Alzheimer’s Treatment: How Amyloid Plaque Removal May Contribute to Brain Volume Loss

A recent study led by UCL researchers found that brain volume loss linked to new Alzheimer’s immunotherapies may result from the removal of amyloid plaques, not from neuron loss or brain tissue damage. This research, published in Lancet Neurology, analyzed data from various clinical trials of amyloid-targeting immunotherapies, including lecanemab, which the UK’s MHRA has approved.

Researchers believe that the changes in brain volume are linked to the elimination of amyloid plaques prevalent in Alzheimer’s patients. They suggest that this loss in volume should not raise concerns.

Dr. Christopher Belder, the study’s first author, emphasized the importance of reporting these changes in clinical trials and called for further evaluation to understand them better.

Lecanemab targets beta amyloid, a protein linked to neuronal damage in Alzheimer’s. The National Institute for Health and Care Excellence (NICE) has indicated that the benefits of lecanemab may be too slight to justify its cost on the NHS, but this decision will be reviewed after public feedback.

In summary, while brain volume changes occur with these therapies, they likely reflect the removal of harmful plaques rather than neuron loss. As research progresses, clear reporting and understanding of these effects will be crucial for future Alzheimer’s treatments.