Related Experiment Video
Updated: Feb 18, 2026
A High Throughput, Multiplexed and Targeted Proteomic CSF Assay to Quantify Neurodegenerative Biomarkers and Apolipoprotein E Isoforms Status
Published on: October 20, 2016
Longitudinal Neuroimaging Analysis in Mild-Moderate Alzheimer's Disease Patients Treated with Plasma Exchange with 5%
Gemma Cuberas-Borrós1, Isabel Roca1,2, Mercè Boada3,4
1Department of Nuclear Medicine, Institut de Diagnòstic per la Imatge (IDI), Hospital General Universitari Vall d'Hebrón, Universitat Autònoma de Barcelona, Barcelona, Spain.
Background:
Recently, modifications of Aβ1-42 levels in CSF and plasma associated with improvement in memory and language functions have been observed in patients with mild-moderate Alzheimer's disease (AD) treated with plasma exchange (PE) with albumin replacement.
Objective:
To detect structural and functional brain changes in PE-treated AD patients as part of a Phase II clinical trial.
Methods:
Patients received between 3 and 18 PE with albumin (Albutein® 5%, Grifols) or sham-PE (controls) for 21 weeks (divided in one intensive and two maintenance periods) followed by 6-month follow-up. Brain perfusion assessed by SPECT scans using an automated software (NeuroGam®) and brain structural changes assessed by MRI were performed at weeks 0 (baseline), 21, and 44 (with additional SPECT at weeks 9 and 33). Statistical parametric mapping (voxel-based analysis, SPM) and Z-scores calculations were applied to investigate changes to baseline.
Results:
42 patients were recruited (39 evaluable; 37 analyzed: 18 PE-treated; 19 controls). There was a trend toward decreasing hippocampi and total intracranial volume for both patient groups during the study (p < 0.05). After six months, PE-treated patients had less cerebral perfusion loss than controls in frontal, temporal, and parietal areas, and perfusion stabilization in Brodmann area BA38-R during the PE-treatment period (p < 0.05). SPM analysis showed stabilization or absence of progression of perfusion loss in PE-treated patients until week 21, not observed in controls.
Conclusions:
Mild-moderate AD patients showed decreased brain volume and impairment of brain perfusion as expected for the progression of the disease. PE-treatment with albumin replacement favored the stabilization of perfusion.
Insights
Plasma exchange (PE) with albumin replacement may stabilize brain perfusion in Alzheimer's disease (AD) patients. This Phase II trial observed less cerebral perfusion loss in PE-treated individuals compared to controls, suggesting a potential benefit for AD progression.
Area of Science:
- Neuroscience
- Neurology
- Clinical Trials
Background:
- Alzheimer's disease (AD) is characterized by cognitive decline.
- Previous studies suggest plasma exchange (PE) with albumin replacement may improve memory and language in mild-moderate AD.
- Amyloid-beta (Aβ) levels in CSF and plasma correlate with these functional improvements.
Purpose of the Study:
- To evaluate structural and functional brain changes in mild-moderate AD patients undergoing PE treatment.
- To assess the efficacy of PE with albumin replacement in a Phase II clinical trial setting.
Main Methods:
- A randomized controlled trial involving PE with albumin or sham-PE for 21 weeks.
- Brain perfusion assessed via SPECT scans (NeuroGam®) and structural changes via MRI.
- Statistical parametric mapping (SPM) used to analyze changes in perfusion and volume from baseline.
Main Results:
- PE-treated patients showed less cerebral perfusion loss in frontal, temporal, and parietal areas compared to controls.
- Stabilization of perfusion was observed in Brodmann area BA38-R during PE treatment.
- SPM analysis indicated stabilization or absence of perfusion loss progression in PE-treated patients up to week 21.
Conclusions:
- Mild-moderate AD patients exhibit expected brain volume decrease and perfusion impairment.
- PE treatment with albumin replacement demonstrated a trend towards stabilizing cerebral perfusion.
- These findings suggest PE may be a viable therapeutic strategy for slowing AD progression.
Related Concept Videos
01:22Alzheimer's Disease: Treatment
01:26Alzheimer's Disease: Overview
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...