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Alzheimer’s Disease Trial with TPI-287

Tau is a microtubule-associated protein, and abnormal tau function has been proposed to play a role in the development and progression of Alzheimer’s disease (AD). TPI-287 is an stabilizer of microtubule dynamics, and the stabilization of microtubules is hypothesized to compensate for the loss of tau function in AD. The purpose of this study is to determine the dose of TPI-287 that is safe and tolerable in people with mild to moderate AD, as well as to measure the properties and preliminary efficacy of TPI-287.

Summary

  • Study director: Adam Boxer, MD, PhD
  • Sponsor: UCSF (Funder: Alzheimer’s Association)
  • Recruiting?: Yes
  • Official study title: A Phase I, Randomized, Double-Blind, Placebo-Controlled, Sequential Cohort, Dose-Ranging Study of the Safety, Tolerability, Pharmacokinetics, Pharmacodynamics, and Preliminary Efficacy of TPI-287 in Patients with Mild to Moderate Alzheimer’s Disease

Alzheimer’s Disease Trial of Solanezumab

The production and deposition of amyloid plaques in the brain is thought to contribute to the development and progression of Alzheimer’s disease (AD). Solanezumab is hypothesized to reduce accumulation of amyloid plaques and thus slow the progression of AD. The primary purpose of the study is to determine if solanezumab will slow cognitive and functional decline in participants with mild AD.

Summary

  • Study director: Adam Boxer, MD, PhD
  • Sponsor: Eli Lilly & Company
  • Recruiting?: Not recruiting
  • Official study title: Effect of Passive Immunization on the Progression of Mild Alzheimer’s Disease: Solanezumab (LY2062430) Versus Placebo
  • ClinicalTrials.gov identifier: NCT01900665
  • Conditions studied: Mild Alzheimer's disease

Anesthesia

The risk of cognitive decline related to surgery and anesthesia continues to be debated in the scientific literature. Some animal studies suggest that anesthesia may worsen the development of the plaques and tangles associated with Alzheimer’s disease while others identify the surgical procedure itself to be a problem by causing inflammation and release of harmful proteins. Others attribute temporary or permanent cognitive changes to the medications used to manage pain or other complications of being hospitalized. Ultimately, although this is a very active area of research, there are no definitive studies in older humans that prove a causative effect on the brain from anesthesia or provide recommendations on specific choices of anesthesia. Despite this, we hope to be able to identify information that may help our patients with cognitive problems evaluate the risk and make informed choices about surgery and anesthesia.

The risk of cognitive decline related to surgery and anesthesia continues to be debated in the scientific literature. Some animal studies suggest that anesthesia may worsen the development of the plaques and tangles associated with Alzheimer’s disease while others identify the surgical procedure itself to be a problem by causing inflammation and release of harmful proteins. Others attribute temporary or permanent cognitive changes to the medications used to manage pain or other complications of being hospitalized.

Serggio Lanata, MD

Clinical Instructor and Behavioral Neurology Fellow

Dr. Serggio Lanata was raised in Peru, where he began his undergraduate studies in general science. He later earned a bachelor of science degree from the University of Florida. He obtained his medical degree from the University of South Florida, and then completed his medicine internship and neurology residency at Brown University. He joined the UCSF Memory and Aging Center in July 2013 as a Clinical Instructor and Behavioral Neurology Fellow. He evaluates and treats patients referred to the MAC clinic.

Currently, he is mostly interested in the phenotypic overlap that exists between behavioral variant FTD and different psychiatric disorders, and how our understanding of bvFTD can inform our knowledge of the pathophysiology that underlies specific psychiatric disorders.

Salvatore Spina, MD, PhD

Clinical Instructor and Behavioral Neurology Fellow

Dr. Spina received his medical degree from the University of Catania, Italy. He completed a neurology residency at the University of Siena, Italy from which he also obtained his doctorate degree on mechanisms of neurodegeneration. He was trained in neuropathology of dementia syndromes at the Indiana Alzheimer Disease Center, Indianapolis in the laboratory of Dr. Bernardino Ghetti. Later, he completed an internship in internal medicine and a neurology residency at Indiana University. Dr. Spina’s research focuses on the clinicopathologic and genetic correlations in neurodegenerative dementia syndromes, with a special interest on frontotemporal lobar degeneration.

Richard Tsai, MD

Clinical Instructor and Behavioral Neurology Fellow

Dr. Richard Tsai received his undergraduate degree in molecular and cell biology at University of California, Berkeley and a joint MD/MBA degree at Drexel University. He completed a neurology residency at Albert Einstein College of Medicine in New York, serving as chief resident in his last year. During his residency Dr. Tsai studied dementia and elderly populations in the developing world and worked on white matter imaging of dual task gait performance.

Dr. Tsai is fluent in English and Mandarin Chinese. In addition to evaluating patients at the Memory and Aging Center, he sees patients at the Chinese Hospital and SFDPH Chinatown Public Health Center in Chinatown.

Elissaios Karageorgiou, MD, PhD

Adjunct Assistant Professor

Dr. Karageorgiou was born in Glasgow, Scotland, and raised in Athens, Greece, where he graduated from Athens College and subsequently obtained a medical degree and a PhD degree from the National and Kapodistrian University of Athens. Upon completion of his medical studies, he worked as a post-doctoral associate at the Brain Sciences Center of the University of Minnesota under the mentorship of Apostolos P. Georgopoulos, MD, PhD, studying the encephalographic brain patterns in health and diseases such as dementia, multiple sclerosis, and schizophrenia. He subsequently completed residency training in neurology at the University of Minnesota, where he also served as the Associate Chief Resident for Research and Education. After his residency, he joined the Memory and Aging Center at the University of California San Francisco where he trained as a behavioral neurologist. He subsequently joined the faculty at the Memory and Aging Center providing care and conducting research in the field of dementia, with a special interest in elucidating distinct patterns of brain rhythm disruption in dementia across the sleep wake cycle

Dr. Karageorgiou’s primary goal is the provision of optimal care to his patients and their families, a goal which also guides his translational research. He has been awarded the Robert Katzman, MD, Clinical Research Training Fellowship by the American Brain Foundation and the Alzheimer’s Association to pursue research on magnetoencephalographic neural interactions in frontotemporal dementia. He is also the recipient of the Young Investigator Award by the International Congress on Schizophrenia Research for his work on the early diagnosis of schizophrenia and related psychoses. During his residency at the University of Minnesota, he received the John R. Gates Award for his clinical qualities and patient advocacy and the Benjamin Shapiro Award for his research on the early and noninvasive diagnosis of brain disorders.

UCSF Over 80 Clinic

The staff of the UCSF Over 80 Clinic seek to address the complex dementia care issues commonly seen when caring for the oldest old. This care often requires an in-depth understanding of co-existing non-dementia medical illnesses, medication interactions, and the integrated living environment encountered in care of elders.

The staff of the UCSF Over 80 Clinic seek to address the complex dementia care issues commonly seen when caring for the oldest old. This care often requires an in-depth understanding of co-existing non-dementia medical illnesses, medication interactions, and the integrated living environment encountered in care of elders. In contrast to the clinical priorities for younger patients with cognitive decline, diagnosis is often only a small factor in maximizing outcomes.

Christine Walsh, PhD

Assistant Professor

Christine M. Walsh, PhD, received her BA degree in physiology from Trinity College Dublin, University of Dublin in Ireland. Dr. Walsh did her doctoral work at the University of Michigan studying the effects of REM sleep modulation on learning and memory. She also studied the neural correlates of cognitive aging. In 2011 Dr. Walsh joined the UCSF Memory and Aging Center where she has been studying sleep in both healthy older adults and in individuals with neurodegenerative diseases. Dr. Walsh is particularly interested in the contribution of sleep disturbance to cognitive decline.

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