Can a simple blood test along with a brief neuropsychological checkup diagnose Alzheimer’s disease? Can taking a daily supplement prevent cognitive decline in the early stages of the disease?
A researcher at the sprawling campus of the National Center for Brain Research in the foothills of the Aravalis is trying to answer these questions with a specialized MRI machine. Unlike those seen in tertiary care hospitals, this one can not only photograph the brain, but also differentiate between the chemicals present in it and the compounds it absorbs. And he has helped Dr. Pravat Mandal discover a relationship between a natural antioxidant called glutathione and iron levels in the blood and brain. “It’s not like any other MRI machine: we’ve trained it so that it can detect chemicals in the brain that have a different frequency. Once we know this frequency, we can focus on it and only that compound will be visible. Using this technique, we have been able to measure glutathione levels in the brain of healthy and Alzheimer’s participants,” he says.
In addition, this MRI machine can also detect the difference in the texture of brain tissues that have absorbed iron. Why is this important? Dr. Mandal, who is an engineer by training and went on to work in the radiology, anesthesiology and psychiatry departments of reputable US institutes, has a hypothesis. He believes that levels of the antioxidant glutathione and iron in critical parts of the brain are predictors of Alzheimer’s disease. “When we go about our daily lives, we create free radicals in our brain. Our mood, lifestyle, what we eat and the type of air we breathe determine the level of free radicals generated. Now, the body has a natural mechanism to neutralize these free radicals with the antioxidant glutathione. An imbalance between iron levels, which is a generator of free radicals, and glutathione levels is probably one of the causes of Alzheimer’s disease,” says Dr. Mandal.
His team has already shown the difference in iron and glutathione levels in the hippocampus of healthy individuals and those with Alzheimer’s. In fact, his research is among those challenging the theory of amyloid beta protein deposition as the cause of Alzheimer’s. Instead, he views these bowel movements as a symptom of the neurodegenerative disease. “If we compare Alzheimer’s to the river Ganges, the researchers thought the amyloid beta protein deposit was Gangotri when in fact they were probably in Kanpur or Haridwar. We still have a ways to go before we reach Gangotri or the source of the disease,” explains Dr. Mandal.
So how does your research lead to the development of a treatment or diagnosis for the disease? With this theory in mind, Dr. Mandal began imaging the brains of healthy subjects and performing blood tests at the same time. The as-yet-unpublished results of this study of 70 healthy subjects have helped him establish a baseline of iron and glutathione levels in the brain, as well as in the blood in different age groups. Comparing this with declining glutathione levels and increased iron levels in the brains of Alzheimer’s patients may help create a scale for detecting the disease.
“My previous study showed that, unlike in healthy subjects, there is a decrease in glutathione levels and an increase in iron levels in the brains of people with mild cognitive impairment and Alzheimer’s, but at that time we have not looked at the subjects’ blood. Now, we have data from healthy individuals and a simple trial to do the same in Alzheimer’s patients will help us develop the scale,” said Dr. Mandal. Once this scale is developed, a simple blood test performed even in basic laboratory facilities can predict the disease and, in conjunction with a neuropsychological test, can be used to determine early if the person has the disease.
Tests to determine cognitive functions in a patient are even now done to determine if a person might have the disease. But various tests are also needed to rule out other possibilities of such cognitive impairment. This new method can simplify diagnosis. Doctors may sometimes suggest cerebrospinal fluid analysis or brain imaging to look for amyloid beta protein deposits that are a marker of the disease.
Using the same principle, Dr. Mandal hypothesizes that daily supplementation of glutathione, already marketed as a nutraceutical, may help prevent decline in patients with mild cognitive impairment. An assay will be performed with AIIMS.
#simple #blood #test #key #detecting #Alzheimers