Gatchel Untangles the Causes of Mood and Anxiety Symptoms and Loss of Brain Function in Aging Populations

Jennifer Gatchel studying Alzheimer's disease

Massachusetts General Hospital researcher Jennifer Gatchel, MD, PhD, is using brain imaging technology to learn more about the connections between mental illness and cognitive decline in aging populations.


Often referred to as the golden years, life after retirement can sometimes turn out to be less than sunny.

Dramatic lifestyle changes such as admittance to an assisted care facility and loss of mobility or independence can take a toll on mental health.

In fact, twenty percent of people over 55 suffer from a mental disorder, and two-thirds of nursing home residents exhibit mental and behavioral problems.

As a geriatric psychiatrist at Massachusetts General Hospital and McLean Hospital, Jennifer Gatchel MD, PhD, works with adults ages 60 and over to help them cope with life’s transitions.

For many of her patients, symptoms of mental illness are often compounded by symptoms that indicate the onset of degenerative conditions like Alzheimer’s disease.

“These are conditions I see every day in my practice that I find highly compelling,” says Gatchel. “Could psychiatric symptoms in older adults be driven in part by Alzheimer’s disease pathology and proteins impacting brain circuitry? If so, it would represent an important shift in the way we think about treating older adults presenting with these symptoms.”

Gatchel is using a combination of neuroimaging, cognitive testing, clinical assessments, and her ongoing interactions with patients to inform her research on the relationships between mood and anxiety symptoms and dementia.

She ultimately hopes to improve care and brain health for older patients and help them make the most of their golden years. Continue reading “Gatchel Untangles the Causes of Mood and Anxiety Symptoms and Loss of Brain Function in Aging Populations”

Study Predicts Alzheimer’s Cases to Double in US by 2060. How Mass General Researchers are Fighting Back.

Alzheimer's disease crumbling brainScientists at the National Institutes of Health (NIH) released some unsettling new estimates about the number of individuals affected with Alzheimer’s disease this week—and how that number is expected to skyrocket in the near future.

The NIH team estimates that there are 6 million Americans who currently have either Alzheimer’s disease or some form of cognitive impairment, and that number is expected to more than double to 15 million by 2060.

These staggering statistics highlight the pressing need to better understand how and why Alzheimer’s disease develops, as well as how to treat it.

Here are just some of the ways researchers at Massachusetts General Hospital are working on new strategies to improve diagnosis and treatment.

How “Alzheimer’s in a Dish” Could Improve Research and Treatment Efforts

Scientists and clinicians at Mass General’s Institute for Neurodegenerative Disease (MIND) have developed a creative solution to overcome the challenges of modeling Alzheimer’s disease in the lab.

The laboratory teams of Doo Yeon Kim, PhD, an investigator in the Genetics and Aging Research Unit at MIND, and Rudy Tanzi, PhD, have found a way to grow human neural stem cells in a three-dimensional gel matrix.

One of the challenges in studying the progression of Alzheimer’s disease in the laboratory is that the brain exists in three-dimensions. A Petri dish is flat. Thus it has been difficult to replicate the disease solely by culturing neuronal stem cells and growing them in a dish.

The new 3D model is capable of housing and supporting neuronal stem cells that have been genetically engineered to develop the same plaques and tangles found in the genetic form of Alzheimer’s disease.

The gel not only provides a more brain-like environment for the neurons, allowing them to create more connections, it also helps to retain the Alzheimer’s-linked proteins that are produced by the genetically engineered neuronal cells.

This new model could represent a big step forward in Alzheimer’s research, as it will allow investigators to test thousands of chemical compounds against a more realistic model of the disease, which could speed development of new therapies.

Learn more

Scent Recognition and Recall Test Could Better Predict Onset of Alzheimer’s Disease

A Mass General research team, led Mark Albers, MD, PhD, of the Center for Alzheimer’s Research, has developed a series of four tests designed to measure early indications of Alzheimer’s disease based on an individual’s ability to recognize, remember and distinguish among odors.

The 30-minute scent test was given to 183 people between 60 and 80 years old – some with mild cognitive impairment or possible Alzheimer’s disease—and of those, about 20 percent showed signs of olfactory deficiencies.

Genetic and imaging testing revealed that that these same individuals had other deficiencies that have been linked to the illness, including thickening of certain brain structures and a mutation in a gene associated with increased risk of Alzheimer’s disease.

Learn more

New Brain Scans Used to Detect Risk

Researchers at the Martinos Center for Biomedical Imaging are using a computer aided system called BrainPrint to analyze MRI brain scans to help distinguish individuals who are having minor memory issues from those who are in the silent, early stages of Alzheimer’s disease.

The research, led by Martin Reuter, PhD, has shown there are more pronounced asymmetrical differences in the shapes of critical structures between the left and right sides of the brain in individuals who are later diagnosed with Alzheimer’s.

A better understanding of the early signs of Alzheimer’s could improve detection and treatment strategies, and delay or prevent the significant cognitive decline that occurs in later stages of the disease.

Learn more

Non-Invasive Imaging Techniques Help Researchers See Tau and Amyloid Development

Jorge Sepulcre, MD, PhD, and team at Mass General’s Gordon Center for Medical Imaging have been working to improve noninvasive tests to detect amyloid plaques and tau tangles. Specifically, they are investigating the pathways through which tau spreads and amyloid builds up over time.

Their research has found that the tau and amyloid proteins use different brain pathways to reach the areas where they accumulate.

These findings could help researchers describe the stage of the disease in a given patient and may improve their ability to track responses to potential therapeutic interventions, says Sepulcre.

Studying A Small Group in South America Could Help Alzheimer’s Patients Worldwide

The Familial Dementia Neuroimaging Lab, led by Yakeel T. Quiroz, PhD, is investigating how brain changes may lead to memory loss or dementia later in life. Their research is focused on a large group of related individuals Colombia who carry a genetic mutation that predisposes them to develop an inherited form of Alzheimer’s disease.

“If our findings only apply to our population from Colombia, we will still help thousands of people”, says Edmarie Guzman-Velez, PhD, a postdoc in Quiroz’s lab. “But if what we find can also be applied to those who develop sporadic (non-hereditary) Alzheimer’s disease, we could help millions of people around the world.”

New Screening Technique Makes Waves in The Quest for Earlier Diagnosis of Alzheimer’s Disease

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How could the study of patients under anesthesia lead to a new way to diagnose Alzheimer’s disease? It could all come down to brainwaves.

Patrick Purdon, PhD, a researcher with the Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine, is investigating how changes in brainwave patterns could potentially detect early signs of Alzheimer’s disease.

For the past decade, Purdon and his colleagues have been using electroencephalogram, called EEG, to measure the brainwaves of patients under sedation. That research has demonstrated that different anesthetic drugs produce distinct brainwave patterns in patients.  After finding these brainwave patterns in elderly patients under anesthesia were slower and smaller than those of younger adult patients, Purdon and colleagues examined the areas that were affected by age and discovered they align with brain areas that typically undergo degeneration in Alzheimer’s.

This led to an intriguing possibility—could EEG measurements be used as a diagnostic tool for Alzheimer’s disease?

With a grant from the NIH, Purdon is now studying the brainwave patterns of early Alzheimer’s patients, and monitoring how those brainwaves change over the progression of the disease.  Purdon and his team hope to determine whether EEG can provide a clearer picture of the process of neurodegeneration and changes in brain function.

If they’re successful, EEG could be used as an inexpensive alternative for screening of neurodegenerative problems, potentially leading to earlier diagnosis of Alzheimer’s disease, where treatments could be more effective at slowing or halting its progression. Brainwave measurements could also provide a more accurate measure of the disease’s progression over time.

Read the full story in Proto Magazine here.

How a 3D Model of Alzheimer’s Disease is Providing New Hope in the Search for Treatments

Reigning in Alzheimer’s disease continues to be a challenge — more than 10 million families are affected by this degenerative neurological disease, and the number of patients dying from the disease has increased 68 percent since 2010.

In the past decade, attempts at developing drugs to slow or halt the progression of Alzheimer’s disease have been unsuccessful. The traditional path for early testing of promising therapies – mouse models – has been ineffective, and more than a dozen major clinical trials have failed.

But scientists and clinicians at Massachusetts General Hospital’s Institute for Neurodegenerative Disease (MIND) have developed an innovative new approach that could significantly improve the drug development process.  The laboratory teams of Doo Yeon Kim, PhD, an investigator in the Genetics and Aging Research Unit at MIND, and Rudy Tanzi, PhD, have found a way to grow human neural stem cells in a three-dimensional gel matrix.

This gel system allows the neural cells to grow more naturally and form into 3-D networks just like they do in the brain. It also provides a more accurate model of the signature plaques and tangles that develop around these neurons in Alzheimer’s disease.

The stem cells used in this lab model are genetically engineered to produce two proteins that are the hallmarks of Alzheimer’s disease – β-amyloid and tau. In the brains of people with Alzheimer’s, excessive accumulation of β-amyloid results in the formation of plaques in the spaces between neural cells, while tau is the main component of destructive neurofibrillary tangles within the cells.

Until Dr. Kim’s success, no single model of Alzheimer’s disease contained both amyloid plaques and neurofibrillary tangles. It usually takes a year to develop plaques in mouse models, it took only six weeks to develop both plaques and tangles in the “dish.”

Dr. Kim is now working with a consortium of labs to test thousands of FDA-approved drugs in this “Alzheimer’s in a dish” model to see if any of the drugs are effective in reducing levels of p-tau, a protein that is increased in Alzheimer’s patients.

Of the 2,400 drugs that have been tested, the team had approximately 40 promising hits that they can now investigate further.

Learn more: https://giving.massgeneral.org/fresh-alzheimers-approach-sparks-hope/

Researchers and Clinicians Revolutionize Prevention Efforts for Brain Disease

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What if you had a strong family history of Alzheimer’s disease, but weren’t currently showing any symptoms? What could you do to stave off the cognitive decline and loss of memory associated with this devastating disease? A team of researchers and clinicians at Massachusetts General Hospital wants to be your resource in situations like these.

The Institute for Brain Health at Mass General is revolutionizing the way we treat brain disease by developing new strategies for prevention, risk reduction and early treatment. They work with individuals who are at high genetic risk for brain diseases as well as healthy individuals who want to maintain good brain function as they age.

The Institute encourages life-long relationships with its patients to support the establishment of healthy brain habits and to provide guidance when new illnesses develop that can impact the brain. In doing so, the research team is able to collect longitudinal data about the development and progression of brain diseases throughout the life cycle. This data is helping to advance understanding about the progression of diseases like Alzheimer’s, in which so much is still unknown.

Learn more about the Institute for Brain Health in this article.

The Research Institute:
Saving Lives Through Science
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The Massachusetts General Hospital Research Institute is the largest hospital-based research program in the United States, with a community of over 10,000 people working across more than 30 institutes, centers and departments.

Our researchers work side-by-side with physicians to pioneer the latest scientific advancements for curing disease and healing patients in Boston, across the United States and around the world.

To learn more about the Research Institute, please visit our website.

A Snapshot of Science: Detection of Alzheimer’s Disease, Development of Type 1 Diabetes, and Much More

We wanted to share some recent Mass General research that has been published in high impact, top-tier journals. This is just a small snapshot of the incredible research that takes place at Mass General each day — there’s lots more to find at massgeneral.org/research/news!

 

DETECTING AND TREATING STIFF TUMORS
Published in Nature Scientific Reports on August 14, 2017
(Summary submitted by Peter Caravan, PhD, of the Martinos Center for Biomedical Imaging)

In tumors, cancer cells are surrounded by a collection of proteins, enzymes, sugars, lipids, and minerals called the extracellular matrix (ECM). Many cancers have a fibrotic ECM, making the tumor stiff and preventing delivery of anti-cancer drugs. The presence of a fibrotic ECM is often associated with poor prognosis. We developed a new MRI method to detect tumor fibrosis non-invasively, and studied its effect in a mouse model of pancreatic cancer. The potential impact of this work is a new tool to stage the aggressiveness of tumors, guide treatment planning, and monitor the effectiveness of new tumor ECM altering treatments.

 

IMPACT OF BLOOD AND URINE FILTRATION IN LEAKY KIDNEY FILTERS
Published in Scientific Reports on August 16, 2017
(Summary submitted by Hua A. Jenny Lu, MD, PhD, of the Nephrology Division)

One major function of the kidney is filtering blood through an intricate “glomerular filter”. Disruption of any components of this highly sophisticated and dynamic filter’s structure leads to proteinuria (protein in the urine), a condition frequently seen in diabetic nephropathy and many other glomerular diseases. How blood filters though the glomerular filter and how proteinuria develops when the filter becomes leaky has not been well understood. This paper reports the application of a novel and powerful scanning microscopy technology, the Helium Ion microscopy (HIM) to identify previously unrecognized ultrastructural abnormalities of proteinuric glomerulopathy in animals. These newly discovered abnormalities provide important insight into the molecular and cellular mechanism underlying proteinuria kidney diseases.

 

OBSERVING THE DEVELOPMENT OF TYPE 1 DIABETES
Published in PNAS on August 24, 2017
(Summary submitted by Ralph Weissleder, MD, PhD, Director of the Center for Systems Biology)

Type 1 diabetes (T1D) is an autoimmune disease where insulin-producing cells are destroyed. Inflammation in islets of human patients has been hard to evaluate, given the challenging access to material. Now, our research team has discovered how the different cellular players interact. We created new reporter mice and new imaging agents where cells of interest (lymphocytes, macrophages, dendritic cells, beta cells) are fluorescent and can be observed by imaging. We were able to observe the intricate “dance” of different immune cells interacting with each other as diabetes develops. Throughout the process, Tregs (a unique type of T-lymphocyte) control the activation of many cell types. The “dynamic geography” of events uncovered here provide important clues to immunoregulation that underlies diabetes development.

 

NON-INVASIVE MEASUREMENT OF BRAIN ACTIVITY AND MEMORY ENCODING
Published in Scientific Reports on August 25, 2017
(Summary submitted by Meryem Yucel, PhD, of the Martinos Center for Biomedical Imaging)

Alzheimer’s disease (AD) is the most frequent cause of severe memory loss in the elderly. Early detection of AD is the key to preventing, slowing or stopping the disease. Near-infrared spectroscopy (NIRS) is a non-invasive neuroimaging technique capable of monitoring brain activation. Here, we investigated the utility of fNIRS in measuring the brain activity of healthy adults during memory encoding and retrieval under a face-name paired-associate learning task. Their study demonstrates that fNIRS can robustly measure memory encoding and retrieval-related brain activity. Future work will include similar measurements in populations with progressing memory deficits. Their approach, if successful, will introduce a non-invasive, inexpensive and easily accessible tool for identifying early stages of AD.

Research Awards and Honors: August 2017

Massachusetts General Hospital’s talented and dedicated researchers are working to push the boundaries of science and medicine every day. In this series we highlight a few individuals who have recently received awards or honors for their achievements:

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Gaurdia Banister, RN, PhD, NEA-BC, FAAN, executive director of the MGH Institute for Patient Care and director of the Yvonne L. Munn Center for Nursing Research, has been named the inaugural incumbent of the Connell-Jones Endowed Chair in Nursing and Patient Care Research. The Department of Nursing and Patient Care celebrated the establishment of the chair June 26 at the Paul S. Russell Museum of Medical History and Innovation. The establishment of the chair is the second endowed chair in the Department of Nursing and Patient Care and will help advance the nursing profession and patient-and-family-centered-care through a diverse range of research programs. (Pictured from left: Britain Nicholson, MD, senior vice president for Development; Margot C. Connell, the donor; Banister; and Jeanette Ives Erickson, RN, DNP, NEA-BC, FAAN, chief nurse and senior vice president of Patient Care Services)

“It is impossible to put into words how honored and humbled I feel to have been chosen as the Connell- Jones Endowed Chair for Nursing and Patient Care Research. Advancing nursing knowledge and using that knowledge to deliver exemplary patient care is extremely important to me. One of my research interests is understanding and eliminating the barriers that compromise African American nurses and nursing students from achieving their full potential as clinicians and nurse leaders. Although minorities constitute 37 percent of the country’s population, minority nurses make up only 16.8 percent of the total nurse population. The disparity is even greater in leadership positions. Lack of access to health care providers who can deliver culturally and linguistically appropriate care can adversely contribute to existing health disparities. Improving the diversity of the nursing profession to meet the needs of patients and their families and eliminating these disparities are essential.”

GatchelJennifer Gatchel, MD, PhD, Mass General psychiatrist, has received the Outstanding Emerging Researcher Award from the BrightFocus Foundation. She presented her latest research during a June 8 reception and dinner event at the Andrew W. Mellon Auditorium in Washington, D.C.

“Improving the lives of older adult patients with depression, anxiety, and changes in memory and thinking is my central motivation as a Geriatric Psychiatrist and physician scientist. Towards this goal, my research at MGH focuses on better understanding the earliest mood and behavioral symptoms in older adults at risk for Alzheimer’s disease.  I am doing this by using a combination of clinical measures and novel brain imaging technology that enables visualization of disease-associated proteins in the brains of living older adults. The ultimate goal of my research is to translate this knowledge into ways to better prevent and treat Alzheimer’s disease and to promote healthy brain aging in vulnerable older adults.

I was thrilled and extremely honored to be recognized as the Outstanding Emerging Research Scientist by the Bright Focus Foundation in recognition of my work. This award has provided critical support to me as junior investigator.  It has helped make it possible for me to begin to develop an area of important research to benefit our aging population and their families—central to my mission as a Geriatric Psychiatrist.”

Hata.jpgAaron Hata, MD, PhD, of the Mass General Cancer Center, has received a 2017 Clinical Scientist Development Award from the Doris Duke Charitable Foundation. The awardees distinguish themselves by the rigor of their research endeavors and their commitment to future excellence as independent clinical researchers in the biomedical field. The award makes possible for recipients to dedicate 75 percent of their professional time to clinical research at a time when they are facing competing priorities as both researcher and clinical care provider.

“My research focuses on understanding how drug resistance develops in lung cancer patients whose tumors have mutations in the EGFR gene. Over the past decade, a number of new “EGFR-targeted” drugs have been developed that are able to initially shrink these tumors, however, they invariably stop working and relapse occurs. We are trying to understand how some cells are able to persist during treatment and ultimately grow back.

I am thrilled to receive a Clinical Scientist Development Award from the Doris Duke Charitable Foundation. This award will enable us to generate a high-resolution understanding of how individual tumor cells evolve in patients over the course of treatment. Ultimately our goal is to develop new therapies that can target these surviving cells early before drug resistance is able to develop.”

LiangSteven H. Liang, PhD, of the Department of Radiology, has received the 2017 Early Career Award in Chemistry of Drug Abuse and Addiction from the National Institute on Drug Abuse. The award is to facilitate basic chemistry research applied to drug abuse and addiction.

“My scientific interests are radiochemistry, nuclear medicine and positron emission tomography (PET) imaging – a key and fast-growing ground for translational science and precision medicine in patient care. I have developed several novel radiolabeling technologies and PET imaging biomarkers to access important biological targets that were previously inaccessible.

As the recipient of 2017 Early Career Award in Chemistry of Drug Abuse and Addiction (ECHEM award) from NIH, my team will develop and translate new PET biomarkers for imaging an important biological enzyme, monoacylglycerol lipase (MAGL) in the endocannabinoid system. MAGL inhibition has recently emerged as a therapeutic strategy to treat drug addiction, substance-use disorders as well as neurodegenerative diseases including Alzheimer’s disease. I am thankful to the NIH for this support which will help us develop an imaging tool which we hope can be progressed for translational human imaging studies and used to investigate underlying mechanisms of MAGL-linked diseases.”

Pittet.jpgMikael Pittet, PhD, Samana Cay MGH Research Scholar, of the Center for Systems Biology, has received the inaugural MGH Principal Investigator Mentoring Award. This award is given to a principal investigator who has contributed to the success of PhD graduate students at Mass General.

Mikael Pittet’s laboratory at Center for Systems Biology studies the role of the immune system in cancer. Established in 2007, the Pittet laboratory has made several discoveries, which indicate new ways to successfully treat cancer with immunotherapy. Mikael also directs the Cancer Immunology Program at CSB and currently mentors three PhD students.

“I am greatly honored to be the recipient of this inaugural mentoring award. I am lucky to work with the most terrific students, and grateful about the fact that they nominated me. Thank you, team!”

SippoDorothy Sippo, MD, MPH, a Radiologist in Breast Imaging, has been awarded an Association of University Radiologists GE Radiology Research Academic Fellowship Award. The fellowships help radiologists by strengthening the research interest of radiologist-investigators by broadening their opportunities for continuing scholarship and by fostering original clinical and health services research in technology assessment, health and economic outcome methods and decision analysis.

“My project entitled, ‘Development and Assessment of an Automated Outcomes Feedback Application to Optimize Radiologist Performance Using Digital Tomosynthesis with Mammography,’ aims to automatically provide mammographers with feedback about the outcomes of their patients (whether or not breast cancer is ultimately diagnosed). The goal of this feedback is to enable continuous learning integrated into the patient care setting to aid mammographers in providing the highest quality care.

It is thanks to the strength and diversity of our research team, bringing together mentors and collaborators from the MGH Radiology Department, Harvard Medical and Public Health Schools that we have been able to formulate this informatics feedback intervention. It is being built into the electronic system breast imagers use for reporting. The GERRAF will support my study of radiologists using the feedback application for one year, with in-depth quantitative and qualitative analyses. My goal is for it to be an important stepping stone to future independent research funding.”

Both Patients and Researchers Have a Role to Play in Preserving Brain Function

Reposted from the Mass General Giving Website

green-braintreeBrain health is key to living a long and happy life.

Too many Americans suffer from Alzheimer’s and other brain conditions that rob them of their memories, their independence and their lives. In fact, 1 of every 3 seniors dies due to Alzheimer’s and other forms of dementia.

Here are some tips for improving brain health:

First, exercise is essential.

Promoting blood flow to the brain is vitally important, so exercise is a key part of maintaining brain health. Keeping your heart pumping provides the vital oxygen your brain requires to stay active.

Second, be social.

Those who have social networks maintain healthier brains than those who are isolated. So, visit with your friends, family and neighbors. Seek out social occasions and fight back against isolation.

Third, maintain a healthy balance.

Focus upon a diet that is high in fiber and fruit, be sure to get at least 7 to 8 hours of sleep each night, and avoid stress as much as possible.

An active brain is more likely to stay a healthy brain. You must constantly challenge your brain.

Fourth, use it or lose it.

An active brain is more likely to stay a healthy brain. You must constantly challenge your brain. Puzzles alone are not enough. Learn new things. Constantly educate your mind, because learning results in positive, physical changes in our brain.

 

Mass General created the Institute for Brain Health to integrate our research into Alzheimer’s, strokes, Parkinson’s, ALS and other brain-related diseases and conditions that affect too many Americans. The doctors and staff are working to develop new treatments to preserve brain function and prevent these diseases.

The Institute’s co-founder Jonathan Rosand, MD, MSc, chief of the Division of Neurocritical Care and Emergency Neurology, has led groundbreaking research into preventing brain disease, and Bradford Dickerson, MD, director of Clinical Applications, is studying older adults who have maintained the resilient minds of younger people.

While our researchers do their job to fight brain diseases, please do your part to protect your brain by keeping it active. Check out our Brain Health Quiz, learn something new and keep your brain healthy today.

For Alzheimer’s Patients, Every Day is the Longest Day

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June 21st is not only the longest day of the calendar year, but it is also a special day focused on Alzheimer’s disease (AD), an irreversible progressive form of dementia that slowly destroys memory and thinking skills.

The challenges of living with AD make each day the “longest” in terms of sheer survival. The Longest Day is meant to pay tribute to those suffering from AD and their loved ones and caregivers; to raise awareness of the challenges that come with a diagnosis of AD; and to raise funds for continued AD research.

Today an estimated 5 million Americans have AD. With that figure expected to quadruple in the next 30 years, there’s a growing need to find a way to prevent or stop progression of this devastating disease.

Massachusetts General Hospital researchers are hard at work trying to learn more about the disease. Here are a few examples of their recent discoveries:

  • Abnormal accumulation of tau and amyloid beta proteins in the human brain are two characteristics of AD. In a recent study using advanced imaging techniques, lead author Jorge Sepulcre, MD, PHD, of the Gordon Center for Medical Imaging, looked at the distribution of tau and amyloid beta deposits in the brains of elderly, cognitively normal individuals. Read how the clues his team found about the spreading pathways of AD could help researchers one day identify a specific target to try and stop the disease’s progression.
  • Could the development of amyloid beta plaques in the brain be a response to infection? Mass General researchers Rudy Tanzi and Robert Moir are investigating amyloid beta’s role in the body. Their findings could possibly open new fronts for treating or preventing AD by attacking infection before plaques begin to form.
  • New research from the Mass General Epilepsy Service suggests a potential connection between the devastating memory loss associated with AD and “silent” seizures in the memory center of the brain. Learn how this discovery could lead to potential new treatment options for patients with AD.
  • If you are wondering about your risk of developing AD, the answer may be found right under your nose. A team from the Center for Alzheimer’s Research has developed a series of four tests designed to measure early indications of AD based on an individual’s ability to recognize, remember and distinguish among odors. Learn more about the tests.

Researchers Detect “Silent” Seizures in Alzheimer’s Patients

First let’s define a key word:
Hippocampus: The brain structure responsible for memory development. The hippocampus is a key part of the brain affected by Alzheimer’s disease, and also a common source of seizures in people with epilepsy.

New research from Massachusetts General Hospital suggests a potential new connection between the devastating memory loss associated with Alzheimer’s disease (AD) and “silent” seizures in the memory center of the brain.

The small study enrolled two female patients in their 60s with early AD and no known history of seizures. Because electrodes placed on the scalp are often unable to detect seizure activity deep in the brain, researchers surgically implanted electrodes on both sides of the brain through the foramen ovale (FO), a narrow opening at the base of the skull, in addition to scalp EEG. Each patient’s brain activity was monitored for 24 to 72 hours.

The FO electrodes recorded evidence of seizures in the hippocampuses of both patients, while the scalp EEG readings did not detect any abnormal electrical activity. Most notably, these seizures primarily occurred when patients were asleep, a critical time for memory consolidation.

“While it is not surprising to find dysfunction in brain networks in Alzheimer’s disease, our novel finding that networks involved in memory function can become silently epileptic could lead to opportunities to target that dysfunction with new or existing drugs to reduce symptoms or potentially alter the course of the disease,” says Andrew Cole, MD, Director of the Mass General Epilepsy Service and senior author of the Nature Medicine paper.

One patient received anti-seizure medicine as a treatment following the scan, which seemed to cut down on AD-linked symptoms such as confusion and repeating the same question. The other patient started on the medication but it had to be discontinued due to adverse effects on her mood.

A recent study led by Alice Lam, MD, PhD, also of the MGH Epilepsy Service and lead author of the current study, demonstrated a novel tool for detecting hippocampal seizures not detectible by scalp EEGs in patients with epilepsy. Cole and his team are working to refine this tool and apply it to AD.

Due to the small size of the study, further research is also needed to validate the results with a broader population.