JOAN’S BLOG – WEDNESDAY/THURSDAY, MAY 21/22, 2008 – THE NEUROLOGY APPOINTMENT – I HATE THE MINI-MENTAL TEST!!!!/ POSSIBLE DRUG TRIAL FOR SID

Wednesday was Sid’s neurology check-up. I’ll admit it – I’m a real pain in the neck to neurologists. I spent almost 10 years administering language function tests to kids ranging in ages from 3 years to 20+ years, so I think I am pretty aware of the limitations of tests. The mini-mental test administered to Alzheimer patients at the beginning of each neurology appointment drives me NUTS!  Except for the short term memory part (name 4-legged animals, and repeat 15 words presented), it does not measure any of the functions that my husband is losing. Like executive functioning, reasoning, abstract thinking, language comprehension and processing, to name a few. So out of a perfect 30, he always scores between 26 and 29.

I couldn’t help myself – I brought that little peeve of mine to Dr. S’s attention, mainly because I felt he should know more accurately how Sid is functioning, what is stable, and what is slipping.  He usually teases me about being so intense, and he did manage to get in a little joke about it later on, but on the mini-mental, he not only agreed, but he seemed quite in tune to exactly where Sid was fitting on the performance scale.

Because Sid was under 60 years of age when symptoms first occurred, and is only 65 now, Dr. S. would like to keep him stable, and hold off progression as long as possible, so he can live a longer, better life. Unfortunately, his diabetes and some of his medications have always excluded him from the drug trials. This time, there is a very promising vaccine trial for which he may be eligible.

I have reservations about allowing Sid into the trial if he is eligible, (We find out on Friday) because of the previous problems with brain inflammation in the first trial. On the other hand, I don’t want to deprive him of the chance to improve. We were told he could drop out at any time, if he felt he did not want to continue.

I would like to hear from those of you whose spouses have been involved in trials. Has anyone been in a vaccine trial? What did you think about it? Was it worth it? Did you see any improvement?

Since I am woefully inadequate in explaining anything scientific, I am reprinting portions of an article that describes the new trial. It gives you contact information if you are interested in applying for it in the South Florida area. You can call the Memory Disorder Clinic in your area to find out if they offer it. Although this is not a complete list, it is a good place to start – click here – to find a comprehensive clinic in your area.

Amyloid Vaccine by Carl H. Sadowsky*, MD. FAAN

“………….The culprit in  Alzheimer’s disease is the overproduction and toxicity of a protein called beta amyloid 42…………….The vaccines developed to treat disease work by binding to and removing amyloid from the brain. The vaccines are basically antibodies to the amyloid protein. The antibody responders in the early vaccine trials demonstrated better outcomes on functional scales (e.g. handling money, use of the telephone and toileting) and less Alzheimer’s pathology in the brain then those patients that did not develop antibody.

The initial ELAN trial (2005) used antibody to the entire beta amyloid 42 protein. Eighteen cases of brain inflammation (out of 300 patients) caused that trial to be discontinued.

Current vaccine studies are now being started that are using antibodies that target smaller pieces of the amyloid protein. It is believed that these “shorter chain” antibodies will be able to remove amyloid from the brain and avoid the inflammatory reactions of the initial ELAN vaccine.

…………..For information call Dr. E. Triana at 561-845-0500  ext. 211.”

From September 10th, 2007 - Hippocampus - 6 Volume Issue 1

*Dr. Carl H. Sadowsky
Clinical Associate Professor
Nova Southeastern University
Director Premiere Research Inst.
Director St. Mary’s Hospital Memory Disorders Center
Fellow American Academy of Neurology
Recognized in Best Doctors in America 1998-2007

Please post comments under existing Message Board Topic: Drug Trials.

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