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 Hope for Alzheimer's? 
The following is one in an ongoing series of columns entitled What Doctors Don't Tell You by . View all columns in series

On the near horizon, the curry spice curcumin is being investigated as a potential anti-AD compound, after it was recognized that people in India have lower rates of the disease. Lab tests by neurologists at UCLA have already shown that curcumin can repair brain cells damaged by AD, and clinical trials are currently underway (J Alzheimers Dis, 2006; 10: 1-7).

Traditional Chinese medicine offers two sets of herbal mixtures: Yi-Gan San is a combination of seven different plants, headed by angelica root; and Ba Wei Di Huang Wan (BDW) com-prises eight herbs, including cinnamon and peony. Initial research shows that they may be useful in AD (Evidence-Based Complement Altern Med, 2006; 3: 441-5).

There is currently excitement over one Chinese herb in particular, a rare club moss called Huperzia serrata.

Five years ago, an extract of the moss-huperzine alpha (Hup-A)-was tested in more than 200 Chinese diagnosed with mild-to-moderate AD. The results were described as "remarkable". After taking 400 mcg of Hup-A for less than three months, 60 per cent of the patients were observed to be "clinically on the mend". Only about a quarter of patients failed to respond. Side-effects were "mild and transient" and, in any case, affected very few of the patients (Zhonghua Yi Xue Za Zhi, 2002; 82: 941-4).

How does Hup-A work? It's thought to increase acetylcholine levels in the brain. But, in fact, it's much better than that. It penetrates the brain more effectively than the current drugs, and lasts longer. It also has a wider range of effects, including protecting cells against further damage from inflammation and oxidation (Acta Pharmacol Sin, 2006; 27: 1-26). Here again, a clinical trial is currently ongoing.

The Chinese also use acupuncture for Alzheimer's, and there is evidence that it may work (Zhongguo Zhen Jiu, 2005; 25: 390-2). In a Westernized variation of this, doctors have tested TENS (transcutaneous electrical nerve stimulation) therapy. Applied to various parts of the body (even the face), TENS has been shown to have some value, particularly in the early stages of AD. However, according to the Japanese doctors using it, the therapy needs to be repeated to sustain benefits beyond six months (Front Med Biol Eng, 2002; 11: 237-47).

Hopeful horizons
One possible AD treatment is chelation therapy. Often derided as mere quackery, chelation has been used for decades by frontier-spirited cardiologists to combat heart disease. The treatment involves transfusing a chemical cocktail into the bloodstream that will bind itself to harmful agents and carry them away. Chelation's earliest use was to remove toxic levels of lead from workers in the battery and paint industries, but it's now finding a revival in Alzheimer's patients.

The argument is this: if metal toxicity is involved in AD, then chelation may be able to bind and flush away the harmful metals before they can cause brain damage.

One of the first trials of chelation used clioquinol as the chelating agent. The results were promising, showing a slight clinical improvement after three weeks (Dement Geriatr Cogn Disord, 2001; 12: 408-14). However, the results of the only subsequent trial were less encouraging (Cochrane Database Syst Rev, 2006; 1: CD005380).

Despite these disappointing findings, a whole slew of researchers across the globe-from Osaka University to Harvard-are actively pursuing the chelation route in hopes of making a breakthrough. Some scientists are even suggesting using 'nanoparticles' to trick the brain into allowing more powerful chelating agents past its barriers (Neurosci Lett, 2006; 406: 189-93).

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