Michael Rafii M.D. Ph.D

Co-Director of the Memory Disorders Clinic at UCSD Perlman Ambulatory Care Center in La Jolla, Assistant Professor of Neurosciences at the University of California, San Diego, and Associate Medical Director of the Alzheimer’s Disease Cooperative Study, Dr. Rafii specializes in cognitive disorders, including dementias such as Alzheimer’s disease. His current research interests include neuroimaging and clinical trials. He received his M.D. and Ph.D. from Brown University and conducted neurogenetics research at Harvard Medical School. Dr. Rafii went on to complete his neurology residency at the Johns Hopkins Hospital and fellowship in Dementia and Cognitive Disorders at the University of California, San Diego.

Aug 182010
What Does the Cessation of the Lilly Semagacestat Study Mean?

Readers, Eli Lilly and Company announced yesterday that it is halting development of semagacestat, a gamma-secretase inhibitor being studied as a potential treatment for Alzheimer’s disease. The decision was made after preliminary results from two separate phase 3 studies showed that the drug did not slow disease progression and worsened cognition and the ability to perform activities of daily living. In the 2 trials, called IDENTITY (Interrupting Alzheimer’s Dementia by EvaluatiNg Treatment of AmyloId PaThologY) […]

Jul 212010

Readers, Another important finding from the ICAD meeting last week revolves around the relationship between cognitive decline and vitamin D. Several high-profile studies have suggested that high levels of vitamin D lower the risk of developing multiple sclerosis and accumulating evidence suggests previously unsuspected roles for vitamin D in brain development and neuroprotection. Now, a new study shows that low Vitamin D levels may be related to cognitive decline and dementia. Researchers have in fact […]

Jul 142010

Readers, Below is the first of a series of upcoming blogs reporting the news from ICAD, the International Conference on AD taking place this week in Hawaii. For the first time in 25 years, there is a proposal to change the criteria for Alzheimer’s disease, part of a new movement to diagnose and, eventually, treat the disease earlier. As readers will recall, Alzheimer’s is thought to begin years, perhaps even decades, before symptoms are noticeable. […]

Jul 072010

Patients often ask how drugs are selected by the FDA for use in different diseases. Below is a brief review of the process that is used to evaluate and test drugs that may benefit patients. Before a drug can be approved for use by patients, there is a set of clinical tests that must be performed. This is the Pre-Clinical Research Stage, where extensive animal tests are performed on dosing and side effects. Institutional and […]

Jun 302010

As readers of this blog are probably aware, the prevailing theory of AD is that amyloid precursor protein is somehow aberrantly cleaved as it is secreted by neurons, and leads to the formation of beta-amyloid. Beta amyloid is a toxic “oligomer” or protein fragment that becomes improperly folded, and deposits into plaques. It is believed that the small oligomers of beta amyloid are more toxic than their larger aggregated counterparts (i.e.,amyloid fibrils), and in fact, […]

Jun 242010

Building on their previous discovery that people with Alzheimer’s have beta-amyloid deposits that appear as unusual cataracts in the lens of the eye, a team of researchers led by Dr. Lee Goldstein at Boston University School of Medicine, has discovered that beta-amyloid also accumulates in the eyes of people with Down syndrome. Down syndrome patients develop symptoms of Alzheimer’s Disease often by the age of 30 because they have an extra copy of a key […]

Jun 162010

Readers, A relationship between vascular risk factors and Alzheimer disease has been considered for over 20 years. In fact, it was widely accepted that “a hardening of the arteries” was to blame for senile dementias. There is also evidence that vascular diseases such as stroke, atherosclerosis, and hypertension are associated with an increased risk of dementia and AD, and that an abnormally elevated level of fibrinogen, the protein critical for blood clot formation, is correlated […]

Jun 082010

Increasing evidence indicates that there are reductions in testosterone and estrogen levels in older men and women. These hormonal reductions may be risk factors for cognitive impairment and the development of Alzheimer’s disease (AD). As testosterone levels decline as men age, there is an urge to treat this natural process with hormone replacement, just as it is done for many women undergoing menopause. The enzyme aromatase in the male brain converts some of the testosterone […]

Jun 022010

Readers, The Alzheimer’s Disease Neuroimaging Initiative (ADNI) continues to provide us with greater and more detailed information about AD. For quite some time, we have known that the ApoE4 genotype leads to an increased risk of developing sporadic AD. Patients with the ApoE4 gene (carriers) typically develop Alzheimer’s disease five to seven years earlier than those without the gene (non-carriers). One or more copies of the ApoE4 gene are present in 20 percent to 30 percent of the […]

May 262010

Readers, Two of the key elements when taking a history from a patient include smoking tobacco and alcohol consumption. Both of these activities have been shown to affect general health. Now, in a recently published study from Barcelona, Spain, it appears that they may be important risk factors in Alzheimer’s disease (AD), but in a unique way. Knowledge regarding environmental factors influencing the risk of AD is surprisingly scarce, despite substantial research in this area. […]

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