Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

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TheresaB wrote: Mon Jul 25, 2022 7:30 am
ApropoE4 wrote: Sun Jul 24, 2022 9:59 am I think Hellmuth is basically saying he doesn't believe a non peer reviewed analysis of data from a study funded by sweat lodge hippies and designed to just barely be able to claim no conflict of interest.
Not only have you violated our Community Guidelines as pointed out by Tincup, you are factually incorrect.

Dr Hellmuth is a female.

Dr Bredesen's paper was peer reviewed. https://content.iospress.com/articles/j ... /jad215707
I don't see what a doctor's gender has anything to do with our discussion, or how and why I'm supposed to know it.

I could be wrong, but isn't the Journal of Alzheimer's Disease a pay-to-play journal (with a very low impact factor) where the paper author elects their own reviewers? Also didn't this publication, if we should take it seriously, come after Hellmuth's critique?
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by TheresaB »

ApropoE4 wrote: Mon Jul 25, 2022 7:55 am I don't see what a doctor's gender has anything to do with our discussion, or how and why I'm supposed to know it.

I could be wrong, but isn't the Journal of Alzheimer's Disease a pay-to-play journal (with a very low impact factor) where the paper author elects their own reviewers? Also didn't this publication, if we should take it seriously, come after Hellmuth's critique?
That you are trying to paraphrase the opinion of another authority and get that authority's gender incorrect doesn't mar the opinion of the originator but casts shadows on your credibility. Additionally, not providing the originator's direct quote, but paraphrasing with hyperbole, "sweat lodge hippies" further discredits your post.

Further, I posted a link to Dr Bredesen's paper published in ISO press, not the Journal of Alzheimer's disease, which is peer-reviewed.
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

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Sorry but I don't know which gender the author goes by and it does not cast any sort of shadow on my credibility as it is irrelevant and immaterial. I already changed my post to reflect that the sweat lodge people may or may not be hippies. Please edit your post as it attacks me in asserting that I am not credible without providing evidence other than your opinion.

The article was in fact published in the JoAD which is part of IOS press (and their crown jewel with an impact factor over 3!!!). You can see that here:

"DOI: 10.3233/JAD-215707

Journal: Journal of Alzheimer's Disease, vol. Pre-press, no. Pre-press, pp. 1-11, 2022

Accepted 31 May 2022 | Published: 04 July 2022"
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by Brian4 »

Has anyone considered engaging in a dialog with Hellmuth by means of a response to her Lancet article? That would be normal scientific procedure. She's made a number of very specific claims that are either right are wrong. If they're wrong, it should be easy to show that. Showing that in a peer-reviewed format could be the best way to respond.

The parenthetical comment in the subject header about having "lost scientific curiosity" might not be productive, I would humbly submit. (And doesn't that violate our standards – at least as much as calling someone a sweat lodge hippie (which I personally would take as a compliment!)? Take a look at Hellmuth's research into post-COVID cognitive impairment. It is characterized by extraordinary curiosity, passion, and an obvious desire to solve a serious problem.

Thanks,
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by ApropoE4 »

Speaking of credibility - I noticed that in the supplementary table submitted with the article, several individuals showed terrific growth in grey matter volumes - 23%, 23%, and 15% in annualized terms. I'm not a neurologist, but do such increases ever occur in aged adult brains?

Maybe someone here with access to the authors can clarify.
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by Julie G »

I’ve caused a ruckus without even being aware. Please know that I didn’t publish this blog here, nor did I chose the subject line. (I’m not trying to dump on Theresa who I know had good intentions by sharing.) If I were to have posted, I would have framed the blog with some context. That said, I certainly stand behind every word. I tried (perhaps unsuccessfully) to word my letter to question Dr. Hellmuth’s motivations rather than assuming that I knew them. I’m completely open to being proven wrong and warmly welcome her to a conversation as I indicated in my blog. This blog post is anything but anti-science. I (and our entire organization) remain open to any and all strategies that will benefit our population.

Brian, yes! I appreciate the new focus on long-COVID which has offered another avenue for Dr. Hellmuth to build her reputation. Our NF52 also shared a case study in which Dr. Hellmuth helped to identify a stroke condition in an elderly man presenting with dementia. I love to see this positive example that could have come from a member of Dr. Bredesen’s team. She identified and addressed a contributor to this patient’s cognitive decline and thereby improved his cognition- brilliant! There are always more things that bring us together than divide us.

ApropoE4, you’ve taken a page from Dr. Hellmuth’s playbook. Rather than discussing the science, you’ve cast shade on the funders of Dr. Bredesen’s recent trial, cast doubt upon his Conflict of Interest declarations, attacked the journal in which he published, and questioned the data in the trial, the sum total of which is an effort to discredit the research itself without ever discussing his actual research. I especially appreciate that you’ve noted the improvement in volumetrics, which I find to be the most compelling of all of the data. Dr. Cyrus Raji analyzed the imaging for the clinical trial. I know he would welcome any questions that you have; you can reach him at craji@wustl.edu.

Instead of an ad hominem attack, I wonder if we could have a conversation about Dr. Bredesen’s Alzheimer’s hypothesis that was born over 30 years of laboratory research before transitioning to clinical practice. Dr. Bredesen asserts that Alzheimer’s results from an imbalance in the brain’s neuroplasticity signaling. As we age and are exposed to multiple assaults over time, damaging forces overtake repair forces, resulting in a downsizing of the brain’s ability and subsequent cognitive decline. His goal is to change your biochemistry to provide optimal conditions for our brains to thrive by identifying and addressing personalized contributors (metabolic derangement, poor nutrient status, lack of oxygen from OSA, exposure to viruses, etc.) that are contributing to the damage. He asserts that amyloid-beta (if present) is actually the body’s response to damage. You can read more about the background of the science here.

The fact remains that Dr. Bredesen is the only researcher to my knowledge who is making any substantive progress in treating Alzheimer’s disease. Eight-four percent patients in this trial experienced significant cognitive and imaging improvements that we haven’t seen elsewhere. The best that any pharmaceuticals (to-date) have been able to do is slow decline. IMHO, anyone who is working in this field should be curious about his results. Alzheimer’s is among the only top ten causes of global death for which we have no sustainable effective treatment. There are many millions suffering now (in the early stages) and many millions more with the underlying pathophysiology who may be able to benefit from this approach. As an Alzheimer’s activist, simply ignoring it is doing a disservice to our population.

Let’s also keep in mind the deeply flawed system in which all Alzheimer’s research is conducted. As we’re all aware hundreds of trials and billions of dollars have been spent on the amyloid hypothesis which still hasn’t panned out. Researchers have successfully been able to reduce amyloid-beta but that has NOT led to an improvement in cognition — the ultimate goal. Even worse, a recent report suggests that some of the the data of which that hypothesis was build may have been falsified which just adds another layer of “messiness” to a system that has already failed to gain a foothold on this disease. To fully understand how “evidence-based” medicine is rigged to disregard alternative theories (even those that are successful) read Jason Fung, MD’s blog: The Corruption of Evidence-Based Medicine: Killing for Profit. The Aduhelm debacle is a recent shining example of this dysfunctional system. It not only failed to benefit cognition, but it was also extraordinarily pricey, with potentially dangerous (even fatal in several cases) side-effects in up to 40% of users.

Dr. Bredesen appears to have a promising treatment, with no side-effects. Should it be morally withhold it from a population whose certain outcome is decline and death? The critics would have us wait. We need to ask why.
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

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Julie G wrote: Tue Jul 26, 2022 8:15 am ApropoE4, you’ve taken a page from Dr. Hellmuth’s playbook. Rather than discussing the science, you’ve cast shade on the funders of Dr. Bredesen’s recent trial, cast doubt upon his Conflict of Interest declarations, attacked the journal in which he published, and questioned the data in the trial, the sum total of which is an effort to discredit the research itself without ever discussing his actual research. I especially appreciate that you’ve noted the improvement in volumetrics, which I find to be the most compelling of all of the data. Dr. Cyrus Raji analyzed the imaging for the clinical trial. I know he would welcome any questions that you have; you can reach him at craji@wustl.edu.
The journal is a super crappy one, yes. Why publish there if you've got genuinely valuable, reproducible results?

The grey matter volume data seems too good to be true. Maybe there are some conditions where exercise and nutrition can have such a dramatic effect (and certainly they'd be interesting to study), but I'd really be interested in seeing the raw data. If you exclude these three outliers the rest are in line with the expected rate of decline.

I raised another point regarding the unlikely distribution of e2/3/4 if the dementia in question is all LOAD and not some other issues.

Do I believe getting people to exercise and diet can help their well being and even their mental abilities? of course! Do I believe there's any more to it than that? no.

Regarding the attack on the establishment - it is indeed sad that there's been no progress yet, and that drug companies can get useless drugs on the market if they're insistent enough, but since you mention HIV let's not forget that the first HIV drug was a disused cancer drug that made it through a vast screening effort that took years to complete, and that while it was effective it also had terrible side effects and only offered a decade of additional life (and was quite expensive by 80s standards) - and yet none of the "alternative" treatments offered from outside the establishment ever worked - the only thing that did work was more pharma research.

https://www.latimes.com/archives/la-xpm ... story.html
One California-based public interest law firm filed suit in June against the FDA and the National Institutes of Health, accusing them of failing to test quickly and make available drugs that hold promise for treating AIDS.

The suit was filed in federal court by National Gay Rights Advocates of San Francisco and West Hollywood on behalf of the 1.5-million Americans estimated to have been exposed to the AIDS virus. More than 37,000 people have developed the disease and nearly 22,000 have died.

“The process is so slow,” said John James of San Francisco, who publishes a biweekly newsletter with nationwide circulation examining alternative treatments. ". . . A lot of people are not willing to wait until they’re dead. The delays have been just unbelievable.”
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by NF52 »

ApropoE4 wrote: Wed Jul 27, 2022 8:17 am
The grey matter volume data seems too good to be true. Maybe there are some conditions where exercise and nutrition can have such a dramatic effect (and certainly they'd be interesting to study), but I'd really be interested in seeing the raw data. If you exclude these three outliers the rest are in line with the expected rate of decline.
I always like to burrow into supplementary charts also, especially after hearing a biostatistician say that while confidence intervals and statistical significance are key, she finds the "outliers" on scatter plots and other charts "fascinating". I was, like you, skeptical that such changes were possible in 9 months. So yes, it is fascinating that the annualized percentage change on gray matter volume had a mean change of 0.302%, which obscures a range of 39.666% across this cohort, from a -16.564% change in one individual to an annualized 23.102% increase in another. https://content.iospress.com/download/j ... 7-s001.pdf

This description of part of the study protocol provides one possible explanation for those with markedly better GMV:
Exercise, both aerobic and strength training, was encouraged for at least 45 minutes per day, at least six days per week (for aerobic exercise) and at least twice per week (for strength training), and facilitated by the personal trainers. High-intensity interval training (HIIT) was recommended a minimum of twice per week.
https://content.iospress.com/articles/j ... /jad215707

Based on this 2010 research: Aerobic Exercise Training Increases Brain Volume in Aging Humans Fifty-nine older (60–79 years) were randomized to receive either an aerobic exercise intervention or a non-aerobic stretching and training program. The aerobic intervention sounds similar to the "personal trainer" and HIIT intervention in the Bredesen protocol:
Intensity levels began at 40%–50% HR reserve increasing (15) to 60%–70% HR reserve over the course of the trial. Intensity levels and exertion were recorded in daily exercise logs and monitored by trained exercise leaders. Participants in the older nonaerobic exercise control group followed the same activity schedule and format as the aerobic exercise group did, but engaged in a program of whole-body stretching and toning designed for individuals 60 years old or older. and..older adults who participated in the 6-month aerobic exercise program showed a significant increase in regional brain volume, compared to older adult controls. As might be expected from the human behavioral research on aerobic training effects on cognition (3,4), the largest changes in volume were present in the frontal lobes of the brain, and included regions of cortex that are implicated in a broad array of higher order attentional control and memory processes (20–22)....aerobically exercising participants showed a significant increase in white matter volume after the 6-month intervention, compared to control participants.... These white matter tracts allow the left and right hemispheres of the brain to communicate, and deterioration in these regions has been implicated in age-related cognitive decline (23,24). [/b]
Dr. Richard Isaacson, until recently the Director of the Alzheimer's Prevention Clinic at Weill-Cornell Medical Center, was a co-author on a 2018 meta-analysis of Clinical Application of APOE in Alzheimer’s Prevention: A Precision Medicine Approach which is also available on our wiki ApoE ε4 Alzheimer's Research: What's New and How YOU Can Accelerate Research. He clearly believes that physical exercise may not only be helpful, but essential, to those with ApoE4:
Physical activity may not only prevent cognitive decline, but may also improve cognitive function. For example, one neuroimaging study showed that physical activity improved semantic memory processing for ε4 carriers as measured by fMRI brain imaging (23). While another RCT found that non-carriers had greater improvement in cognitive function in response to physical activity, this study was performed in patients already experiencing subjective cognitive complaints at baseline (24). This further suggests that physical activity may be most effective for ε4 carriers during a critical window of AD prevention before clinical symptoms begin to develop. Overall, the current evidence demonstrates that exercise is a critical intervention, especially for non-impaired ε4 carriers.
So I see some common ground among various views---and I need to step up my step intensity!!
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by ApropoE4 »

Thanks, that's interesting and supports the notion that exercise is good for you :)
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Re: Julie's letter to Dr. Hellmuth (& all who've lost scientific curiosity & support status quo in AD research)

Post by Brian4 »

Friends,

As it happens I had my annual NeuroQuant scan done a couple weeks ago, and met with the radiologist yesterday. I asked about gray matter changes, and he pointed out that gray matter volume can sometimes increase dramatically if one is sick. Looking at particular regions is key to interpreting the meaning of gray matter changes. The caudate nucleus, for example, would typically get smaller if the brain as a whole is inflamed, then would return to normal afterwards.

Speaking of inflamed brains, I have COVID-19 (minimal lung involvement, so I'll be fine), so I'm too exhausted to look at Bredesen's paper, but if someone with a non-inflamed brain can look into this, s/he may discover evidence that the cases of apparent miraculous gray matter recovery may just be cases of people who were ill in some way.

Brian
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