Neurology, psychiatry establish independent prescription systems

Precision diagnosis, MRI monitoring strengthen safety management

An amyloid PET scan image. [Provided by Seoul St. Mary's Hospital]
An amyloid PET scan image. [Provided by Seoul St. Mary's Hospital]

Seoul St. Mary's Hospital of the Catholic University of Korea announced Tuesday that it has reached 200 cases of antibody treatment aimed at slowing the progression of Alzheimer's disease.

The milestone signals that Alzheimer's treatment is shifting in earnest — away from symptom management and toward early precision diagnosis and disease-modifying therapy.

Alzheimer's disease accounts for roughly 70 percent of all dementia cases. It is a chronic, progressive condition in which abnormal accumulations of beta-amyloid and tau proteins in the brain gradually damage and destroy nerve cells, causing a progressive decline in cognitive function — including memory — and ultimately a loss of the ability to carry out daily activities.

South Korea introduced anti-amyloid monoclonal antibody therapies into clinical practice in late 2024, marking a new turning point in dementia treatment. The drugs directly target amyloid protein, one of the disease's underlying pathological hallmarks.

However, accurate diagnosis and rigorous patient selection are essential before prescribing the treatment. It can only be administered to patients with mild cognitive impairment or early-stage Alzheimer's disease in whom abnormal protein deposits in the brain have been confirmed through amyloid PET (positron emission tomography) or cerebrospinal fluid testing.

During treatment, adverse reactions known as amyloid-related imaging abnormalities, or ARIA — which manifest as brain edema or microhemorrhages — have been reported in approximately 21 percent of patients receiving the drug.

Most of these cases are asymptomatic, detectable only through high-resolution brain MRI scans conducted on a scheduled basis. When identified early through routine monitoring and the dosage is adjusted accordingly, the abnormalities are generally manageable and resolve naturally within normal ranges.

In rare cases, however, severe brain hemorrhage or edema can occur. That means the treatment can only be safely administered at medical institutions equipped with experienced neurologists and radiologists working in collaboration, as well as systems capable of immediate emergency response.

The hospital's record is regarded not merely as a tally of prescriptions, but as a measure of the clinical capability to continuously and safely treat each individual patient under a rigorous safety management framework.

The two clinical departments treat patients within a shared hospital-wide infrastructure — encompassing radiology, nuclear medicine, laboratory medicine and nursing — that provides uniform support across precision amyloid PET diagnosis, regular MRI safety monitoring and intravenous drug administration. The clinical team currently includes professors Yang Dong-won, Yoon Bo-ra and Lee Hyeok-je from the neurology department, and professors Lee Chang-wook, Kang Dong-woo and Byun Ki-hwan from the psychiatry department.

Research achievements have accompanied the clinical work. The neurology research team won awards at both international and domestic academic conferences for two consecutive years for a study that analyzed the awareness and perceptions of patients and caregivers ahead of new Alzheimer's drug treatment and proposed tailored communication indicators.

"We will continue to advance our clinical practice and research in the field of neurodegenerative brain diseases, providing patients with more accurate diagnoses and the best possible treatment," said Yang Dong-won, a neurology professor.

"Reaching 200 cases is the result of experience accumulated through the safe and systematic application of new immunotherapies in actual clinical settings," said Kang Dong-woo, a psychiatry professor. "We will continue to work toward realizing precision medicine — delivering optimized treatment strategies for each individual patient, grounded in precision diagnostic technology and clinical experience."


woo@heraldcorp.com