"Forget Typical Alzheimer's: AI Finds Four Types."

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Fc1345linville
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"Forget Typical Alzheimer's: AI Finds Four Types."

Post by Fc1345linville »

Interesting article on Alzforum.

Fc


https://www.alzforum.org/news/research- ... four-types
NF52
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Re: "Forget Typical Alzheimer's: AI Finds Four Types."

Post by NF52 »

Fc1345linville wrote:Interesting article on Alzforum.

Fc
https://www.alzforum.org/news/research- ... four-types
Thanks for sharing this!

While several different "types" of Alzheimer's have been proposed, including by Dr. Bredesen, what makes this study unusual is that they looked at lots of images of tau from PET scans in the brain. Most studies have looked at the amount of amyloid beta plaques on PET scans or the areas of brain atrophy or thinning of the cortex on MRIs. Tau comes in different forms and seems to "seed" in specific areas of the brain for reasons that are not yet well understood. Importantly, these areas may make a difference when it comes to personalized predictions of how likely any one person is to progress from having tau in the brain to actually showing signs of cognitive impairment. They may also respond differently to drugs, or may affect how well people would respond to other interventions.

I thought the following comment following the article by Dr. Eric Reiman of the Banner Institute in Arizona explained the impact of this research in good layperson terms: (Emphasis added)
This study capitalized on cross-sectional tau PET and related data from an extremely large number of research participants in preclinical, MCI, and dementia stages. It used a machine learning algorithm to characterize four spatial patterns of tau-tangle burden and explore the extent to which these patterns are related to the pattern and severity of cognitive characteristics, the presence or absence of the APOE4 allele, and demographic characteristics including sex. The authors suggest implications for clinical course and subsequent tau-tangle deposition. The study supports the suggestion from smaller tau PET studies that the pattern of tau-tangle deposition is more heterogeneous and individually variable than suggested by neuropsychological studies and Braak stage.

The study raises a number of intriguing questions that could be put to the test or confirmed in future studies. For instance, what accounts for the different patterns of tau-tangle deposition? To what extent does it impact a person’s phenotype? What is its relationship to CSF or plasma p-tau or other biomarker measurements, to age at biomarker and clinical onset or clinical course? How does it fit with pathophysiological progression, or differential response to disease-modifying treatments now in development? To what extent are these patterns related to APOE variants, other genetic and non-genetic risk and protective factors? What implications do the findings have for the size and design of clinical trials, participant enrichment or stratification, the analysis of tau PET images, and their role as a trial endpoint?
4/4 and still an optimist!
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