![]() While a definitive clinical diagnosis requires histopathological evidence by biopsy or autopsy, this is not usually feasible. It is increasingly accepted, however, as knowledge of AD grows that diagnosis is subtle and complex. Criteria such as the NINCDS/ARDA Alzheimer’s criteria (National Institute of Neurological and Communicative Disorders and Stroke/The Alzheimer’s Disease and Related Disorders Association) dating from 1984, are still in common use today with a sensitivity and specificity of 81% and 70%, respectively for AD. ![]() Įstablished AD in living patients has traditionally depended on clinical examination for diagnosis. Lifestyle factors such as diabetes, obesity, smoking, and depression have been highlighted as areas where modifications could decrease incidence of the disease, as is the area of vascular health. This early phase, if recognized, may be a key point for successful interventions. Typically, the disease has a preclinical phase of decades. ĪD is a complex multifactorial disease with an intricate, and as yet not fully understood, pathophysiology. Currently the annual cost of AD in the United States is of the order of $172 billion. These regions are also projected to have an increase in elderly population in the future, with a consequential increase in AD burden. Despite this, there is a clear correlation between onset and diagnosis of AD with age, with a higher prevalence in regions such as North America and Western Europe. Specifically, dementia rates in people under 50 years old are less than 1 in 4,000, of which 30% are due to AD. The typical cohort affected by AD are individuals aged over 60 years old, but it is increasingly being recognized that AD can affect younger people as well. The key pathological, and perhaps defining, characteristic of AD is the presence in the brain of extracellular deposits of amyloid-β (Aβ) and intracellular neurofibrillary tangles (NFT) of tau. Alzheimer’s disease (AD) is the most prevalent cause of dementia, accounting for about 70–80% of cases. This figure is expected to double every 20 years, until at least 2050. INTRODUCTION: AN OVERVIEW OF ALZHEIMER’S DISEASEĭementia, characterized by cognitive impairment, affects between 24–50 million people globally. Although use in clinical scenarios is still a relatively recent area of research, the technique shows good signs of efficacy and may represent an important option for treating AD in the future. The use of a therapy based on modulation of gamma neuronal activity represents a novel non-invasive, non-pharmacological approach to AD. A table summarizing the results of clinical studies applied to AD patients is also reported and may aid future development of the modality. The review then presents a selection of relevant studies that describe the neurophysiology involved in brain stimulation by external sources, followed by studies involving application of the modality to clinical scenarios. Next, the concept of external simulation triggering brain activity in the gamma band with potential demonstration of benefit in AD is introduced with reference to a recent important study using a mouse model of the disease. The epidemiology, diagnostics, existing pathological models, and related current treatment targets are initially briefly reviewed. The gamma frequency band is roughly defined as being between 30 Hz-100 Hz, with the 40 Hz point being of particular significance. This review examines a novel therapeutic modality that shows promise for treating AD based on modulating neuronal activity in the gamma frequency band through external brain stimulation. Existing treatments for Alzheimer’s disease (AD) have questionable efficacy with a need for research into new and more effective therapies to both treat and possibly prevent the condition.
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