Researchers at Emory University's Brain Health Center hope to better understand the root causes of dementia diseases such as Alzheimer's and mental health disorders such as depression by examining individual patients' biological, medical and lifestyle factors.
The idea is known as precision or personalized medicine, and has been effective in understanding cancers, Dr. Allan Levey with the Brain Health Personalized Medicine Institute said.
For example, a harmful variant in the genes BRCA1 or BRCA2 — named from BReast CAncer — can be inherited from either parent, and each child of a parent who carries any mutation in one of these genes has a 50% chance of inheriting the mutation, according to the National Cancer Institute.
People who inherit harmful variants in one of these genes have increased risks of several cancers — most notably breast and ovarian cancer, but also several additional types of cancer.
"Some people have certain genetic pathways involved or genetic risks that confer a disease or a risk of a disease," Levey said.
Through the BHPMI, Emory plans to combine its existing strengths in clinical and research neuroscience programs by integrating data obtained from Emory Healthcare with cutting-edge research capabilities in the Georgia community, Dr. Jonathan Lewin, executive vice president for health affairs and Emory Healthcare CEO, said.
“Very few academic medical centers are as rich as Emory in the number of neuroscientists and healthcare providers in brain health,” Lewin said. “The rich academic culture extends to partnering institutions at Georgia Tech, the Atlanta VA Medical Center and Georgia State University, establishing Atlanta as one of few cities globally with such a strong neuroscience research and care community.”
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So, while doctors diagnose Alzheimer's or Parkinson's diseases, stroke, ALS or — in psychiatry — depression or anxiety disorder based on the symptoms, scientists are learning that many brain diseases have shared genetic contributions.
"For 150 years we've siloed or bucketed these diseases based on the symptomology, but brain science is teaching us that they actually are far more related," Levey said. "So there's often a shared genetic susceptibility to some of these brain diseases."
The brain is also very responsive to behavior and lifestyle in both good and bad ways, Levey said.
"So, for example, education is very important in helping the brain develop and function throughout life," he said. "So even early life education has long lasting effects."
On the negative side, Levey said a sedentary lifestyle is bad for the brain, and puts people at greater risk of stroke and heart disease.
An inactive lifestyle is also a risk factor for Alzheimer's disease, Levey said.
The ability to treat a disease is tied to all the aspects that make us uniquely human, which is why Levey believes getting the right person the right treatment at the right time is critical.
"There's going to be a revolution in brain science and brain health over the next decade," he said.
Part of the research involves biomarkers, which help doctors predict disease. Cholesterol is a biomarker for heart disease, for example.
"We're just at the beginning of developing those same types of biomarkers for brain diseases," Levey said.
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Researchers are also studying the relationship between the immune response called inflammation and a host of neurological conditions.
"Common to the vast majority of brain diseases is inflammation in our immune system," Levey said, "whether it's from autism, a developmental disorder, to traumatic brain injury to Parkinson's, Alzheimer's and certainly depression."
Better understanding of inflammation could shed light on some of the “long-hauler” symptoms of the coronavirus as well, he said.
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