points to the fact that the biopharmaceutical industry is not using frequently clinical trials simulators, which could nevertheless provide powerful insights into the relevance of endpoint choice and duration of treatment, before engaging in costly and lengthy trials.

It has been known for sometime that non-therapeutic intervention can be beneficial for people living with dementia and other related diseases.  Listening to music is one of them.

The power of music to unlock memories and other cognitive capacities in Alzheimer’s disease has been studied for quite a while, although its scientific validation is not straightforward at this stage. Studies by severak groups of researchers have identified areas activated during music memory tasks in healthy young adults, in particular the anterior cingulate and the ventral presupplementary motor area, including the anterior temporal, the frontal poalr and insular cortices. These areas were found to be relatively less affected by Alzheimer’s disease than other areas of the cortex, as indexed using standard neuroimaging biomarkers. In terms of clinical outcomes it has been shown that listening to favorite songs has the following effects:

• Music brings back memories and stimulates emotions
• Listening to music is one of the only remaining cognitive skills in advanced Alzheimer’s patients
• Music helps Alzheimer’s patients to reconnect to their loved ones and helps them to feel more secure.
• Listening to music and singing can help to manage excessive stress and agitation of patients in releasing serotonin, melatonin and prolactin.
• Listening to music engages the right side of the brain, but singing requires the left side.

In another study recently reported, it was clearly shown that “Individualized Music & Memory Programs” were associated with improvement on behavioral and psychological symptoms of dementia among nursing residents with Alzheimer’s disease and related dementia.

In spite of extensive research I could not find any study showing that professional musicians are less prone to Alzheimer’s disease than any other highly brain active professions.

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