A 57 yo man began to have difficulty with memory and in work performance as a computer programmer, leading to dismissal from his job. Over the next five years his cognition continued to decline, he developed navigational difficulties, had difficulties with attention and multi-tasking, and become quieter and less self-assured. He had been a superb guitarist, and he lost both the chord progression memory and the nuance in his playing. Evaluation by a neurologist included a normal brain MRI, and he was placed on Aricept, which he discontinued after two months.
Seven years after symptom onset he was again evaluated and found to be homozygous for apoE4. An FDG PET scan was strongly suggestive of Alzheimer's Disease ,with reductions in glucose utilisation in the temporal, parietal, posterior cingulate and frontal regions. He scored 22/30 on the mini-mental state examination, having lost points for failing to know the date or day, location, and failing tasks of attention and short-term recall.
He was placed on the program, and his MMSE increased to 26 after four months, and to 29 after 10 months. His wife noticed clear improvement in his memory and navigation. His guitar skills improved, with his chord progressions and the nuances of his playing, such that he was able to play several pieces for the neurologist.
Reversal of cognitive decline in Alzheimer's Disease. Bredesen D. et al. Aging, June 2016, Vol 8 No 6