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Antioxidants for Alzheimer Disease: Caution Raised

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Antioxidants for Alzheimer Disease: Caution Raised

Post  Admin on Tue Mar 20, 2012 8:23 pm

Antioxidants for Alzheimer Disease
A Randomized Clinical Trial With Cerebrospinal Fluid Biomarker Measures

Arch Neurol. Published online March 19, 2012.

Objective To evaluate whether antioxidant supplements presumed to target specific cellular compartments affected cerebrospinal fluid (CSF) biomarkers.

Design Double-blind, placebo-controlled clinical trial.

Participants Subjects with mild to moderate Alzheimer disease.

Intervention Random assignment to treatment for 16 weeks with 800 IU/d of vitamin E (α-tocopherol) plus 500 mg/d of vitamin C plus 900 mg/d of α-lipoic acid (E/C/ALA); 400 mg of coenzyme Q 3 times/d; or placebo.

Main Outcome Measures
- Changes from baseline to 16 weeks in CSF biomarkers related to Alzheimer disease and oxidative stress,
- Cognition (Mini-Mental State Examination), and
- Function (Alzheimer's Disease Cooperative Study Activities of Daily Living Scale).

- Study drugs were well tolerated, but accelerated decline in Mini-Mental State Examination scores occurred in the E/C/ALA group, a potential safety concern.
- Changes in CSF Aβ42, tau, and P-tau181 levels did not differ between the 3 groups.
- Cerebrospinal fluid F2-isoprostane levels, an oxidative stress biomarker, decreased on average by 19% from baseline to week 16 in the E/C/ALA group but were unchanged in the other groups.

- Antioxidants did not influence CSF biomarkers related to amyloid or tau pathology.
- Lowering of CSF F2-isoprostane levels in the E/C/ALA group suggests reduction of oxidative stress in the brain.
- However, this treatment raised the caution of faster cognitive decline, which would need careful assessment if longer-term clinical trials are conducted.

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