Monday, April 30, 2018

Alzheimer's Disease and Driving


It is self-evident that Alzheimer’s Disease (AD) is one of the most prevalent disease among the older population and also the fourth leading cause of death in the U.S, plaguing over 5.5 million people. It is projected that halfway through 21st century the figure will rise to three times as many AD patients. Alzheimer’s also happens to be one of the saddest and worst kind of disease to be diagnosed with, as this disease attacks the hippocampal neurons in most patients, which results in patient losing their cherished memories. Dr. Roberto Fernandez’s study Early Alzheimer’s disease blocks responses to accelerating self-movement began by giving background information about the disease itself, he explained that this disease is most common in population older then 65 and is also the most common form of dementia. This disease has early symptoms of impairment of recent episodic memories; there is no cure yet, no preventative measure to slow the disease down, or even an effective method to diagnose or prescreen this disease. These are some of the reasons given by Dr. Fernandez’s introduction which outlines the importance of the research of the Alzheimer’s disease.
            Dr. Fernandez explained that AD occurs with presence and accumulation of Amyloid Beta plaques which serve as the hallmark of this disease as well as genetic risk factors, selective vulnerability, and why some group of people are predisposed at greater rate to AD. Dr. Fernandez’s study concentrates on relationship of the visual motion. Dr. Fernandez described exactly what his research has focused on by discussing the posterior cortical distribution of AD pathology. The reason why Dr. Fernandez chose to do this study was due to there being certain selective vulnerability of specific neuronal populations and the spread of pathological functional networks that are associated with the Alzheimer’s Disease. He specifically chose to perform detail study on the parietal lobe function and the perceptual base of navigation because it is very ideal to study in the aging population and the correlation with AD. Lastly, AD is known for its notorious association with the posterior cortical atrophy and this research focuses on those effects in the AD patients. 
            I greatly appreciated the way Dr. Fernandez set up his lab experiment. The experiment was set up in a visual reality driving test stimulation which was focused on the optic flow and the optic motion that is present during movement and self-movement. The visual reality driving test was tested and the test subjects were as followed: a younger group of subjects without the AD, an older group of subjects without AD, and finally another older group of subjects with AD. The study was testing what is known as Event Related Potentials (ERPs), which are accumulation of stimuli that result in firing of a neurotransmitter. The ERPs, involve horizontal moving dot patterns which induce a negative wave peaking at around 200ms and the driving simulations tested the presence of the N200 response. The results of the study were predictable and as hypothesized by Dr. Fernandez. There was a greater motion consistency and quicker optic flow which produced great N200 peaks; this was seen in the younger population because they did not suffer from the AD. However, the study proved that AD is involved in smaller optic flow and reduced N200 peaks in the older group of subjects with AD. It was also interesting to see that age difference had little effect on the N200 peaks as the both younger and older test subjects without AD had very little difference in their N200 peaks but compared to subjects who suffered from AD had significantly reduced N200 peaks.
            I also came across another study; Lack of sleep may be linked to risk factor for Alzheimer's disease: Preliminary study shows increased levels of beta-amyloid, however, there is currently less known about the impact in the human brain as this study was done on mice. As a student who has to stay awake for long periods of time due to studying for exams and other academic related work, it is a bit concerning and scary reading about this. The study gives new insight about potentially harmful effects of lack of sleep on the brain which tells us even more about the pathology of AD. This study was led by Dr. Ehsan Shokri-Kojori and Nora D. Volkow of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and Dr. Volkow who is also the director of the National Institute on Drug Abuse at NIH.
To understand the possible correlation between the sleep and Amyloid Beta build up, PET scans were taken from 20 healthy subjects ranging from age 22 to 72, after a night of rested sleep and then after sleep deprivation (being awake for about 31 hours). They found beta-amyloid increases of about 5 percent after losing a night of sleep in brain regions including the thalamus and hippocampus, regions especially vulnerable to damage in the early stages of Alzheimer's disease. However, the study does not answer whether the increase in Amyloid Beta may possibly subside following a night of rest. Although, this sample size was small for the demonstration of this type study but the preliminary assessments do point in the direction that there might be some correlation between sleep and Amyloid Beta accumulation.
            In retrospect of both studies, looking at Alzheimer’s Disease and the rate at which it is rising in population is scary and especially the detrimental effect it has on the people that are diagnosed with AD. It is evident that patients with late onset AD, are completely dependent on family and nursing homes to carry on day to day tasks. I learned from Dr. Fernandez that AD patients lose the ability to function in motion related tasks, which in his study concentrated on driving simulation. AD is a very pressing, important and aforementioned is in fact a very sad disease because patients are simply unable to take care of themselves which can have a huge emotional and physical toll on their loved ones and themselves. However, going back to the dynamics of the study which clearly showed the decrease in ability to drive safely in patients with dementia, it is of paramount importance to educate people and state legislations to take effective measures to prevent AD patients from driving after a certain time period in their disease state without stigmatizing them. This initiative will not only decrease the number vehicle related accidents of AD patients but also spread awareness about the disease itself.



 Work Cited 

1) Early Alzheimer’s disease blocks responses to accelerating self-movement
https://loyolauniversitychicago-my.sharepoint.com/personal/rmorrison_luc_edu/Documents/Forms/All.aspx?slrid=0b66629e%2D3002%2D5000%2Dcfcc%2D24d288cc413e&FolderCTID=0x01200052F973E683B96F4F97B49148A837C07C&id=%2Fpersonal%2Frmorrison%5Fluc%5Fedu%2FDocuments%2FNEUR%20300%2F%2803%2E27%2E18%29%20%2D%20Roberto%20Fernandez%2DRomero%2FNBA2012%2Epdf&parent=%2Fpersonal%2Frmorrison%5Fluc%5Fedu%2FDocuments%2FNEUR%20300%2F%2803%2E27%2E18%29%20%2D%20Roberto%20Fernandez%2DRomero

2) Lack of sleep may be linked to risk factor for Alzheimer's disease: Preliminary study shows increased levels of beta-amyloid
https://www.sciencedaily.com/releases/2018/04/180413155301.htm

3) https://www.cdc.gov/aging/aginginfo/alzheimers.htm

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