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@@johnsmith9903 That's why i smoke pot and in my state it's legal so my Geriatric team has no problem with this. It definitely relaxes my mind and i don't stress so much and NO bp mds or anything like that. I walk 3+ miles each day & i'm 69 . So, if all else fails....go with THC/CBD
been focusing on enhancing bdnf by way of ghrelin expression: by spreading out my nutrition needs over 6 smaller meals a day to keep the stomach stretch receptors non-stretched but still getting all my nutrition, leading to BDNF expression upregulation. another bdnf boost i've found was Rxn Buspar + activation of the [MT] Melatonin receptor (that i achieve with my Ramelteon insomnia medication)
My grandpa had Alzheimer's and was in a nursing home for 2 years. He passed away yesterday. The approval of a minimally effective (if not completely ineffective) drug for the purpose of, let's face it, providing at least one profitable treatment for sufferers is incredibly disheartening. Big corporations are getting tired of investing money on research and not making an immediate profit. I guess gaining ground against a horrifying disease isn't enough for them...
I’m very sorry to hear about your grandfather. My grandfather passed away a few months ago due to Parkinson’s. These diseases are so evil. Rip to your grandfather
This. It's just about money anymore for these drugs manufacturers. They don't care who suffers in the process. The opioid crisis proved that. They're no better than the pusher on the street corner.
Corporations only care about money. All the money. Every conceivable penny. They're not in this to help people, that's just a happy side effect. Capitalism is out of control here in the US and we've allowed it to get here. The medical industry also has gotten outrageous here. Something really needs to be done to reign it in.
I am genuinely impressed, even surprised, to be honest, at how accurate this segment was. Doubts were already be cast on the beta-amyloid hypothesis as early as 2000 when I was a graduate student, and even then many were turning a suspicious eye toward Tau. Over two decades later, we've watched numerous beta-amyloid scrubbers (Solenuzemab, Bapenuzemab, etc.), effectively scour away the biomarker, but provide no clinical benefit whatsoever, and in fact lead to worsening due to micro-bleeds. I was worried you were going to herald Aducanumab as some sort of revolutionary treatment (apparently, I didn't read your video title carefully), but you accurately portrayed the level of controversy around FDA's decision to approve a drug based on no positive data whatsoever, despite near-unanimous recommendation against approval by their own appointed advisory board. Given the FDA's remit, and their track record of withholding or delaying drug approvals at times for trivial reasons, this decision was nothing short of surreal. There is the argument for hope...however, Alzheimer's is one of those diseases that is not particularly responsive to the placebo effect. Approving an extremely expensive drug that provides no net benefit (and like any drug has to potential to harm) isn't the kind of hope we need. You did a great job on researching this topic and presenting the full picture.
Yes! I'm constantly puzzled by how the amyloid hypothesis persisted as long as it has (at least in the "plaques are the problem" form) in the face of well-designed research that showed the opposite (e.g. D'Andrea et al. 2001, DOI: 10.1046/j.1365-2559.2001.01082.x )
If the glial cell hypothesis is correct then could this drug actually increase The amount of glial cells that go into overdrive? Producing more inflammation and more amyloid and tao proteins
This is such a great, great episode of scishow. Great science journalism and science communication, at the same time! Wonderful work from the scishow team! Thanks for all you hard work.
The way I've thought of it is that if Alzheimer's is a fire, Beta Amyloid is ash. The ash is a sign that there was a fire, but clearing out the ash isn't going to fix the damage that the fire caused. The goal should be preventing the fire from happening in the first place. I think targeting Tau or causes of inflammation could be promising in this aspect, but I guess we won't know for sure until more research is done. It's entirely possible that they are also just different kinds of "ash", though hopefully that isn't the case.
well if its ash your comparing it too then i think soot or even pollution would also work right? so why not try to put a filter on the smoke stack and keep most of the bad pollutants out.
@@tjl102 You completely missed the point of the illustrative example and changed it with no regard to content and message simply to suit your own personal belief and narrative without even attempting to explain a logical parallel. Congratulations.
There were some recent announcement for likely link between Multiple Sclerosis and Epstein-Barr virus. COVID-19 is also know to sometimes cause neurological brain damage, associated with long-covid symptoms like brain-fog and cognitive decline.
@@Kazini_ because the example was trash. A better example would be if the ash was still hot and burning. Removing it would help stop future damage but the damage that has been done is still there
Wow, this episode was really, really good. Often on scishow it is written to be punchy and to-the-point, skipping over going in depth on questions that arise from watching the video seemingly because it was "out of the scope of the video." That style of writing is understandable, but compared to this one, where it took the drug getting approval as a jumping off point to inform about the current scientific knowledge tide shifting about Alzheimer's, and current possibly promising areas of research, it really shows how informative you can get in a single relatively short video. I really appreciate this video, and hope to see many more like it
I will add my agreement to this as well. I know over-10 minute videos may not garner the same number of views, but I appreciate the quality information presented in this video.
Agreed! I feel like the channel used to be more detailed like this and then it was dumbed down over the years. This is a refreshing video that just gives us the full picture and doesn’t assume we won’t understand it.
I'm a Alzheimer's researcher in the UK (no Aducanumab). After research on the topic, these kind of antibodies were found to be pretty poor for Alzheimer's treatment, especially since their target isn't the only thing seen in Alzheimer's! Seems like a drug that can be used for "last resort" patients in the US, but definitely no revolution yet unfortunately.
shortening the version of Tau seems like a better vector to research. I'm a biologist with a family history, [copied from a previous post]: been focusing on enhancing bdnf by way of ghrelin expression: by spreading out my nutrition needs over 6 smaller meals a day to keep the stomach stretch receptors non-stretched but still getting all my nutrition, leading to BDNF expression upregulation. another bdnf boost i've found was Rxn Buspar + activation of the [MT] Melatonin receptor (that i achieve with my Ramelteon insomnia medication) I'd be happy to share my data with you.
Wow so are there any actual interesting developments? Im kind of hoping perhaps cocktails of amyloid and tau plaque targeting drugs, antiinflamatories that can reach the brain may be of some benefit (like minocycline, actually an antibiotic drug I took for acne as a teenager, which is also (used to be, before the advent of better drugs) used in lower doses for rheumatoid arthritis and other inflammatory diseases had some interesting side effects) I think whatever targets we find we'll have to target patient selection to early detection (and that may steer us again off course by focusing on people who present to clinic and not people screened routinely- yet)
@@TheOrganicartist ohhh hey minocycline! Low dose, 40mg (instead of the 100, 75 or 50mg, antibiotic capsules- altho a higher dose may be needed to reach the brains immune modulators, glial cells) - it should also help, its a cb2 agonist that is neuropenatrant and also a weak NMDA antagonist - it, well not 'helped' but when i was on opioids it seriously SERIOUSLY prevented me from experiencing a normal rate of tolerance (and i think especially opioid tolerance is in part mediated by a withdrawal related proinflamatory boost in the brains immune cells, in part because of the rate of tachyphylaxis (alone) seen in shorter acting analgesic and narcotic drugs like fentanyl (unfortunately a lot of people having experience with that drug now- bad enough in 100mcg patches with 10mg reservoirs, but now....) I was on this drug for acne as a teen during the absolute height of the opioid epidemic (welcome to America! If your not from here it's a thing:/ Anyway sorry to ramble, Just an armchair pathophysiology enthusiast here btw, but i really think it could boos your regimine "spectrum" of pharmacological intervention to include anti-inflammatory drugs that have a tendancy to affect perhaps the brains system separately from the body as a whole (which is a separate system we used to think of the brain, well individual neurons, as "privileged site" from typical inflammatory related immune cells via the blood brain barrier but it turns out glial cells do it all !)
I'm a dementia researcher and this video was such an excellent summary of the situation! It's been really sad to see some of my participants get excited at this 'new' drug being approved in the US and thinking that soon it will come to the UK but we've known for years now that it's not effective.
@@JingleMallet it's possible. Personally, I think I'd be more curious to see if the drug or a similar drug could be used a lot earlier to stop amyloid plaques from forming in the first place and if that could have a preventive effect.
Take care of your brain b4 symptoms show even if there is no family history of dementia or Alzheimer's. Amyloid plaque is a symptom, not a cause! *PESTICIDES & HERBACIDES over time, would cause considerable health problems to the gut biome, not to mention in many mechanisms / organs of humans. It would certainly account for the nerve damage and dementia and cancers for which there is a plethora. *Nervous damage is how it kills the insects - these are the same symptoms as Alzheimer's. HAVE YOU EVER seen an insect with a bit of insecticide on it - the death process starts with nerves shaking uncontrollably until it is unable to breathe or do anything else.
@@Mosaik777 To me, it seems like it doesn't have that big of an effect. I'm not sure I'd be able to tell the difference between two people with dementia that are only 0.5-1 point apart on a psychometric test (but we do use different tests in the UK). Considering there may be side effects that negatively impact quality of life, overall I'm not sure that it's going help anyone in a meaningful way. But I'd be happy to be wrong!
My father is upposed to be part of a trial for this through a Hospital here in Oregon. One of the doctors we have talked to called this a waste of time and money and is what makes people doubt the ethics and reliability of science. The other doctor called it an amazing breakthrough that can help millions.
They are both wrong. One discounts a drug without human trials to confirm it’s use, safety and effectiveness and the other claims it’s a breakthrough again without proof giving people and families suffering with this disease false hope.
Science is not a crystal ball, it's a self correctling process that over time increases our knowledge while removing human bias. But the process takes time and can venture down blind alleys.
Thank you so much for talking about this! I’ve been a fan of SciShow from the beginning (back when I was in high school!) and now I work in a lab studying fluid biomarkers of AD. Our clinical trials unit was responsible for measuring CSF amyloid for solanezumab and gantenerumab, two similar drugs. We finished our trials but failed to get approval because although plaque burden was reduced, cognition didn’t improve. The most frustrating thing about the aducanumab situation is that the approval has drastically changed how we approach clinical trials. Because a treatment is available, it’s no longer considered ethical to have a placebo control group. As a result, multiple studies that were getting ready to begin weeks after the final decision was made by the FDA had to be completely redesigned at the last minute. The drug has become a huge issue for clinicians too. Performing cognitive tests for dementia already requires a lot of training and practice; in our clinic, two neurologists review every cognitive exam performed and must be in agreement on the diagnosis. These clinicians were already swamped with patients, but are now also getting an influx of people with possible cognitive problems who want to get on the AD drug ASAP. TLDR; the whole aducanumab situation has ended up being a real problem in the field rather than a solution.
It’s kinda like starting out with the observation that people who had good grades in school went on to get good jobs and then trying to increase high level employment by giving students the answer to all their exams beforehand: You’ll have students (=patients) showing consistently good grades (=low biomarkers) because you’re directly eliminating bad grades (=antibody treatment) but that doesn’t mean you’ll get good high-level employment rates (=successful disease treatment) as you haven’t changed the cause of bad grades in the first place (=mechanistic cause of the disease) which could be anywhere from the quality of teaching, the intelligence of the students etc. (=multifactorial, exogenous and endogenous disease factors).
pharmacology graduate here! there's many things to be miffed about when it comes to the approval of aducanumab, but i have to say the thing i'm most annoyed about is that the benefits of it are so so minimal, if there even are any at all, and it's a monoclonal antibody drug! i'd be less annoyed about this if it was another 'regular' small molecule drug. i haven't looked up the price for aducanumab specifically but mAb therapies are always SO expensive. i think it's disgusting that such an expensive treatment has been approved with so little data, when people KNOW that for some people this is their last hope for keeping a loved one alive/functional for a little longer and will fork out the money for it whether it has enough data behind it or not
That's literally the point - it's a big money grab banking on the desperate and uninformed being easy targets. There are individual people out there who still care, but overall the modern medical industry is a grifter's game.
And it's not just "so little data" - they literally didn't publish ANY data showing improved outcomes. This is a travesty of corruption in the approval process, and insurance companies should refuse to pay.
@@telegramsam "The medicine doesn't seem to be working his mental decline is just getting worse" Doctor: "Eh but he has no biomarkers so he doesn't technically have Alzheimer's anymore" "But..." Doctor: "Ya so insurance won't cover treatment anymore" "But..."
Biogen is asking for $56,000 per year for Aduhelm (the brand name for aducanumab). Per year. And they've not ruled out increasing the price in later years. ICER (the Institute for Clinical & Economic Review) reviewed the health-benefit price benchmark: maximum $8,400 / year, they said. Any higher and most vulnerable patients will suffer significantly more from the enormous health costs versus the next-to-nothing benefit of this drug. I quote, "Biogen should lower the price of aducanumab to a value-based price range determined by independent research to fairly align with demonstrated benefits for patients. Fair pricing is required to fulfill the social responsibility held by manufacturers to avoid financial toxicity that falls hardest on the most vulnerable patients. "
A study in the Neurology journal (12 Jan 2022, Whittington | Cost-Effectiveness and Value-Based Pricing of Aducanumab for Patients With Early Alzheimer Disease ) also reviewed the initial impact from aducanumab patients. Patients gained ~4 months in an earlier stage of Alzhemier's, while paying $204,000. The drug did very, very little for an enormous, preposterous cost. I quote, "Patients treated with aducanumab received minimal improvements in health outcomes at considerable cost. This resulted in incremental cost-effectiveness ratios that far exceeded commonly used value thresholds, even under optimistic treatment effectiveness assumptions. These findings are subject to the substantial uncertainty regarding whether aducanumab provides any true net health benefit, but evidence available currently suggests that an annual price of aducanumab of $56,000 is not in reasonable alignment with its clinical benefits."
This video is really well made. I've worked a little with Alzheimer's Disease Epigenetics, and I'm amazed at how you approached this subject. Good job!
My mother died of Alzheimer's disease in 2019. This drug getting approval because... well just because "Let's fast track something!" is kind of depressing. Drugs like this tend to give false hope to families when, at least in my opinion, they're better off dealing with what's going to happen rather than fast tracking garbage.
I would also consider research regarding Alzheimer’s and insulin resistance, as insulin blocks what removes the amyloid plaques, as a pathway to which these plaques form. That being, they might just be a side affect of an underlying problem of metabolic dysfunction in the brain. Research regarding use of MCTs in Alzheimer’s patients does demonstrate that alternative fuel sources such as ketones improve symptoms which suggests an underlying metabolic issue.
Unfortunately, brain metabolic dysfunction may not be as robustly researched as other possible causes, due to no clear path for an expensive pharmaceutical treatment/cure, in spite of observed benefits from MCT use. Especially egregious that a drug offering NO symptomatic benefit got FDA approval.
Your reaction is the same as most scientists do. Have a problem (like insulin resistance) and try to connect it with other diseases BUT i think you are on the right way if you start with treating the cause of insulin resistance. Search the solution in less sugar consumption and more phytonutrients to optimize your immune system! Of course does Keto-diet both!
@@michaelramsey3643 Sad to say that’s 100% true. Our healthcare system doesn’t focus on prevention because it’s not as lucrative as treatment. Biochemistry and good RCTs of nutrition clearly show how refined carbs and excess linoleic acid from seed oils are responsible for chronic disease, but instead of solving the route cause by cutting them out we prescribe medications to “treat” the issues.
The research makes me hopeful even if it isn't always successful. Unfortunately, the genetics around this disease isn't in my favor or that of my father and brothers.
My grandma (paternal) passed away from Lewy body dementia in 2020. My paternal grandpa and his family seems to be able to live forever, and my mom’s side is fine as well. I am hoping I don’t get it when I’m older because I don’t want my kids (or any grandkids if that happens) to watch me wither away the way that my family, especially my dad, had to watch that happen. It was pretty awful.
Learn an instrument and play it occasionally Learn a new language and use it occasionally Get lots of sleep, really try to get 8 hours a night no matter what Those three things will drop your Alzheimer's risks dramatically
There are things you can do tho to preserve brain function while this vital research goes on- try some of these new apps to learn a second language, eat a healthy diet and avoid known proinflamatory things like staying awake for 24+ hrs, tobacco (including nicotine vapes!) excessive caffine and if you can, stimulant medication
All the best and hoping it skips you. I think given the nature of the disease, a phase 4 trial might ultimately reveal some useful information if nothing else.
Reminds me of how endometriosis tissue growth doesn’t necessarily correspond to pain levels. Also sometimes removing the excess tissue growth doesn’t always change pain levels.
I was wondering if SciShow would be shown in schools and it's so cool to see it happen! I went back to college and got in because I brushed up on my biology via crash course 🥰🥰
I was neuroscience major in the 90s and then moved away from the field, but I feel so nostalgic watching this video, and I love that I completely understand what’s happening (for such a complex topic)!
Thank you for this. I worry my aunt has either Alzheimer's or dementia and my great-grandma had it and I have risk factors for it so it's a scary subject for me, one that I am trying to learn more about. Thank you for making this easy to understand and very informative. You are helping people in more ways than you realize by sharing your knowledge. Knowledge is power. You are appreciated. I am so glad I subscribed to this channel this week. 💕
There are recent articles for strong link between Epstein-Barr virus and Multiple Sclerosis. The virus hypothesis is boosted by the observation that COVID-19 sometimes causes MS-like brain damage with symptoms like brain-fog, short memory loss.
Thank you for this excellent exposition of the Issues with Alzheimer’s research. It seems that we have been too narrowly focused at the exclusion of other possible areas of research.
This was a very well done video! Disheartening to learn about how ineffective aducanumab is as a treatment.. I remember reading about in it the news and being so hopeful
As an individual with a history in the family of dementia this gives me some hope. Not with the new drug( mostly because our history is with non Alzheimer’s dementia but also because it seems it’s not the right path)but the fact that it’s being studied and while there will probably not be a cure found in my lifetime perhaps for my childrens lifetime. Meanwhile I take brain exercises, physical exercises and avoiding sugars and diabetes very seriously. Thanks for the video!
I think having my mother in law do brain games and crosswords or word searches, does just as much good as the Aricept and other pills they had her on. We never noticed a change while she was taking her med but she started having more energy and was up and about more when she started playing brain games.
All the pharmacoligical interventions are stopgaps their nootropics (that btw would improve YOUR functioning probably just as much- they dont do anything to treat tje underlying condition, and i truly suspect inflammation, the kind of chronic inflammation that might make a joint begin to feel stiffened, starting in the morning in your late 20s to whenever, and progressing to a hand that can work with a lot of effort and pain, to an unusable limb in the course of 20-40 years depending on how you treat the issue- if you start a specific regimine and follow basic steps like physical exercise, gentle movement, meds if its particularly aggressive (like RA and AS, or if we have pharmacological intervention that would make it feasible for anyone we find in the clinic) avoiding the typical American proinflamatory vices like caffeine, stimulant medication (always been part of our culture, even if underground....ask your grandma about pep-pills, because we also like) our 24+hour days in college and 12+hr workdays being called "American", smoking (not near as much as in the past) and garbage food the pharmacology can never stop entirely the "lifestyle" aspects and itll probably be so for Alzheimer's too- Edit- we dont like to think or admit our brains are foggy, but when a brain teaser, or basic reality checks like "millions of babies arnt taken to whoever fox and Facebook scared you with this morning memaw- well because there arnt enough babies for one, and remember Denise from church- how she died from covid because that wasnt a hoax" when theze are hard it means they need MORE engagement not less. I guess hopefully the whole family votes the same party:/ but Yea brain teaser are prolly better than any drug the docs can give you
@@garou12 it's literally called "Brain Games" it has Sudoku, puzzles, different logic games, I think it just stimulates areas of her brain that being stagnant doesn't touch. Physical exercise would probably work too if she was capable. Right now she can barely walk to the driveway and back. But at least she can carry on a conversation without getting lost or starting to talk about something from her childhood that no one could possibly know about.
Thank you guys for making science like this available to the layman. As a biochemist it's easy to forget that scientific literacy is not a skill many develope, and much less so to a high degree. Content like this can be invaluable for people with difficult decisions to make that just aren't able to dig into research themselves
The head of my department was part of the team that discovered the beta secretase gene. This drug and what it means for AD has been a frequent topic of discussion in our department. Researchers are pivoting away from amyloid and digging deeper into other things going wrong in the brain. I'm excited about the impact of glial cells like astrocytes on the disease process. I love to see great science reporting that makes complex science accessible for everyone!
I did some early work on Protollin, a preventative immunotherapy intended to stimulate the immune cells to clear both beta-amyloid plaques and Tau-tangles that just started trials in August, specifically in developing the nozzle (its a nasal spray) to direct the particles in the desired path. I’ve seen enough of their data to be hopeful about its efficacy, but the failure of aducanumab does somewhat undercut that hope. Whatever happens, I sincerely hope someone comes up with a viable treatment or preventative measure sooner rather than later.
Wow, this was one of the best scishow videos i have seen. Amazingly researched, thus perfectly accurate and explained in a way, that anyone who is new to the subject now has a really good understanding of the problems and challenges in alzheimer research. Very high quality video thank you very much. I would have loved for you to talk about soluble a-beta, which correlates better with symptoms. There are some interesting targets for its efflux like APO-E, ABCB1-Pg (MDR1) or LRP1. Also i loved that you mentioned trials for different treatment starting points. The future of Azheimer cure will be preventative
This video is accurate. However, the video does not mention the fact that about a half dozen clinical trials of tau lowering agents have been conducted, and they all failed too. Another inaccuracy is that the host says that aducanumab targets amyloid-beta plaques. It does lower plaques (and pThr181-tau), but it primarily lowers soluble amyloid-beta oligomers. The video also does not mention that BAN2401/Lecanemab, which primarily targets amyloid-beta protofibrils, was recently shown to significantly slow Alzheimer's progression in mild cognitive impairment and early Alzheimer's patients by ~30-60% in a phase II clinical trial. Personally, I do not think this means that amyloid cascade hypothesis or its ad-hoc variants are correct, although it does suggest that neurotoxic soluble amyloid-beta protofibrils and oligomers likely do contribute non-trivially to early Alzheimer's progression. This video also arguably perpetuates the over-simplistic view that Alzheimer's is due to amyloid-beta, tau, and neuroinflammation, while ignoring all the many other factors that have been shown to be implicated, such as oxidative stress and damage, DNA damage, impaired DNA repair, mitochondrial dysfunction, insulin/IGF1 resistance, metal ion dyshomeostasis, iron and aluminum accumulation, hormonal disturbances, abnormal mitotic signaling, etc. However, I also understand this is a short RUclips video made by someone who is not an Alzheimer's researcher, so that is understandable, and to be fair, most professional Alzheimer's researchers rely on these kinds of oversimplifications too. I am pointing it out because I personally think that ignoring the true complexity of the disease in favor of oversimplistic falsified hypothesis is a big part of what's holding the field back. I can post citations for any of this if anyone's curious.
I read somewhere that the plaque is like tombstones in a graveyard: Removing them will not have an effect on the cause of death for the people buried below. In Alzheimer's case, the argument was that something caused an inflammation in the brain at some point in your life. Since the brain doesn't feel pain, people don't notice it. This triggers the accumulation of the plaque which builds up over years, maybe decades. So with this theory, when you get Alzheimer's, you were sick 10 years earlier. I think it was by this guy: Lon Schneider, an Alzheimer's researcher at the University of Southern California's Keck School of Medicine. Any updates from his team? In the short term: Don't pick your noses and make sure you keep your teeth healthy. Wounds there allow germs to travel into the brain more easily than everything else.
I have Huntington's disease and this gives me hope. I knew the plaque buildup was a fraction of the problem and was disappointed to see too much focus on it
My father has Alzheimer's which advanced rapidly in the past few months. Memantine had been helping some since he started it on New Years 2021, but the improvements did not last long after each dose increase. He started in-home hospice last month and then had 2 bad falls the next week. He died 2 weeks ago tomorrow.
I've watched a couple videos with Dr. Matthew Walker on sleep and its effects...there seems to be a very direct correlation between the amount of sleep you get and the likelihood of Alhzeimers. Sleep is free, and no side effects...get your ZZZs folks!
This is so depressing. The FDA used to be an organization that protected us. Now, there's too many higher up in the organization that were put there 2 to 6 years ago that just didn't care about patients, but wanted that green stuff in their pockets. I hope they can be removed and better individuals put in that aren't after that lobbyist money.
@@spacetoast7783 The drug in question in this video costs around $28,200 per year. It is very, very expensive, and used to be double that price before backlash.
@@spacetoast7783 If you wanted to push an unproven and highly expensive drug to the market while the advisors of the FDA are voting against it, how do you think you get them to approve it anyways?
thank you for this episode- it's hard to hear about the drug not being useful for treatment yet- but the other studies going on and their trials give me hope that these might be able to treat me or my parents as we get older. My family has a big history of Alzheimers, and I don't want my parents to get it in the next ten years or so before any treatment pops up. thanks again for supplying info, the studies, and explaining what's going on with the studies themselves- it's really appreciated:)
love that this topic is getting attention, i just wrote and am trying to publish a review paper on modeling AD with organoids, and i'm starting that project this month for my phd :D
I remember seeing a study about why there are fewer people with Alzheimer's now than before, and it concluded that education plays a big part. I think it would be better to prevent dementia 10 to 20 years before onset by learning something new instead of taking an unproven drug that most definitely has side effects.
It's far more reasonable to hypothesise at this point that amyloid beta, while definitely correlated with Alzheimer's disease, may not be a pathological factor per se but rather a sign of its progression. This change in focus could be similar to the discovery that bacteria in rotting matter is mainly responsible for causing sickness, not the foul gasses produced as a byproduct of decomposition (i.e. the displacement of miasma theory by germ theory).
This is very interesting. When I was in school we were taught about amyloid plaques and even discussed in class what might be a possible causation between the bio marker and the symptoms. Apparently we were wrong. I think it is still open to debate whether or not there is a causal connection, I think it's reasonable to assume that a possibly effect years or decades of amyloid buildup has on cognition, may not be resolved in such a short time (possibly can not be resolved at all). I'm looking forward to research going into new directions and hopefully a breakthrough on the actual mechanism behind Alzheimers.
My grandmother currently has some form of dementia (unable to get a dignosis because she is illiterate and for some reason the tests require writing and reading.) And although shes too far gone, i truly hope we figure out a treatment for dementia nd alzhiemers; it really is one of the worst mental disabilities
There's some evidence Viagra prevents tangle formation, even in those for whom it's usual purpose has been unhelpful. I might try it - tho risk having a night I'd rather forget. Good video, well written.
@@victorc777 Indeed, no harm done.. but it's actually a serious point, addressing the false logic associated with plaque disruption. My guess is that these manifest disorders will prove multifactorial in causation, including stuff of which we presently have no knowledge :)
Sounds like data over time is critical in the first effort. Removing plaque from the neurons might not help if the damage is already done. Stopping it from accumulating in the first place could still be a winner.
Removing objects that inhibit neurotransmission is a good strategy and worth the effort to research. At the same time there are already many other strategies that have been shown anecdotally to help. One other strategy is the regrow brain tissue faster than necrosis occurs. Paul Stamets popularized one way of doing that using Psilocybin/niacin/lions mane extract. A different strategy would be to increase serotonergic and dopaminergic signaling by changing the threshold for release into the synaptic cleft. People with Parkinson's have been experimenting with Iboga to do that. It doesnt abolish Parkinsons but supposedly it reduces symptoms significantly. When supplements that increase GDNF are taken in conjunction with serotonin receptor agonists the brain can build new pathways around damaged, nonfunctional tissue. Supplements such as Uridine monophosphate and microdoses of LSD come to mind.
Fascinating. It does seem that we are learning more about ALZ by the failure of this drug. In the past we medical professionals did assume that the marker of the disease corrected would fix the underlying problem. High blood sugar=diabetes, correct blood sugar level= less adverse symptoms & effects of diabetes. Now it seems the plagues are a result of the brain inflammation, a scarring as it were. So thinking the removal of the plague would fix ALZ is as absurd as thinking if we only remove a burn patients scars, we create a situation where the burn never occurred. We have to trouble shoot what caused the inflammation. Diet? Genetics? Environmental exposure to some chemical?
Follow the science...thank you for helping us do that. I would love to see an episode on whether low carb diets have any statistical results for reducing symptoms as I've seen some articles but don't know how trustworthy they are.
I have Parkinsons Disease. The video reminds me of the question about what causes what; do plaques cause Parkinsons or does Parkinsons cause plaques. Regardless, it's interesting that Parkinsons starts to develop 10-20 years before symptoms show up, just like Alzhei,mers. Coincidence? I don't think so. BTW, I am a strong adherent to the 'triggered gene' theory that says that it takes two elements to get the disease: genetics and a trigger, such as pesticides or heavy metals or something else 'modern' that is causing the epidemic of brain degenerative disease that we are seeing these days (same with cancers).
As a caregiver, I propose the possibility that patients are being used as "data-collection points". The drug companies give perks to the doctors for submitting drug results. In this case, I've overheard "They're dying anyway" on a few occasions.
It is sadly very understandable that people would try to give their loved one a drug that might not even help. A lot of the already available drugs have a high potential of not working, either. My mother will receive a new medication in a month, and we are aware that there is only a 60% chance it might help. 60% was enough for me to give it a try, given that we do have another drug to fall back on if it doesn't work. But I cannot really fault anybody who is willing to try lower percentages. As said in the video, Alzmeiner's often happens in families without previous history of this disease. This is the case in my family. I have been a caregiver to my aging grandparents for years, but nobody had any form of dementia. Now I am the sole caregiver for my mom and I am a fish out of water. If I'm honest with myself, then I have to admit that I'm simply not used to being treated badly. Alzheimer's makes people scared and angry and sometimes they lash out on their caregiver. Nobody in the extended family has any advice and I have to rely on strangers (who are trying their best but the healthcare field is struggling in a lot of countries!) to lead me step by step. Had we not found a drug that at least makes life a bit easier for Mom, even though it doesn't stop the decline, then I think I'd be about ready to try anything now. Life's hard every day and I have asked our doctor any question under the sun - could we get drugs from other countries if we paid for them ourselves, could we use alternative therapies, could we use stem cells or anything that I could donate, could we try XYZ thing I've found online - but there's only a few things available that have a chance of working. I was and am very angry sometimes, that in 2022 we have no cure for a disease that affects so many people. Even in our little town there is an assisted living facility for Dementia patients. In the end, I can only hope that research goes on and that there will be some breakthrough in the future. I have agreed to share Mom's medical info with research teams, just to feel less useless in this matter. Maybe it'll help someone a few years down the line.
Take a drinking glass, smash it on the floor. Whats left? Pieces. So this drug is the broom that sweeps up the pieces. Thats it. it doesnt stop the glass from being broken, it only removes the trash afterwards.
It is more like finding a band aid on a festering wound and assuming the band aid is somehow the reason why the wound is not healing and so it removes it...
Thanks for this informative video! I'll be sharing this with my parents. But also, surely I wasn't the only one who heard "brain plaque" and thought, "does that make it LITERAL mental floss?!" XD
![Kodak Black - Catch Fire [Official Music Video]](http://i.ytimg.com/vi/A4ch-olIuZo/mqdefault.jpg)
Head to linode.com/scishow to get a $100 60-day credit on a new Linode account. Linode offers simple, affordable, and accessible Linux cloud solutions and services.
linode is pretty good imo.
might as well just use pot. might not help but hey? who cares,lets have more drugs eh?
@@johnsmith9903 That's why i smoke pot and in my state it's legal so my Geriatric team has no problem with this. It definitely relaxes my mind and i don't stress so much and NO bp mds or anything like that. I walk 3+ miles each day & i'm 69 . So, if all else fails....go with THC/CBD
been focusing on enhancing bdnf by way of ghrelin expression: by spreading out my nutrition needs over 6 smaller meals a day to keep the stomach stretch receptors non-stretched but still getting all my nutrition, leading to BDNF expression upregulation.
another bdnf boost i've found was Rxn Buspar + activation of the [MT] Melatonin receptor (that i achieve with my Ramelteon insomnia medication)
us med is terrible at developing and applying appropriate treatment measures. "mirror-mirror" international reports continuously show this.
My grandpa had Alzheimer's and was in a nursing home for 2 years. He passed away yesterday. The approval of a minimally effective (if not completely ineffective) drug for the purpose of, let's face it, providing at least one profitable treatment for sufferers is incredibly disheartening. Big corporations are getting tired of investing money on research and not making an immediate profit. I guess gaining ground against a horrifying disease isn't enough for them...
I’m very sorry to hear about your grandfather. My grandfather passed away a few months ago due to Parkinson’s. These diseases are so evil. Rip to your grandfather
This. It's just about money anymore for these drugs manufacturers. They don't care who suffers in the process. The opioid crisis proved that. They're no better than the pusher on the street corner.
The last two years were like a pharma CEO orgasm tragically. So there's your measure of their character.
Corporations only care about money. All the money. Every conceivable penny.
They're not in this to help people, that's just a happy side effect.
Capitalism is out of control here in the US and we've allowed it to get here. The medical industry also has gotten outrageous here. Something really needs to be done to reign it in.
Exactly.
I am genuinely impressed, even surprised, to be honest, at how accurate this segment was. Doubts were already be cast on the beta-amyloid hypothesis as early as 2000 when I was a graduate student, and even then many were turning a suspicious eye toward Tau. Over two decades later, we've watched numerous beta-amyloid scrubbers (Solenuzemab, Bapenuzemab, etc.), effectively scour away the biomarker, but provide no clinical benefit whatsoever, and in fact lead to worsening due to micro-bleeds. I was worried you were going to herald Aducanumab as some sort of revolutionary treatment (apparently, I didn't read your video title carefully), but you accurately portrayed the level of controversy around FDA's decision to approve a drug based on no positive data whatsoever, despite near-unanimous recommendation against approval by their own appointed advisory board. Given the FDA's remit, and their track record of withholding or delaying drug approvals at times for trivial reasons, this decision was nothing short of surreal. There is the argument for hope...however, Alzheimer's is one of those diseases that is not particularly responsive to the placebo effect. Approving an extremely expensive drug that provides no net benefit (and like any drug has to potential to harm) isn't the kind of hope we need. You did a great job on researching this topic and presenting the full picture.
Yes! I'm constantly puzzled by how the amyloid hypothesis persisted as long as it has (at least in the "plaques are the problem" form) in the face of well-designed research that showed the opposite (e.g. D'Andrea et al. 2001, DOI: 10.1046/j.1365-2559.2001.01082.x )
Can you comment on RadioLab's episode on cutting edge Alzheimer's research in mice titled 'Bringing Gamma Back, Again'?
If the glial cell hypothesis is correct then could this drug actually increase The amount of glial cells that go into overdrive? Producing more inflammation and more amyloid and tao proteins
@@Sarah-fi6cd honestly I see it very similar to the dopamine hypothesis and substance abuse. Although that might even be a more complicated topic.
We need to get corporations and the profit motive away from healthcare.
This is such a great, great episode of scishow. Great science journalism and science communication, at the same time! Wonderful work from the scishow team! Thanks for all you hard work.
Easy Donald
@James Henry Smith l
The way I've thought of it is that if Alzheimer's is a fire, Beta Amyloid is ash. The ash is a sign that there was a fire, but clearing out the ash isn't going to fix the damage that the fire caused. The goal should be preventing the fire from happening in the first place. I think targeting Tau or causes of inflammation could be promising in this aspect, but I guess we won't know for sure until more research is done. It's entirely possible that they are also just different kinds of "ash", though hopefully that isn't the case.
well if its ash your comparing it too then i think soot or even pollution would also work right? so why not try to put a filter on the smoke stack and keep most of the bad pollutants out.
@@tjl102 You completely missed the point of the illustrative example and changed it with no regard to content and message simply to suit your own personal belief and narrative without even attempting to explain a logical parallel. Congratulations.
@@Kazini_ Damn
There were some recent announcement for likely link between Multiple Sclerosis and Epstein-Barr virus.
COVID-19 is also know to sometimes cause neurological brain damage, associated with long-covid symptoms like brain-fog and cognitive decline.
@@Kazini_ because the example was trash. A better example would be if the ash was still hot and burning. Removing it would help stop future damage but the damage that has been done is still there
Wow, this episode was really, really good. Often on scishow it is written to be punchy and to-the-point, skipping over going in depth on questions that arise from watching the video seemingly because it was "out of the scope of the video." That style of writing is understandable, but compared to this one, where it took the drug getting approval as a jumping off point to inform about the current scientific knowledge tide shifting about Alzheimer's, and current possibly promising areas of research, it really shows how informative you can get in a single relatively short video. I really appreciate this video, and hope to see many more like it
I totally agree. This video is exactly the type of scientific communication that could spur critical thinking
Massively in agreement.
I will add my agreement to this as well. I know over-10 minute videos may not garner the same number of views, but I appreciate the quality information presented in this video.
Agreed! I feel like the channel used to be more detailed like this and then it was dumbed down over the years. This is a refreshing video that just gives us the full picture and doesn’t assume we won’t understand it.
They are usualy "infusion" format. Scishow have many... There are longer... Explains ones... Like this one
I'm a Alzheimer's researcher in the UK (no Aducanumab). After research on the topic, these kind of antibodies were found to be pretty poor for Alzheimer's treatment, especially since their target isn't the only thing seen in Alzheimer's! Seems like a drug that can be used for "last resort" patients in the US, but definitely no revolution yet unfortunately.
Thanks for your insight
shortening the version of Tau seems like a better vector to research.
I'm a biologist with a family history, [copied from a previous post]: been focusing on enhancing bdnf by way of ghrelin expression: by spreading out my nutrition needs over 6 smaller meals a day to keep the stomach stretch receptors non-stretched but still getting all my nutrition, leading to BDNF expression upregulation.
another bdnf boost i've found was Rxn Buspar + activation of the [MT] Melatonin receptor (that i achieve with my Ramelteon insomnia medication)
I'd be happy to share my data with you.
Wow so are there any actual interesting developments? Im kind of hoping perhaps cocktails of amyloid and tau plaque targeting drugs, antiinflamatories that can reach the brain may be of some benefit (like minocycline, actually an antibiotic drug I took for acne as a teenager, which is also (used to be, before the advent of better drugs) used in lower doses for rheumatoid arthritis and other inflammatory diseases had some interesting side effects)
I think whatever targets we find we'll have to target patient selection to early detection (and that may steer us again off course by focusing on people who present to clinic and not people screened routinely- yet)
@@TheOrganicartist ohhh hey minocycline! Low dose, 40mg (instead of the 100, 75 or 50mg, antibiotic capsules- altho a higher dose may be needed to reach the brains immune modulators, glial cells) - it should also help, its a cb2 agonist that is neuropenatrant and also a weak NMDA antagonist - it, well not 'helped' but when i was on opioids it seriously SERIOUSLY prevented me from experiencing a normal rate of tolerance (and i think especially opioid tolerance is in part mediated by a withdrawal related proinflamatory boost in the brains immune cells, in part because of the rate of tachyphylaxis (alone) seen in shorter acting analgesic and narcotic drugs like fentanyl (unfortunately a lot of people having experience with that drug now- bad enough in 100mcg patches with 10mg reservoirs, but now....)
I was on this drug for acne as a teen during the absolute height of the opioid epidemic (welcome to America! If your not from here it's a thing:/
Anyway sorry to ramble, Just an armchair pathophysiology enthusiast here btw, but i really think it could boos your regimine "spectrum" of pharmacological intervention to include anti-inflammatory drugs that have a tendancy to affect perhaps the brains system separately from the body as a whole (which is a separate system we used to think of the brain, well individual neurons, as "privileged site" from typical inflammatory related immune cells via the blood brain barrier but it turns out glial cells do it all !)
Any comments on the recent announcement for link between Epstein-Barr virus and Multiple Sclerosis?
I'm a dementia researcher and this video was such an excellent summary of the situation! It's been really sad to see some of my participants get excited at this 'new' drug being approved in the US and thinking that soon it will come to the UK but we've known for years now that it's not effective.
Do you think it’s at least part of the puzzle? Like a combination of that plus something in the future to tackle the tau problem could work?
@@JingleMallet it's possible. Personally, I think I'd be more curious to see if the drug or a similar drug could be used a lot earlier to stop amyloid plaques from forming in the first place and if that could have a preventive effect.
Take care of your brain b4 symptoms show even if there is no family history of dementia or Alzheimer's. Amyloid plaque is a symptom, not a cause! *PESTICIDES & HERBACIDES over time, would cause considerable health problems to the gut biome, not to mention in many mechanisms / organs of humans. It would certainly account for the nerve damage and dementia and cancers for which there is a plethora. *Nervous damage is how it kills the insects - these are the same symptoms as Alzheimer's. HAVE YOU EVER seen an insect with a bit of insecticide on it - the death process starts with nerves shaking uncontrollably until it is unable to breathe or do anything else.
So what is your standpoint on lecanemab.
@@Mosaik777 To me, it seems like it doesn't have that big of an effect. I'm not sure I'd be able to tell the difference between two people with dementia that are only 0.5-1 point apart on a psychometric test (but we do use different tests in the UK). Considering there may be side effects that negatively impact quality of life, overall I'm not sure that it's going help anyone in a meaningful way. But I'd be happy to be wrong!
My father is upposed to be part of a trial for this through a Hospital here in Oregon. One of the doctors we have talked to called this a waste of time and money and is what makes people doubt the ethics and reliability of science. The other doctor called it an amazing breakthrough that can help millions.
They are both wrong. One discounts a drug without human trials to confirm it’s use, safety and effectiveness and the other claims it’s a breakthrough again without proof giving people and families suffering with this disease false hope.
Science is not a crystal ball, it's a self correctling process that over time increases our knowledge while removing human bias. But the process takes time and can venture down blind alleys.
@@codename495 the other?
For-Profit Healthcare in a nutshell
@@toby9999 Very well said
Thank you so much for talking about this! I’ve been a fan of SciShow from the beginning (back when I was in high school!) and now I work in a lab studying fluid biomarkers of AD. Our clinical trials unit was responsible for measuring CSF amyloid for solanezumab and gantenerumab, two similar drugs. We finished our trials but failed to get approval because although plaque burden was reduced, cognition didn’t improve. The most frustrating thing about the aducanumab situation is that the approval has drastically changed how we approach clinical trials. Because a treatment is available, it’s no longer considered ethical to have a placebo control group. As a result, multiple studies that were getting ready to begin weeks after the final decision was made by the FDA had to be completely redesigned at the last minute. The drug has become a huge issue for clinicians too. Performing cognitive tests for dementia already requires a lot of training and practice; in our clinic, two neurologists review every cognitive exam performed and must be in agreement on the diagnosis. These clinicians were already swamped with patients, but are now also getting an influx of people with possible cognitive problems who want to get on the AD drug ASAP.
TLDR; the whole aducanumab situation has ended up being a real problem in the field rather than a solution.
White collar crime at its worst 😤. It's outrageous researchers like you and trials had to suffer because of one greedy corporation and a corrupt FDA.
It’s kinda like starting out with the observation that people who had good grades in school went on to get good jobs and then trying to increase high level employment by giving students the answer to all their exams beforehand:
You’ll have students (=patients) showing consistently good grades (=low biomarkers) because you’re directly eliminating bad grades (=antibody treatment) but that doesn’t mean you’ll get good high-level employment rates (=successful disease treatment) as you haven’t changed the cause of bad grades in the first place (=mechanistic cause of the disease) which could be anywhere from the quality of teaching, the intelligence of the students etc. (=multifactorial, exogenous and endogenous disease factors).
Or noting there is a correlation between peaches and poison ivy during warm months. Then removing peach trees in the hopes of treating poison ivy.
@@nosuchthing8 It’s the eternal correlation doesn’t equate to causation fallacy
pharmacology graduate here! there's many things to be miffed about when it comes to the approval of aducanumab, but i have to say the thing i'm most annoyed about is that the benefits of it are so so minimal, if there even are any at all, and it's a monoclonal antibody drug! i'd be less annoyed about this if it was another 'regular' small molecule drug. i haven't looked up the price for aducanumab specifically but mAb therapies are always SO expensive. i think it's disgusting that such an expensive treatment has been approved with so little data, when people KNOW that for some people this is their last hope for keeping a loved one alive/functional for a little longer and will fork out the money for it whether it has enough data behind it or not
That's literally the point - it's a big money grab banking on the desperate and uninformed being easy targets. There are individual people out there who still care, but overall the modern medical industry is a grifter's game.
And it's not just "so little data" - they literally didn't publish ANY data showing improved outcomes. This is a travesty of corruption in the approval process, and insurance companies should refuse to pay.
@@telegramsam "The medicine doesn't seem to be working his mental decline is just getting worse"
Doctor: "Eh but he has no biomarkers so he doesn't technically have Alzheimer's anymore"
"But..."
Doctor: "Ya so insurance won't cover treatment anymore"
"But..."
Biogen is asking for $56,000 per year for Aduhelm (the brand name for aducanumab). Per year. And they've not ruled out increasing the price in later years. ICER (the Institute for Clinical & Economic Review) reviewed the health-benefit price benchmark: maximum $8,400 / year, they said. Any higher and most vulnerable patients will suffer significantly more from the enormous health costs versus the next-to-nothing benefit of this drug. I quote, "Biogen should lower the price of aducanumab to a value-based price range determined by independent research to fairly align with demonstrated benefits for patients. Fair pricing is required to fulfill the social responsibility held by manufacturers to avoid financial toxicity that falls hardest on the most vulnerable patients.
"
A study in the Neurology journal (12 Jan 2022, Whittington | Cost-Effectiveness and Value-Based Pricing of Aducanumab for Patients With Early Alzheimer Disease
) also reviewed the initial impact from aducanumab patients. Patients gained ~4 months in an earlier stage of Alzhemier's, while paying $204,000. The drug did very, very little for an enormous, preposterous cost. I quote, "Patients treated with aducanumab received minimal improvements in health outcomes at considerable cost. This resulted in incremental cost-effectiveness ratios that far exceeded commonly used value thresholds, even under optimistic treatment effectiveness assumptions. These findings are subject to the substantial uncertainty regarding whether aducanumab provides any true net health benefit, but evidence available currently suggests that an annual price of aducanumab of $56,000 is not in reasonable alignment with its clinical benefits."
This video is really well made. I've worked a little with Alzheimer's Disease Epigenetics, and I'm amazed at how you approached this subject. Good job!
My mother died of Alzheimer's disease in 2019. This drug getting approval because... well just because "Let's fast track something!" is kind of depressing. Drugs like this tend to give false hope to families when, at least in my opinion, they're better off dealing with what's going to happen rather than fast tracking garbage.
I would also consider research regarding Alzheimer’s and insulin resistance, as insulin blocks what removes the amyloid plaques, as a pathway to which these plaques form. That being, they might just be a side affect of an underlying problem of metabolic dysfunction in the brain. Research regarding use of MCTs in Alzheimer’s patients does demonstrate that alternative fuel sources such as ketones improve symptoms which suggests an underlying metabolic issue.
THANK YOU!!! Dementia is type3 diabetes. I do not know about Alzheimer's specifically, but it must be connected.
Unfortunately, brain metabolic dysfunction may not be as robustly researched as other possible causes, due to no clear path for an expensive pharmaceutical treatment/cure, in spite of observed benefits from MCT use. Especially egregious that a drug offering NO symptomatic benefit got FDA approval.
Your reaction is the same as most scientists do. Have a problem (like insulin resistance) and try to connect it with other diseases
BUT i think you are on the right way if you start with treating the cause of insulin resistance.
Search the solution in less sugar consumption and more phytonutrients
to optimize your immune system!
Of course does Keto-diet both!
I've always thought it was another form diabetics but when I suggest this people laugh at me. Glad to see I'm not alone.
@@michaelramsey3643 Sad to say that’s 100% true. Our healthcare system doesn’t focus on prevention because it’s not as lucrative as treatment. Biochemistry and good RCTs of nutrition clearly show how refined carbs and excess linoleic acid from seed oils are responsible for chronic disease, but instead of solving the route cause by cutting them out we prescribe medications to “treat” the issues.
The research makes me hopeful even if it isn't always successful. Unfortunately, the genetics around this disease isn't in my favor or that of my father and brothers.
I wish you the very best in your mental health! Hopefully research will be more in your favor in the future
My grandma (paternal) passed away from Lewy body dementia in 2020. My paternal grandpa and his family seems to be able to live forever, and my mom’s side is fine as well. I am hoping I don’t get it when I’m older because I don’t want my kids (or any grandkids if that happens) to watch me wither away the way that my family, especially my dad, had to watch that happen. It was pretty awful.
Learn an instrument and play it occasionally
Learn a new language and use it occasionally
Get lots of sleep, really try to get 8 hours a night no matter what
Those three things will drop your Alzheimer's risks dramatically
There are things you can do tho to preserve brain function while this vital research goes on- try some of these new apps to learn a second language, eat a healthy diet and avoid known proinflamatory things like staying awake for 24+ hrs, tobacco (including nicotine vapes!) excessive caffine and if you can, stimulant medication
All the best and hoping it skips you.
I think given the nature of the disease, a phase 4 trial might ultimately reveal some useful information if nothing else.
Very informative piece. My husband and I were just discussing Alzheimer's a few days ago. He'll be very interested.
Also, love the hair.
This is a super important episode. Thanks for doing this, folks.
Wow this is the first time that I have been impressed with how well the research is presented in a RUclips video! Great work!
Reminds me of how endometriosis tissue growth doesn’t necessarily correspond to pain levels. Also sometimes removing the excess tissue growth doesn’t always change pain levels.
@Kathryn Caughill plus just the rampant sexism in medical schools and how they teach Doctors to treat patients.
I was wondering if SciShow would be shown in schools and it's so cool to see it happen! I went back to college and got in because I brushed up on my biology via crash course 🥰🥰
its been shown in some of my science classes before so kinda lol
Wonderfully put together!
I was neuroscience major in the 90s and then moved away from the field, but I feel so nostalgic watching this video, and I love that I completely understand what’s happening (for such a complex topic)!
Thank you for this. I worry my aunt has either Alzheimer's or dementia and my great-grandma had it and I have risk factors for it so it's a scary subject for me, one that I am trying to learn more about. Thank you for making this easy to understand and very informative. You are helping people in more ways than you realize by sharing your knowledge. Knowledge is power. You are appreciated. I am so glad I subscribed to this channel this week. 💕
There are recent articles for strong link between Epstein-Barr virus and Multiple Sclerosis.
The virus hypothesis is boosted by the observation that COVID-19 sometimes causes MS-like brain damage with symptoms like brain-fog, short memory loss.
Thank you for this excellent exposition of the Issues with Alzheimer’s research. It seems that we have been too narrowly focused at the exclusion of other possible areas of research.
So not only do we have to be looking forward with questions, we have to keep polishing what we think we know!
This video was genuinely an excellent recap of my university seminar on Alzheimer's
This was a very well done video! Disheartening to learn about how ineffective aducanumab is as a treatment.. I remember reading about in it the news and being so hopeful
As an individual with a history in the family of dementia this gives me some hope. Not with the new drug( mostly because our history is with non Alzheimer’s dementia but also because it seems it’s not the right path)but the fact that it’s being studied and while there will probably not be a cure found in my lifetime perhaps for my childrens lifetime. Meanwhile I take brain exercises, physical exercises and avoiding sugars and diabetes very seriously. Thanks for the video!
I think having my mother in law do brain games and crosswords or word searches, does just as much good as the Aricept and other pills they had her on. We never noticed a change while she was taking her med but she started having more energy and was up and about more when she started playing brain games.
All the pharmacoligical interventions are stopgaps their nootropics (that btw would improve YOUR functioning probably just as much- they dont do anything to treat tje underlying condition, and i truly suspect inflammation, the kind of chronic inflammation that might make a joint begin to feel stiffened, starting in the morning in your late 20s to whenever, and progressing to a hand that can work with a lot of effort and pain, to an unusable limb in the course of 20-40 years depending on how you treat the issue- if you start a specific regimine and follow basic steps like physical exercise, gentle movement, meds if its particularly aggressive (like RA and AS, or if we have pharmacological intervention that would make it feasible for anyone we find in the clinic) avoiding the typical American proinflamatory vices like caffeine, stimulant medication (always been part of our culture, even if underground....ask your grandma about pep-pills, because we also like) our 24+hour days in college and 12+hr workdays being called "American", smoking (not near as much as in the past) and garbage food the pharmacology can never stop entirely the "lifestyle" aspects and itll probably be so for Alzheimer's too-
Edit- we dont like to think or admit our brains are foggy, but when a brain teaser, or basic reality checks like "millions of babies arnt taken to whoever fox and Facebook scared you with this morning memaw- well because there arnt enough babies for one, and remember Denise from church- how she died from covid because that wasnt a hoax" when theze are hard it means they need MORE engagement not less. I guess hopefully the whole family votes the same party:/ but Yea brain teaser are prolly better than any drug the docs can give you
could you name some of these games? i want my mom to play em...anything to help her :(
Thinking brain games increases intelligence wrong. The only way to regrow neurons is by aerobic exercise.
@@garou12 it's literally called "Brain Games" it has Sudoku, puzzles, different logic games, I think it just stimulates areas of her brain that being stagnant doesn't touch. Physical exercise would probably work too if she was capable. Right now she can barely walk to the driveway and back. But at least she can carry on a conversation without getting lost or starting to talk about something from her childhood that no one could possibly know about.
@@jrbird1983 we're about in the same boat. thanks for the tip
Thank you guys for making science like this available to the layman. As a biochemist it's easy to forget that scientific literacy is not a skill many develope, and much less so to a high degree. Content like this can be invaluable for people with difficult decisions to make that just aren't able to dig into research themselves
The head of my department was part of the team that discovered the beta secretase gene. This drug and what it means for AD has been a frequent topic of discussion in our department. Researchers are pivoting away from amyloid and digging deeper into other things going wrong in the brain. I'm excited about the impact of glial cells like astrocytes on the disease process. I love to see great science reporting that makes complex science accessible for everyone!
I did some early work on Protollin, a preventative immunotherapy intended to stimulate the immune cells to clear both beta-amyloid plaques and Tau-tangles that just started trials in August, specifically in developing the nozzle (its a nasal spray) to direct the particles in the desired path. I’ve seen enough of their data to be hopeful about its efficacy, but the failure of aducanumab does somewhat undercut that hope. Whatever happens, I sincerely hope someone comes up with a viable treatment or preventative measure sooner rather than later.
This video is fantastic! So much great information and perfectly presented. I like these longer video lengths as well. Well done!
Fixed the engine by turning off the check engine light
Wow, this was one of the best scishow videos i have seen. Amazingly researched, thus perfectly accurate and explained in a way, that anyone who is new to the subject now has a really good understanding of the problems and challenges in alzheimer research. Very high quality video thank you very much. I would have loved for you to talk about soluble a-beta, which correlates better with symptoms. There are some interesting targets for its efflux like APO-E, ABCB1-Pg (MDR1) or LRP1. Also i loved that you mentioned trials for different treatment starting points. The future of Azheimer cure will be preventative
Wow kudos to whoever is writting these episodes 10/10
This video is accurate. However, the video does not mention the fact that about a half dozen clinical trials of tau lowering agents have been conducted, and they all failed too. Another inaccuracy is that the host says that aducanumab targets amyloid-beta plaques. It does lower plaques (and pThr181-tau), but it primarily lowers soluble amyloid-beta oligomers. The video also does not mention that BAN2401/Lecanemab, which primarily targets amyloid-beta protofibrils, was recently shown to significantly slow Alzheimer's progression in mild cognitive impairment and early Alzheimer's patients by ~30-60% in a phase II clinical trial. Personally, I do not think this means that amyloid cascade hypothesis or its ad-hoc variants are correct, although it does suggest that neurotoxic soluble amyloid-beta protofibrils and oligomers likely do contribute non-trivially to early Alzheimer's progression.
This video also arguably perpetuates the over-simplistic view that Alzheimer's is due to amyloid-beta, tau, and neuroinflammation, while ignoring all the many other factors that have been shown to be implicated, such as oxidative stress and damage, DNA damage, impaired DNA repair, mitochondrial dysfunction, insulin/IGF1 resistance, metal ion dyshomeostasis, iron and aluminum accumulation, hormonal disturbances, abnormal mitotic signaling, etc. However, I also understand this is a short RUclips video made by someone who is not an Alzheimer's researcher, so that is understandable, and to be fair, most professional Alzheimer's researchers rely on these kinds of oversimplifications too. I am pointing it out because I personally think that ignoring the true complexity of the disease in favor of oversimplistic falsified hypothesis is a big part of what's holding the field back.
I can post citations for any of this if anyone's curious.
I read somewhere that the plaque is like tombstones in a graveyard: Removing them will not have an effect on the cause of death for the people buried below.
In Alzheimer's case, the argument was that something caused an inflammation in the brain at some point in your life. Since the brain doesn't feel pain, people don't notice it.
This triggers the accumulation of the plaque which builds up over years, maybe decades.
So with this theory, when you get Alzheimer's, you were sick 10 years earlier.
I think it was by this guy: Lon Schneider, an Alzheimer's researcher at the University of Southern California's Keck School of Medicine.
Any updates from his team?
In the short term: Don't pick your noses and make sure you keep your teeth healthy. Wounds there allow germs to travel into the brain more easily than everything else.
HSV1 a huge cause in my opinion. Receding clicking the sore with your tongue very bad.
I have Huntington's disease and this gives me hope. I knew the plaque buildup was a fraction of the problem and was disappointed to see too much focus on it
My father has Alzheimer's which advanced rapidly in the past few months. Memantine had been helping some since he started it on New Years 2021, but the improvements did not last long after each dose increase. He started in-home hospice last month and then had 2 bad falls the next week. He died 2 weeks ago tomorrow.
I'm sorry you both had to suffer with this issue, though in different ways.
Condolences from England.
I actually learned about Alzheimer's in my lectures recently. Thanks for the refresher. Interesting stuff as usual :)
"research is generally more complicated than an Agatha Christie novel" XD love it!
Keeping your composure during that seemed very difficult. I applaud your professionalism and pursuit of knowledge.
+
I truly and deeply enjoyed this video! Thank you so much for letting me get smarter every day with SciShow 😁
I've watched a couple videos with Dr. Matthew Walker on sleep and its effects...there seems to be a very direct correlation between the amount of sleep you get and the likelihood of Alhzeimers. Sleep is free, and no side effects...get your ZZZs folks!
Sleep is free, but doing more work gives money. Sleep is not free for time.
@@oxybrightdark8765 If you get a chance, go watch one of his videos, you may find sleep is worth more than money.
@@microbuilder True, but so is food, affording medicine, affording rent.. in our world, money is important, so sometimes it has to come first.
I have a range of body paints that can totally remove one biomarker of jaundice. Can I sell it at a huge markup to the US medical industry?
This is so depressing. The FDA used to be an organization that protected us. Now, there's too many higher up in the organization that were put there 2 to 6 years ago that just didn't care about patients, but wanted that green stuff in their pockets. I hope they can be removed and better individuals put in that aren't after that lobbyist money.
Do you have any examples of this?
@@spacetoast7783 The drug in question in this video costs around $28,200 per year. It is very, very expensive, and used to be double that price before backlash.
@@Saltience How is that an example of FDA board members stuffing their pockets with lobbyist money?
@@spacetoast7783 If you wanted to push an unproven and highly expensive drug to the market while the advisors of the FDA are voting against it, how do you think you get them to approve it anyways?
@@Saltience They didn't vote against the drug in this video. Did you not watch?
thank you for this episode- it's hard to hear about the drug not being useful for treatment yet- but the other studies going on and their trials give me hope that these might be able to treat me or my parents as we get older. My family has a big history of Alzheimers, and I don't want my parents to get it in the next ten years or so before any treatment pops up. thanks again for supplying info, the studies, and explaining what's going on with the studies themselves- it's really appreciated:)
I really love that line from the end: " Science never really ends. It only changes direction."
this is real journalism right here. A+ content
love that this topic is getting attention, i just wrote and am trying to publish a review paper on modeling AD with organoids, and i'm starting that project this month for my phd :D
I remember seeing a study about why there are fewer people with Alzheimer's now than before, and it concluded that education plays a big part. I think it would be better to prevent dementia 10 to 20 years before onset by learning something new instead of taking an unproven drug that most definitely has side effects.
My wife's Grandpa suffers from Alzheimer's Its very sad! wouldn't wish it upon anyone
Why is Michael’s voice so dang soothing? Would love to listen to an audiobook narrated by him 😆🙏🏼
Thanks for covering this important research development. Great job!
Great episode guys. Thanks so much for this deep dive.
This was a great video on the development of this treatment. Hopefully we can find that missing factor sooner than later to better treat people.
I love this show. We should never stop learning, and this channel is a wonderful resource for doing that.
This video is very good. It explained a very complex subject, very well
This medication approval was so infuriating. It gave false hope, which is worse than none at all.
It's far more reasonable to hypothesise at this point that amyloid beta, while definitely correlated with Alzheimer's disease, may not be a pathological factor per se but rather a sign of its progression. This change in focus could be similar to the discovery that bacteria in rotting matter is mainly responsible for causing sickness, not the foul gasses produced as a byproduct of decomposition (i.e. the displacement of miasma theory by germ theory).
So we are trying to figure out if we fixed “the engine” (Alzheimer’s) or just removed the “check engine light” (protein marker)…
Such a good episode! Even with such a complex subject and terms to address, the video is simple and understandable. Good job and keep going :)
Ayyy early bird gets the learn
Nice
Sorry bro I gotta steal this phrase… I’ll give it back I promise 🙏😁
Excellent
Stole
But the second mouse gets the cheese
Thank you so much for your tempered, well-researched videos.
It's pretty cool to see how long so many of you have been a part of the scishow team.
Loving Michael's hair is absolutely amazing!!!
Thanks for clearing it up
Minute 11:31 "Science never really ends, it just changes direction."
Nicely put, SciShow team! I'd buy that bumper sticker!🤓
I saw a Moodle project attempt at a previous job. OMG what a disaster. If someone tries to sell you Moodle, run the other way.
I'm so glad you guys did this video...
“…because science never really ends, it just changes direction. “ -SciShow 2022
🙏❤️
This is very interesting. When I was in school we were taught about amyloid plaques and even discussed in class what might be a possible causation between the bio marker and the symptoms. Apparently we were wrong.
I think it is still open to debate whether or not there is a causal connection, I think it's reasonable to assume that a possibly effect years or decades of amyloid buildup has on cognition, may not be resolved in such a short time (possibly can not be resolved at all).
I'm looking forward to research going into new directions and hopefully a breakthrough on the actual mechanism behind Alzheimers.
My grandmother currently has some form of dementia (unable to get a dignosis because she is illiterate and for some reason the tests require writing and reading.) And although shes too far gone, i truly hope we figure out a treatment for dementia nd alzhiemers; it really is one of the worst mental disabilities
No improvement in cognition would still be good if it prevented degradation of cognition, but it doesn't do that either. That is pretty important.
There's some evidence Viagra prevents tangle formation, even in those for whom it's usual purpose has been unhelpful. I might try it - tho risk having a night I'd rather forget. Good video, well written.
Well, if it doesn't work, you'll likely forget anyways, right? :P
Viagra and similar drugs mostly improve erections, they don’t automatically cause them.
@@victorc777 Indeed, no harm done.. but it's actually a serious point, addressing the false logic associated with plaque disruption. My guess is that these manifest disorders will prove multifactorial in causation, including stuff of which we presently have no knowledge :)
@@Sashazur Indeed. Not my point.
Exercise and increased blood flow is good for your brain.
Sounds like data over time is critical in the first effort. Removing plaque from the neurons might not help if the damage is already done. Stopping it from accumulating in the first place could still be a winner.
This almost makes me feel hopeful despite how skeptical I was. Very impressive. Thank you
absolutely fantastic video
Excellently researched and presented video
Removing objects that inhibit neurotransmission is a good strategy and worth the effort to research. At the same time there are already many other strategies that have been shown anecdotally to help. One other strategy is the regrow brain tissue faster than necrosis occurs. Paul Stamets popularized one way of doing that using Psilocybin/niacin/lions mane extract. A different strategy would be to increase serotonergic and dopaminergic signaling by changing the threshold for release into the synaptic cleft. People with Parkinson's have been experimenting with Iboga to do that. It doesnt abolish Parkinsons but supposedly it reduces symptoms significantly.
When supplements that increase GDNF are taken in conjunction with serotonin receptor agonists the brain can build new pathways around damaged, nonfunctional tissue. Supplements such as Uridine monophosphate and microdoses of LSD come to mind.
Fascinating. It does seem that we are learning more about ALZ by the failure of this drug. In the past we medical professionals did assume that the marker of the disease corrected would fix the underlying problem. High blood sugar=diabetes, correct blood sugar level= less adverse symptoms & effects of diabetes. Now it seems the plagues are a result of the brain inflammation, a scarring as it were. So thinking the removal of the plague would fix ALZ is as absurd as thinking if we only remove a burn patients scars, we create a situation where the burn never occurred. We have to trouble shoot what caused the inflammation. Diet? Genetics? Environmental exposure to some chemical?
Great episode, thank you
Follow the science...thank you for helping us do that. I would love to see an episode on whether low carb diets have any statistical results for reducing symptoms as I've seen some articles but don't know how trustworthy they are.
Wow, thanks!
Very interesting episode. Thank you.
I KNEW this video would be about that drug. It's unfortunate.
I have Parkinsons Disease. The video reminds me of the question about what causes what; do plaques cause Parkinsons or does Parkinsons cause plaques. Regardless, it's interesting that Parkinsons starts to develop 10-20 years before symptoms show up, just like Alzhei,mers. Coincidence? I don't think so. BTW, I am a strong adherent to the 'triggered gene' theory that says that it takes two elements to get the disease: genetics and a trigger, such as pesticides or heavy metals or something else 'modern' that is causing the epidemic of brain degenerative disease that we are seeing these days (same with cancers).
That’s the same with autoimmune disease. Genes and a trigger. I’m so sorry.
Sadly is seams like we have come no closer to a treatment for many, many years. Really frustrating!!!!
As someone with family members with this disease and knowing I have a chance of getting it later, I think some help and some hope is better than none
7:49 That was uncalled for
Do one of these about cholesterol
As a caregiver, I propose the possibility that patients are being used as "data-collection points". The drug companies give perks to the doctors for submitting drug results. In this case, I've overheard "They're dying anyway" on a few occasions.
It is sadly very understandable that people would try to give their loved one a drug that might not even help. A lot of the already available drugs have a high potential of not working, either. My mother will receive a new medication in a month, and we are aware that there is only a 60% chance it might help. 60% was enough for me to give it a try, given that we do have another drug to fall back on if it doesn't work.
But I cannot really fault anybody who is willing to try lower percentages.
As said in the video, Alzmeiner's often happens in families without previous history of this disease. This is the case in my family. I have been a caregiver to my aging grandparents for years, but nobody had any form of dementia. Now I am the sole caregiver for my mom and I am a fish out of water. If I'm honest with myself, then I have to admit that I'm simply not used to being treated badly. Alzheimer's makes people scared and angry and sometimes they lash out on their caregiver.
Nobody in the extended family has any advice and I have to rely on strangers (who are trying their best but the healthcare field is struggling in a lot of countries!) to lead me step by step.
Had we not found a drug that at least makes life a bit easier for Mom, even though it doesn't stop the decline, then I think I'd be about ready to try anything now. Life's hard every day and I have asked our doctor any question under the sun - could we get drugs from other countries if we paid for them ourselves, could we use alternative therapies, could we use stem cells or anything that I could donate, could we try XYZ thing I've found online - but there's only a few things available that have a chance of working. I was and am very angry sometimes, that in 2022 we have no cure for a disease that affects so many people. Even in our little town there is an assisted living facility for Dementia patients.
In the end, I can only hope that research goes on and that there will be some breakthrough in the future. I have agreed to share Mom's medical info with research teams, just to feel less useless in this matter. Maybe it'll help someone a few years down the line.
Does 0 percent count? They published exactly no data showing there was ANY improved outcomes with the drug.
Take a drinking glass, smash it on the floor. Whats left? Pieces. So this drug is the broom that sweeps up the pieces. Thats it. it doesnt stop the glass from being broken, it only removes the trash afterwards.
It is more like finding a band aid on a festering wound and assuming the band aid is somehow the reason why the wound is not healing and so it removes it...
Would love to see one on Huntingtons vs Parkinson’s
Hey, Mike, your hair looks really good.
Thanks for this informative video! I'll be sharing this with my parents.
But also, surely I wasn't the only one who heard "brain plaque" and thought, "does that make it LITERAL mental floss?!" XD
7:18 Oh man the Warhammer 40k fans would love this!