New approach challenges pharmacological advancements in Alzheimer’s disease

MedTech & Diagnostics News: Growing evidence suggests that dysfunction in neural networks is a factor contributing to cognitive decline in Alzheimer’s disease, presenting a promising avenue for therapeutic intervention. Professor Kate Hoy of the Bionics Institute has recently unveiled pioneering research, highlighting alterations in brain activity and cognitive function among Alzheimer’s disease patients.

In pharmacological advancements for Alzheimer’s disease, the spotlight is currently on amyloid beta-directed monoclonal antibodies. Among these are Aduhelm (aducanumab), a product of collaboration between Biogen and Eisai, and Leqembi (lecanemab), developed by Eisai. Biogen withdrew its TGA submission for Aduhelm in 2022, while the TGA evaluation for Leqembi is ongoing. Demonstrating their potential, both treatments have proven effective in amyloid removal. However, when considering clinical benefit, Leqembi exhibited a 27% reduction in decline among individuals in the early stages of Alzheimer’s disease, whereas Aduhelm fell short in demonstrating clinical efficacy.

The more promising monoclonal antibody, Eli Lilly’s donanemab, was reported to produce around 30% reduction in decline in early-stage Alzheimer’s disease, but has yet to receive TGA approval.

Melbourne-based Bionics Institute’s research sheds light on the efficacy of a novel form of magnetic brain stimulation therapy in altering brain activity and improving cognitive function among Alzheimer’s disease patients. In a randomised controlled trial, the therapy known as intermittent theta burst stimulation (iTBS), was administered over a span of six weeks, and its effects on brain connectivity and memory were analysed.

The study unveiled promising outcomes associated with iTBS therapy, showcasing enhanced gamma connectivity and improved delayed recall for episodic memory for individuals grappling with mild to moderate Alzheimer’s.

Professor Hoy remarked on the nature of their approach, stating, “This is the first trial to provide iTBS to multiple brain regions in Alzheimer’s disease. We were able to show that our iTBS treatment successfully improved a specific type of brain activity that is closely associated with cognitive functioning, and that this was linked with improvement in memory.”

She added “Importantly, our research indicates that improvements in recall memory may be predicted by measuring the strength of a patient’s brain connectivity before the magnetic stimulation therapy.”

The significance of these findings cannot be overstated, serving as a stepping stone in the advancement of Alzheimer’s disease therapies. Alzheimer’s, the most prevalent form of dementia globally, affects an estimated 55 million individuals.

With the burden of this disease looming large, Professor Hoy is at the forefront, leading a world-first clinical trial to delve deeper into the potential of personalised magnetic brain stimulation in restoring dysfunctional brain connections and alleviating memory loss.

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