3 posts tagged “Science”

Talking brain donation with Dr. Deborah Mash

Posted September 1st, 2015 by

Dr. Deborah Mash is a professor of neurology and molecular/cellular pharmacology at the University of Miami School of Medicine. She’s also the director of the university’s Brain Endowment Bank, and she recently spoke with PatientsLikeMe about her research and exactly what goes into donating your brain to science. As she says, “we still know very little about that which makes us uniquely human” – read her Q&A interview below.

What led you to study diseases of the brain? 

The brain is the next biologic frontier. We have learned more about the human brain in the past twenty years than throughout all of human history. And, we still know very little about that which makes us uniquely human – our brain. I was always very interested in the anatomy and the chemistry of the brain and in disease-related Neuroscience. I consider it a privilege to study the human brain in health and disease.

How would you explain the process of brain donation to PatientsLikeMe members who might be new or uncomfortable with the idea of donating this organ to science?

Brain donation is no different than donating other organs after death. Organ and tissue donations can give life or sight to another person. Transplanted tissues are used in surgeries to repair damaged bones and joints. And these donated tissues are also important for research studies to advance best practices that are used by doctors. The gift of a brain donation supports research studies that will bring about new treatments, better diagnosis and ultimately cures for disorders of the human brain like Alzheimer’s disease, Autism, ALS, schizophrenia and depression, drug and alcohol addiction, bipolar disorder, and multiple sclerosis to name a few.

A brain donation does not interfere or delay a family’s plans for the funeral, burial or cremation. There is no cost to the family to make this final gift.

What brain bank research would you most like to share with the PatientsLikeMe community? Our ALS, MS, Parkinson’s and mental health members might be interested to hear about brain bank research for their conditions.

Studies of the human brain have led to seminal discoveries including the loss of dopamine neurons in Parkinson’s disease and the association of beta amyloid with Alzheimer’s disease. Without examining the human brain after death, these discoveries could not have happened. Medications for Parkinson’s disease were advanced because scientists identified the loss of dopamine that causes many of the symptoms.

We have new technology that provides an unprecedented opportunity to rapidly examine large-scale gene expression of human brain for the first time. This powerful approach can facilitate understanding the molecular pathogenesis of Amyotrophic lateral sclerosis (ALS), a disease that is usually fatal in five years. Motor neurons in ALS undergo degeneration, causing secondary muscle atrophy and weakness. Studies of ALS in human brain are beginning to identify multiple processes involved in the pathogenesis of ALS.

We have yet to fully understand the progression of multiple sclerosis (MS).

This disease is different for everyone who has it. The symptoms it causes and when they flare up is different not only between people but also throughout one person’s life. This makes the diagnosis difficult and complicates treatment. The science behind MS is slowed because there are too few brains donated for research. We get many more requests for well-characterized MS cases and too few brain specimens are available to support the research. This lack of donated brains from MS patients is a barrier for MS research.

Examining the brain after death is important to understand how well experimental treatments are working in clinical trials to see if the drug did what it was supposed to do. An autopsy follow-up on 13 patients from a recent Alzheimer’s drug trial showed that although the drug had cleared the beta amyloid protein, it hadn’t changed the course of the disease — an incredibly important observation needed to advance the direction of Alzheimer’s disease research. The same is true for anyone who participates in clinical trials for any brain disorder.

When you ask people (or their family members) to consider donating their brain to UMBEB or another brain bank, what do you want them to know?

A brain donation is a final gift that contributes to the health and well being of the next generation – your children and grandchildren. It is a very special endowment that lives on by advancing research that can lead to the next scientific breakthrough.

People who want to be organ donors typically sign a card letting others know their wishes, but brain donations require an additional pledge card. This is not always well promoted. How can PatientsLikeMe members who are interested in brain donation obtain the special brain donation pledge cards?

It is important to make your wish known by registering in advance. We make it an easy process and provide donor registration cards for your wallet. You can share this information with your family and friends. You can request information or become a registered donor by visiting us online at http://brainbank.med.miami.edu or call 1-800-UM-Brain.

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Share and Compare: A PatientsLikeMe Year in Review (Part III – more R&D)

Posted January 5th, 2011 by

The research team is very proud of how our team has grown in 2010 and the impact we’ve made in the academic community.  In 2010 alone, PatientsLikeMe and our work were mentioned in scientific literature more than 133 times.  All of this is because of what you share with us.

Yesterday, we highlighted some of the research work we’ve done in 2010 across our four newest communities.  Today, we’ll highlight our older communities.  Below is also a highlights reel of some of this work.

HIV

  • Throughout 2010, we discussed the goal and benefits to measuring your quality of life (QoL). This concept of measuring QoL started in our HIV Community at the end of 2009. Earlier this year in a blog and podcast, Researcher Michael Massagli Ph.D. discussed some of the insights that are being shared by HIV patients through the QoL survey. For instance, we found that the average physical, mental and social well-being score of patients with a CD4 count below 200 is significantly lower than for those of you with a count above 200.

Parkinson’s Disease

  • The Parkinson’s Community has always excelled in reporting their health status through the Parkinson’s Disease Rating Scale (or PDRS). When answering the questions on this scale, members often asked us: “Should I respond when my drugs are working and I’m at my best (‘On’) or when my drugs aren’t working and I’m at my worst (‘Off’)?” Back in October, we released a brand new feature in the PD community that allows you to rate your symptoms as either “On,” “Off”, or in both conditions so now you can see the effect of your medications for yourself.

Multiple Sclerosis

  • We hear a lot from you about the difficulty of adhering to medication. Early last year, our research team developed a new rating scale for patients with MS to assess the difficulties of sticking to their medication. We presented findings at the Consortium of Multiple Sclerosis Centers (CMSC), the main North American conference for MS specialist physicians, nurses, and researchers. The team is currently working on publishing these findings.

ALS

  • Co-founder Jamie Heywood discussed our research into lithium in ALS at the TEDMED conference late in 2009. In early 2010, TEDMED released the video of his presentation where he shares our vision of the future of medicine. The team is currently working on publishing the lithium findings.
  • PatientsLikeMe, in collaboration with researchers at Oxford University, discovered that when ALS patients get symptoms in their arms first, they’re most likely to get it in their dominant hand. This research was presented at the ALS MND Symposium and cited on this MND Research blog.
  • We also collaborated with the Northeast ALS Consortium (NEALS) to examine the decision-making process that patients with ALS go through when considering whether or not to take part in research studies; this was published in the peer-reviewed journal Amyotrophic Lateral Sclerosis.

Here’s a short video highlighting much of the research you’ve helped us do in 2010.

Finally, I want to recognize how our team has expanded this year to better focus on what matters to you most.  Some new additions include:

  • Brant Chee, Ph.D. – a specialist in natural language processing and detecting drug safety data in patient reported text
  • Kate Slawsky, MPH – an outcomes researcher helping to develop custom surveys for our partners and our platform
  • Shivani Bhargava – a research assistant supporting the team in ensuring our platform holds high-quality data about our patients

Thank you all for having a voice in research. There’s so much being learned from what you are sharing every day, and we are excited about what 2011 will bring.

PatientsLikeMe member pwicks


A new gene for ALS: What sharing your genetics could mean for research

Posted February 27th, 2009 by

In today’s issue of the journal Science two papers describe the discovery of a new gene for ALS (you can read the abstracts here and here). Around 90% of ALS cases are sporadic, i.e. we don’t know what causes them, but for 5-10% of patients the disease runs in their family (known as familial ALS, FALS). Until today, there was only one major causative gene that we knew about, called SOD1, which accounted for 20% of familial cases. Today’s new discovery of the gene FUS (also known as ALS6) accounts for an additional 3-5% of familial cases and was the result of an international collaboration between scientists in Boston, London, and Sydney. This is very exciting for research because the more we know about what causes ALS, the better our chances of finding an effective treatment through better understanding of the pathways involved in motor neuron degeneration.

Here at PatientsLikeMe, we’ve recently upgraded our ALS platform to capture data on familial ALS patients’ known genetic mutations. The goal is to help familial ALS patients find another patient like them, and to enhance understanding of the phenotype of each mutation, e.g. if different types of mutation cause a faster or slower disease progression. Ultimately our aim is to try and establish whether there might be any treatments that have a differential effect on patients with different disease-causing mutations. There are examples of this already known in other diseases; for instance the presence of absence of the Philadelphia chromosome in chronic myelogenous leukemia (CML) predicts whether the patient will respond to the drug Gleevec. Although there is currently only a single effective treatment for ALS (Rilutek), there are a number of trials underway investigating the potential of drugs for patients with specific gene mutations.

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The unique outcome data captured on the PatientsLikeMe platform also allows us to learn more about the nature of the disease for FALS patients with different genetic mutations. In the graph above you can see the average rate of progression for patients with three different FALS mutations; the common and aggressive A4V mutation (sadly average survival is ~18 months), the rarer recessive D90A mutation (much longer average survival of ~13 years), and a very rare and recently identified mutation of VAPB, referred to as ALS8. Collecting genetic data and combining it with high-quality patient-reported outcomes helps a patient to answer the question “Given my status, what is the best outcome I can expect to achieve, and how do I get there?”.

Note: If you have familial ALS and know your genetic mutation status please consider joining our ALS community and sharing your genetic information through your diagnosis history.

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