Could an epilepsy drug help to slow Alzheimer's?

A drug currently used for the treatment of epilepsy may help to slow the progression of Alzheimer's disease, suggest the results of a new study.

Researchers from Beth Israel Deaconess Medical Center (BIDMC) in Boston, MA, and colleagues found that a drug called levetiracetam reduced seizure-like activity in the brains of patients with mild Alzheimer's disease.

Previous research has found that seizure-like activity is widespread in patients with Alzheimer's, and studies have associated such brain activity with cognitive decline.

"In the field of Alzheimer's disease research, there has been a major search for drugs to slow its progression," says study leader Dr. Daniel Z. Press, of the Cognitive Neurology Unit at BIDMC and an associate professor of Neurology at Harvard Medical School in Boston, MA.

"If this abnormal electrical activity is leading to more damage, then suppressing it could potentially slow the progression of the disease," he adds.

Dr. Press and team recently reported their results in the Journal of Alzheimer's Disease.

Testing the effects of levetiracetam

The researchers came to their findings by analyzing the effects of levetiracetam in seven patients with mild Alzheimer's disease. Levetiracetam is a medication used to treat seizures in children and adults with epilepsy.

For the study, participants were required to visit BIDMC on three separate occasions. Each visit began with an electroencephalogram (EEG), which was used to measure the participants' electrical brain activity.

Patients were then given either a low dose (2.5 milligrams per kilogram) or high dose (7.5 milligrams per kilogram) of levetiracetam, or an inactive placebo. Both the drug and placebo were delivered by injection.

The study was double-blind, meaning that neither the participants nor the healthcare professionals at BIDMC were aware of which injection the subjects were given. However, all participants received both doses of levetiracetam at some point during the study.

After each injection was administered, participants underwent another EEG. They also underwent MRI, which is used to measure blood flow in the brain.

Additionally, each participant completed a standardized cognitive test. This measured a number of cognitive functions affected by Alzheimer's disease, including memory, executive functioning, and visuospatial ability.

Levetiracetam normalized brain waves

At baseline EEGs, all participants demonstrated abnormalities in brain wave frequencies - specifically, their brain wave frequencies were either too low or too high.

However, the team found that high doses of levetiracetam appeared to normalize brain wave frequencies among the subjects.

While a single dose of the drug was not associated with any improvements in cognitive function, the researchers believe that their findings warrant further investigation. The researchers write:

"The pattern of decreased coherence in the lower frequency bands and increased coherence in the higher frequency bands suggests a beneficial effect of LEV [levetiracetam] for patients with AD [Alzheimer's disease]."

"Larger longitudinal studies and studies with healthy age-matched controls are needed to determine whether this represents a relative normalization of EEG patterns, whether it is unique to AD as compared to normal aging, and whether longer-term administration is associated with a beneficial clinical effect," they add.

It is estimated that more than 5 million people in the United States are living with Alzheimer's disease. By 2050, this number is expected to reach up to 16 million.

The majority of studies investigating potential new treatments for Alzheimer's have focused on clearing beta-amyloid and tau proteins from the brain, which are believed to play a role in the condition.

However, as Dr. Press and colleagues note, such studies have so far failed to yield success.

"There have been a lot of disappointments," says Dr. Press. "So our findings represent an interesting new avenue."

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