NeuRA Magazine #21

NEURA PARTICIPATES IN GLOBAL RESEARCH INTO ALZHEIMER’S PREVENTION

In conversation with Dr Bill Brooks
Tell us about your work with families with the genetic form for Alzheimer’s disease
I have been working with these families for over 25 years and we are involved here at NeuRA with a global research study called DIAN (Dominantly Inherited Alzheimer Network). This study set out to look for biological changes that occur in people before they develop the Alzheimer’s symptoms such as memory loss. Over the last two years, we have been working on a clinical trial aimed at preventing the symptoms of Alzheimer’s disease, by removing amyloid from the brain, before symptoms develop and before the nerve cells deteriorate. It has been a lot of work for us – and it’s an even more demanding task for the clinical trial participants, but it is all going well so far.

 

What is the next big step in the DIAN program?
By the end of this year everyone in the study worldwide will have been on the double-blind phase of the trial for two years, so at the end of this year, we will start looking at the data to examine the evidence and results which will frame the next phase of this ground-breaking research program.

 

What does the next phase of the research look like?
The next phase of the DIAN trial, as far as the first two drugs are concerned, is that they will be reviewed to see whether they have a significant influence on reducing amyloid deposition in the brain. If so, the trial participants will go on for another two years, to see if we the trial can demonstrate an effect on people’s memory and thinking. We also have plans to start a third drug arm this year. This process will roll on until a breakthrough is discovered which prevents the symptoms of Alzheimer’s.

 

How do you feel being at the pointy end of science?
When I was a medical student there was no treatment or cure for Alzheimer’s. It was not even on the horizon. It was thought probably to be one of those things, which were just not treatable. Over the last couple of decades, we have seen gradual but major increases in our knowledge, and we are now in a position where we hope we can make the same inroads into Alzheimer’s as we have into cancer, heart disease and stroke.

Here at NeuRA, we are really proud to be part of this international effort to find a preventative drug treatment for Alzheimer’s disease. For me it’s a culmination of many decades of work. To be stepping closer to discovery is what drives us all to keep pushing into the next phase of the DIAN research program.

 

We need your help to keep clinical trial running in Australia to make sure that the next phase of the trial is completed. You can donate at neura.edu.au/donate/

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Abdominal muscle stimulation to improve bowel function in spinal cord injury

Bowel complications, resulting from impaired bowel function, are common for people living with a spinal cord injury (SCI). As a result, people with a SCI have high rates of bowel related illness, even compared with those with other neurological disorders. This includes high rates of abdominal pain, constipation, faecal incontinence and bloating. These problems lower the quality of life of people with a SCI and place a financial burden on the health system. A treatment that improves bowel function for people with a SCI should reduce illness, improve quality of life and lead to a large cost saving for health care providers. Bowel problems have traditionally been managed with manual and pharmacological interventions, such as digital rectal stimulation, enemas, and suppositories. These solutions are usually only partially effective, highlighting the need for improved interventions. The abdominal muscles are one of the major muscle groups used during defecation. Training the abdominal muscles should improve bowel function by increasing abdominal pressure. During our previous Abdominal FES research with people with a SCI, we observed that Abdominal FES appeared to lead to more consistent and effective bowel motion. However, this evidence remains anecdotal. As such, we are going to undertake a large randomised controlled trial to investigate the effectiveness of Abdominal FES to improve the bowel function of people with a SCI. This study will make use of a novel measurement system (SmartPill, Medtronic) that can be swallowed to measure whole gut and colonic transit time. We will also assess whether Abdominal FES can change constipation-related quality of life and the use of laxatives and manual procedures, as well as the frequency of defecation and the time taken. A positive outcome from this study is likely to lead to the rapid clinical translation of this technology for people living with a SCI.
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