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Research Studies Abound in Alzheimer’s Program at Barrow

When Dr. Marwan Sabbagh joined Barrow Neurological Institute as the director of the Alzheimer’s and Cognitive Disorders Program, one of his goals was to grow the program’s research efforts.

A little more than a year into his role, Dr. Sabbagh said the program’s number of research studies has increased threefold and the number of patients enrolled in studies has increased by a factor of nine.

According to Dr. Sabbagh, the program now has nearly 20 studies in different phases, approximately a dozen of which are actively enrolling patients. He said more than 60 Barrow patients are enrolled in studies, ranging from investigation of prevention techniques to trials of treatments for different types and stages of dementia.

Dementia is the general term for loss of memory and other cognitive abilities that is severe enough to affect a person’s daily life. It is caused by physical changes in the brain. There are several different types of dementia, but Alzheimer’s disease is by far the most common.

According to the Alzheimer’s Association, as many as 5.4 million people in the United States are living with the disease. Ten percent of people over the age of 65 and 50 percent of people over the age of 85 will develop the disease in their lifetime. As one of the top 10 causes of death, it is the only disease that currently cannot be prevented, cured, or even slowed.

Doctors and scientists at Barrow are collaborating to better understand Alzheimer’s disease in hopes of being able to diagnose it earlier, develop new treatments to slow its progression, and achieve milestones that could someday lead to cure.

“There’s a huge landmark study for prevention that I was very keen to get called the A4 study,” Dr. Sabbagh said.

The A4 study is evaluating an anti-amyloid treatment to determine whether it can slow memory loss caused by Alzheimer’s disease. Amyloid is a protein normally produced in the brain, but scientists believe a buildup of this protein in older people may play a role in memory loss related to Alzheimer’s disease.

The A4 study is for people ages 65 to 85 who do not have any outward signs of Alzheimer’s disease but may be at risk. Potential participants undergo a positron emission tomography (PET) scan and can continue with the study if the scan shows a buildup of amyloid plaque deposits in their brains. Participants are randomly assigned to receive either the investigational drug or a placebo, and all participants complete the same memory assessments to compare changes in their cognitive function over time.

Dr. Sabbagh said Barrow is also one of three sites in North America conducting a clinical trial of a vaccine for Alzheimer’s disease prevention in people with Down syndrome. According to the Alzheimer’s Association, studies suggest that more than 75 percent of people with Down syndrome aged 65 and older have Alzheimer’s disease. That’s nearly six times the percentage of people in this age group who do not have Down syndrome.

Barrow also offers clinical trials for people with mild cognitive impairment, which is the pre-dementia state of Alzheimer’s. It is characterized by mild memory loss but no associated functional impairment. Three drugs are being tested to determine if they can delay the progression to Alzheimer’s disease in these patients. Two of the drugs are oral medications called beta amyloid cleaving enzyme inhibitors, which stop the production of amyloid in the brain. The third drug is an intravenous (IV) infusion that is intended to clear the brain of amyloid plaques.

I want to be able to offer a study to every patient walking through the door.

-Dr. Marwan Sabbagh, Barrow Neurologist

“We’re doing many studies in pre-dementia because a lot of people think that is the moment in time when you want to intervene, before they go into that dementia state,” Dr. Sabbagh said.

Dr. Sabbagh is leading a global study of another kind of medication known as a RAGE inhibitor. It blocks a receptor in the brain that is believed to play a critical role in cognitive impairments associated with Alzheimer’s disease, which could augment the effects of approved drugs to potentially improve memory function and other areas of cognition. This trial is focused on people with mild to moderate Alzheimer’s disease.

Dr. Sabbagh noted that not all of the studies at Barrow are treatment trials. In the Imaging Dementia – Evidence of Amyloid Scanning (IDEAS) study, researchers are trying to determine the value of PET scans in diagnosing Alzheimer’s disease and other dementias. An earlier, more certain diagnosis could translate into earlier counseling and interventions, ultimately improving patient outcomes.

“I like to have, essentially, a menu of studies to offer my patients,” Dr. Sabbagh said. “I want to be able to offer a study to every patient walking through the door.”

About Barrow Neurological Institute

Since our doors opened as a regional specialty center in 1962, we have grown into one of the premier destinations in the world for neurology and neurosurgery. Our experienced, highly skilled, and comprehensive team of neurological specialists can provide you with a complete spectrum of care–from diagnosis through outpatient neurorehabilitation–under one roof. Barrow Neurological Institute: Discover. Educate. Heal.