New treatment modalities in Alzheimer's disease

Abstract

Alzheimer’s disease (AD) is still a major public health challenge without an effective treatment to prevent or stop it. Routinely used acetylcholinesterase inhibitors and memantine seem to slow disease progression only to a limited extend. Therefore, many investigations on new drugs and other treatment modalities are ongoing in close association with increasing knowledge of the pathophysiology of the disease. Here, we review the studies about the new treatment modalities in AD with a classification based on their main targets, specifically pathologic structures of the disease, amyloid and tau, neural network dysfunction with special interest to the regulation of gamma oscillations, and attempts for the restoration of neural tissue via regenerative medicine. Additionally, we describe the evolving modalities related to gut microbiota, modulation, microglial function, and glucose metabolism.

Keywords: Alzheimer’s disease treatment; Anti-amyloid; Anti-tau; Gamma oscillations; Stem cell therapy

Core tip: This review discusses various new treatment modalities in Alzheimer’s disease (AD) based on the classification of their mechanism of action. New anti-amyloid, anti-tau, and treatments targeting network dysfunction with particular attention to deep brain stimulation to modulate gamma oscillations in the brain are evaluated. Moreover exciting developments in stem cell therapy especially combined with tissue engineering techniques are presented. Lastly some other modalities including microglial function modulators, gut microbiome transplantation, modulation of vagus nerve and metabolic arrangements are mentioned. It seems that new treatments in AD will involve each of them individually or in combination.