A controversial Alzheimer's surgery is said to reverse symptoms
nature.comBeing from Scotland I'd trust an NHS evaluation more than random news reports.
If your Alzheimer's is caused by poor drainage due to a one off blockage this would solve it completely, but if its due to something else this would probably just be temporary as the article notes.
The government shouldn't be in the business of telling people what they can do, or have done, to their own bodies.
There is a lot of history in this. Cancer and autism communities have fallen victim to these schemes as far back as those conditions have been recognized. Every year there is a new batch of researchers who claim they’ve found a cure but the government meanies are preventing them from curing the whole world. They generate a lot of false hope, take a lot of money from desperate patients, and then fade into obscurity after the communities realize nobody is actually getting cured by these treatments.
This happens in every condition where there is not yet a good medical treatment. Long COVID is a good example of a recent condition where hundreds of doctors have claimed to have invented new treatments. They generate a lot of headlines, collect a lot of money from desperate patients before everyone realizes the cure isn’t working, and then they abandon their cure like it never existed.
This is why governments regulate these things. If you assume all of the treatments might work, it seems cruel for governments to get in the way. If you look at the history of how this plays out, they almost never actually have any substance behind them. It’s almost 100% grift or researchers who can’t admit when they’re wrong.
Real life is more complicated.
Other laws still exist too.
Owning pillows is legal. Killing people is not legal. Just because owning a pillow is legal doesn't mean you can smother someone to death with it.
I would hope that someone diagnosed with a mental disorder such as Alzheimers would lose their drivers license (not sure if this is the case), but if they were subsequently cured and passed a new driving test, then would you have a problem with that?
You can throw the book at people taking any experimental drug that can have a gazillion side effects they have no clue about, but this doesn't help the people that might get killed because someone experimented with a cure, did not want to harm anyone but still did. People are not numbers, but real parts of the world and someone else's lives. Laws are there to keep people safe, but are just the last line of defense.
You can take both positions, but your argument is overly simplistic.
I gave the pillow example because it clearly shows how ridiculous it is to link things like this together. Your arguing that people should be denied experimental Alzheimers surgery because (paraphrasing) "maybe they'll feel cured, but won't be, and will kill someone in a car accident" (WTF?!), is no different to arguing that people should not be allowed to buy pillows because they might use them to smother someone.
Making laws against killing or endangering others (driving impaired, etc) is fine and desirable. Using the need for such laws to apparently try to make a case for banning experimental surgery is absurd.
But they absolutely should be in the business of licensing and controlling claims you make as a professional.
If you're someone who is performing this procedure and not making claims of medical benefits based on your license, I can see the arguments for allowing it. The flip side is you lose some of the legal protections you get as this is not a medically sanctioned procedure. Let the family sue you for the harm you may have caused and the department of justice arrest you for any lives that may be lost.
> The rapid adoption, in the absence of hard evidence, prompted Chinese regulators to intervene. Last year, they restricted the procedure to more-formalized clinical research settings, rather than the ad hoc use that had proliferated previously. And Xie, the pioneer of the technique, has been in detention since September for undisclosed reasons.
Seems you missed out on 10-15 years of development. Regulation strictness these days rival western.
I would guess that there are a lot of variables to eliminate too - eg is it possible that just having a surgery and recovering from anaesthesia can yield some of these benefits in some circumstances? Given that we don’t really understand how most inhaled anaesthetics fully work
It did cure some people, it yielded some improvements on average but it did yield extreme improvements in some people. That part isn't controversial.
> (and even if it were noticed: periods of lucidity are not rare. It would probably be ignored)
A year of being able to walk and talk normally when a patient could barely function at all would be noticed for sure.
Cure has a very specific definition. I don't think it applies here.
Look up how double blind tests are done on things that involve surgeries (eg implants)
> And of the ones that are, the family wouldn't notice the dramatic cognitive improvement shown in this article, but they noticed it here?
Because they’re primed to look for that improvement because they’re told that is the expected outcome
I've witnessed dementia patients take a fall, and then be dramatically more confused the next couple days. I've also seen them get some kind of social exposure, sunshine, exercise, etc. and present better for several days afterwards. Measuring "how well is the mind working" isn't like reading a digital meter.
I wouldn't assume you could. I guess that's why people study these things.
(Disclaimer: the non-paywalled part of the article did not mention side-effects or complications of the treatment so I don’t know what they are.)
In particular, I wish there was more detail on the 100-cohort study where patients experienced "modest improvements" and how that's calculated. Is that average increase of X points on an MMSE, etc.
In my experience in my family, dementia is not a linear slide. My 85yo mother with Alzheimer's will sometimes present very well and you have to really get into conversational details to notice the dementia. On other days, she'll pick up a paperback and try to use it as a phone. Some days she's steady on her feet, some days coordinating all of those muscles is just too much.
Over the course of a couple years, you can track the decline, but it's not a straight line. "Modest improvements" makes me concerned that they measured a valley to a peak. It's only 6 months since the 100-cohort study.
> The mean MMSE score change were 1.6 at 48 hours (95% CI: 1.079 to 2.158; p < 0.001), 1.25 at 1 month (95% CI: 0.603 to 1.888; p < 0.001), 1.17 at 3 months (95% CI: 0.343 to 2.01; p = 0.004), 1.28 at 6 months (95% CI: 0.311 to 2.344; p = 0.016) after surgery
I favor trials, of course, but the ones suppressing it would rather just bury it.
And honestly, caution is valuable here. People with Alzheimer's are extremely vulnerable. As are their loved ones. Ensuring it's got rigorous data so caregivers can understand the tradeoffs seems important. Surgery at an advanced age is risky, no matter what.
For all we know, it might in the future be possible to do it less invasively, like how a cardiac stent is installed. For us to get there, we have to pursue it aggressively. Dwelling too much on the current paradigm seems more constricting than helpful. We need an engineering-focused wartime approach to accelerate it.
The amyloid theory is a dead end, a wild goose chase which has led to tunnel vision and wasted three decades of research into Alzheimer. We're essentially back to square one save for some interesting data that viruses may be involved.
This had led to desperate patients seeking help from charlatans and quacks like the one described in this article.
That said, if it turns out that a treatment for some Alzheimer’s is some kind of “brain fluid” dialysis, it would be an amazing breakthrough.
Most conditions are like that, particularly ones where the underlying cause is poorly understood. We see symptoms that lookalike and assume they all point to the same thing
i think fixing the plumbing there may be a treatment for a bunch of issues given that for example the whole volume of the cerebrospinal fluid is normally refreshed 3-4 times a day (imagine changing oil in your car engine 3-4 times a day :) - i.e. any hiccup in the plumbing (even a temporarily one and even in the healthy people like a bad sleeping position) and you already may get headache, etc. One can imagine that any chronic performance degradation of the plumbing may lead to a bunch of issues (similar to say what happens in any other organ/limb when blood or lymphatic flow is degraded)
Specifically for Alzheimer's - we do know about direct importance of that plumbing system here - poor sleep is well correlated with Alzheimer's as during deep slow-wave sleep, the brain's glymphatic system actively washes away metabolic waste and toxic proteins, including Alzheimer-related plaques while chronic sleep deprivation increases the buildup of toxic brain proteins like amyloid-beta and tau.
That Alzheimer's surgery brings up another very important and pretty fascinating aspect - not only the Alzheier's may be not permanently damaging the brain, we may speculate that various things we observe as age related brain degradation may be not actual brain cells/core degradation and instead similarly fixable issues of just some utilitarian subsystems.
They aren't trying very hard, it's still on the front page and being discussed and read about.
https://youtu.be/yAqwXoUS7sE?si=Gs-EGJ_Xtkh9TG7R
If this is correct, it’s a new discovery that these channels exist at all