Computerized cognitive testing is increasingly playing a key role in therapy development for dementia and Alzheimer's disease. At the Alzheimer's Association International Conference, Keith Wesnes Ph.D., Practice Leader of Bracket and founder of the CDR System™, discussed new data for novel therapies at two poster presentations.
Poster Title: Cognitive evidence in Alzheimer's disease patients that compromised hippocampal neurogenesis is related both to APOE4 status and CSF Abeta42
This presentation provides the first behavioural data in Alzheimer's patients which associates genetic and biomarker activity to dysfunction in a major brain area involved both in memory and the production of new nerve cells (neurogenesis), This exciting finding obtained in collaboration with a group including Kaj Blennow, University of Gothenburg, found that patients with two APOE ϵ4 alleles (which confer a 10 to 30 fold increased risk of developing Alzheimer's disease) showed a selective decline in a computerised cognitive test measure associated with activity in the hippocampal dentate gyrus. Furthermore, in all patients studied, this test measure was more closely associated with the levels of the Aβ42 biomarker for the disease than a number of other memory measures associated with different hippocampal regions.
As interest in Alzheimer's research is shifting to begin treating the disease at its earliest stages, these findings identify a potential genetic and biomarker strategy for selecting individuals for early treatment with therapies which may promote hippocampal neurogenesis.
Poster Title: Memantine improves attention and verbal episodic memory in Parkinson's disease dementia and dementia with Lewy bodies: a double-blind placebo-controlled multicentre trial
A second presentation provides the first data that performance on objective tests of attention and memory can be improved by memantine in two other major forms of dementia - Parkinson's disease dementia and dementia with Lewy Bodies. The improvements detected were highly statistically reliable and of clinically relevant effect sizes; indicating that memantine can produce cognitive benefits in patients with these dementias which match those seen previously with anticholinesterases.
Both studies utilised the CDR System™, an automated cognitive test system, making a strong case for benefits for the increased sensitivity and specificity that such procedures bring to dementia research, when compared with the traditional tests which have been historically employed.
Another recent Alzheimer's trial conducted by Orion Corporation demonstrated proof of concept of a new drug with a novel mode of action. The phase II clinical trial tested ORM-12741 -- the first drug to target a specific subtype of adrenergic receptors (alpha-2c) in the brain, which are believed to be involved in modulation of brain functions under stressful conditions. The trial of 100 patients showed significant positive effects on episodic memory in patients with moderate Alzheimer's disease. Efficacy was assessed using the CDR System™.