Pilot Study Suggest Precision Medicine Approach May be Effective for Early-Stage Dementia

In a small pilot study, published in the Journal of Alzheimer's Disease, treatment of early Alzheimer disease (AD) with a precision-medicine approach resulted in improved cognitive scores for 8 of the 9 participants. In this multisite study, signs of improvement were also seen in MRI measures of regional brain volume and care-partner assessment of symptoms.

All participants received MRI scans for regional brain analysis and showed improvements for grey matter volume and hippocampal volume. Increase in hippocampal grey matter volume 0.3% increase of grey matter volume, a 63% change decrease in the rate of hippocampal atrophy.

Lead author Dr. Kat Toups noted, "I have been the principal investigator on more than 20 long-term clinical trials for patients with MCI and dementia where the benchmark for success was merely a slowing in cognitive decline. This trial is the first to show actual improvement in multiple domains of functioning, as well as improvements in MRI brain scans."

Senior author of the study, professor Dale Bredesen, said, "We believe that the future of medicine, for treatment of complex chronic conditions such as AD, cancer, and cardiovascular disease, lies not in simplistic, single-drug medicine but rather in larger data sets and precision medicine protocols such as the one used in this trial."

Participants in the study were ages of 50 to 76 and had either mild cognitive impairment (MCI) or early dementia. At the start of this pilot study, they had assessments of potential risk factors and drivers of AD including: nutritional deficiencies, genotyping, gut and oral microbiome analysis, hormone and growth factor levels, presence of leaky gut, metabolic status, sleep apnea, specific pathogens and toxins, vascular abnormalities, and other potential contributory factors. These were then addressed with a personalized, precision medicine approach.

Digital health measurements are central to this approach. Posit Science, the on-line cognitive assessments used were developed by CNS Vital Signs, the MRI volumetrics technology was developed by Brainreader and CorTechs, and the evaluation and treatment algorithm, dubbed ReCODE, was developed by Apollo Health in collaboration with Bredesen.