Wednesday, November 20, 2019

Understanding brain activity can predict Alzheimer’s progression

For a person with Alzheimer’s disease, there’s no turning back the clock. By the time a person begins to experience memory loss and other worrisome signs, cognitive decline has already set in. Decades of clinical trials have failed to produce treatments that can help people regain their memory.

Today, researchers at Gladstone Institutes are approaching this devastating disease from a different angle. In a study, they demonstrate that particular patterns of brain activity can predict far in advance whether a young mouse will develop Alzheimer's-like memory deficits in old age. 

The new work builds on a 2016 study of mice engineered to carry the gene for apolipoprotein E4 (ApoE4). Carrying the gene is associated with an increased risk – but not a guarantee, of Alzheimer’s disease in humans. As they age, ApoE4 mice often, but not always, develop signs of memory loss similar to those seen in people with Alzheimer’s.

In the previous study, Huang and his team investigated a type of brain activity called sharp-wave ripples (SWRs), which play a direct role in spatial learning and memory formation in mammals.

“SWRs have two important measurable components: abundance and short gamma (SG) power,” said the lead author of the new study. “Broadly, SWR abundance predicts how quickly an ApoE4 mouse can learn and memorize how to get through a maze, and SG power predicts how accurate that memory will be.”

The earlier study revealed that aging ApoE4 mice have lower SWR abundance and weaker SG power than seen in healthy aging mice. Based on those results, Jones and her colleagues hypothesized that measuring SWR activity could predict the severity of demonstrable memory problems in ApoE4 mice during aging.

“We actually successfully replicated this experiment 2 years later with different mice,” said Huang, who is also a professor of Neurology and Pathology at UCSF. “What was striking is that we were able to use the results from the first cohort to predict with high accuracy the extent of learning and memory deficits in the second cohort, based on their SWR activity.”

Even more striking were the unexpected results of the team’s next experiment.

The researchers were curious about how SWR activity evolves over a mouse’s lifetime, which no one had previously investigated. So, they periodically measured SWRs in ApoE4 mice from an early age – long before memory deficits appeared – through middle age, and into old age.

“We thought that, if we got lucky, the SWR measurements we took when the mice were middle-aged might have some predictive relationship to later memory problems,” Jones said.

Surprisingly, the analysis revealed that deficits in SWR abundance and SG power at an early age-predicted which mice performed worse on memory tasks 10 months later – the equivalent of 30 years for a human.

“We were not betting on these results, the idea that young mice with no memory problems already have the seed of what’s going to lead to deficits in old age,” Jones said. “Although we would love to, we thought it would be ridiculous to be able to predict so far in advance.”

Since SWRs are also found in humans, these findings suggest that SWR abundance and SG power could potentially serve as early predictors of Alzheimer’s disease, long before memory problems arise.


As a next step toward evaluating that possibility, Huang will work with colleagues at the UCSF Memory and Aging Center to determine whether SWRs in Alzheimer’s patients show deficits in abundance and SG power similar to those seen in mouse models of the disease.

“A major advantage of this approach is that researchers have recently developed a non-invasive technique for measuring SWRs in people, without implanting electrodes in the brain,” the researcher said.

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Wednesday, February 27, 2019

Pioneering trial offers hope for restoring brain cells damaged in Parkinson's


A pioneering clinical trial programme that delivered an experimental treatment directly to the brain, offer hope that it may be possible to restore the cells damaged in Parkinson's.

The study, aimed to investigate whether boosting the levels of a naturally-occurring protein, Glial Cell Line Derived Neurotrophic Factor (GDNF), can regenerate dying brain cells in people with Parkinson's and reverse their condition. 

This is something which no existing treatment can do.

A specially designed delivery system was designed to get GDNF to the brain cells that need it. In total, 41 participants underwent robot-assisted-surgery to have four tubes carefully placed into their brains, which allowed GDNF to be infused directly to the affected brain areas with pinpoint accuracy, via a port in the side of their head.

Six took part in the initial pilot study to assess the safety of the treatment approach. A further 35 people then participated in the nine-month double blind trial, where half were randomly assigned to receive monthly infusions of GDNF and the other half placebo infusions.

After the initial nine months on GDNF or placebo, all participants had the opportunity to receive GDNF for a further nine months.

While there were some encouraging signs of improvements in those receiving GDNF, disappointingly there was no significant difference between the active treatment group and those who received placebo on any assessments of Parkinson's symptoms.

However, results from brain scans revealed extremely promising effects on damaged brain cells.
After nine months, there was no change in the scans of those who received placebo, whereas the group who received GDNF showed an improvement of 100 per cent in a key area of the brain affected in the condition - offering hope that the treatment was starting to reawaken and restore damaged brain cells.

By 18 months, both groups showed moderate to large improvements in symptoms compared to their scores before they started the study.

This offers further encouragement that the treatment may have long-term beneficial effects but because everyone knew they were receiving the active treatment and there was no comparison group, these improvements need to be treated with caution.

The Principal Investigator on the GDNF trial, said, "The spatial and relative magnitude of the improvement in the brain scans is beyond anything seen previously in trials of surgically delivered growth-factor treatments for Parkinson's. This represents some of the most compelling evidence yet that we may have a means to possibly reawaken and restore the dopamine brain cells that are gradually destroyed in Parkinson's," adding, "Its failure to produce the same effect on symptoms could be for a number of reasons. It may be that the effects on symptoms lag behind the improvement in the brain scans, so a longer double-blind trial may have produced a clearer effect.'

The researchers further added that it is also possible that a higher dose of GDNF would have been more effective, or that participants at an earlier stage of the condition would have responded better.
The study author said, "While the results are not clear-cut, the study has still been a resounding success. It has advanced our understanding of the potential effects of GDNF on damaged brain cells, shown that delivering a therapy in this way is feasible and that it is possible to deliver drugs with precision to the brain."

 The lead neurosurgeon and designer of the device, commented, "This trial has shown that we can safely and repeatedly infuse drugs directly into patient's brains over months or years through a small implanted port that emerges through the skin behind the ear. This is a significant breakthrough in our ability to treat neurological conditions, such as Parkinson's because most drugs that might work cannot cross from the blood stream into the brain due to a natural protective barrier."

Another researcher said the results are encouraging, adding, "These results, particularly the brain scans show that GDNF, delivered with Convection Enhanced Delivery, has promise as a potential treatment to slow, stop or even reverse Parkinson's. However, it is critical we now concentrate on how to best support moving GDNF forward, to understand if it can be a viable treatment to potentially regenerate dopamine cells and impact the lives of people living with Parkinson's."

Another doctor commented that while the results are not as clear cut as would have been desirable, they are exciting signs of promise for Parkinson's. He added that, in particular, when the scores on three of the key assessments are combined - motor response, activities of daily living and good quality it reveals a highly significant difference between the treatment and placebo groups.

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Friday, March 14, 2014

Brain hard-wired to link what we see with what we do

Scientists have found for the first time that our brain’s ability to instantly link what we see with what we do is down to a dedicated information ‘highway’.
Researchers from University College London and Cambridge University found a specialised mechanism for spatial self-awareness that combines visual cues with body motion.
Standard visual processing is prone to distractions, as it requires us to pay attention to objects of interest and filter out others.
The new study found that our brains have separate’hard-wired’ systems to visually track our own bodies, even if we are not paying attention to them.
In fact, the newly discovered network triggers reactions even before the conscious brain has time to process them.
The researchers tested 52 healthy adults in a series of three experiments. In all experiments, participants used robotic arms to control cursors on two-dimensional displays,where cursor motion was directly linked to hand movement.
Their eyes were kept fixed on a mark at the centre of the screen, confirmed with eye tracking.
In the first experiment, participants controlled two separate cursors with their left and right hands, both equally close to the centre.
Occasionally, the cursor or target on one side would jump left or right, requiring subjects to take corrective action.
Each jump was ‘cued’ with a flash on one side, this was random so did not always correspond to the side about to change.
People reacted faster to target jumps when their attention was drawn to the ‘correct’ side by the cue. However,reactions to cursor jumps were fast regardless of cuing,suggesting that a separate mechanism independent of attention is responsible for tracking our own movements.
“The first experiment showed us that we react very quickly to changes relating to objects directly under our own control, even when we are not paying attention to them,” said Dr Alexandra Reichenbach of the UCL Institute of Cognitive Neuroscience, lead author of the study.
“This provides strong evidence for a dedicated neural pathway linking motor control to visual information,independently of the standard visual systems that are dependent on attention,” Reichenbach said.
The second experiment was similar to the first, but also introduced changes in brightness to demonstrate the attention effect on the visual perception system.
In the third experiment, participants had to guide one cursor to its target in the presence of up to four dummy targets and cursors, ‘distractors’, alongside the real ones.
In this experiment, responses to cursor jumps were less affected by distractors than responses to target jumps.
“These results provide further evidence of a dedicated’visuomotor binding’ mechanism that is less prone to distractions than standard visual processing,” said Reichenbach.
The newly discovered system could explain why some schizophrenia patients feel like their actions are controlled by someone else, researchers said.

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