Cuttler & Associates, Vaughan, ON, Canada.
Baycrest Health Sciences, Toronto, ON, Canada.
J Alzheimers Dis. 2021;80(3):1119-1128. doi: 10.3233/JAD-200620.
In 2015, a patient in hospice with Alzheimer's disease (AD) was treated with ionizing radiation to her brain using repeated CT scans. Improvement in cognition, speech, movement, and appetite was observed. These improvements were so momentous that she was discharged from the hospice to a long-term care home. Based on this case, we conducted a pilot clinical trial to examine the effect of low-dose ionizing radiation (LDIR) in severe AD.
To determine whether the previously reported benefits of LDIR in a single case with AD could be observed again in other cases with AD when the same treatments are given.
In this single-arm study, four patients were treated with three consecutive treatments of LDIR, each spaced two weeks apart. Qualitative changes in communication and behavior with close relatives were observed and recorded. Quantitative measures of cognition and behavior were administered pre and post LDIR treatments.
Minor improvements on quantitative measures were noted in three of the four patients following treatment. However, the qualitative observations of cognition and behavior suggested remarkable improvements within days post-treatment, including greater overall alertness. One patient showed no change.
LDIR may be a promising, albeit controversial therapy for AD. Trials of patients with less severe AD, double-blind and placebo-controlled, should be carried out to determine the benefits of LDIR. Quantitative measures are needed that are sensitive to the remarkable changes induced by LDIR, such as biological markers of oxidative stress that are associated with AD.
2015 年，一位患有老年痴呆症（AD）的临终关怀患者接受了重复 CT 扫描对大脑进行的电离辐射治疗。观察到认知、言语、运动和食欲都有所改善。这些改善非常显著，以至于她从临终关怀病房出院到长期护理院。基于此病例，我们进行了一项小样本临床试验，以检验低剂量电离辐射（LDIR）在严重 AD 中的疗效。
确定在其他 AD 患者中重复给予相同治疗时，是否可以再次观察到之前报道的 LDIR 在单一 AD 病例中的益处。
在这项单臂研究中，4 名患者接受了 3 次连续的 LDIR 治疗，每次间隔 2 周。观察并记录与近亲交流和行为的定性变化。在 LDIR 治疗前后进行认知和行为的定量评估。
在治疗后，4 名患者中有 3 名在定量测量上有轻微改善。然而，认知和行为的定性观察表明，在治疗后几天内有显著改善，包括整体警觉性提高。一名患者没有变化。
LDIR 可能是一种有前途的 AD 治疗方法，尽管存在争议。应进行针对病情较轻的 AD 患者的临床试验，采用双盲和安慰剂对照，以确定 LDIR 的疗效。需要采用对 LDIR 诱导的显著变化敏感的定量测量方法，如与 AD 相关的氧化应激生物标志物。
