Alzheimer’s Disease - Testing ADHD Medicine

Alzheimer’s patients may soon be administered ADHD medication to improve their symptoms. At first glance, this may seem odd and illogical, but the science checks out. A recent analysis explains why and how ADHD medication works for Alzheimer’s.

One of the primary reasons why Alzheimer’s disease (AD) is so devastating is that it affects multiply brain areas. As more and more neurofibrillary TAU tangles (twisted protein fibers) accumulate in brain cells, they block nutrients from reaching the cells and ultimately cause whole clusters of neurons to die off. 

 

This damage to the brain cells, in turn, produces the infamous symptoms of Alzheimer’s disease, such as memory loss and cognitive decline. But there is one more group of Alzheimer’s symptoms that gets less press - the behavioral kind. These symptoms include depression, apathy, agitation, and even aggression. And they can be just as severe and disruptive to the life of the person with Alzheimer’s and their loved ones as memory loss and cognitive decline. 

 

A clear-cut review study published in July 2022 in the Journal of Neurology Neurosurgery & Psychiatry shows that both cognitive and behavioral symptoms of Alzheimer’s can be improved by treating patients with medications used to treat attention deficit hyperactivity disorder (ADHD).  

 

Why can an ADHD treatment help patients with Alzheimer’s?

Let’s begin by clarifying that the types of ADHD medication considered in the analysis are noradrenergic drugs - medications that target a compound called noradrenaline. 

 

And if the word “noradrenaline” rings a bell, you’re not mistaken. Adrenaline is a hormone released by the adrenal glands located on top of both kidneys in response to stress or low blood pressure. That is where we get the term “adrenaline rush.” But when adrenaline travels to the brain, it gets the name nor-adrenaline and turns into a neurotransmitter - a brain chemical used to communicate between nerve cells. 

 

Noradrenaline (also called norepinephrine) is made by specialized noradrenergic nerve cells in the brain as well as the adrenal gland. As a neurotransmitter, norepinephrine plays a huge role in cognition. It aids us to stay focused, improves our ability to learn and memorize new information, and helps us control inappropriate behaviors.

In Alzheimer’s disease, low noradrenaline levels and the loss of neurons that produce norepinephrine are well documented across many brain areas. These disruptions contribute to symptoms often observed in Alzheimer’s disease - from loss of appetite, depression, and sleep disturbances to restlessness, aggression, irritability, and anxiety. 

 

Given that we already have a selection of noradrenergic medications available, researchers have long posited that administering such drugs to people with Alzheimer’s may help reduce AD symptoms.

What did the research find? 

The study authors examined 19 clinical trials from 1980 to 2021 that used noradrenergic drugs (e.g.atomoxetine, guanfacine, and methylphenidate) in people with Alzheimer’s disease and mild cognitive impairment. These studies involved a total of 1811 participants. The results were examined across two main kinds of symptoms: 

 

Cognition involved memory, language, attention, and visuospatial orientation. 

 

Behavior and neuropsychiatric symptoms, such as depression, apathy, and agitation.

The analysis showed that noradrenergic drugs had a small positive effect on general cognition and a large improvement in apathy. And the researchers conclude, “Repurposing of established noradrenergic drugs is most likely to offer effective treatment in Alzheimer’s disease for general cognition and apathy.” 

 

Obviously, using existing medications to treat AD has many advantages. For one, these drugs don’t have to be tested separately for safety and needn’t be approved by the FDA. All the required testing and certification have already been done in the past, which is a massive time saver. 

 

But it's not all rainbows and unicorns. A few more specific questions regarding the use of noradrenergic medications for Alzheimer’s disease are yet to be answered. For instance, we still don’t know which particular patients would benefit from this treatment the most, as well as the specific doses at which noradrenergic drugs should be administered in AD.

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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Recovery period from normal concussion can last up to one month

The findings of the largest study to be ever done on college athletes has redefined the timeline for recovery from concussion. Previously the normal recovery time was of up to 14 days, which has now been extended up to 28 days. The findings have been detailed in a sports journal.

The study's lead researcher, Steve Broglio, director of the University of Michigan Concussion Center, is on the CARE Consortium leadership team and leads the CARE clinical study core. "Normal return-to-play time was previously set at 14 days--meaning 50 per cent of people recovered in that time. Our paper suggests that 28 days more fully encapsulates the recovery process. At that point, 85 per cent of people have returned to play," Broglio said.

The study found that though median recovery times were consistent with the previously suggested 14 days, it was not until one month post-injury that most athletes were cleared for unrestricted sports participation. This doesn't mean that universities must revise their return to play protocols. "The RTP protocols are driven by clinical presentation (symptoms), not time, so they don't need to be revised," Broglio said.

Rather, coaches, parents, and athletes should reframe their expectations for return to play, in part to avoid stigmatizing concussed athletes who take longer than 14 days to recover, he said. Reframing the normal recovery time to 28 days helps eliminate unintentional social pressure from teammates, coaches, or parents who hope to see their players back on the field. If a concussed athlete takes longer than 14 days or up to a month, that's completely normal, he said. There wasn't much variation in recovery times among study subgroups, with various factors altering recovery by only up to two days. The total return-to-play duration was shorter with ADHD medication usage, males and greater assessment frequency. Those with greater initial post-injury symptom severity, practice/training-related injuries and three or more prior concussions had longer recoveries.

Concussion management recommendations are outlined every four years by the Concussion in Sport Group, an international body that reviews the medical literature and develops guidelines on clinical care. This paper and others resulting from the CARE Consortium will likely be taken into consideration when the group meets next year, said Broglio, who is also a member of CISG. Despite increased research in concussion over the previous decade, the trajectory of concussion recovery times across diverse populations of athletes has remained poorly defined, because most sports concussion research centred on male athletes in collision sports, or on female soccer players, Broglio said.

The current study included 34,709 male and female athletes from 30 colleges and universities--more than 1,700 of whom were concussed while participating in 22 sports. Concussed male athletes most commonly played football (54.7 per cent), soccer (10.7 per cent), basketball (6.8 per cent) and wrestling (6.4 per cent), while concussed female athletes most commonly played soccer (23.4 per cent), volleyball (14 per cent), basketball (12.9 per cent) and lacrosse (8.4 per cent). Broglio said male and female athletes took about the same amount of time to recover from concussion, give or take a day.

Concussion education and treatment have improved dramatically in the last two decades, he said. "Back when I started in concussion research 20 years ago, we'd manage these injuries with a light switch. We'd ask, 'Do you have symptoms?' and if the answer was no, the athlete was put back on the field. Gone are the days when concussed athletes are put back in the same day," Broglio said.

He added, "Now, we can think of it as a dial, where we slowly progress people back into the sport. Once a player is asymptomatic, it can still take some time. We have to respect the injury and respect the recovery process."

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

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https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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