Therapeutic Innovations in Alzheimer's Disease

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder associated with abnormal protein modification, inflammation and memory impairment.  In many ways, Alzheimer's can be considered as the epidemic of the 21st century. An entity associated with age and that, according to WHO data, affects around 50 million people worldwide, of which around 60% live in low- and middle-income countries. About 10 million new cases are registered each year. It is estimated that between 5% and 8% of the general population aged 60 years and older suffer from dementia at any given time. The total number of people with dementia is expected to reach 82 million in 2030 and 152 million in 2050. Much of this increase can be attributed to the fact that in low- and middle-income countries the number of people with dementia will tend to grow increasingly.

Alzheimer’s disease is a multifactorial pathology, for which no cure is currently available. To date, we do not have any effective treatment that cures it or an effective brake on the evolution of degeneration. Associated risk factors such as smoking, alcohol, sedentary life, obesity, cognitive inactivity have been identified. Although it is true that age is the main risk factor, still that is not always the case.

Although it is not currently curable, new innovations in the diagnosis and treatment of Alzheimer’s disease and other dementias are in sight. A significant number of candidate therapies are in late stage trials and, assuming successful trials and approval, are on a path to be on market in the next five years. David Schick, a neurology specialist practicing in the state of New York, has participated in clinical trials of varied diseases including peripheral neuropathies, human immunodeficiency virus infections, and central nervous system’s (CNS) diseases like AD.

According to David Schick, the pharmacological interventions used to date have obtained a more than modest benefit and non-pharmacological interventions are becoming more and more common. Along these lines, a systematic review and network meta-analysis has recently been published where it is concluded that non-pharmacological interventions (massage and tactile therapy, multidisciplinary care, music therapy) appear to be more effective than traditional antipsychotics and antidepressants.

Therefore, we find ourselves in a scenario where traditional treatments and approaches are being complemented with unusual alternatives. It is in this context that transcortical shock wave stimulation emerges. There was already evidence at an experimental level of the usefulness of a treatment of these characteristics that protected the structural changes produced by ischemia in the brain. The first series of patients with Alzheimer's disease in whom the use of transcranial stimulation with ultrasound pulses has obtained a positive result has already been published.

This, according to New York neurologist David Schick, opens a door to hope in the management of these patients and their families. Treatment with non-invasive, bloodless and effective techniques is now a reality. Therapeutic innovation in Alzheimer's disease is a necessity and we have to keep working on it. So far, our results in the application of transcranial stimulation with ultrasound pulses in patients with cognitive impairment coincide with the recently published work. This reaffirms us that it seems to be a valid alternative.