A new approach to the treatment of Alzheimer's disease: the need for a controlled study.

It has been widely believed that decreased cerebral blood flow (CBF), known to occur in Alzheimer's disease (AD), is the result of neuronal degeneration that causes a decrease in the need for adequate CBF. There is new interest in the idea, however, that it is not neuronal degeneration that leads to decreased CBF to critical neurons, but it is the decrease in CBF which is the cause of the neuronal deterioration seen in AD patients. In order to increase CBF to the AD brain, an operation called omental transposition has been developed in which an intact elongated omental pedicle, when placed directly on the brain, provides additional CBF and other biological nutrients to the brain. It is understandable that AD patients are awaiting a method to control their disease, but this may take years to become available. Placing the omentum on the AD brain has demonstrated increased CBF which may be the reason that several studies have shown that omental transposition to the brain can improve the cognitive ability of AD patients who have undergone the operation. What is needed is a prospective controlled study that could scientifically establish the benefit of the procedure.