Efforts to clear amyloid-β from the brains of Alzheimer’s patients might have turned the corner these past few years, with immunotherapies beginning to show results that are something other than abject failure. The lengthy period of years in which trial after trial of potential anti-amyloid therapies failed inspired a great deal of theorizing on alternative models for Alzheimer’s disease. I think it likely that the condition has several causes, each of which produces a sizable fraction of the overall symptoms. Combine that with the theories that suggest amyloid-β aggregation is an early mechanism that enables tau aggregration to do the real damage later on, and it looks plausible that clearing amyloid is both useful and necessary, but not enough on its own to reliably help patients.
This is why I favor development of the new and as yet unrealized approach of restoring drainage of cerebrospinal fluid, which holds the potential of reducing the buildup of all forms of molecular waste in the brain – amyloid-β, tau, α-synuclein, and so forth. Still, the signs of progress reported here join the 2016 aducanumab results and others as an indication that at
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