Summer Internship Program – 2017 Research

2017 Internship Research

Characteristics of Patients Evaluated for A Randomized, Double-Blind, Placebo Controlled and Delayed-Start Clinical Trial to Investigate the Safety and Efficacy of an investigational product in Mild Alzheimer’s Disease Dementia

Contributors

Jasen Ocol1, Alec Sheppard1, Richard Ho1,2, William Lew1,3, Daniel Ota1,4, Mitsuki Ota1,5, Adam Schadler1,2, Jennifer Rose del Castillo, MD1, Levy Jo Manuntag, MD1, Kore Kai Liow, MD, FACP, FAAN1,6,7,8

1Research and Clinical Trial Unit, Hawaii Pacific Neuroscience, Honolulu, HI,
2University of Hawaii atManoa, Honolulu, HI,
3Saint Francis High School, Mountain View, CA,
4Creighton University, Omaha, NE,
5Punahou School, Honolulu, HI,
6John A. Burns School of Medicine, University of Hawaii, Honolulu, HI,
7Center for Healthy Aging, Memory and Brain Health, Hawaii Pacific Neuroscience, Honolulu, HI,
8The Parkinson’s, Movement Disorder & Neurodegenerative Diseases Center, Hawaii Pacific Neuroscience, Honolulu, HI

Introduction

Alzheimer’s dementia is a progressive neurodegenerative disease that affected roughly
27,000 individuals over the age of 65 in Hawai’i this past year. Some individuals afflicted with Alzheimer’s
dementia only experience Mild Cognitive Impairment (MMSE 18-23), while others experience Severe Cognitive
Impairment (MMSE 0-17). One of the physical indicators of Alzheimer’s dementia is a high density of
amyloid beta plaque (Aβ) in the brain, which is a product of the cleavage of the amyloid precursor protein,
which is carried out by beta secretase BACE. LY3314814/AZD3293 is a human Beta-site amyloid precursor
protein-cleaving enzyme 1, inhibiting beta secretase BACE from cleaving and preventing the production
of Aβ plaque. LY3314814/AZD3293 may potentially modify the progression of Alzheimer’s dementia.

Objective

The Center for Healthy Aging, Memory and Brain Health at Hawaii Pacific Neuroscience is
one of the selected sites in the US currently conducting a randomized, double-blind, placebo-controlled
and delayed-start study of LY3314814/AZD3293 for the treatment of patients with Mild Alzheimer’s Disease
Dementia. The primary objective of this project was to describe the patient population that may be
suited for this study.

Methods

A systematic retrospective review was performed on patients referred to Hawaii Pacific Neuroscience between January 2010 and July 2017. Data was extracted from patient charts using ICD-10 codes for dementia.

Results

Of 156 patients, 61 were male (39.1%) and 95 were female (60.9%). Of the total sample population, 46 were Asian (29.5%), 44 were Caucasian (28.2%), and 31 were Pacific Islander (19.9%). Of the four AD medications, Donepezil (52.8%) was the most common, followed by Memantine (37.3%), Rivastigmine (8.1%), and Galantamine (1.9%). Alongside Alzheimer’s Disease, Vascular Dementia (53) was common among this patient population, followed by Mixed Dementia (48), Parkinson’s Disease (12), Fronto-temporal Dementia (7), and Lewy Body Dementia (4). From 156 patients, Asians (32) portrayed MMSE scores indicating Mild Cognitive Impairment and Severe Cognitive Impairment, followed by Pacific Islanders (27), Caucasians (24) and Other Minorities (9). Pacific Islanders (.037427) portrayed statistical significance in AD patients with MMSE scores indicating MCI. Caucasians (.005515) and Pacific Islanders (.025159) revealed statistical significance in AD patients with MMSE scores indicating MCI and SCI.

Conclusions

Statistical analysis shows that there is a significant correlation
between Pacific Islanders (.037427) and MMSE scores indicative of Mild Cognitive Impairment, while there
is no significant correlation to any other ethnicity within this patient population. With Hawaii’s diverse
community, this correlation may be attributed to differences in lifestyle between Pacific Islanders and the
other ethnicities represented. Mild and Severe Cognitive Impairments have a significant correlation with
the Caucasian (.005515) and Pacific Islander (.025159) patients. The correlation between Pacific Islanders
and Cognitive Impairment support the theoretical idea of lifestyle differences within this ethnically diverse
population, which makes them predisposed to developing Cognitive Impairment.

Characteristics of Psychogenic Nonepileptic Seizure Patients in Hawaii Pacific Neuroscience

Contributors

Michael Yang DO1,2, Jasen Ocol1, Richard Ho1,4, Carol Lu5, Mitsuki Ota6,
Shelby Dolim4, Alexander Kaplan MD, MPH2, Eric Lee MD2, Christopher Wilson
DO2, Enrique Carrazana MD ,Kore Kai Liow, MD, FACP, FAAN1,3,7,8

1Research and Clinical Trial Unit, Hawaii Pacific Neuroscience, Honolulu, HI,
2Tripler Army Medical Center, Honolulu, HI,
3Video-EEG Epilepsy Monitoring Unit (EMU), Hawaii Pacific Neuroscience, Honolulu,
4University of Hawaii at Manoa, Honolulu, HI,
5Moanalua High School, Honolulu, HI,
6Punahou School, Honolulu, HI,
7John A. Burns School of Medicine, University of Hawaii, Honolulu, HI,
8Center for Healthy Aging, Memory and Brain Health, Hawaii Pacific Neuroscience, Honolulu, HI

Introduction

Psychogenic nonepileptic seizures (PNES) are sudden and
time-limited disturbances of motor, autonomic, cognitive, sensory, or cognitive
function. This study analyzes all of the patients that exhibits PNES diagnosis,
concurrent or nonconcurrent of epilepsy and categorize patients into clusters
based on the movements shown in the video EEG summary reports or history
present illness from doctor’s notes. These clusters include rhythmic motor, hypermotor,
complex motor, dialeptic, non-epileptic auras, and mixed when symptoms
from two or more clusters are shown.

Objective

To describe the sociodemographic
and clinical characteristics of a sample of patients that had
gone under an overnight video EEG at this clinic and to compare between patients
with different ethnicities of their presentations of psychogenic nonepileptic
seizures.

Methods

A systematic retrospective review of patients referred to Hawaii Pacific Neuroscience up until July 2017. Data was extracted from patient charts using ICD-10 codes and VEEG referral and monitoring.

Results

Of 133 patients evaluated for Psychogenic Nonepileptic Seizures, 61 were male (46%) and 72 were female (54%). Caucasian (25.6%) was the most represented ethnic group, followed by Pacific Islander (24.8%), Asian (18.0%), and other Minorities (10.5%). 56 patients were identified with Depression, 35 with Anxiety, and 11 with Post-Traumatic Stress Disorder. 63 patients were diagnosed with Epileptic Seizures and Psychogenic Non-Epileptic Seizures. 70 patients experienced somatic symptoms including: migraine, headache, abnormal pain, paresthesias, recurrent vomitting episodes, dyspnea without clear etiology. Of 17 patients identified with PNES via VEEG reports, 12 patients portrayed events clustered as Non-Epileptic Auras and 3 patient revealed Rhythmic motor.

Conclusion

The result portrayed from this study had shown an
expected sociodemographic presentation on an island in the Pacific. Most of
the events seen on VEEG were non-epileptic auras and further analysis into
the ethnic distribution to compares its similarities and differences amongst each
other can provide valuable insight into the social-cultural aspects of psychogenic
nonepileptic seizures.

Comparing Patient Age Groups and Analyzing Trends between Age and Levetiracetam, Lacosamide, Topiramate Usage

Contributors

Jason Lau1, Dylan Lawton2, Yoo Been Chang1, Sean Choi4, Adam Schadler3, Kore Kai Liow, MD, FACP, FAAN5,6

1Boston University,
2Santa Clara University,
3University of Hawai‘i Manoa
4University of California,Los Angeles, CA,
5John A. Burns School of Medicine,
6Hawaii Pacific Neuroscience

Introduction

Epilepsy is a chronic disorder of the brain characterized
by recurrent seizures that encompass symptoms including loss of consciousness,
convulsions of the body, strange sensations, and confusion.
The most common form of treatment for epilepsy are Anti-epileptic drugs
(AED). Three AEDs, Levetiracetam (Keppra), Lacosamide (Vimpat), and
Topiramate (Topamax) were prevalent in a majority of patients screened.

Objective

Hawaii Pacific Neuroscience is participating in a clinical trial
evaluating the pharmacokinetics and efficacy of Diazepam Buccal Soluble
Film in patients with epilepsy. This project was to determine if there is a
correlation between a patient’s age and the type of AED they are taking,
specifically Levetiracetam, Lacosamide, and Topiramate.

Methods

A systematic chart review was performed on patients, ages 18 to 65 with Epilepsy at HPN using ICD-10 G40 codes. Descriptive statistics were performed on this cohort in Microsoft Excel.

Results

Within the age range of 18-25, 26-35, 36-45, 46-55, and 56-65, the percentages of Levetiracetam taken is 50, 54, 44.88, 52.52, and 66.88 respectively. The percentage of patients who had taken Lacosamide within age range is 5.26, 8.67, 11.02, 12.23, and 7.64 respectively. Topiramate resulted percentages of 11.84, 12, 18.11, 6.47, and 4.46 respectively.

Conclusions

Percentage shows that all of the age groups had around half of patients using Levetiracetam and comparatively smaller number of patients used Lacosamide and Topiramate. There was no significant difference in AED usage between the age groups. No trends could be made between the age group and the type of AED used.

Psychosocial Factors Predictive of Agitation in Ethnically Diverse Patients with Dementia

Contributors

Bryce Kalei Chang1,2, Mitsuki Ota1,3, Jasen Ocol1, Richard Ho1,4, William Lew1,5, Carol Lu1,6, Ryan Nip1,7, Daniel Ota1,8, Pat Borman, MD1,2,9, Barbara L. Pitts, PhD1,9, Kore Kai Liow, MD, FACP, FAAN1,2,9

1Research and Clinical Trial Unit, Hawaii Pacific Neuroscience, Honolulu, HI,
2John A. Burns School of Medicine, University of Hawaii, Honolulu, HI,
3Punahou School, Honolulu, HI,
4University of Hawaii at Manoa, Honolulu, HI,
5Saint Francis High School, Mountain View, CA,
6Moanalua High School, Honolulu, HI,
7Weston High School, Weston, MA,
8Creighton University, Omaha, NE,
9Center for Healthy Aging, Memory and Brain Health, Hawaii Pacific Neuroscience, Honolulu, HI

Introduction

Currently, 6.9% of North Americans over the age of 60 have dementia—a neurodegenerative syndrome deteriorating cognitive processes severe enough to hinder activities of daily living—however, the proportion of dementia patients will grow by 150% over the next forty years. During the course of the disease, 60% of dementia patients will exhibit agitation, defined as verbal or motor disturbances resulting from unmet needs or confusion of the agitated individual. Dementia patients who exhibit agitation are more likely to experience earlier progression to severe dementia and poorer quality of life. There are currently no FDA approved treatments for agitation in patients with dementia. The American Psychiatric Association advises judicious use of antipsychotics may be appropriate for the management of agitation in dementia patients. In order to facilitate treatment discovery, better understanding of why some patients experience agitation is required. Few studies have examined what factors make a dementia patient more likely to experience agitation. For example, potential risk-factors of agitation have been identified in predominately white nursing home patients with dementia. Cognitive status was an independent predictor of agitation. Additionally, sleep disturbances in nursing home residents with dementia can explain agitation independently of cognitive function. Comorbidities correlated to agitation in dementia patients include depression and anxiety. While some minority groups, such as African Americans and Latinos, may experience more dementia-related behavioral disturbances, no studies have examined predictors of agitation in ethnically diverse dementia patients. Hawaii is a unique state
with ethnic diversity where non-Hispanic whites do not form a majority of the population. Given the growing heterogeneity of the mainland United States, a sample investigating ethnic differences is
warranted since studies done with predominantly white patients may or may not hold for other ethnicities. This study examines factors predicting agitation in an ethnically diverse sample of
dementia patients as a step toward developing preventive strategies and therapies for use in the unique patient population of Hawaii.

Objectives

This study aims to analyze factors predicting agitation in Hawaii’s ethnically diverse dementia.

Methods

A systematic retrospective review was performed on patients referred to Hawaii Pacific Neuroscience between January 2010 and July 2017. Data was extracted from patient charts using ICD-10 codes for dementia and statistical analysis was performed in SPSS.

Results

Of 350 patients, 135 were male (38.6%), 215 were female (61.4%). Of 350 patients, 107 were Asian (30.6%), 95 were Caucasian (27.1%), and 55 were Pacific Islander (15.7%). 109 patients were agitated, and 241 were not agitated. MMSE scores (-.170), measuring level of cognitive impairment, portrayed statistical significance in dementia patients with agitation. All other hypothesized factors revealed statistical significance: sleep disturbances (.176), depression (309), and anxiety (.452).

Conclusions

Previous studies have shown associations between agitation and cognitive and psychosocial factors in samples of predominantly white dementia patients. In agreement with previous literature, we have shown that decreased cognitive function is a strong predictor of agitation. Cognitive impairment strongly predicts agitation because it underlies and influences the psychosocial factors predicting agitation, including sleep disorders, depression, and anxiety. Significant psychosocial factors, such as depression and anxiety, are clinically important because they also predict accelerated cognitive decline, institutionalization, and increased cost of care (Beaudreau & O’Hara, 2008; Gibbons, Teri &
Logsdon, 2002).

Characteristics of Patients Being Screened for a Clinical Trial to Investigate the Safety and Tolerability of an Investigational Product as Adjunctive Therapy in Levodopa-treated Parkinson’s Disease Patients Experiencing Motor Fluctuations

Contributors

Heather Acidera1, Tamara Ohta2, Dylan Lawton3, Sean Choi1, Kore Kai Liow, MD, FACP, FAAN4,5

1University of California, Los Angeles, CA,
2University of Portland, OR,
3Santa Clara University, CA,
4The Parkinson’s, Movement Disorder & Neurodegenerative Diseases Center, Hawaii Pacific Neuroscience, Honolulu, HI,
5Research and Clinical Trial Unit, Hawaii Pacific Neuroscience, Honolulu, HI

Introduction

Parkinson’s Disease (PD) is a neurodegenerative disorder
of the central nervous system characterized by the progressive death
of dopaminergic neurons in the substantia nigra. PD is the second most
common neurological disorder, distinguished by four clinical parkinsonian
motor features: bradykinesia, resting tremor, muscular rigidity, and postural
and gait impairment. There is no cure for PD, but there are medications
that can help treat its symptoms. The most common medication used to
treat PD is levodopa–a synthetic precursor to dopamine. However, a wearing
off phenomenon occurs in which levodopa does not provide the same
effects as it used to. Because levodopa is not an entirely efficient drug,
discovering new medications to treat Parkinson’s is of utmost importance.

Objective

To characterize patients referred to Hawaii Pacific Neuroscience
being screened for a clinical trial to investigate tozadenant as adjunctive
therapy with levodopa-treated patients.

Methods

A retrospective chart review was conducted at the Parkinson’s Disease, Movement Disorders, and Neurodegenerative Diseases Center at Hawaii Pacific Neuroscience between July 2011 and July 2017.

Conclusion

Due to the limited patient population at Hawaii Pacific Neuroscience, we are not
able to make any significantly statistical conclusions. However, because
the cause of PD is supposedly correlated with a combination of genetic
and environmental factors, it would be of much benefit to increase the
population size to include more Native Hawaiians and Other Pacific Islanders.

Results

Of the different types of Parkinsonian conditions, the frequency of Parkinson’s Disease was the highest (57%), followed by Vascular (31%), Parkinsonism (7%),
and Neuroleptic Induced Parkinsonism (6%). Of patients diagnosed with
Parkinson’s Disease, majority were Caucasian (34.2%), Asian (22.5%),
and Native Hawaiian or Other Pacific Islander (8.8%).

Characteristics of Patients Evaluated for A Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy and Safety of an Investigational Product in Participants at Risk for the Onset of Clinical Symptoms of Alzheimer’s Disease (AD)

Contributors

Mitsuki Ota1,2, Carol Lu1,3, Paul Adapon, MD1, Kore Kai Liow, MD, FACP, FAAN1,4,5,6

1Research and Clinical Trial Unit, Hawaii Pacific Neuroscience, Honolulu, HI,
2Punahou School, Honolulu, HI,
3Moanalua High School, Honolulu, HI,
4John A. Burns School of Medicine, University of Hawaii, Honolulu, HI,
5Center for Healthy Aging, Memory and Brain Health, Hawaii Pacific Neuroscience, Honolulu, HI,
6The Parkinson’s, Movement Disorder & Neurodegenerative Diseases Center, Hawaii Pacific Neuroscience, Honolulu, HI

Introduction

Alzheimer’s dementia (AD) is a progressive neurodegenerative disease characterized by
memory loss and behavioral disturbances, precipitating physical, emotional, and financial burden. Over 5 million
Americans are currently living with this affliction and as many as 16 million are projected to have the disease in
2050. Although we have not established the appearance of any specific biomarkers to the emergence of clinical
symptomatology, the amyloid cascade hypothesis states that deposition of amyloid beta (Aβ) is an early event in
the pathogenesis of AD, starting a decade or longer before the first clinical symptoms. Aβ is a product of the
cleavage of the amyloid precursor protein, which is carried out by beta secretase BACE. A new drug currently
under research serves as an orally active BACE-1 inhibitor and has been shown to reduce Aβ concentrations in
cerebrospinal fluid (CSF) and the brain in animals by up to 90%. This investigational product may have a profound
clinical and public health impact by helping to slow down or prevent the progression of AD by targeting
preclinical AD, a newly defined stage of the disease, which reflects current evidence that measurable changes in
brain biomarkers may occur years before symptoms appear.

Objectives

The Center for Healthy Aging,
Memory and Brain Health at Hawaii Pacific Neuroscience is one of the selected sites in the US currently conducting
a randomized, double-blind, placebo-controlled, parallel group study of CNP520 for the evaluation of its
efficacy and safety in the treatment of participants at risk for the onset of clinical symptoms of Alzheimer’s disease
(AD). The primary objective of this project was to describe the patient population that may be suited for this
study.

Methods

A systematic retrospective review was performed on patients referred between August 2015
and August 2017 for complaints of memory loss selected with ICD-10 code F06.7.

Results

Of 194 patients with complaints of memory loss, 91 were male (46.9%) and 103 were female (53.09%). Among this population,
47 patients were shown to adhere to the inclusion and exclusion criteria of the study. Within this group, 20
(42.6%) were male and 27 (57.4%) were female. Of the sample population, 18 were Caucasian (38.3%), 15
were Asian (31.9%), and 4 were Native Hawaiian or Other Pacific Islander (8.5%). Between the medications
proven to contribute to memory loss, painkillers (34.0%) were the most common, followed by statins (27.7%),
hypertension drugs (19.1%), and sleep medications (17.0%). Of the conditions behavioral factors shown to be
predictive of the decline into dementia, dyslipidemia (38.3%) was common among this population, followed by
tobacco use (34.0%), alcohol use (25.5%), and hypertension (25.5%). Of 47 patients, 11 had MMSE scores and
10 had qualifying scores. The majority of these qualifying scores were of Asians, with 5 (50%) portraying MMSE
scores representing a lack of cognitive impairment.

Conclusions

Statistical analysis shows that there is a
significant correlation between Caucasians (0.029818) and dyslipidemia while there is no significant correlation
to any other ethnicity in the study group. However, it should be noted that the average age of the Caucasian
group with dyslipidemia (68.89) is considerably higher than the average age of the pool of 47 patients (65.98)
(Wang, S., Xu, L., Jonas, J., You, Q., Wang, Y., Yang H., 2011). As such, further analysis through logistic regression
is likely needed to reach a more precise conclusion regarding the relationship between ethnicity and dyslipidemia
. The significant correlation between hypothryoidism and the Caucasian patient pool (0.013521) is
supported by national literature (Stoppa-Vaucher, S., Vliet, G., Deladoëy, J., 2011) and is attributed to the lack of
genetic diversity and in turn a lack of inheritance of susceptibility to hypothryoidism. On the contrary, hyperthyroidism
had a significant correlation with the Pacific Islander patients (0.003299). This correlation agrees with
national literature (McLeod, D., Caturegli, P., Cooper, D. et. al., 2014) and supports the idea of lifestyle differences
of Pacific Islanders within the ethnically diverse population of Hawai’i. In particular, this correlation points
to the high genetic diversity of the Pacific Islander population.

Characteristics of Dementia Patients Evaluated for a Phase III, Multicenter, Randomized, Double–Blind, Placebo–Controlled, Parallel Group Investigation of the Safety and Efficacy of an Investigational Product in Patients With Prodromal to Mild Alzheimer’s Disease

Contributions

Bryce Kalei Chang1,2, Mitsuki Ota1,3, Jasen Ocol1, Richard Ho1,4, William Lew1,5, Carol Lu1,6, Ryan Nip1,7, Zarina Nip1,8, Daniel Ota1,9, Adam Schadler1,4, Pat Borman, MD1,2,10, Kore Kai Liow, MD, FACP, FAAN1,2,10

1Research and Clinical Trial Unit, Hawaii Pacific Neuroscience, Honolulu, HI,
2John A. Burns School of Medicine, University of Hawaii, Honolulu, HI,
3Punahou School, Honolulu, HI,
4University of Hawaii at Manoa, Honolulu, HI,
5Saint Francis High School, Mountain View, CA,
6Moanalua High School, Honolulu, HI,
7Weston High School, Weston, MA,
8University of California, San Diego, La Jolla, CA,
9Creighton University, Omaha, NE,
10Center for Healthy Aging, Memory and Brain Health, Hawaii Pacific Neuroscience, Honolulu, HI

Introduction

One out of every nine Americans over the age of 65 is diagnosed with
Alzheimer’s Disease (AD)—progressive and fatal neurodegeneration. Current therapies for
Alzheimer’s Disease provide symptomatic relief, but there is currently no known cure for the disease.
Research regarding therapy for Alzheimer’s disease has recently been trending towards
addressing and curing the disease itself, as opposed to treating its symptoms. One promising
disease-modifying treatment of Alzheimer’s disease involves innovative immunotherapy. A new
medication currently under research is a fully humanized monoclonal IgG4 backbone antibody
providing a reduced FCγR binding affinity, inflammatory effector function, and risk of toxicity. This
investigational product binds all forms of Aβ, inhibits Aβ peptide aggregation, and disaggregates
Aβ Protofibrils.

Objective

The Center for Healthy Aging, Memory and Brain Health at Hawaii
Pacific Neuroscience is one of the selected sites in the US currently conducting a phase III, multicenter,
randomized, double-blind, placebo-controlled, parallel-group study of a fully humanized
anti-Aβ monoclonal antibody for the treatment of patients with prodromal to mild Alzheimer’s Disease.
The primary objective of this project was to describe the patient population that may be
suited for this study.

Methods

A systematic retrospective review was performed on patients referred to Hawaii Pacific Neuroscience between January 2010 and July 2017. Data was extracted from patient charts using ICD-10 codes for dementia.

Results

From 350 patients, 135 were male (38.6%) and 215 were female (61.4%). The majority of patients with dementia were Asian
(30.6%), followed by White (27.1%), and Pacific Islander (15.7%). AD comprised the highest proportion of dementia cases (42.2%), followed by vascular (29.6%), mixed dementia (13.2%), Parkinson’s (9.6%), fronto-temporal (3.6%) and Lewy Body (1.9%). Of the four drugs prescribed for symptomatic relief of AD, donepezil was the most used (54.8%), then memantine (37.1%). Comorbidities of dementia include aortic stenosis, orthostatic hypotension, myocardial infarction, CABG, asthma, COPD, sleep apnea, stroke, TIA, epilepsy, headache, neuropathy, tremor, hyperthyroid, hypothyroid, and diabetes. Hypertension (62%) and hyperlipidemia (50%) were most prevalent among the dementia patient population..

Conclusion

Among Hawaii Pacific Neuroscience’s
patient population, dementia was common among Asians (30.6%) and Caucasians
(27.1%). Native Hawaiians and Pacific Islanders, unique to this patient population, followed with
55 patients (15.7%). AD and vascular dementia comprise the highest prevalence of dementia,
which agrees with national data. However, the observed proportion of AD (42%) is lower than the
national prevalence of AD, which comprises 70% of dementia cases. Conversely, the proportion of
vascular dementia (30%) exceeds the national prevalence, in which 10% of dementia is vascular.
Hawaii’s unique ethnic composition and high occurrence of hypertensive comorbidities may contribute
to this trend. 15 patients met the inclusion and exclusion criteria for possible participation in
clinical investigation of this investigational product, a monoclonal antibody inhibiting β-amyloid
aggregation as a potential treatment for Alzheimer’s Disease.