Investigating the surgical transmissibilty of amyloid-based neurodegenerative disease: A retrospective case control study
Misfolded amyloid beta is a key characteristic of several neurodegenerative processes, including Alzheimer’s disease. Increasing evidence suggests that misfolded amyloid beta shares characteristics with prion proteins, including the potential for transmissibility between individuals. Through a seeding mechanism, surgical instruments have been hypothesized to act as a fomite for misfolding amyloid beta, introducing it to the body and initiating a seeding mechanism that results in Alzheimer’s disease. In this study, patient questionnaires and electronic medical records at a neurocognitive disorders clinic were analyzed to determine differences between the surgical histories of patients with amyloid-based neurodegenerative processes, and neurological and healthy controls. The amyloid-based group consisted of patients with early or late onset Alzheimer’s disease, mild cognitive impairment with confirmed amyloid deposition, and Lewy Body Disease. The neurological controls consisted of patients at the clinic who did not suffer from an amyloid-based process. The healthy control group consisted of the spouses of both the abovementioned patient groups. Variables of interest included the number and types of surgeries preceding symptoms onset and the time from both the oldest and most recent surgery to onset of symptoms. Demographics, medical risk factors, and surgical histories were collected from the electronic medical record and questionnaires of the patient groups. For healthy controls, study questionnaires were the only data source available. Bivariate analysis of these variables determined that only one surgical outcome differed between groups, time from first surgery to onset of symptoms (p=.017). However, when controlling for covariates in a linear regression, this association was no longer found to be significant (p=.499). The findings of this project do not depict significant differences between the surgical histories of patients with amyloid-based disease, neurological controls and healthy controls. There are a number of limitations that threaten the validity of these findings. This study should be repeated in a larger cohort with standardized and validated measurement tools.^
Ressler, Kelly, "Investigating the surgical transmissibilty of amyloid-based neurodegenerative disease: A retrospective case control study" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10127416.