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      Hyperbaric oxygen therapy for Alzheimer's dementia with positron emission tomography imaging: a case report

      case-report

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          Abstract

          A 58-year-old female was diagnosed with Alzheimer’s dementia (AD) which was rapidly progressive in the 8 months prior to initiation of hyperbaric oxygen therapy (HBOT). 18Fluorodeoxyglucose ( 18FDG) positron emission tomography (PET) brain imaging demonstrated global and typical metabolic deficits in AD (posterior temporal-parietal watershed and cingulate areas). An 8-week course of HBOT reversed the patient’s symptomatic decline. Repeat PET imaging demonstrated a corresponding 6.5–38% regional and global increase in brain metabolism, including increased metabolism in the typical AD diagnostic areas of the brain. Continued HBOT in conjunction with standard pharmacotherapy maintained the patient’s symptomatic level of function over an ensuing 22 months. This is the first reported case of simultaneous HBOT-induced symptomatic and 18FDG PET documented improvement of brain metabolism in AD and suggests an effect on global pathology in AD.

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          Whole exome sequencing study identifies novel rare and common Alzheimer’s-Associated variants involved in immune response and transcriptional regulation

          Joshua Bis, Xueqiu Jian, Brian Kunkle … (2018)
          The Alzheimer’s Disease Sequencing Project (ADSP) undertook whole exome sequencing in 5,740 late-onset Alzheimer disease (AD) cases and 5,096 cognitively normal controls primarily of European ancestry (EA), among whom 218 cases and 177 controls were Caribbean Hispanic (CH). An age-, sex- and APOE based risk score and family history were used to select cases most likely to harbor novel AD risk variants and controls least likely to develop AD by age 85 years. We tested ~1.5 million single nucleotide variants (SNVs) and 50,000 insertion-deletion polymorphisms (indels) for association to AD, using multiple models considering individual variants as well as gene-based tests aggregating rare, predicted functional, and loss of function variants. Sixteen single variants and 19 genes that met criteria for significant or suggestive associations after multiple-testing correction were evaluated for replication in four independent samples; three with whole exome sequencing (2,778 cases, 7,262 controls) and one with genome-wide genotyping imputed to the Haplotype Reference Consortium panel (9,343 cases, 11,527 controls). The top findings in the discovery sample were also followed-up in the ADSP whole-genome sequenced family-based dataset (197 members of 42 EA families and 501 members of 157 CH families). We identified novel and predicted functional genetic variants in genes previously associated with AD. We also detected associations in three novel genes: IGHG3 (p = 9.8 × 10−7), an immunoglobulin gene whose antibodies interact with β-amyloid, a long non-coding RNA AC099552.4 (p = 1.2 × 10−7), and a zinc-finger protein ZNF655 (gene- based p = 5.0 × 10−6). The latter two suggest an important role for transcriptional regulation in AD pathogenesis.
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            Challenges for Alzheimer's Disease Therapy: Insights from Novel Mechanisms Beyond Memory Defects

            Rudimar Frozza, Mychael V. Lourenco, Fernanda G De Felice (2018)
            Alzheimer's disease (AD), the most common form of dementia in late life, will become even more prevalent by midcentury, constituting a major global health concern with huge implications for individuals and society. Despite scientific breakthroughs during the past decades that have expanded our knowledge on the cellular and molecular bases of AD, therapies that effectively halt disease progression are still lacking, and focused efforts are needed to address this public health challenge. Because AD is classically recognized as a disease of memory, studies have mainly focused on investigating memory-associated brain defects. However, compelling evidence has indicated that additional brain regions, not classically linked to memory, are also affected in the course of disease. In this review, we outline the current understanding of key pathophysiological mechanisms in AD and their clinical manifestation. We also highlight how considering the complex nature of AD pathogenesis, and exploring repurposed drug approaches can pave the road toward the development of novel therapeutics for AD.
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              The diagnostic value of FDG and amyloid PET in Alzheimer’s disease—A systematic review

              Louise Rice, Sotirios Bisdas (2017)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Gas Res
                Journal ID (iso-abbrev): Med Gas Res
                Journal ID (publisher-id): MGR
                Title: Medical Gas Research
                Publisher: Medknow Publications & Media Pvt Ltd (India )
                ISSN (Electronic): 2045-9912
                Publication date Collection: Oct-Dec 2018
                Publication date (Electronic): 09 January 2019
                Volume: 8
                Issue: 4
                Pages: 181-184
                Affiliations
                [1 ]Department of Medicine, Section of Emergency and Hyperbaric Medicine, Louisiana State University School of Medicine, New Orleans, LA, USA
                [2 ]Department of Radiology, University of North Dakota School of Medicine and Health Sciences, Bismarck, ND, USA
                Author notes
                [* ]Correspondence to: Paul G. Harch, paulharchmd@ 123456gmail.com .

                Author contributions

                Conception and design of the work, definition of intellectual content, literature research, data acquisition, data analysis, manuscript preparation, manuscript editing, and manuscript review: PGH and EFF.

                Author information
                http://orcid.org/0000-0001-7329-0078
                Article
                Publisher ID: MGR-8-181
                DOI: 10.4103/2045-9912.248271
                PMC ID: 6352566
                PubMed ID: 30713673
                SO-VID: b7351343-09d9-47c0-a1fc-f35b8e585c6c
                Copyright © Copyright: © 2019 Medical Gas Research
                License:

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Date received : 01 September 2018
                Date accepted : 22 October 2018
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Molecular medicine
                Keywords: alzheimer's dementia,hyperbaric oxygen,textural analysis,positron emission tomography,imaging pharmacokinetics,pressure pharmacodynamics
                Data availability:
                ScienceOpen disciplines: Molecular medicine
                Keywords: alzheimer's dementia, hyperbaric oxygen, textural analysis, positron emission tomography, imaging pharmacokinetics, pressure pharmacodynamics

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