Health

Spinal puncture gives new hope to patients with early dementia

Spinal puncture gives new hope to patients with early dementia

Alzheimer’s treatment ‘turned up to 11’ with new spinal test to spot early signs of dementia that offers rapid drug therapy

  • Almost one million Britons have dementia, the most common being Alzheimer’s disease
  • Spinal lupine pilot study accurately identifies 90 percent of dementia cases
  • Early treatment can delay the devastating effect of dementia on patients

A spinal tap test to detect the early stages of Alzheimer’s disease could soon be introduced NHS so that a radical new treatment can be started in time.

Almost a million Britons have it dementia – with the most common form being Alzheimer’s disease – which damages the brain, causing memory loss, confusion and behavioral changes.

Spinal puncture, which is currently in a pilot study, uses a long needle to remove fluid from the spinal cord and has been shown to correctly identify 90 per cent of dementia cases, and experts believe it is faster than traditional NHS screening tools such as memory tests and brain scans.

Although the procedure, also known as a lumbar puncture, is potentially painful, experts say the results could be valuable in allowing doctors to offer anti-dementia drugs at the earliest stages of the disease, when they are most effective.

Spinal puncture, which is currently in a pilot study, uses a long needle to remove fluid from the spinal cord and has been shown to correctly identify 90 per cent of dementia cases, and experts believe it is faster than traditional NHS screening tools such as memory tests and brain scans

Early diagnosis of Alzheimer’s disease is also key to a breakthrough new drug, lekanemab, which has been found to slow the progression of the disease by almost a third and could be available on the NHS next year.

Alzheimer’s disease is believed to be caused by the accumulation of amyloid, a toxic protein, in the brain. Lekanemab, given by injection every two weeks, has been shown to bind and destroy amyloid, slowing the progression of the disease. But currently only one in 20 Alzheimer’s patients can benefit from the drug because many are diagnosed too late for it to be effective.

While most Alzheimer’s diagnoses in the UK are made using memory tests, many countries already use spinal taps. This looks for amyloid deposits in the spinal fluid, as well as another protein, tau, which is suspected of being linked to Alzheimer’s disease. But many patients resist undergoing the test because of side effects that can include headaches, swelling and long-term back pain.

‘This test is cheap, effective and used around the world, so it’s strange that it’s not used on the NHS,’ says Professor Dag Aarsland, head of geriatric psychiatry at King’s College London. ‘Early detection of disease is always key, but it will be especially so with this new drug.

While most Alzheimer's diagnoses in the UK are made using memory tests, many countries already use spinal taps

While most Alzheimer’s diagnoses in the UK are made using memory tests, many countries already use spinal taps

‘The sooner you detect Alzheimer’s disease, the more brains there will be to save.’

Researchers at King’s College London are now carrying out a pilot study to analyze how feasible it would be to introduce the lumbar puncture test – developed by medical company Roche – to the NHS.

“We want to know if patients are happy to undergo it and if doctors feel comfortable using it,” says prof. Aarsland. ‘If lekanemab is approved then it will absolutely be more accepted in the NHS.’



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