With the benefit of hindsight, the story of the amyloid hypothesis will be written either as one where scientists soldiered on despite setbacks, or one where a wrong idea derailed a field for 25 years. And the field of Alzheimer’s research is no stranger to ideas inflated, abandoned, and sometimes resurrected.
Settled science is real. Obama and Al Gore both agreed on it. Some fools deny it though.
Well, dissected brains of dead Alzheimer’s patients have…beta-amyloid plaques all over them.
Its a reasonable hypothesis, whether right or wrong.
yes, and great scientific minds like Obama and Gore could never be wrong.
I’ll have to stop thinking about things like this, because they could cause an imbalance in my humours which, as all doctors agree, could cause me to become ill.
Alzheimer’s. now that’s a fun disease.
hey SDA, wanna go out for a coffee?
sure ! what’s a coffee?
Some science IS (fundamentally) … settled. However THAT science NEVER refers to itself as “settled”. Why? Because truly “settled” science has no opposition. No one needs to be “convinced”
BTW … when “a science” becomes “settled” … doesn’t that mean we can STOP FUNDING “investigations” and “proof” of the already “proven” ? Seems a WASTE of resources that could go to “proving” new things …
The disconcerting part of the article is this:
“Perry says his trainees’ research grant applications have negative feedback from reviewers for working with him because of his outspokenness against the amyloid hypothesis. The problem, he contends, is that people invested in the hypothesis are entrenched.”
Fifty-five years after Thomas Kuhn’s The Structure of Scientific Revolutions was published and it doesn’t seem that we have learned very much.
Good point. We should definitely not take any kind of preventive health action to preserve our cognitive functioning, or even acknowledge that Alzheimer’s disease is a real thing, until such time that every last scientist on the planet is in complete agreement on the scientific explanation of its cause, pathology, etc.
Besides, isn’t Alzheimer’s just a scam by the world’s physicians to increase their fee-for-service billings?
The phrase “the science is settled” implies that the results of the corresponding research or investigation was already known. Any data, any evidence that didn’t support that had to be rejected–no exceptions.
So much for Occam’s Razor or Sherlock Holmes’s famous statement that once one has eliminated the impossible, whatever is left over, improbable though it may be, must be true.
It appears the cholinergic and amyloid theories were merely
clinical trials with no clinical results just as the anti- pyschotics
that preceded them. Its all progress as long as the researchers
don’t forget their past failures.
“Its a reasonable hypothesis, whether right or wrong.” Well, in a way and only as far as it goes. A very relevant question is, are amyloid bodies in the brain the cause or are they the response and result.
The problem that I have always had with modern medicine is that in many cases the treatment is not a cure but rather a way to mitigate the symptoms. Is anti-amyloid medicine treating symptoms?
I don’t know the answer but in my personal view, Alzheimer’s is the worst possible thing to get……Cogito ergo sum. No congito, no sum.
I think what we’re seeing is massive pharmaceutical industry inertia. When I was a medical student, Aluminum was still considered one of the causes of Alzheimers; turns out that Amyloid is just very good at binding Aluminum. The model for this was the dementia early dialysis patients got because Aluminum wasn’t taken out of the dialysate.
Had almost forgotten about the amyloid removal idea as have moved on thinking of Alzheimers disease as more akin to a prion disorder (most commonly known one is mad-cow disease). There are two major neurodegenerative disorders: the tauopathies (of which Alzheimer’s is the model) and synucleinopathies (Parkinson’s disease). Both are characterized by accumulation of misfolded proteins which accumulate in the brain. Parkinson’s disease, according to some papers I’ve read, starts in the appendix and spreads from there. Seemed so bizarre that did multiple searches to verify this was really the case. When I was a med student, the prevailing dogma was that Parkinson’s wasn’t hereditary but it appears that there’s a hereditary predisposition to picking up a prion-like protein that starts the slow process. Prions all have the capacity to bind metals which is why they’re almost impossible to eradicate from surgical tools without boiling the tools in concentrated lye solution at high pressures and temperatures. There’s a correlation between prion disorders and how many surgeries people have had. What really frightened me was that the one possible overlooked source of prions might be through dental cleaning when metal tools are used and just conventionally sterilized. A research project for someone to take on if they’re interested.
Prion proteins, once they change state into an almost insoluble mass that self-catalyzes the assembly of similar proteins into prions grows until it eventually kills the cells in which the deposit is forming. These are also essential proteins in the brain and one hypothesis is that they’re involved in long term memory formation.
How we look at diseases changes often on a yearly basis but once a massive research project has been started, it’s almost impossible to change given the huge investment in funds and personnel that have taken place. Doubling down seems to be the most common response to failure of the project to yield expected results.
The other hypothesis about Alzheimer’s is that it’s a form of cerebral diabetes. The fastest lost of brain tissue I’ve ever seen in one of my patients was in a lady with poorly controlled diabetes who went from normal to very demented to dead in 6 months with brain shrinkage visible on serial CT scans.
What I’ve found in medicine is that the stupidest thing one can do is the equivalent of a drunk staggering around a lamp post looking for his lost key “because there’s more light there”. Some of the biggest changes in how I think of pathophysiology have come from the most unexpected sources and what one needs to do is be prepared for ones beautiful theory to be totally blown apart and a new model to take its place often on a yearly basis.