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Spinal-Fluid Test Confirmed To Predict Alzheimer's

Soulskill posted more than 4 years ago | from the denny-crane dept.

Medicine 138

omnibit writes "The New York Times reports that researchers have found a spinal-fluid test can be 100 percent accurate in identifying patients with significant memory loss who are on their way to developing Alzheimer's disease. The new study included more than 300 patients in their seventies, 114 with normal memories, 200 with memory problems, and 102 with Alzheimer's disease. Their spinal fluid was analyzed for amyloid beta, which forms plaques in the brain, and for tau, another protein that accumulates in dead and dying nerve cells in the brain. Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels."

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Thank goodness: (1)

Fluffeh (1273756) | more than 4 years ago | (#33198126)

I hope that an easy text will be developed from this in the next few years. I couldn't imagine walking into a haze of Alzheimer's without knowing about it. This is one of those tests that I will ABSOLUTELY not be missing once I book it in.

Re:Thank goodness: (1, Insightful)

solevita (967690) | more than 4 years ago | (#33198146)

And on the plus side, if you do have Alzheimer's you will at least be able to forget about the late life spinal tap.

Und this affects NERDLINGS how? (-1, Offtopic)

Anonymous Coward | more than 4 years ago | (#33198508)

I mean that my memory is fine, so are the nerdlings ever-present and accounted for here.

When I was young
I'd listen to the radio
Waitin' for my favorite songs
When they played I'd sing along
It made me smile

Those were such happy times
And not so long ago
How I wondered where they'd gone
But they're back again
Just like a long lost friend
All the songs I loved so well

Every sha-la-la-la
Every wo-o-wo-o
Still shines
Every shing-a-ling-a-ling
That they're startin' to sing's
So fine

When they get to the part
Where he's breakin' her heart
It can really make me cry
Just like before
It's yesterday once more

Lookin' back on
How it was in years gone by
And the good times that I had
Makes today seem rather sad
So much has changed

It was songs of love
That I would sing to then
And I'd memorize each word
Those old melodies
Still sound so good to me
As they melt the years away

Every Sha-la-la-la
Every Wo-o-wo-o
Still shines
Every shing-a-ling-a-ling
That they're startin' to sing's
So fine

All my best memories
Come back clearly to me
Some can even make me cry
Just like before
It's yesterday once more

Every Sha-la-la-la
Every Wo-o-wo-o
Still shines
Every shing-a-ling-a-ling
That they're startin' to sing's
So fine

Every Sha-la-la-la
Every Wo-o-wo-o
Still shines
Every shing-a-ling-a-ling
That they're startin' to sing's
So fine

Re:Und this affects NERDLINGS how? (1)

flydpnkrtn (114575) | more than 4 years ago | (#33199320)

Now I have Karen Carpenter stuck in my head you insensitive clod!

Re:Thank goodness: (1)

v1 (525388) | more than 4 years ago | (#33198578)

And on the plus side,

Ok, cue the "One of the great things about having Alzheimer's is..." jokes

- you can wrap your own presents
- you get to meet new people every day
- you can hide your own easter eggs (my fav)

need more!

Re:Thank goodness: (5, Insightful)

cgenman (325138) | more than 4 years ago | (#33198754)

In her early onset of Alzheimer's, I used to say shocking things about my life to my Grandmother. She'd be surprised, righteously indignant, and secretly curious. She'd ask all sorts of questions. Fifteen minutes later, we'd do it all again.

When I left from these visits, she'd be absolutely glowing. She'd be awake, excited, and extremely happy. And she had no idea what happened. Next time in, I could make the shocking revelations again with the same effect.

Re:Thank goodness: (1)

Profane MuthaFucka (574406) | more than 4 years ago | (#33200406)

-Republicans will still look up to you for your intelligence

Re:Thank goodness: (5, Funny)

0100010001010011 (652467) | more than 4 years ago | (#33198640)

Only 100% accurate? Given the necessity for a spinal tap it should go to 110%.

Re:Thank goodness: (5, Funny)

hey (83763) | more than 4 years ago | (#33198884)

If I had points I'd bump you to 6.

Re:Thank goodness: (4, Funny)

electrostatic (1185487) | more than 4 years ago | (#33199122)

Man visits his doctor.

Man: "What's the news, Doc."

Doc: "Not so good. Test results show cancer, and ... spinal fluid indicates ... Alzheimers."

Man: "... Well, at least I don't have cancer."

Re:Thank goodness: (1)

DrGamez (1134281) | more than 4 years ago | (#33200504)

Please take this comment in lieu of actual Karma points, because I have none.

Re:Thank goodness: (1)

Khyber (864651) | more than 4 years ago | (#33201106)

Some of us may need that tap in mid-life. Seeing how a majority of my family passed away, I know I'm certainly getting the test done.

Re:Thank goodness: (0)

Anonymous Coward | more than 4 years ago | (#33198172)

For easy texts, refer to creations from CS Lewis and Roald Dahl

Re:Thank goodness: (3, Insightful)

Rei (128717) | more than 4 years ago | (#33198214)

Yeah... too bad it's a spinal fluid test. Those are nasty. My spouse had one and the hole in the dura refused to close, which is apparently a fairly common side effect. Net result: unbearable, nonstop, over-10-on-a-1-to-10-scale headaches that can't be controlled with headache medicine. Caffeine on an IV drip works, but only temporarily. The headaches lasted for weeks until the doctors finally managed to close the hole with a blood clot. The clot doesn't actually fix the problem, but the dura managed to repair itself while the clot held. I've heard of people, however, who *never* healed from it. What a miserable experience.

Re:Thank goodness: (5, Informative)

ColdWetDog (752185) | more than 4 years ago | (#33198304)

That happens, but it is rare. But because of the potential numbers of people who would want the test, the difficulty of doing a lumbar puncture (spinal tap) on persons who have arthritis in the back (very common among us ancient folk), are of the supersized persuasion, or have other reasons to dissuade themselves, I don't think this is going to be the ultimate test.

Instead it will serve as a proxy to allow simpler tests to be developed. TFA also notes that PET scans are fairly accurate. These are available at many larger medical centers but are also pretty pricey and technically complex.

This is also not the first time that lumbar punctures for beta amyloid [elements4health.com] have been used to diagnose Alzheimer's. And finally, the abstract [ama-assn.org] of the original article for your viewing pleasure.

Re:Thank goodness: (2, Informative)

Rei (128717) | more than 4 years ago | (#33199858)

The debilitating headache is not rare; it occurs in a third of all cases and normally lasts 24-48 hours. What's rare is when it lasts a year or more. Somewhere in-between is my spouse's case, which lasted a couple weeks and took medical remediation.

Re:Thank goodness: (1)

epp_b (944299) | more than 4 years ago | (#33200176)

Actually, if the procedure is performed properly and you actually lie flat in a bed for two hours like you're supposed to, the risk of headache is very low.

Re:Thank goodness: (1)

Rei (128717) | more than 4 years ago | (#33200864)

Link [mayoclinic.com] : "Spinal headaches occur in up to 30 percent of those who undergo a spinal tap (lumbar puncture) or spinal anesthesia."

And almost nobody gets up during those two hours because the doctors typically make you lie flat. The dura just doesn't deal well with being punctured. Some people heal quickly. But a large minority don't. And some never heal.

Re:Thank goodness: (1)

jordan_robot (1830144) | more than 4 years ago | (#33200338)

...are of the supersized persuasion...

You mean, like a huge cock?

Sucks for those guys.

Re:Thank goodness: (1)

tkjtkj (577219) | more than 4 years ago | (#33200546)

Your comment "But because of the potential numbers of people who would want the test, the difficulty of doing a lumbar puncture (spinal tap) on persons who have arthritis in the back (very common among us ancient folk), are of the supersized persuasion, or have other reasons to dissuade themselves, I don't think this is going to be the ultimate test." is misleading. As a retired anesthesiologist with well over 20 years medical experience i can state that i have never experienced any patient whom i could not obtain a successful "spinal tap". Yes, a very small number were difficult, but in the hands of a professional your concern is misguided.

Re:Thank goodness: (3, Interesting)

Have Brain Will Rent (1031664) | more than 4 years ago | (#33198456)

Yup my Dad had that done and he said it was the most painful thing he'd ever had happen... and this was a guy who grew up on a farm (a great source of pain), served years in combat during WWII and so on and so, on without ever raising a complaint.

The next time he had to go in was because of a disc problem and they essentially injected his spine with meat tenderizer to dissolve the ruptured disk away. He said compared to the spinal tap that didn't hurt at all (except for the nurse yanking his boxers off without first checking for protrusions - yikes!).

Re:Thank goodness: (0)

Anonymous Coward | more than 4 years ago | (#33200148)

That's sounds like an awful side effect that I've been fortunate enough never to experience in any of the several lumbar punctures (herein refereed to as "LPs") I've endured.

A huge part of the pain with LPs is the fear of the unknown; not knowing exactly when the needle will hit because you can't actually see it happening. I know and understand the hesitance associated with LPs, but there are actually two ways to do it.

There's what I would call the jar-of-leeches way: performing the procedure at the hospital bed while the patient sits upright, with the needle placement guided by an educated guess. This was how I experienced my first LP; it was so excruciatingly painful, I'd have passed out if I had it had been completed just a few seconds later. I've experienced a lot of pain related to medical procedures for my chronic condition, including surgeries, biopsies and so-on, and I've the only thing that came close on the pain richter-scale was having six feet of cotton jammed up each of my nostrils (not an exaggeration). I would not consent to an LP being performed this way again.

Then, there's the proper and modern way of doing it: performing the procedure in a semi-dedicated lab with a fluoroscope while lying on a specialized bed tiled to about 25 degrees. This allows the specialist performing the procedure to literally see a live x-ray so that the needle can be placed very precisely; ie.: to miss nerves and minimize the risk of misplacement. When performed in this manner, it's still uncomfortable, but it's not even that bad in terms of pain level.

Re:Thank goodness: (1, Troll)

c0lo (1497653) | more than 4 years ago | (#33198322)

I hope that an easy text will be developed from this in the next few years. I couldn't imagine walking into a haze of Alzheimer's without knowing about it. This is one of those tests that I will ABSOLUTELY not be missing once I book it in.

:) Suggestion: make sure you make a note - actually, many of them - and post them all over in your home: this is to avoid the risk of forgetting about the test by the time it gets approved :)

Re:Thank goodness: (1)

c0lo (1497653) | more than 4 years ago | (#33198520)

Apologies, I thought the smiley-s would clearly indicate the post as meant to be on the funny side (and by no means offensive, flame-ing, much less trolling).

On the serious side, if the original poster thinks her/himself at risk, I wouldn't recommend the original poster to skip any Alzheimer's test just because of this piece of news: given the time required for FDA's approval [wikipedia.org] it may be too late (granted, since it is a test only, the time to approval may be shorter than for a drug, but anyway...)

Re:Thank goodness: (1)

Kepesk (1093871) | more than 4 years ago | (#33198560)

What was this test for? I can't remember... And how did I get up in this tree?

Re:Thank goodness: (1)

aqk (844307) | more than 4 years ago | (#33200586)

I hope that an easy text will be developed from this in the next few years. I couldn't imagine walking into a haze of Alzheimer's without knowing about it. This is one of those tests that I will ABSOLUTELY not be missing once I book it in.

Ummm.. don't you remember?
You had one of those tests last week. You told me so.

100% of the time? (0, Offtopic)

Some.Net(Guy) (1733146) | more than 4 years ago | (#33198132)

Did they only test one person because they kept forgetting they'd tested him?

Re:100% of the time? (0)

Anonymous Coward | more than 4 years ago | (#33198190)

I'm more confused by this.

researchers have found a spinal-fluid test can be 100 percent accurate

Later followed by

Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels

So it can 100% predict what not 100% of them have...?

Re:100% of the time? (1)

Aladrin (926209) | more than 4 years ago | (#33198342)

Actually, they're saying that if they detect amyloid beta, you are on your way to Alzheimer's. Guaranteed. If they don't detect it, all bets are off.

Oh wait, that's not even right:

"And about a third of people with normal memories had spinal fluid indicating Alzheimer’s. Researchers suspect that those people will develop memory problems."

So it's just a lie about the '100%'.

Re:100% of the time? (1)

interkin3tic (1469267) | more than 4 years ago | (#33198392)

Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels

So it can 100% predict what not 100% of them have...?

There were two proteins being tested. Say out of the hundred alzheimer positives, two had tau levels that were below the average for alzheimer patients by a statistically significant amount BUT significantly higher than the average your non-alzheimer population , and their beta amyloid levels were normal for an alzheimer positive, then you could say it was 100% accurate, nearly every patient had the -characteristic- levels, and the NY times would probably summarize it like they did.

Alternatively, maybe beta amyloid and tau were not detectable above noise in people without alzheimers, and were present in every alzheimer patient, but there was some variety in the levels due to amount of plaques present (amount of tissue leaking these proteins). That could also account for the "nearl every person had the characteristic levels..."

Re:100% of the time? (1)

interkin3tic (1469267) | more than 4 years ago | (#33198340)

300 people. In the summary.

100% meant it was, as tested, 100% accurate with no false positives or negatives.

Spinal test fluid confirmed to ... umm what? (-1)

h00manist (800926) | more than 4 years ago | (#33198138)

Sorry I forgot what I was going to say

Re:Spinal test fluid confirmed to ... umm what? (0)

binarylarry (1338699) | more than 4 years ago | (#33198174)

Don't worry, I remember perfectly.

Apparently Spinal Tap is reforming and they're kicking off the new world tour in Alzheimer, Germany.

It's going to be killer.

Silly question (1)

MichaelSmith (789609) | more than 4 years ago | (#33198160)

I know that amyloid beta in the Cerebrospinal fluid is a secondary symptom of plaques on neurons, but I wonder of filtering or replacing the CSF would help the situation at all?

Re:Silly question (1)

interkin3tic (1469267) | more than 4 years ago | (#33198310)

I'd guess it wouldn't be worth the expense since, as you noted this is secondary. It's not even a secondary -symptom-. It's not going to do anything besides cause massive headaches. Literal headaches, that is. It would be a bit like trying to fight a fire by clearing the smoke out of a burning building.

Re:Silly question (1)

MichaelSmith (789609) | more than 4 years ago | (#33198514)

massive headaches

Yeah I know. My nephew has fungal meningitis, which is weird, nobody knows where it came from. He is otherwise very healthy. His condition was diagnosed when the infection pushed up the pressure of his CSF and caused exactly those symptoms.

Re:Silly question (0)

Anonymous Coward | more than 4 years ago | (#33199666)

Not silly at all. Some of the current R&D drugs are focused on dispersing plaques to increase the brain free amyloid levels so that it can wash out --either blood or possibly into the csf pool. Also plaque formation is not on neurons but in the inter-cellular spaces.

Ouch! (0)

Anonymous Coward | more than 4 years ago | (#33198186)

And who put this tube in my spine?!?!?

Why was I hitting submit again?

100% Accurate, Nearly All of the Time! (4, Insightful)

Alphanos (596595) | more than 4 years ago | (#33198230)

So, just to clarify, this test "can be 100% accurate", while at the same time "Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels."

That's a pretty neat trick.

Sex Panther (1)

mosb1000 (710161) | more than 4 years ago | (#33198288)

60% of the time, it works every time.

Re:Sex Panther (2, Funny)

mtinsley (1283400) | more than 4 years ago | (#33198600)

I'm gonna be honest with you, that smells like pure gasoline

Re:100% Accurate, Nearly All of the Time! (5, Interesting)

GNUALMAFUERTE (697061) | more than 4 years ago | (#33198332)

Yeah, not only that, but also it says that many people without Alzheimer's turned out positive too ... so they assumed those are going to develop Alzheimer's.

It produces false negatives, and it might be producing false-positives, but we won't know until 10 or 20 years later. But it still is 100% accurate. Nice math there. This trend of early publishing non peer reviewed material while making extraordinary claims, only to never hear from it again is starting to get really old.

Re:100% Accurate, Nearly All of the Time! (1)

BitZtream (692029) | more than 4 years ago | (#33198744)

Peer reviewed ... heh, a simple random 'read it myself before I hit submit' should fix most of this kind of crap it seems to me.

Re:100% Accurate, Nearly All of the Time! (0)

Anonymous Coward | more than 4 years ago | (#33198906)

This trend of early publishing non peer reviewed material while making extraordinary claims, only to never hear from it again is starting to get really old.

Starting? It's as old as the newspaper if not older. Everyone in accedimia knows that publishing outside of peer review is admitting there are serious flaws someone didn't feel like fixing.

Still, since the article comes out tomorrow, I'm willing to assume they didn't claim 100% accuracy. That's the kind of silliness that gets added by a journalist. Every time one of our articles (geophysics) gets covered in the press you can hear people laughing the next office over as they read the story.

Re:100% Accurate, Nearly All of the Time! (4, Insightful)

timeOday (582209) | more than 4 years ago | (#33198964)

Read it again, because there is nothing in the article that contradicts the claim that "researchers have found a spinal-fluid test can be 100 percent accurate in identifying patients with significant memory loss who are on their way to developing Alzheimer's disease.":

"Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels. Nearly three quarters of people with mild cognitive impairment, a memory impediment that can precede Alzheimer's, had Alzheimer's-like spinal fluid proteins. And every one of those patients with the proteins developed Alzheimer's within five years. And about a third of people with normal memories had spinal fluid indicating Alzheimer's. Researchers suspect that those people will develop memory problems. "

However, the test can only be 100% accurate if the spinal fluid proteins that presage Alzheimer's decrease after full onset.

The fact that not everybody who tested positive developed Alzheimer's during the study is no counter-indicator at all, especially if they kept testing new subjects throughout the trial (i.e. some were only tested recently).

Of course, the usual caveats apply - you can't predict with 100% accuracy who will develop Alzheimer's years from now because some will die first of other causes. And in biology (and medicine), even if your test is correct on the first 10 patients, and the first 100, and 1000, you just know some smart-alec is going to buck the trend eventually :) Biology is just too messy to follow any simple rules all the time. But that doesn't necessarily have a whole lot of relevance to clinical applications.

Re:100% Accurate, Nearly All of the Time! (1)

GNUALMAFUERTE (697061) | more than 4 years ago | (#33199128)

NEARLY. NEARLY. They said NEARLY every person with Alzheimer's tested positive. If NEARLY every person develops the characteristics you are testing for, NEARLY ALL ALL. NEARLY 100%. That means they are getting FALSE NEGATIVES.

On the other hand, out of the people tested, many were POSITIVE, but we don't yet know if they are going to have Alzheimer's or not. So, we MIGHT HAVE FALSE POSITIVES.

That is exactly what my post said.

Don't get me wrong, a technique to easily prove for a hard to detect and identify disease, that has a low rate of false positives/negatives is still AWESOME. But it's not 100% effective, which is what the article claimed.

Re:100% Accurate, Nearly All of the Time! (1)

timeOday (582209) | more than 4 years ago | (#33200104)

NEARLY. NEARLY. They said NEARLY every person with Alzheimer's tested positive. If NEARLY every person develops the characteristics you are testing for, NEARLY ALL ALL. NEARLY 100%. That means they are getting FALSE NEGATIVES.

That's not the point - the claim was that "researchers have found a spinal-fluid test can be 100 percent accurate in identifying patients with significant memory loss who are on their way to developing Alzheimer's disease." You are inferring that people who already have Alzheimer's should also test positive - but nobody said it was 100% effective for that. Perhaps the spinal fluid protein levels characterize people who are on their way to developing Alzheimer's, but not always those in whom the disease is advanced. I don't know if that's true, I'm just saying the article is not internally inconsistent.

Re:100% Accurate, Nearly All of the Time! (0)

Anonymous Coward | more than 4 years ago | (#33199740)

ADNI (the study on which the paper is based) has been tracking these folks for 5+ years. Enough cog normal folks have developed MCI and MCI's into full blown AD that the hazards analysis can be done with decent power. Don't pound on the stat's methods unless you read the paper ; NYT and other papers are known for doing hack jobs on "translating'" for the masses. CSF abeta is a decent bio-marker; there are pubs out there which show basic equivalency of the PET (PIB) tracers and CSF levels -- unless you need the spatial information from PET (which you probably don't if all you want is a go/no-go) there is no reason for the cost nor for the additional radiation exposure. PIB PET spatial specificity has not proven terribly useful to date.

The paper is peer reviewed.

Re:100% Accurate, Nearly All of the Time! (1)

sjames (1099) | more than 4 years ago | (#33200150)

I wonder if the statistician tested positive?

Re:100% Accurate, Nearly All of the Time! (1)

jethr0211 (996156) | more than 4 years ago | (#33198362)

Probably meant they predict near zero rate of false positives.
Ahh, statistics; in the hands of amateurs, any conclusion is possible.

Re:100% Accurate, Nearly All of the Time! (1)

rickyb (898092) | more than 4 years ago | (#33198364)

Exactly. Especially in medicine, no diagnostic test can ever be considered 100% accurate unless it could be tested on every single person who ever had the disease in question and who ever will have the disease. Try getting funding for that! Any article (or summary of an article) discussing the statistics of a diagnostic test should also include mention of the specificity and sensitivity of the test. Biostats 101, guys (and gals).

Re:100% Accurate, Nearly All of the Time! (0)

Anonymous Coward | more than 4 years ago | (#33198440)

300 patients, one misdiagnosed
299/300 = .9966 = 99.66%
you want 3 sigfigs
100%

Re:100% Accurate, Nearly All of the Time! (2, Informative)

h4rr4r (612664) | more than 4 years ago | (#33198536)

299/300 = .9966 = 99.66%
you want 3 sigfigs

99.7%

Re:100% Accurate, Nearly All of the Time! (0)

Anonymous Coward | more than 4 years ago | (#33200398)

Heh...to be pedantic, 300 has one significant digit. You need to specify that it is an exact number in some other form, such as 299/300. or by using scientific notation, 299/3.00x10^2.

Re:100% Accurate, Nearly All of the Time! (1)

ezralanglois (1151947) | more than 4 years ago | (#33198628)

This is simple to clarify. The tests to detect these proteins are not 100% perfect but they get more sensitive every year. So just because they are not detectable in certain patients does not mean they are not there. So, this paper just came out recently, that means it was probably submitted for review 3 months (or more) and the actual experiments may have taken place at least a year ago. So in that time, the tests for these proteins have improved yet all the samples that were collected a year or more ago have been used up. Thats only part of the reason they claim "can be 100%"; the other part is that there is already strong evidence to indicate that these proteins are involved in Alzheimer's so they should be present even if they were not detected.

Re:100% Accurate, Nearly All of the Time! (0)

Anonymous Coward | more than 4 years ago | (#33199010)

So, just to clarify, this test "can be 100% accurate", while at the same time "Nearly every person with Alzheimer's had the characteristic spinal fluid protein levels."

That's a pretty neat trick.

Everyone with the indicated levels has Alzheimers. But not everyone diagnosed with Alzheimers has the indicated levels. Why is that a neat trick?

Re:100% Accurate, Nearly All of the Time! (0, Troll)

dissy (172727) | more than 4 years ago | (#33199870)

Yes, because news reporters don't know how to be accurate or consistent, lets just ignore and discredit the real scientists work :/

Re:100% Accurate, Nearly All of the Time! (1)

priegog (1291820) | more than 4 years ago | (#33201064)

That's why when doing actual hard medicine (and taking important decisions regarding implementing certain test and whatnot) these claims do not bode. "100% accuracy" (or any percentage, really) means squat to a statistics-trained professional. There are precise measurements of the effectiveness and potency of a particular test, these mainly been sensibility and specificity. So a particular test may be very sensible yet not very specific (like the mammography, for detecting breast cancer), which means it can have many false positives (but not many false negatives), or the contrary, very specific but not very sensible...
There are related concepts like positive predictive value and such, but the important thing is, these things need to be measured before this test can make it's way into everyday clinical practice. If they weren't rated, medicine would be a very obscure art.

BAPtists and Tauists? (2, Insightful)

Garrett Fox (970174) | more than 4 years ago | (#33198300)

I'd heard years ago that there was dispute between researchers who thought the disease was caused by "beta amyloid plaques" versus by this "tau" protein. Does the test for both show that there's still no consensus on the cause, or has one been established as the cause and the other an effect?

Re:BAPtists and Tauists? (2, Funny)

Mishotaki (957104) | more than 4 years ago | (#33198678)

Tau? i'd bet it's the Orks, not the Tau that's the problem!

Re:BAPtists and Tauists? (2, Interesting)

interkin3tic (1469267) | more than 4 years ago | (#33198948)

Does the test for both show that there's still no consensus on the cause, or has one been established as the cause and the other an effect?

I think the fact that both are used merely shows that there's consensus that both are strong markers of the disease. Actually proving cause and effect is going to require better animal models, better culture systems to replicate the disease in a dish, or people willing to sacrifice themselves. I heard a seminar about 3 years ago by a "tauist," who was arguing that if you artificially expressed tau in mouse brains, their neurons started acting like early stages of alzheimers, but the mice never developed plaques. He suggested plaques might be a symptom that only comes up in human brains, or after several years longer than mice live, or some more complicated reasons, but he really didn't know. I haven't heard any research from a BAPtist, so I don't know the other side of the story. I'm guessing there haven't been any definitive answers since then.

The answer could be entirely academic anyway, this one causes that other one but both are necessary for the actual disease, so a treatment for the dependent step might be all you need, or the answer could be that both are required together, or that either one is sufficient to cause the other one.

Re:BAPtists and Tauists? (0)

Anonymous Coward | more than 4 years ago | (#33199834)

Animal models in AD are on the receiving end of a lot of skepticism -- the plaques in "Swedish" mice aren't the same as in human AD -- at least that's what I think I remember.

Interestingly enough the APOE markers for AD correlate with differences in functional connectivity *in YOUNG people* (Filipini et al PNAS sometime in 2008 or 2009). So maybe the whole amyloid/tau discussion doesn't mean squat and by the time these percolate to measurable levels the brain has already started to fry circuits.
 

Not just a test benefit (4, Insightful)

Eccles (932) | more than 4 years ago | (#33198306)

Not only does this give an actual test for Alzheimers, it also means that there's a definitive symptom for it. Wipe out the cause of that symptom and maybe you can stop or reverse the progression of this horrible affliction.

My father is already at the moderate dementia stage of this illness, and it's devastating. Not so much for him as it is for my mother.

Re:Not just a test benefit (1)

blind biker (1066130) | more than 4 years ago | (#33198410)

Let's first see exactly what the test is. If they test for amyloid beta peptides, the test may give false positives (a lot of people with amyloid beta plaques have not had any cognitive decline (note that prior to this test, the plaques could be only detected posthumously)). And if this "new" test is like the one I have read about previously, then it does only look for Abeta peptides. And nowadays most of the Alzheimer's durg research is moving in the direction of the Abeta plaque removal or prevention of their formation, but NONE of these drugs have managed to slow the cognitive decline in test group patients, as I have written in my previous post.

Re:Not just a test benefit (1)

thePowerOfGrayskull (905905) | more than 4 years ago | (#33198796)

Heck with that - let's first wait until the paper is peer-reviewed.

Re:Not just a test benefit (1)

blind biker (1066130) | more than 4 years ago | (#33198494)

That said, I feel very much with you, regarding your father's dementia. In this phase (before apathy sets in), AD is a frightening experience for the patient, too, especially if he/she was/is an intellectual worker, such as a researcher or such. Forgetting words that you used commonly, is scary. Forgetting the names of your colleagues is scary. Forgetting the names of your friends is scary. It's not easy. Then, at the more severe stage, the patient becomes apathetic and then, I guess, it's easier for him/her.

I wish you, with my whole heart, that a cure for AD is found before it's too late for your father.

Re:Not just a test benefit (1)

priegog (1291820) | more than 4 years ago | (#33201034)

Unfortunately, it's been known for a number of years now that the histological characteristics of alzheimers were the accumulation of beta-amyloid and the presence of tau protein, so this test is only that, a test, not any significant discovery on the disease itself...

Requires a spinal tap (1)

Meshach (578918) | more than 4 years ago | (#33198320)

From TFA:

One drawback, though, is that spinal fluid is obtained with a spinal tap, and that procedure makes most doctors and many patients nervous. The procedure involves putting a needle in the spinal space and withdrawing a small amount of fluid.

I know that more education is needed in this area. Any thing involving the back is inherently risky. The wikipedia article indicates [wikipedia.org] . that well the risk is low it is a major procedure and not many people will be comfortable in having one for just a test.

no kidding (2, Funny)

RelliK (4466) | more than 4 years ago | (#33198350)

The spinal needle goes up to 11 (inches).

Potentially huge problem with the test (1)

blind biker (1066130) | more than 4 years ago | (#33198336)

Amyloid-beta plaques are not a necessary condition for Alzheimer's. I don't know, of course, the details of this latest cerebrospinal fluid test, but the previously published one was only looking for traces of Abeta peptides. If the claim of 100% accuracy is actually true (we have to see the article), then it perhaps also takes into consideration tau protein traces. I am really just speculating here, but tau protein tangles seem to be clearer indicators of Alzheimer's disease.

Many people have been found to have Abeta plaques in their brain tissue without having any cognitive loss. And drugs that remove or prevent the formation of Abeta plaques have NOT proven to be efficient in slowing down the progress of AD. I am puzzled at the hundreds of millions of $ spent by big pharma developing and testing drugs that combat Abeta plaques, when none of those drugs has shown any statistically significant cognitive improvements in AD patients.

Re:Potentially huge problem with the test (2, Informative)

PatrickThomson (712694) | more than 4 years ago | (#33198606)

Amyloid beta was there and it was targetable by the methodology available to drugs companies. Now, they've discovered it doesn't work, and there's a few years of lag time between findings synchronising. I don't think there are any more gamma-sec or beta-sec programs in drug discovery. Let's just hope there's another target around.

Re:Potentially huge problem with the test (1)

blind biker (1066130) | more than 4 years ago | (#33200940)

Virtually all current Phase III evaluations center on Abeta. Sadly.

wtf (0)

Anonymous Coward | more than 4 years ago | (#33198368)

Didn't RTFA (standard) - what the hell does 100% accuracy mean? No false positives and no false negatives? *Bullshit*

Does knowing early help? (3, Insightful)

RabbitWho (1805112) | more than 4 years ago | (#33198422)

There's no treatment for it and nothing they can do. I'd rather not know for as long as possible, you start going crazy as you watch yourself deteriorating every day. If I forget and put door keys in the microwave I think "oh I'm such an idiot." and laugh. I don't feel the terror that someone with Alzheimers feels, thinking every mistake is a sign.

Re:Does knowing early help? (2, Insightful)

olsmeister (1488789) | more than 4 years ago | (#33198688)

While I tend to agree with your position, there are many who would want to know, particularly if there is a family history of this disease. It might affect your planning for the future, and even the way you live your life today.

Re:Does knowing early help? (4, Interesting)

phantomfive (622387) | more than 4 years ago | (#33198958)

Watching my grandpa suffer through Alzheimer's, this is a real issue. At first he took it with a sense of humor, when I called he'd say, "hey, I almost forgot about you! Call more often!" But soon I could see it was really getting to him, and he was starting to withdraw into that stupor that people get into at convalescent homes.

So I forced him to be active; when he tries to tell me something, and can't think of the word, I just wait for him to spit it out, or tell him to explain it a different way. Get him active, help him see that life can be good even though he doesn't remember quite as well. I treat him like a human and make him connect to me like a human. No withdrawing into that shell just because you can't remember well. I took him to see giant trees and waves and stuff. Giant trees and waves always make you feel alive.

So now he is happier, got over his anger streak, and he doesn't worry if he can't remember everything (it doesn't matter if you can find a way to work around it).

Re:Does knowing early help? (0)

Anonymous Coward | more than 4 years ago | (#33199080)

Thank you for sharing your experience. I was too young to do much for my grandfather, but all his children treated him like an invalid and continued to be disrespectful and borderline insulting as his Alzheimer's continued. They refused to help him and he became quite destructive in his angry phase, until he was too physically weak to fight and was by then in a home. I think because he was abusive to them in their youth, they used his illness as a chance to get back knowing he couldn't do much.

I wish they treated him as you have treated your grandfather. What you are doing is wonderful and I applaud you and him for making the best of a difficult situation.

Re:Does knowing early help? (2, Interesting)

Ironhandx (1762146) | more than 4 years ago | (#33199720)

Shit, all my grandfathers children are treating him like a borderline invalid now, and he's still in good shape. I took him out cutting wood for a few weeks winter before last. Sure he can't do as much as he used to, but not being treated like an invalid and doing something useful for a few weeks... the poor guy looked better for months afterwards than he had for years previously.

Seriously though, a man that can still safely swing a chain saw plus haul the logs he cut(all but the biggest, some of which I couldn't even move without further segmenting) is far from an invalid. I personally think this is a very widespread flaw in the current 30-60 generation in regards to their parents. I guess a lot of the 40-60 crowd led cushier lives and already can't do a lot of what their parents still can at 60-80+. I know thats a lot of the reason my grandfathers children treat him like an invalid. They basically look at it and go "Shit, I can't even begin to do that, theres no way its even safe for him to try!" Meanwhile he'd run circles around them.

I'm currently looking for a good part time job for him(something suitable, similar to what he did all his life, but of course without too much back breaking labour, he is in his 70's) just to get his spirits up. People don't understand it, my own generation included, but sometimes people are happier when they're WORKING. Not everyone digs the "Get as much money saved as I can so I can be as lazy as possible for as long as possible" lifestyle. My grandfather retired at 65 because the family basically forced him to. He wouldn't have if it was his choice.

Obviously his situation isn't going to be the situation of every other older person out there. If you've got one of those age related bone diseases or develop heart problems... things like that, then obviously for your own health you can't do what you've always done. Otherwise... people should just be more supportive and let folks do whatever the hell they want to do.

One other pet peeve of mine is that people complain that "Oh but that 65 year old man/woman doesn't need to work, they're taking a job away from a young person just starting out!". Well let me be the first one to say, if you're 15-25 and you can't out work a 65 year old its time to put down the god damn cheetos and get off the couch.

Sorry for going a bit far off topic, but back on topic: My grandfather is in a high risk group for developing a particularly nasty brand of alzheimers, and one of the most effective methods of keeping it at bay is exercise, so it really hits home for me when people mention this sort of thing, and pisses me off to no extent at the rest of my family.

Re:Does knowing early help? (1)

RabbitWho (1805112) | more than 4 years ago | (#33199088)

I guess there are a lot of things that can make it easier to deal with, but there is nothing that can slow it down or stop it.

It's great to read your experience with your grandfather, you must be a great comfort to him.

Re:Does knowing early help? (1)

phantomfive (622387) | more than 4 years ago | (#33199388)

Yeah, I know that's true, but I'm going to make sure his memory he does lose is from alzheimer's, and not from some old-age malaise!

Re:Does knowing early help? (1)

interkin3tic (1469267) | more than 4 years ago | (#33198994)

To an individual, maybe not, but for drug trials, yes. Knowing definitively that your test subjects had the disease or did not would be better than judging by symptoms. I'd also wager that there are probably a few other non alzheimers problems that show similar symptoms early on, it would be valuable to know if it was AZ or not AZ and instead might be a brain tumor, for example.

knowledge is power (1)

circletimessquare (444983) | more than 4 years ago | (#33199052)

and power is um... pancakes

Re:Does knowing early help? (2, Insightful)

dr_dank (472072) | more than 4 years ago | (#33199300)

There's no treatment for it and nothing they can do. I'd rather not know for as long as possible, you start going crazy as you watch yourself deteriorating every day.

And to think we used to cluck our tongues at the people who ate badly, smoked, drank, etc who died of a coronary at 60-70. Now you can live to 90 and be a vegetable. Hooray.

Until the mind can be prolonged the same way medicine has prolonged the body, it's all for nothing.

Re:Does knowing early help? (1)

RabbitWho (1805112) | more than 4 years ago | (#33199386)

Of course it's not "all for nothing". Not everyone gets Alzheimers, strokes and brain tumours.
Ordinary dementia can be fought tooth and nail by reading/listening to the radio/watching television/having friends and family around you.

My grandfather lived to be 87 and was sharp as a tack right up until the day he died.

Excercise (1)

neorush (1103917) | more than 4 years ago | (#33198528)

There is a bunch of research [google.com] out there pointing out that proper exercise can reduce your risk for Alzheimer's and other forms of dementia by something like 70-75%. So its great there is a test and all, but you can still effect the outcome SIGNIFICANTLY with your lifestyle choices. There is also a link to fruits / vegetable intake as well.

What's the benefit for general use? -- Why do it? (1)

sgent (874402) | more than 4 years ago | (#33198622)

This is an expensive test with a fairly high side effect profile. On top of which, a positive result leaves the doctor and patient with no change in treatment options. Since Alzheimer's is an uncureable disease, early diagnosis doesn't accomplish anything. Neuro-Psychological tests (DRS-2) have very high accuracy in diagnosing the disease in late-early and moderate staged disease. The real question is... we have a positive (or negative) result, so how does this change our proposed treatment. The answer is it doesn't.

That being said, this is a significant advance for research purposes, which should allow for double blind studies without needing an autopsy.

100% is not 'nearly all' (1)

BitZtream (692029) | more than 4 years ago | (#33198732)

Good job guys

I can't wait to see if I will be getting alzified (1)

bagboy (630125) | more than 4 years ago | (#33198800)

I'm looking forward to committing the pillage and plundering knowing I won't have to remember the consequences afterward...

I have a feeling... (0)

Anonymous Coward | more than 4 years ago | (#33198854)

...there will be a lot of DUPES for this article!

Re:I have a feeling... (1)

binarylarry (1338699) | more than 4 years ago | (#33198870)

This is about Alzheimer's, not retardation.

Re:I have a feeling... (1)

Siridar (85255) | more than 4 years ago | (#33199290)

This is about Alzheimer's, not retardation...

I'd like to concur with previous posters. (1)

EnsilZah (575600) | more than 4 years ago | (#33199036)

It may be a useful test but watching This Is Spinal Tap is a painful experience and should be avoided if at all possible.

They need a test for faggots (0)

Anonymous Coward | more than 4 years ago | (#33199136)

That way we can kill them before they're even born.

From someone that lost his mother to Alzheimer's (3, Interesting)

pgmrdlm (1642279) | more than 4 years ago | (#33199148)

I don't know if this is good or not. Please let me explain.

If you have ever had the misfortune of having a relative with Alzheimer disease, you know they are nothing like the person you loved and cherished. Everything from forgetfulness, to wanderings where you search the streets for them, to the extreme mood swings where they get violent. Its a terrible experience for both you and the people that have this disease.

If you are diagnosed with this disease in advance, and there are no cures? How do you tell your family and friends? What are you going to think about the pain you know that you may be putting them in?

Knowing how my mother became with this disease, if I find out that I have it and there are no cures. I don't want to put my friends and family through the same experience. I would rather drive my car into a wall at 120 miles an hour.

Just my perception, sorry.

Re:From someone that lost his mother to Alzheimer' (0)

Anonymous Coward | more than 4 years ago | (#33200404)

Haivng worked in a nursing home for elderly people when I was younger, I agree. If I was starting to suffer from mild cognitive impairment (a common precurser for dementia of different types) then, no, I would not want this test. What's the point? They can't cure it. Sure you can settle your affairs, but there's probably 10 years or so till you die so it's a bit too far in advance to known sit and mope over the fate that awaits you. But too soon to kill yourself.

No thanks (0)

Anonymous Coward | more than 4 years ago | (#33199452)

No thanks. This reminds me of the "definitive test" for gout. How does that go? You stick a needle in the (likely already inflamed) joint and draw out some fluid. Then, you look under the microscope for uric acid crystals, which have a recognizeable shape. Needless to say, I've never heard of anybody actually getting this test.

Instead, they just monitor your blood uric acid levels and give you gout drugs. Taking the blood uric acid level is less reliable, but probably an order of magnitude less painful.

Given that Alzheimers is much more serious, perhaps knowing that this is a reliable indicator will lead to a clue, or a less invasive test. Maybe they'll be able to give you something benign that crosses the barrier, binds to those molecules, and shows up on an MRI. Until then, for most of us, it's not going to make a difference.

So what's the point? (1)

jewishbaconzombies (1861376) | more than 4 years ago | (#33199558)

So great - you'll know if you're doomed. That sounds like fun.

I'd rather see more data on a cure before I'm supposed to invest myself psychologically in the diagnostics. I've heard things being developed, and ways to help prevent, but living a life with a lit fuse running into your skull doesn't sound like a miracle of medicine - it sounds like a death-clock at the least, and a suicide watch at the most.

Count me out.

thanks (1)

marketmpb (1874850) | more than 4 years ago | (#33200372)

Thats a great finding, congrats! It gives us hope against this awful disease.... for a marketing blog that is sexy and funny, check out.. marketmpb.blogspot.com matt

Oh, really! (0)

Anonymous Coward | more than 4 years ago | (#33201010)

The test confirms what is already known? What a tremendous breakthrough! Real Nobel Prize stuff... NOT.

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