Review of Tattoo on my Brain Part Four

 Part Four

Review of Tattoo on my Brain by Dr. Dan Gibbs

P 91

" A recent study reported in JAMA Neurology showed that high cognitive reserve, as measured by education and high baseline intelligence, DOES NOT  protect from Tau-associated brain atrophy but it DOES lead to a delay in cognitive impairment, postponing the onset of of the symptoms of Alzheimrers disease."

p 96

"There's no way yet to measure cognitive reserve."

p 102

"In March 2016, I (Dr Gibbs) entered a phase 3 clinical trial of the antibody called aducanumab.

Three positive points about this new drug.

"First... was based on a naturally occurring antibody found in the blood of elderly people who did not have any cognitive impairment."

"Second, side effects appeared minimal." 

ARIA (amyloid related imaging abnormalities)

"Most of the patients with ARIA had no symptoms at all"

Third, "the results of the earlier  phase one trial looked very encouraging

p 109

Chapter 13

The most important and climatic chapter in the book

At the end of Sept. 2017 Dr Gibbs had his first infusion of aducanumab. No side effects.

Next month after the second infusion he experiences 

a new phantosmia.

A week after the third infusion, the headaches began.

"On December 13, about six weeks into this treatment period I started having trouble reading simple words."

"About a week later, late one evening, my headache suddenly exploded with excurciating pain." 

Admitted to ICU he had an MRI which showed

"many areas of brain swelling and microhemorhages...these were classic imaging findings of ARIA."

"Repeat MRI a month later showed the brain swelling was actually a little worse despite not getting any more infusions of the test drug"

Dr Gibbs was the first trial participate who required treatment for the side effects of aducanumab.

His side effects were considered "unique and concerning".

Dr Gibbs "doctors decided to treat it as they would a serious flare-up of Multiple Sclerosis (MS)."

Treatment was "five daily infusions of very high dose steroids."

"After the third day my headaches went away and I was able to read again."

"By the summer of 2018, I was feeling really good"