Dementia risk in surgery

The possibility of developing dementia as a result of surgery needs to be urgently investigated, according to the head of the Department of Neurodegenerative Disease at the UCL Institute of Neurology in London.

Professor John Collinge told the journal, Nature, there are growing concerns that the proteins widely blamed for dementia can be transferred during some surgical procedures.

The disease may not develop for years, but certain types of surgery may provide the ‘seed’ for the disease.

“The risk may turn out to be minor,” he said, “but it needs to be investigated urgently.”

Prof. Collinge’s findings stem from events that occurred decades ago when some British children were treated with a growth hormone taken from dead donors. A number of those children died in their 30s, 40s and 50s from Creutzfeldt-Jakob disease (CJD).

Subsequent experiments on mice have shown that the proteins widely believed responsible for Alzheimer’s can be transmitted.

Prof. Collinge stressed that Alzheimer’s was not contagious, however there was a risk that the harmful proteins could be spread through brain surgery and other rare procedures.

“We don’t know if any cases of Alzheimer’s disease are related to medical or surgical procedures, but in my view we should take a precautionary approach,” he said.

“With CAA (cerebral amyloid angiopathy) and probably with Alzheimer’s disease, there may be certain circumstances, though hopefully rare, that transmission of the pathology can occur.”

He said surgical procedures rather than blood transfusions posed the greater risk.

“Transfusion is not a major risk for me, I’m more concerned about neurosurgical instruments,” he said. “I think it’s important we do further research on this and develop new ways to remove these seeds, so any risk that is there is removed.”

Prof. Collinge urged further studies be conducted to examine any link between certain medical procedures and Alzheimer’s disease and to find ways to better decontaminate surgical instruments.

“No one should not have neurosurgery as a result of this,” he said. “But if we can avoid any transmission of CAA or Alzheimer’s disease we should do it, even if it’s only a handful of people who are at risk.”

Dr Rob Buckle, chief science officer at the Medical Research Council, which funded the study, said in a statement: “This study provides new insights into the molecular mechanisms underlying the role of amyloid in Alzheimer’s disease.

“However, these experiments were in mice predisposed to develop Alzheimer’s disease pathology and there is currently no evidence that AD can be transmitted between people.”

Do you take a keen interest in research that involves dementia? Is enough being done to investigate way to contain the disease?

Written by Janelle Ward

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