Memory and Dementia

Memory and dementia 

 

Memory loss is a common condition occurring with age.  Because there are over 40 causes of progressive memory loss in addition to Alzheimer's disease, comprehensive and accurate diagnosis is essential to effectively treat the underlying cause of cognitive decline. 

 

Our comprehensive evaluation targets identification of the following conditions:

  • Nutritional deficiencies including B12, thiamine

  • Microvascular disease affecting the smallest blood vessels in the brain

  • Post-concussive disorder and traumatic brain injury

  • Mood disorders including depression and anxiety

  • Hydrocephalus

  • Seizure disorders

  • Medication side effects

  • Neuro-inflamamtory and infectious disease affecting the brain

  • Sleep disorders including insomnia and apnea

  • Neuro-degenerative disease including Alzheimer's and fronto-temporal dementia

 

We believe that all patients, regardless of the causes of cognitive decline, have the potential for significant improvement in memory and other brain functions with the correct combination of treatments.  Our treatment regimen for a patient diagnosed with Alzheimer's disease typically combines the following  elements:

  • FDA-approved treatments approved for Alzheimer's disease

  • Adjustments to diet and the addition of specific nutritional supplements

  • Evaluation of exercise and referral for physical training or therapies

  • Adjustment of psychoactive medications that can interfere with memory and cognitive functioning

  • Effective treatment of mood disorders including anxiety, insomnia and other sleep disorders, other general medical conditions

Research trials and innovative treatments for memory loss 

 

A number of breakthrough treatments are currently being evaluated by academic institutions and with collaboration of Dr. Franc's research team.  The current projects are currently enrolling or will be enrolling research subjects in the next 1-3 months:

                     ---------------------------------------------------------

Functional and advanced MRI for the evaluation of patients with cognitive decline.  Advanced MRI looking at the brains structure and functioning has been in development for over 25 years, and we were the first clinical site nationwide  to evaluate these technologies for patients presenting with cognitive decline.  Advanced MRI is being studied to differentiate patients with different types of neurodegenerative disease, mood disorder, post-traumatic etiologies, and other conditions that can mimic Alzheimer's disease, and this technology is used to target personalized therapies for patients presenting with cognitive decline.  

 

Protein kinase inhibitors for the treatment of Alzheimer's disease, frontotemporal dementia, and Parkinson-related cognitive decline.  Protein accumulations have been though to underlie the a number of neurodegenerative disease, and recent basic science discoveries have Implicated protein kinase inhibitors as a potential effective target for clearing these proteins from the brain.  We are partnering with an American pharmaceutical manufacturer to test an FDA approved protein kinase inhibitor in patients with cogitive decline from a number of neurodegenerative diseases including Alzheimer's disease and Parkinson disease.  

 

Pulsed ultrasound stimulation for the treatment of Alzheimer's disease.  Ultrasound has been studied in basic science labs as an effective method of facilitating the clearance of the protein accumulations that result in Alzheimer's pathology causing cell loss and brain dysfunction.  This FDA-approved technology is safe and is being tested for effectiveness for the clearance of proteins that cause Alzheimer's disease and for improvement in memory and cognitive functioning. 

 

Transcranial magnetic stimulation for treatment of mood disorders occurring in neurodegeenrative disease.   Transcranial magnetic stimulation is an effective brain stimulation technique that activates brain circuits impaired in mood disorders.  This trial evaluates for cognitive and memory improvement occurring with treatment of mood-related brain circuits.  Stimulation of brain regions affected in Alzheimier's disease is additionally being tested for cognitive improvement.  

 

Anti-seizure medications for the treatment of cortical hyper-excitability in Alzheimer's disease.  Early phase patient studies and basic science research have shown that the damaging hyper-excitability that can occur in Alzheimer's disease can be treated with anti-seizure medications.  Structural and functional MRI brain images and memory test results are used to establish response to treatment.  

 

Microvascular disease diagnosis and ongoing treatment with minocycline.  For patients suffering from memory loss resulting from microvascular and white matter disease, early tests have resulted in improvement in structural brain damage and cognitive tests.  This study uses advanced MRI and transcranial ultrasound direct blood flow measurements to accurately diagnose microvascular brain disease and uses minocycline to treat the underlying microvascular blood flow abnormalities.  

Concierge memory care

Coordination of care is frequently neglected in the care of patients with impaired memory and cognitive decline.  The California Neuromodulation and Brain Health team has designed a program to optimize medical treatments for our memory loss patients, coordinate complementary services in support of optimal cognitive care, supervise in-home caregivers, and coordinate care with other medical providers.  This program is supported by a yearly fee.

 

This program aims to be comprehensive and offers the following services:

  • 24/7 access to a medical practitioner by telephone to coordinate emergency and urgent care services

  • Coordination od care with in-home caregivers and family members

  • Regular in-home and telephone-based evaluations to assure that care plans are updated and optimized

  • Support of patients in clinical trials designed to treat memory loss

  • Same day appointments with the memory team for urgent matters

  • Coordination of care with each of a patient's practitioners and hospital providers after any admission

  • Coordination of care with cognitive rehabilitation practitioners, physical therapists