1970s Heart Therapy Shows Promise for Reversing Early Alzheimer's Decline
A randomized trial involving 190 patients with mild cognitive impairment or early Alzheimer's found that external counterpulsation (ECP), a non-invasive heart treatment developed in the 1970s, significantly improved cognitive function. The therapy uses inflatable cuffs on the legs to enhance blood flow to the brain. Results showed that 84% of patients improved during treatment, with benefits persisting six months after cessation. While the device is FDA-approved for heart conditions, it lacks US approval for dementia, though it recently received certification in the EU.
Key points
- External counterpulsation (ECP) uses squeezable cuffs on the calves, thighs, and buttocks to propel blood back to the heart and improve arterial function.
- A randomized, single-blind trial in the US involved 190 patients with mild cognitive impairment or early Alzheimer's disease.
- Participants received full-pressure ECP synchronized with heartbeats three to five times weekly for the first 35 sessions, then twice weekly.
- 84% of the treatment group showed cognitive improvements during the six-month period, with 75% retaining benefits six months after stopping treatment.
- The trial was funded by Renew Research, the manufacturer of the ECP device, and led by Jack Juni and neurologist Patrick Moriarty.
- The Renew Cerezen ECP device received EU certification for mild cognitive impairment but has not yet received FDA approval for this use in the US.
Background
Recent research has highlighted the vascular system's role in Alzheimer's pathophysiology, with studies suggesting reduced blood flow to the brain in dementia patients. This aligns with broader investigations into non-pharmacological interventions for cognitive decline, such as the study of 'paradoxical lucidity' in advanced dementia patients. While anti-amyloid treatments like Kisunla have shown plaque clearance, they do not address all aspects of cognitive decline, prompting interest in vascular-based therapies.
Why it matters
This trial suggests that improving cerebral blood flow via a non-invasive, existing medical device could offer a new avenue for managing early-stage dementia symptoms. If validated in larger studies, ECP could provide a low-risk alternative or adjunct to current Alzheimer's therapies, potentially slowing functional decline without the adverse effects associated with some pharmaceutical treatments.
What to watch
Researchers call for larger cohort studies and longer-term trials to confirm the efficacy and optimal administration of ECP for cognitive decline. The FDA is currently reviewing the device's application for Alzheimer's treatment, following a letter from Renew Research regarding approval delays. Further investigation is needed to determine if the observed benefits apply specifically to Alzheimer's or if they extend to other causes of cognitive decline, such as vascular dementia.
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