Get Involved in Brain Research

by Guy McKhann, M.D.

October 14, 2008

As we approach the final weeks of the U.S. presidential campaign, we are being bombarded with reminders to get involved in the political process—by donating money, knocking on doors, attending rallies and, most of all, voting. In our democratic system we have a say as to how best to improve our country.

Likewise, I would argue that involvement in brain research is important if you have an interest in furthering it and improving mental health treatment. In democracy or brain science, if you’re not participating, don’t complain about what occurs!

Why would you have such an interest in brain research? Many reasons: members of your family may have had a particular disease; you may have risk factors associated with altered brain functions, similar to those for vascular disease such as diabetes or hypertension; members of your family may live a long time, making the aging brain a topic of interest for you. You may think you are doing just fine, but is your brain really OK?

There are several ways to get involved. The first is to sign up for clinical studies of the brain. These come in different forms. The simplest are outcome studies over time. At intervals you undergo testing of your cognitive functions, brief neurological examinations and even imaging of the brain. For example, several ongoing studies of older people are using these methods to try to establish the earliest changes in people who will go on to develop Alzheimer’s disease.

Such longitudinal studies are the only way to get this information. After the subject’s death, researchers obtain the brain in order to make clinicalpathological correlations.

The second way to get involved is to volunteer for a clinical trial of a new medication or some other form of intervention. Years of work and millions of dollars are spent developing potential new treatments for a brain disease.

This work is done in test tubes and on experimental animals, some of which will have genetically induced characteristics of a human disease. Eventually this research has to move to the human. A drug may work in a mouse, but in people is it safe and does it do anything beneficial? And is it any better than what is currently available? The only way to get answers to those questions is to evaluate it in a carefully controlled clinical trial. That requires people getting involved.

Donors in the news

There are two articles in this month’s issue that emphasize another aspect of how you can help: donating your brain to science. The CBC News article “Brain banks: Crucial for Research, Clamoring for Donors” discusses the generic problem of finding sources of brain tissue for research. Brain banks are important when we get a new lead about a disease. We can then rapidly check this possibility in stored tissues. There are many diseases for which we do not have reliable information about the underlying mechanisms. These include schizophrenia and depression. In others, suchas Alzheimer’s disease or Parkinson’s disease, we know the gross pathology, but not why particular groups of nerve cells die.

Another reason for brain banks is the need for normal tissue for comparison. If one finds an abnormality in the brain of a patient with Alzheimer’s disease, how can one be sure it is specific to that disease? Only by comparing the finding with non-Alzheimer tissue, both from normal people and from those with other neurologic diseases, can the specificity be determined.

The New York Times article “Dozen Athletes Leaving Brains to Concussion Study” addresses a very important issue—the long term effects of repeated head injuries. These include problems with memory and behavior. We have been aware of these phenomena in boxers, and even have a specific term for the brain findings: “dementia pugilistica.” It was thought that this was confined to boxers, but now we are not so sure. Careful studies of those with documented head injuries are clearly needed.

Brain research is truly bipartisan. Get involved!