Alzheimer's - Dementia, Author Interviews, Biomarkers / 11.11.2021
Science of Alzheimer’s Disease is Moving Fast: Blood Test Will Make it Easier To Participate in Clinical Trials
MedicalResearch.com Interview with:
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Dr. Grill[/caption]
Joshua D. Grill, PhD
Professor, Psychiatry & Human Behavior
School of Medicine
Professor, Neurobiology and Behavior
School of Biological Sciences
University of California, Irvine
MedicalResearch.com: What is the background for this study?
Response: Alzheimer’s disease is a major public health challenge. More than 6 million Americans have the disease, which causes cognitive problems and eventual dependence on others for daily function. Scientists understand that the disease begins in the brain years before memory and other thinking problems begin and the AHEAD Study aims to intervene in this window of time, to see if a drug that targets these brain changes can delay or prevent symptoms of the disease.
Dr. Grill[/caption]
Joshua D. Grill, PhD
Professor, Psychiatry & Human Behavior
School of Medicine
Professor, Neurobiology and Behavior
School of Biological Sciences
University of California, Irvine
MedicalResearch.com: What is the background for this study?
Response: Alzheimer’s disease is a major public health challenge. More than 6 million Americans have the disease, which causes cognitive problems and eventual dependence on others for daily function. Scientists understand that the disease begins in the brain years before memory and other thinking problems begin and the AHEAD Study aims to intervene in this window of time, to see if a drug that targets these brain changes can delay or prevent symptoms of the disease.
Dr. Mahncke[/caption]
Dr. Mahncke earned his PhD at UCSF in the lab where lifelong brain plasticity was discovered. At the request of his academic mentor, he currently leads a global team of more than 400 brain scientists engaged in designing, testing, refining, and validating the computerized brain exercises found in the BrainHQ app from Posit Science, where he serves as CEO.
Earlier this year, MedicalResearch.com interviewed Dr. Henry Mahncke about the BRAVE Study he led, which showed a digital health app (BrainHQ) was effective in addressing chronic cognitive issues in servicemembers who had been diagnosed with “mild” Traumatic Brain Injury. This week, MedicalResearch.com interviews Dr. Mahncke again about a new independent study among civilians showing similar results in patients with all kinds of Brain Injuries.
MedicalResearch.com: What is the background for this study?
Response: The Centers for Disease Control (CDC) estimates that about 5.3 million people currently live with a chronic disability from a Traumatic Brain Injury (TBI). While most people who suffer a blow to the head recover in a couple days or weeks, for some (estimated as high as 15 percent) the injury persists with a variety of life-disrupting symptoms, including impairments in cognitive abilities, behavior, emotions, and motor function affecting work, relationships, and daily function.
TBIs have been the signature injury of recent wars. Nearly 400,000 service members have been diagnosed with TBIs, of which 82% were diagnosed with so-called “mild” TBIs from concussions and blast injuries. More than a decade ago, we began being asked by military and Veterans organizations, to study whether our brain exercises – which had shown positive effects in measures of cognition, everyday function, mood, and motor function in healthy older adults – could have an impact on people with chronic symptoms from TBIs.
We talked earlier this year, when an 83-person, gold-standard, randomized controlled trial on mTBI (called the BRAVE Study) announced quite positive results from using BrainHQ exercises. That study was funded by the Department of Defense and run as five military and Veterans medical centers. The BRAVE Study found the BrainHQ group showed a statistically and clinically significant improvement on a standard measure of overall cognitive function (compared to a computer games control), and this benefit persisted for at least 12 weeks after training completed. Cognitive function improvements were nearly four times larger in the BrainHQ group than the control (as measured immediately following training) and grew to nearly five times larger (when measured again 12 weeks after training ended). On average, participants in the BrainHQ group improved on the cognitive performance composite measure by 24 percentile ranks – as though they went from the 50th percentile to the 74th percentile.
One large question left unanswered from the BRAVE study was whether this approach might also work for other categories of TBIs, such as moderate and severe TBIs. A new study from independent researchers at NYU answers that question.
Prof. Stewart[/caption]
Willie Stewart, MBChB, PhD, DipFMS, FRCPath, FRCP Edin
Consultant Neuropathologist
Honorary Professor
Department of Neuropathology
Queen Elizabeth University Hospital
Glasgow, UK
MedicalResearch.com: What is the background for this study?
Response: There is concern over the association between participation in contact sports and later life risk of dementia and associated neurodegenerative disease. Much of this comes from observations of a specific form of neurodegenerative pathology - chronic traumatic encephalopathy (CTE)- linked to history of traumatic brain injury (TBI) and repetitive head impacts in autopsy studies of relatively small numbers of former athletes, including boxers and soccer players. Nevertheless, although this brain injury linked pathology is described, surprisingly little is known about what this might mean for later life health, specifically risk of dementia.
In a previous study published from our programme of research looking at "Football's Influence on Lifelong health and Dementia risk' (the FIELD Study), we demonstrated that former professional soccer players had an approximately three-and-a-half-fold higher mortality from neurodegenerative disease than matched general population controls. However, these mortality data did not allow us to consider the relationships between varying head injury/impact exposure variables, such as player position and career length, and risk of neurodegenerative disease.
Dr. Kelley[/caption]
Mireille E. Kelley Ph.D.
Staff Consultant for Engineering Systems Inc.
MedicalResearch.com: What is the background for this study?
Response: Youth and high school football players can sustain hundreds of head impacts in a season and while most of these impacts do not result in any signs or symptoms of concussion, there is concern that these repetitive subconcussive impacts may have a negative effect on the brain.
The results of this study are part of an NIH-funded study to understand the effects of subconcussive head impact exposure on imaging data collected at pre- and post-season time points. The present study leveraged the longitudinal data that was collected in the parent study to understand how head impact exposure changes among athletes from season to season and how that relates to changes measured from imaging.
Dr. Begdache[/caption]
Lina Begdache, PhD, RDN, CDN, CNS-S, FAND
Assistant Professor
Health and Wellness Studies Department GW 15
Decker School of Nursing
Binghamton University
MedicalResearch.com: What is the background for this study?
Response: My research focuses on understanding the link between the modifiable risk factors (such as diet, sleep and exercise) and mental distress. In this study, adults of different age-groups (18 years and older) were followed for 4 weeks. Participants recorded their dietary intake, sleep quality, exercise frequency, their physical and mental wellbeing on a daily basis.
Another research interest of mine is to assess these factors in relation to sex (different brain morphology) and age-groups (based on brain maturity). The rationale of this categorization is that brain morphology and brain development vs maintenance and repair may require a different repertoire of food and environmental factors. Therefore, we also studied the sex and age-groups effect.
We also added the season factor as one of our
Dr. Nation[/caption]
Daniel A. Nation, Ph.D.,
Associate Professor of Psychological Science
Institute for Memory Impairments and Neurological Disorders
University of California, Irvin
MedicalResearch.com: What is the background for this study?
Response: Hypertension is a risk factor for cognitive decline and dementia, and treatment of hypertension has been linked to decreased risk for cognitive impairment.
Prior studies have attempted to identify which specific type of antihypertensive treatment conveys the most benefit for cognition, but findings have been mixed regarding this question. We hypothesized that antihypertensive drugs acting on the brain angiotensin system may convey the greatest benefit since they affect the brain angiotensin system that has been implicated in memory function.
Dr. Dunietz[/caption]
Galit Levi Dunietz MPH, PhD
Assistant Professor
Dr. Braley[/caption]
The first step that you should take to finding inner peace is to practice yoga and meditation regularly. Yoga and meditation can give you the chance to slow down and reflect, as well as to clear your mind of the worries and negative thoughts that are concerning you. Not only this, but deep breathing is also an important aspect of both yoga and meditation as this can help you to ground yourself and to reconnect with the world around you.
Dr. Rettew[/caption]
David C. Rettew, MD
Child & Adolescent Psychiatrist
Associate Professor of Psychiatry and Pediatrics
University of Vermont Larner College of Medicine
MedicalResearch.com: What is the background for this study?
Response: Our group, the Wellness Environment Scientific Team at the University of Vermont, hadn’t planned to look at COVID at the outset of this study and instead were going to look at mental health and engagement in wellness activities in college students across a semester. The pandemic disrupted that plan when students were abruptly sent home but fortunately, they continued to do their daily app-based ratings of their mood, stress levels, and engagement in healthy activities. We then realized we had some interesting pre-COVID to COVID data that was worth exploring.
Dr. Master[/caption]
Christina L. Master, MD, FAAP, CAQSM, FACSM
Professor of Clinical Pediatrics
Perelman School of Medicine at the University of Pennsylvania
Co-Director, Minds Matter Concussion Program
Pediatric and Adolescent Sports Medicine, Division of Pediatric Orthopedics
Attending Physician, Care Network - Karabots Center
The Children's Hospital of Philadelphia
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study?
Response: There have been multiple studies investigating potential sex differences in outcomes from concussion which have sometimes had conflicting results with some studies indicating that females take longer to recover than males and some studies reporting no difference in recovery between females and males, with most of these studies being conducted either retrospectively or prospectively in smaller cohorts. This large-scale multi-center prospective study in collegiate athletes provided an opportunity to compare females and males across comparable sports to examine both potential intrinsic or biologic factors (sex differences) or extrinsic (environmental or gender differences) that contribute to outcomes.