Alzheimer’s is like a big jigsaw puzzle – The overall picture changes almost daily

On diabetes drugs, possible disease transmission and the emerging diversity of treatment methods

Alzheimer’s research is undergoing a period of intense development, driven by increasing prevalence and numerous new findings in the scientific community. For decades, the amyloid hypothesis has dominated the understanding of Alzheimer’s disease, but recent research findings are considerably broadening this horizon on the causes and further possible therapeutic approaches. However, the disease still resembles a huge, constantly changing puzzle to which new pieces are added almost daily.

In addition to traditional factors such as beta-amyloid and tau proteins, other potential causes are coming to the fore – and, accordingly, other therapeutic approaches beyond antibody drugs such as lecanemab and donanemab.

For example, the active ingredient semaglutide, which is used for diabetes, is being researched as a possible treatment option for Alzheimer’s disease. In addition, current studies suggest that Alzheimer’s could be contagious in individual cases. These developments challenge us to look at the disease from different perspectives and open up new avenues for therapeutic approaches.

Semaglutide: A promising approach beyond diabetes and obesity

Semaglutide, originally developed to combat diabetes and obesity, is showing promising signs in recent studies that it may also slow brain deterioration. This discovery is particularly noteworthy as it bridges the gap between the treatment of metabolic diseases and neurodegenerative disorders such as Alzheimer’s disease. ¹

Semaglutide belongs to the group of GLP-1 receptor agonists. GLP-1, short for glucagon-like peptide-1, is a naturally occurring hormone in the body that plays a key role in the regulation of blood glucose levels. It not only helps to control blood sugar, but also influences the feeling of satiety by slowing down gastric emptying.

Semaglutide and the promising role of GLP-1

The new discovery with GLP-1, however, is its potential neuroprotective effect. Current research suggests that GLP-1 may be able to protect nerve cells and thus counteract degenerative processes in the brain. This property of GLP-1 could explain why semaglutide may also be effective in the treatment of Alzheimer’s dementia. The idea that a hormone that is primarily associated with metabolic processes could have a protective effect on the brain opens up exciting new avenues in Alzheimer’s research and treatment.

Another aspect of the development of Alzheimer’s: a potentially transmissible disease?

Until now, Alzheimer’s was mainly considered a sporadic or genetic disease. However, a recent British study ² brings another perspective into play. Researchers have now been able to show that Alzheimer’s can possibly be transmitted between people and appear as a disease many years later – but only under very specific conditions.

The albeit small pilot study raises the question of whether Alzheimer’s proteins, if they enter the brain directly, could make the form of dementia transmissible. This surprising finding could have far-reaching implications for Alzheimer’s research and the management of the disease.

British study reveals: Alzheimer’s and the link to historical treatments

The British study, which sheds light on the possible transmissibility of Alzheimer’s, is based on an analysis of eight patients who were treated with growth hormones during their childhood. These hormones were derived from the brain tissue of deceased individuals, which was a common practice worldwide from 1959 to 1985. In the UK, 1,848 people were treated with this therapy during this period.

When it became apparent in 1985 that some of those treated showed symptoms of Creutzfeldt-Jakob disease (CJD) at an unusually early stage, this method was discontinued. These historical events form the background of the study and provide important insights into the potential transmissibility of Alzheimer’s disease.

This historical contextualization shows how medical practices of the past can lead to new insights in today’s research. In addition, according to the scientists, the results of the study could shed light on further underlying mechanisms – and thus further treatment options – for Alzheimer’s disease.

Non-invasive brain stimulation: a new horizon in Alzheimer’s therapy

The influence of physical therapy methods on the treatment of the brain has also been the subject of intensive research for many decades, and the scientific data on this is becoming increasingly comprehensive. Physical therapies based on methods such as shock waves, electromagnetic or electrical waves and other non-invasive approaches have proven to be effective in various medical fields.

In the context of Alzheimer’s therapy, such non-invasive brain stimulation methods (NIBS) are increasingly becoming the focus of research. Approaches such as transcranial pulse stimulation (TPS) are increasingly seen as promising treatment options for neurodegenerative diseases such as Alzheimer’s disease. The use of these methods aims to improve brain function and positively influence the course of the disease.

Due to the growing scientific evidence for the effectiveness of these forms of therapy, professional societies are also increasingly calling for faster and more extensive integration of NIBS into everyday clinical and practical practice. This demand underlines the importance of these therapies for the treatment of Alzheimer’s patients in order to offer them effective treatment options and improve their quality of life.

Alzheimer’s therapy in transition – diversity as the key to success

Alzheimer’s dementia, once considered a disease mainly characterized by amyloid deposits and tau fibrils in the brain, continues to emerge as a much more complex mystery. Progress in research shows that the development of the disease is more complex and it is therefore necessary to put together many different pieces of the puzzle in order to gain a more comprehensive understanding.

The treatment of Alzheimer’s is no longer limited to antibody drugs. Instead, new perspectives are opening up with different treatment methods that can potentially be combined and also personalized. From the discovery of the potential therapeutic role of agents such as semaglutide to innovative non-invasive brain stimulation methods such as Transcranial Pulse Stimulation (TPS), Alzheimer’s therapy is constantly evolving.

The challenge now is to make the best possible use of these various therapeutic approaches and to integrate them promptly into the treatment offering. This requires not only ongoing scientific research, but also a willingness to explore new treatment pathways and implement them in clinical practice. By rising to this challenge, we can hope to positively influence the course of Alzheimer’s disease and improve the lives of those affected in the long term.

Sources:

¹ https://www.nature.com/articles/d41586-024-00118-4
² https://www.nature.com/articles/s41591-023-02729-2