Virginia Research Day 2021

Medical Student Research Cl inical

10 Pilot Study: Novel Therapeutic Strategies for Treatment of Alzheimer’s Disease

Hope Tobey, DO; William Moles, OMS III; Curtis McInnis, OMS II, Allison Savon, OMS II Corresponding author: wmoles@vt.vcom.edu

Via College of Osteopathic Medicine-Virginia Campus

Alzheimer’s Disease affects 5.8 million Americans today, making it the sixth leading cause of death in the United States. 1 It has been well established that the accumulation of metabolic waste products including plaques of abnormally folded amyloid beta and tau neurofibrillary tangles contribute to the pathogenesis of brain tissue degeneration in Alzheimer’s Disease. Currently, management of this disease includes medications that inhibit the reuptake of Acetylcholine and promote the action of N-methyl D-aspartate (NMDA), but do not likely target the true underlying pathology of the disease. It has recently been discovered that the central nervous system (CNS) has a unique lymphatic system with vessels that clear metabolic waste products. 2 This finding

opens an unprecedented capability to increase clearance of macromolecules like amyloid beta by facilitating lymphatic drainage from the CNS. To assess methods of facilitating CNS lymphatic drainage, we are performing a pilot study to determine the impact of Osteopathic Cranial Manipulation Medicine (OCMM) on patients with Alzheimer’s Disease. OCMM comprises a set of gentle, non- invasive techniques aimed at facilitating CNS lymphatic and CSF circulation. The efficacy of OCMM in this setting will be assessed by both an Alzheimer’s Disease cognitive assessment scale (ADAS-cog) looking for improvement over several cognitive domains, and a caregiver burden scale (NPI-Q)

looking for a reduction in caregiver distress. Using these scales, we will determine if there is a significant difference between pre-treatment and post-treatment symptomatic burden in patients with Alzheimer’s Disease who receive OCMM in addition to their standard medical therapy. Given that current medical therapy for Alzheimer’s Disease is at a stalemate, knowing how OCMM affects the cognitive function of patients with the disease may lead to improvement in health care outcomes for this patient population as well as pave the way for future studies in osteopathic cranial medicine at large.

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