Dr. Moura discusses how her American Brain Foundation-funded research eventually led to a widespread adoption of patient-reported outcome (PRO) tools and the impact of the work she’s doing with the Center for Value-Based Health Care and Sciences.

At the American Brain Foundation, we know that funding research lays the foundation for future breakthroughs in diagnosis, treatments, and cures for all brain diseases. Through our partnership with the American Academy of Neurology, our Next Generation Research Grants provide support for a broad range of innovative projects from early-career researchers.

Lidia Maria Moura, MD, MPH, PhD, received a research grant funded by the American Brain Foundation in 2014. She went on to receive additional research support from the American Epilepsy Society and the Epilepsy Foundation, as well as the National Institutes of Health, to investigate epilepsy quality measures and patient-centered outcomes. She currently leads the NeuroValue Lab, is co-director of the Center for Value-Based Health Care and Sciences at Massachusetts General Hospital and is an Associate Professor of Neurology at Harvard Medical School. Her current research draws from neuro-psychiatric epidemiology and incorporates clinical, behavioral, and economic perspectives to design coordinated care delivery models for neurological care.

We spoke with Dr. Moura about how her early American Brain Foundation-funded research impacted her career as a researcher and how this project led to the development of revolutionary patient-reported outcome (PRO) tools that have since been adopted by the American Academy of Neurology. She also discusses the importance of supporting research and her current work with the Center for Value-Based Health Care and Sciences.

Dr. Moura’s responses below have been edited for clarity.

What research did the American Brain Foundation’s 2014 Clinical Research Training Fellowship enable you to work on?

The American Brain Foundation’s 2014 Clinical Research Training Fellowship enabled me to work on a project titled “Variation in quality of epilepsy care and associations with patient-centered outcomes.” In 2014-2016, we piloted and launched the patient-reported outcomes (PRO) program, which is now one of the largest real-life PRO programs in the world. Through this research I demonstrated how systematic collection of provider-reported data linked to patient-reported outcomes and other sources of data (e.g., pharmacy and claims) can help assess and improve outcomes for patients with epilepsy. 

(Read more about this groundbreaking research study here.)

What are patient-reported outcomes, and why are they important?

PROs allow us to integrate the patient’s voice into their care, converting it to a quantitative measure to assess whether their condition is improving or worsening. They empower patients to express their voice in health outcomes in a quantifiable, validated manner, reducing the chance that implicit bias could skew the provider’s understanding or assessment of the patient’s symptomatology. PROs became one of our best indices of quality and value in health care, and they are now one of our most powerful tools to promote health care equity.

How did this early American Brain Foundation-funded grant open doors for additional research funding or future research projects?

In addition to protecting my time for research, the Clinical Research Training Fellowship allowed me to afford the tuition fees of my master’s degree program at Harvard. My master’s training helped me improve the quality of my research and gave me additional research skills, both of which were fundamental in applications that seed-supported the Center for Value-Based Health Care and Sciences.

Additional manuscripts I have since published with colleagues have also promoted awareness of the key challenges and disparities in care delivery—for example, uncovered gaps in patient-provider communication, social stigma with the word epilepsy, and safety issues with patients reporting seizures while driving.

What impact has this research had on your career and within your field?

My methods and instruments have been adopted by other institutions nationally and internationally. I have been invited to give talks at the American Academy of Neurology meetings since 2014. In addition, I was invited to chair or join special interest groups, subcommittees, and committees of the American Academy of Neurology, American Epilepsy Society, and American Neurological Association. After years of publishing my findings and many national advocacy efforts, systematic collection of patient-reported outcome metrics became part of AAN care quality metrics.

The Center for Value-Based Health Care and Sciences has also joined the Epilepsy Learning Healthcare System. Within this initiative, we systematically measure provider performance, patient-reported outcomes, and costs across multiple centers, while enabling researchers to run comparative effectiveness and other study designs. Specifically, I lead the data coordinating center, which brings together data from more than 15 academic institutions and several community centers.

What specific issues is your current research with the Center for Value-Based Health Care and Sciences trying to address?

The Center for Value-Based Health Care and Sciences guides clinicians, patients, and administrators towards higher value, safer, and more equitable medical care via scientific discovery, practice innovation and care redesign, and instruction of a future generation of providers and health-services scientists.

Our vision is to help develop a health care system that is sustainable and resilient during future pandemics, through economic and policy changes, and other major health care shocks such as new and expensive drugs and devices.

What would additional research funding and support enable you to accomplish right now?

In our Center for Value-Based Health Care and Sciences, I have experience in successfully implementing and evaluating practice change, and expertise in epidemiology, implementation, and validation sciences. We also host the learning health care system’s data operations—a data coordinating center for a quality improvement and implementation network of 15+ academic institutions.

However, there are multiple challenges we are trying to overcome, all of which were potentiated by the pandemic economic crisis. To list a few: paucity of essential human resources like quality improvement and program management personnel, data analysts, and post-doctoral students; lack of strategic program investments, such as performance-based incentives for participating clinicians; and limited infrastructure, including data platforms and other critical elements to support program implementation and evaluation.

Investment in the Center for Value-Based Health Care and Sciences now will bolster our ability to help clinicians, patients, and administrators towards the inevitable future of health care—one that focuses on the well-being of health care providers while rewarding every stakeholder for improved patient-reported outcomes.

The American Brain Foundation is committed to supporting the next generation of brain disease researchers. By donating today you can help us achieve a future without brain disease.

At the American Brain Foundation, our vision of Cure One, Cure Many drives our commitment to brain disease research. 

The American Brain Foundation funds research across the entire spectrum of brain diseases because we know the brain is interconnected and there are common threads that link many different diseases. If we find a cure for one disease, it will lead to cures for other diseases.

This connection between brain diseases was the focus of our recent Cure One, Cure Many webinar. Our guest, Frances Jensen, MD, FACP, FAAN, spoke about the impact of brain research and opportunities for future research. Dr. Jensen is a professor of neurology and chairman of neurology at the Perelman School of Medicine at the University of Pennsylvania, as well as co-director of the Penn Translational Neuroscience Center. She is also the current president of the American Neurological Association and member of the American Brain Foundation board of directors.

A Critical Moment in Research

Right now is a critical moment in the field of neurology and neuroscience. To provide some context, Dr. Jensen points out how many incredible breakthroughs have happened in the past 10 years, including the development of treatments to reverse strokes in progress, epilepsy drugs, immunotherapies, new biomarkers for a range of diseases, and gene therapy. “It’s extraordinary,” she says. “We can only hope for more, and I truly believe we’re at an accelerative moment.” 

Dr. Jensen believes “new neurology” is the fastest-moving area of biomedicine and clinical medicine. In recent years we have seen clinical diagnostic innovations and the introduction of highly sophisticated technology built upon a foundation of research. These advances are allowing researchers to observe the effects of treatment and disease progression in humans, not just animal models and cell cultures. 

This progress is important because the prevalence of neurologic and other brain-related disorders is increasing across our lifespan. The burden of brain disease is significant, both in its emotional toll on the lives and families of people affected and as measured in disability-adjusted life years and yearly economic cost. This impact is growing, especially with age-related neurodegenerative disorders such as Alzheimer’s disease and other dementias.

As researchers look deeper into the mechanisms of brain disease, possible genetic factors, better imaging and diagnostic technology, and other areas, we are increasingly recognizing how many brain diseases are actually related. Dr. Jensen suggests that rather than identifying diseases by individual names, in the future, brain diseases could be grouped or classified by their similar characteristics, such as “channelopathies,” “disorders of metabolism,” or “protein accumulation disorders.”

“One of the things that really resonates for me,” Dr. Jensen says, “is this idea of cure one, cure many. [Researchers are] sharing information. Something somebody learns in migraine might inform epilepsy. Something somebody learns in dementia might inform Parkinson’s disease.”

This connection between diseases is igniting an industry-wide effort to share research and the results of clinical trials. “I think we are beginning to see this kind of acceleration because people are communicating and scientists are sharing information, and they’re not only focusing on a single disease,” she says. “We’re able to use the very same metrics and we can gather data across different types of diseases and mine the data for similarities.”

Using Imaging to Understand the Brain

Dr. Jensen points specifically to the importance of imaging technology in advancing our understanding of the brain and how its different parts and functions are connected. When researchers can more accurately map neural pathways and networks in the brain, they can better understand how diseases affect specific areas. 

As an example, she showed how imaging is used in epilepsy research to “track” a seizure’s progress in the brain. The hope is that if scientists can discover the source of seizures and how they move through the brain, we can learn how to regulate the brain’s electrical signals better and enable it to function normally again. This knowledge could potentially apply to other circuit disorders like Parkinson’s disease and tremor. Related research is looking at using programmable, interactive electrodes and other non-invasive ways to stimulate specific areas of the brain.

Researchers are also starting to use artificial intelligence and other tools to analyze brain images and identify different markers of disease or potential genetic patterns. In some cases, researchers are pairing brain imaging with blood samples to better understand conditions like traumatic brain injury (TBI) and Alzheimer’s disease. When taken in conjunction with brain imaging that shows the presence of TBI or Alzheimer’s, blood tests may help to identify biomarkers that can aid in early diagnosis or assessment of the severity of a particular disease or condition. 

“We’re getting to that level of resolution, and it’s not just movement disorders, Parkinson’s, Lewy body, Alzheimer’s, and TBI,” Dr. Jensen says. “This could be used in epilepsy, in migraine—we don’t know yet, but this is, again, this idea that you can apply the same kind of method to multiple diseases.”

Treating Common Characteristics of Brain Diseases

Research benefits when people studying brain function (or dysfunction) as a whole aren’t constrained to seeing it through the lens of one disease. Dr. Jensen discussed how focusing on similar characteristics across different diseases can help researchers unlock insights about potential treatments—such as the use of antibodies to reduce abnormal protein deposits in brain diseases like Parkinson’s, Lewy body dementia, and other dementias.

“You can see these are different diseases, but [treatments arose out of] the same idea—that you need to use an antibody to take away an abnormal protein,” she says. “Again, this kind of science has come out of the Cure One, Cure Many mindset.”

Breakthroughs in newer areas—such as stem cell transplants to treat Parkinson’s disease—offer another example of how learnings from one area can apply to another. “We’re better [able] to understand how to make stem cells work by having seen how successful, or at least partially successful, other treatment methods [like dopamine supplementation or deep brain stimulation] have been,” Dr. Jensen says.

How Making Connections Fuels Progress

Dr. Jensen’s examples show that current brain research is breaking down silos between different diseases. “This is not a pipe dream anymore,” she says. “When we talk about brain research, often we’re talking about ‘one day in the future, we’ll do this. We’ll do that.’ I’m here to tell you that it happened. We have advances already, from this last decade even, of incredible cross-cutting brain research because of this way of thinking about breaking down silos.”

Dr. Jensen does note one challenge to this more interdisciplinary approach to research: When studies are not tied to one specific disease, it can be difficult to get funding. “This is like 21st century research funding,” she says. “It’s not like the old way of doing things. It doesn’t fit traditional funding mechanisms.”

She recognizes that the American Brain Foundation is uniquely positioned to help move the research cycle from its early stages to clinical settings, practice, and beyond. “I think [the Foundation] has the opportunity to take advantage of discoveries that are emerging in one field and help us expand and amplify the importance of those findings,” she says. 

What is the impact of expanding and amplifying research? Large-scale population-based and lifespan research has already provided important insights into different risk factors like hypertension, obesity, and diabetes as well as public health disparities. All of these findings help scientists understand what makes someone more or less likely to develop a brain disease, which in turn can help improve early detection, diagnosis, and treatments.

The American Brain Foundation encourages collaboration and research in more general areas that could have applications across diseases. “One of the most common and easy ways to have these collaborations is in the training of young investigators—to help them develop this kind of mindset of being more open-minded outside of their single silo,” says Dr. Jensen. 

In addition to supporting up-and-coming researchers, the American Brain Foundation partners with many different organizations. For example, the Foundation recently formed a research initiative focused on neuroinflammation, bringing together many associations focused on single diseases to collaborate on research. As another example, the Alzheimer’s Association and the Michael J. Fox Foundation support the American Brain Foundation’s recent research grant awarded to a team of scientists to accelerate progress in the diagnosis of Lewy body dementia. 

Because so many brain diseases share common mechanisms, a breakthrough for one disease will lead to breakthroughs for many others. While brain disease research is moving quickly and changing rapidly, researchers need continued funding to maintain and build upon this recent progress. The American Brain Foundation will continue to fund and support research across the full spectrum of brain diseases with the confidence that when we cure one disease, we will cure many.

The American Brain Foundation was founded to bring researchers and donors together in the fight against brain disease. Learn more about brain disease or make a gift to support groundbreaking brain disease research.

New brain disease research delivers groundbreaking diagnosis techniques, updated prognosis methods, and simple ways to improve quality of life.

In this month’s news round-up, we discuss new ways to predict outcomes after traumatic brain injury and exercises that can help people with neurologic disorders. We also cover innovative new AI technology that will help doctors efficiently diagnose Alzheimer’s disease and research into the impact of iron buildup in the brain.

Blood-Based Biomarkers Help Predict Outcomes After Traumatic Brain Injury

Researchers have discovered a promising new way to more accurately assess an individual’s prognosis following traumatic brain injury (TBI). A recent study found that specific biomarkers can accurately predict someone’s risk of severe disability or death six months after TBI. Measuring biomarkers in the blood on the day of a TBI gives a more accurate prognosis than doctors were able to offer before.

In a study funded by the National Institutes of Health, researchers looked at two specific proteins in the brain (GFAP and UCH-L1) in nearly 1,700 people with TBI. Biomarkers of these proteins were evaluated on the day of the injury and then again six months later. The study found that high levels of GFAP and UCH-L1 measured on the day of TBI were strong predictors of severe disability or death within the following six months.

While measuring GFAP and UCH-1 is currently used to aid in detecting TBI, this new study suggests that measuring these proteins will also improve the accuracy of prognosis methods. Researchers found the predictive value of these biomarkers was strongest for people with moderate to severe TBI. More studies are needed to reproduce these results, but the current findings are an encouraging step toward helping those impacted by TBI plan for recovery.

Iron Buildup in Brain Linked to Higher Risk for Movement Disorders

Many people worry about having low iron levels, but for some, too much iron is a major concern. Caused by a gene mutation, hereditary hemochromatosis is a disorder in which the body absorbs excess iron, resulting in tissue damage and conditions like diabetes, liver disease, and heart problems. Doctors previously believed that the blood-brain barrier protected the brain from iron accumulation, but a recent study shows otherwise. The study found that people with two copies of the hereditary hemochromatosis gene mutation have substantial iron buildup in the brain. This buildup was found in regions of the brain responsible for movement, suggesting that this gene mutation could be a risk factor for developing a movement disorder such as Parkinson’s disease.

In the study, researchers conducted MRI scans for 836 participants, 165 of whom were at high risk for developing hereditary hemochromatosis. The scans of the high-risk individuals revealed iron deposits in the motor circuits of the brain. Researchers then looked at data from nearly 500,000 individuals and found that males with a high genetic risk for hereditary hemochromatosis had a 1.80-fold increased risk of developing a movement disorder. Many of those people did not have a concurrent diagnosis of hereditary hemochromatosis.

The study’s authors hope their work will bring more awareness to this condition so high-risk individuals can get screened for early detection. There are currently safe and approved treatments that can reduce excess iron and potentially prevent health issues associated with the disorder.

Exercises to Improve Balance Can Reduce Falls and Boost Confidence for People With Alzheimer’s Disease

Many people experience problems with balance as they age, but those issues are compounded for people living with neurologic diseases. Fortunately, doctors have found that targeted exercise can improve balance problems, reduce falls and improve quality of life.

Balance involves three different sensory systems. Proprioception is the body’s ability to sense movement, action, and location. The vestibular system, located in the inner ear, provides the brain with information about motion. Lastly, vision helps anticipate obstacles and where to place our feet. Maintaining balance requires gathering input from all three sensory systems, which can be an issue for people with neurologic diseases. For example, people with Alzheimer’s disease are often unsteady, people with Parkinson’s disease can have trouble controlling reflexes related to posture, and people with multiple sclerosis may lose feeling in their feet.

People with trouble balancing are more likely to fall and tend to be less social and more sedentary—all of which pose a health risk and affect quality of life. To counteract these negative effects of different brain diseases, researchers suggest regular exercise that targets balance, flexibility, and strength. Many experts suggest a stability ball as a particularly effective and affordable tool for improving balance because it engages all three sensory systems at once. The safest way to get started is to work with a physical therapist or personal trainer specializing in exercise regimens for people with neurologic challenges.

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Learn how gene therapy is helping researchers build a foundation for better, more effective brain disease treatments.

Research breakthroughs in recent decades have shown that gene therapy has the potential to be an effective treatment and diagnostic tool for various brain diseases. While there are still clear limitations and challenges to gene therapy for brain disease, genetic research has enabled us to develop deeper understandings of disease formation and progression and risk factors for multiple diseases and disorders. Below we discuss how some of these discoveries will help us develop better treatments for brain disease in the future.

How does gene therapy for brain disease work?

While brain diseases have many different causes, including one’s environment and complex biological factors, some are caused by a genetic mutation. When a gene is abnormal in some way, it affects a person’s normal bodily functions and development. By identifying specific gene mutations through genetic testing, researchers have been able to pinpoint the mutations responsible for many brain diseases.

Gene therapy works to correct a genetic mutation. A delivery vehicle, typically a harmless virus called a viral vector, provides the normal version of the mutated gene, which then over time distributes throughout the brain. While researchers have had some success using gene therapy to treat neurodegenerative diseases in rodents, it’s much more complex to apply the same treatment to humans. One challenge is the blood-brain barrier. This barrier is a protective mechanism around the brain. To deliver the normal version of a gene, a viral vector that is injected in the blood has to be able to cross the blood-brain barrier and reach different parts of the brain.

While it’s not quite the same as gene therapy, identifying the specific genes responsible for certain brain diseases has also laid the groundwork for advanced diagnosis and treatment options. When we know which genes correspond to specific diseases, doctors can make more accurate diagnoses and use more effective, targeted treatments. Gene testing can be especially helpful when diagnosing rare genetic brain diseases with presenting symptoms that may closely overlap with other more common disorders.

Can gene therapy cure neurological disorders?

Currently, no—but researchers are trying to develop more effective treatments that target DNA and specific gene mutations. Genetic research and tools like genetic testing may help in the development of new treatments for brain disease, even if those treatments aren’t yet complete cures. It is a victory when gene therapy leads to a significant improvement in brain disease symptoms or a clearer understanding of the mechanisms through which a disease impacts brain function. 

Breakthroughs in gene therapy help researchers learn more about how different delivery vehicles work, how to adjust treatments to make them safer and more affordable, and how to apply these findings to other diseases. Let’s take a closer look at some of the ways genetic research is making progress in brain disease diagnosis and treatment.

Genetic Research Leading to the Development of New Medications

Genetic research can lead to a greater understanding of why a disease develops and how it progresses—and in turn, how to more effectively treat it. Since 1993, scientists have known the genetic cause of Huntington’s disease—a hereditary (inherited) neurodegenerative brain disease that interferes with thinking, behavior, and movement—but there have been no treatments developed specifically targeting this genetic basis for the disease. 

Now, gene therapy is offering hope that new drug treatments could slow or stop the effects of mutated genes in diseases like Huntington’s. The development of drugs called antisense oligonucleotides (ASOs) for Huntington’s disease is one example of how research findings can lead to new drug therapies. 

ASO drugs are pieces of DNA or RNA that link to the disease-causing proteins produced by mutated genes. They can then stop accumulation of these harmful proteins or can replace missing ones in order to rebalance protein levels. While ASO drugs are invasive and not yet widely used, they represent an important step toward improved treatments for Huntington’s disease—and perhaps other brain diseases in the future.

Gene Therapy Shows Promise for Treating Certain Neurodegenerative Diseases

A recent clinical trial shows promise for delivering gene therapy directly to specific parts of the brain by viewing its effects in real time using magnetic resonance imaging (MRI). For this trial, scientists at Ohio State University administered gene therapy to children with a rare neurodegenerative brain disease. 

The disease involves a deficiency that affects the body’s ability to make dopamine and serotonin, which are neurotransmitters or “messengers” in the brain. When this happens, it can cause developmental delays, behavioral problems, and movement issues.

After receiving gene therapy directly to the midbrain, children in the clinical trial saw improvement in symptoms like eye spasms, sleep disturbances, and issues with head control. With the success of this trial, researchers are hopeful that brain-delivered gene therapy could be used to treat other more common neurodegenerative diseases like Alzheimer’s and Parkinson’s disease.

Genetic Testing May Help Diagnose Brain Disease Earlier in Life

The connection between gene mutations and specific brain diseases can help with earlier diagnosis and treatment. Genetic testing, often done through a blood sample, can detect any abnormal or mutated genes. This information can help doctors identify whether a person has a specific disease, is at risk to develop a disease, or is a carrier of a gene mutation they could pass along to their children.

Gene mutations can either cause a condition or increase a person’s risk of developing it, and often multiple genes can play a role in a specific brain disease. There are also different types of genetic testing: diagnostic, when someone has symptoms of a disorder, and presymptomatic, when a person doesn’t have symptoms but has an increased risk based on family history or environmental factors.

As researchers learn more about major and minor gene mutations and which ones may cause certain disorders, genetic testing could become a more helpful tool. Because genes are passed down through family members, the findings of a genetic test can have an impact beyond the person who undergoes testing. It’s also crucial to consider how the results of genetic testing may impact a person’s life and inform potential treatment options. While testing can provide answers, it can also open up more questions.

These three areas—development of new medications, new treatment methods, and genetic testing—are evidence that genetic research has the potential to revolutionize the the way we understand, diagnose, and treat many different brain diseases. This type of research helps make progress toward more effective treatments for all brain diseases. Because the brain is interconnected, as we discover more about genetic mutations and gene therapy for one disease, we will be able to apply these learnings to help treat other brain diseases.

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The latest brain disease research paves the way for innovative new testing, diagnosis, and treatment options for various brain diseases and disorders.

In this month’s news round-up, we look at a groundbreaking new test for Alzheimer’s, the discovery of a missing link in its development, and how an innovative brain imaging study may help treat Alzheimer’s disease and other dementias. We also explore the potential of blood treatments for people with a rare neurologic disorder and how your diet can affect brain health.

Single Brain Scan Can Diagnose Alzheimer’s Disease

Promising new research shows that doctors may be able to diagnose Alzheimer’s disease with a single MRI scan of the brain. Using machine learning technology, researchers analyzed structural features such as shape, size, and texture in each brain region, including those not previously linked with Alzheimer’s. They then developed an algorithm that was able to identify whether a person had Alzheimer’s disease based on specific changes to these specific areas of the brain with 98% accuracy. Perhaps the most exciting aspect of this new method is that it can identify the disease in the early stages when it’s usually difficult to diagnose.

This approach is a vast improvement over current methods of diagnosis, which usually include a series of cognitive and memory tests and brain scans that can take weeks to schedule and process. In contrast, this new approach requires a single MRI scan using a standard machine found in most hospitals. While there currently isn’t a cure for Alzheimer’s disease, early diagnosis could open up possibilities for better treatments and even enable doctors to prevent symptoms from worsening. Accurate early-stage diagnosis will also help researchers learn more about the brain changes that trigger the disease and support the development of effective new treatments. Learn more about how this research can revolutionize the diagnosis of Alzheimer’s disease.

Researchers Develop New Method of Imaging Brain Inflammation in Extreme Detail Over Time

Researchers ​​from the Institute of Neurosciences UMH-CSIC have developed a new brain imaging method that allows them to visualize brain inflammation in greater detail than ever. The technique, using diffusion-weighted magnetic resonance imaging (dw-MRI), can detect the activation of two specific types of brain cells often responsible for chronic inflammation: microglia and astrocytes. This allows researchers to create more detailed images of brain inflammation than current positron emission tomography (PET) scans. 

One of the reasons dw-MRI generates much higher resolution images than other non-invasive brain imaging techniques is that the technology can differentiate between specific types of cells. This means that in addition to more detailed images, researchers can use the scans to distinguish inflammation associated with neurodegeneration from other conditions like the demyelination exhibited in multiple sclerosis.

The new technique using dw-MRI is also non-invasive and safe to use repeatedly over a long time, making it especially useful for doctors and researchers attempting to chart the progression of neurodegenerative diseases like Alzheimer’s, Parkinson’s, and other dementias. Learn more about this innovative new brain imaging method.

Foods With Flavonoids May Reduce the Risk of Parkinson’s Disease

So many risk factors for Parkinson’s disease can’t be controlled, such as genetics and age. But what if there was a factor you could control? The latest research suggests there is: your diet. A recent study found that regular consumption of flavonoid-rich foods has been linked to fewer deaths among those with Parkinson’s disease.

Flavonoids are plant-based compounds found in fruit, vegetables, chocolate, and beverages like tea and red wine. Flavonoids can reduce inflammation by scavenging cell-damaging free radicals in the body. In people with Parkinson’s, flavonoids can reduce the loss of dopamine-producing brain cells, slowing down neurodegeneration. “Adopting a healthy diet, high in colorful fruits and veggies, even after a Parkinson’s diagnosis, could slow disease progression and improve survival rates,” says lead author Xiang Gao, MD, PhD, chair of the department of nutrition and food hygiene at Fudan University’s School of Public Health.

Flavonoids are also thought to protect against other health issues, such as cardiovascular disease, stroke, high blood pressure, and even depression. More and more research supports the idea that flavonoid-rich diets are essential for brain health and good health overall. Kellyann Niotis, MD, a neurologist at Weill Cornell Medicine, acknowledges that “there’s no magic bullet for preventing neurodegenerative diseases like Parkinson’s, but we all can make brain-healthier choices. Adhering to a diet rich in antioxidants and flavonoids may positively affect Parkinson’s disease risk, trajectory, and related complications.” Learn more about the link between diet and Parkinson’s disease.

Scientists Uncover One of the Driving Forces of Alzheimer’s Disease – New Target for Treatment

While there are still gaps in our understanding of how Alzheimer’s disease develops in the brain, groundbreaking new research is starting to fill those gaps and offer hope for the future. A recent study from Flinders University explores how tau proteins—a crucial factor in the development of Alzheimer’s disease—go from healthy to diseased. For decades, neuropathologists have known that accumulations of modified tau proteins in the brain are associated with Alzheimer’s disease. However, it has remained unclear how or why tau proteins become modified and form toxic deposits inside brain cells.

This new study has solved part of that mystery by discovering specific “control sites” on the tau protein through which modifications can be made via protein kinase enzymes. Targeting these “control sites” could enable researchers to significantly reduce tau proteins’ toxic properties in the brains of people with Alzheimer’s disease.

The next steps for the research team are to investigate how their findings may be used to develop new Alzheimer’s treatments. “We have shown that this new concept has therapeutic potential, but future work is needed to understand the role of these master sites in health and disease,” says study lead author Kristie Stefanoska, PhD, Research Fellow in Dementia at Flinders University. Further research will also affect other neurologic disorders that involve tau proteins, such as Parkinson’s disease, CTE, Pick’s disease, and many others. Learn more about the future implications of this breakthrough research.

Preliminary Study: Blood Treatment Is Safe, May Help Treat Stiff Person Syndrome

Stiff person syndrome is a rare neurologic disorder characterized by muscle spasms and stiffness. While symptoms may come and go in the early stages, they eventually become constant. Finding safe and effective treatments can be a struggle, which is why doctors are excited about this new research. A small preliminary study found that a blood treatment called plasmapheresis improved symptoms, function, or both for many of those being treated for stiff person syndrome.

The treatment, also known as therapeutic plasma exchange, cleans the blood by replacing an individual’s plasma with albumin, a naturally occurring protein that can be made from donated plasma. Although the study was small, its findings are encouraging and will lead to further research. “Finding a new way to treat a debilitating and painful disease that has few side effects or risks is a big win. The findings of our research help promote awareness of a treatment that may lead to relief for some people living with stiff person syndrome spectrum disorders,” says study author Scott D. Newsome, DO, of Johns Hopkins University. Read about the full study and the research team’s findings.

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James Grotta, MD, FAAN, explains stroke warning signs and why it’s necessary to seek immediate medical care—even during the COVID-19 pandemic

James Grotta, MD, FAAN, Director of Stroke Research at the Clinical Institute for Research and Innovation at Memorial Hermann Hospital, hosted a Facebook Live with the American Brain Foundation to discuss stroke and COVID-19. “The presence of this pandemic has affected the way we manage stroke as physicians, as nurses, as healthcare providers, and also affects the way patients at risk for stroke are dealing with their disease,” Dr. Grotta explains. Watch his video to learn more about what stroke is, how to identify warning signs as they occur and the most effective ways to prevent stroke.

Stroke Care During the COVID-19 Pandemic

Dr. Grotta reminds us that while hospitals have stopped elective procedures in order to ensure that space, staff and equipment are available to treat COVID-19 patients, stroke treatment is not elective. “We can’t ignore stroke or heart disease, or any other common conditions, just because COVID-19 is going on,” he says. In the US, at least 140,000 people die from stroke every year. Not seeking treatment can be fatal or cause long-term neurological deficits.

Despite this, the COVID-19 pandemic has reduced the number of people calling 911 and seeking life-saving stroke treatment. “People may not want to go to the hospital because of COVID-19 risk and they might think the numbness may go away,” he explains. However, due to the nature of strokes, patients should seek treatment as soon as possible. He goes on, “If you call 911, you’re going to get treated faster and better than if you go to the hospital on your own.”

Dr. Grotta assures patients that hospitals have the ability to treat stroke patients safely. Though the emergency room is busier than before, hospitals “in most parts of the country are able to sequester and deal with COVID-19 patients, and allow stroke patients to be managed separately” with some added protections to maintain safety and cleanliness. His institution uses a mobile stroke unit, specifically deployed to treat stroke patients quickly on the scene.

He also adds that some patients who experience strokes do turn out to have COVID-19—as this virus affects more than just breathing. “It can also affect the nervous system and cause blood clotting in the vessels, which may predispose you to have a stroke,” he says.

What Is Stroke?

Stroke is a brain disease that comes on suddenly—either as the result of a blood clot or a hemorrhage. The first type occurs when “the blood vessel in the brain supplying blood to the brain blocks off suddenly,” Dr. Grotta explains. These clots result in the death of the surrounding brain tissue. “The blood clot needs to be dissolved and opened as soon as possible,” he says.

“Another type of stroke is caused by bleeding, as in brain hemorrhages,” says Dr. Grotta. In this case, the bleeding must be stopped quickly to avoid long-term damage or death.

Stroke Warning Signs

It’s important to know the signs and act immediately to get patients the treatment they need. The following acronym helps people identify the signs of stroke in themselves, loved ones and anyone close by.

BE-FAST

• Balance – Sudden dizziness or loss of balance and coordination
• Eyes – Difficulty seeing
• Face – One side of their face is drooping
• Arm – Can’t lift their arm or are experiencing weakness or numbness in the arm or leg
• Speech – They have slurred speech or are unable to talk
• Time – React right away and call 911

Other symptoms of stroke can include severe headache, vertigo and visual loss that come on abruptly.

Dr. Grotta explains that because patients tend to minimize their symptoms, it is up to others close by to recognize them and ensure they get emergency care as soon as possible. Strokes damage the brain, which means the patient may be unable to react due to their symptoms. If you see stroke symptoms, don’t delay calling 911.

“We now have treatments that can be effective even 12-24 hours later. There is still an option for treatment. A subset of those patients still have salvageable tissue that can be recovered,” he says. He urges those who observe stroke symptoms to react as soon as possible. Even if the stroke occurred during the night or while they were out, it’s still important to seek urgent emergency care as soon as the symptoms are discovered.

Stroke Prevention

There are effective ways to prevent stroke—either through medication or lifestyle changes like starting a healthier diet and exercise routine. While lifestyle changes can be difficult, Dr. Grotta offers hope: “We changed our lifestyle overnight to a stay-at-home lifestyle. If we can make this big lifestyle change overnight, we can make changes that are healthy for us such as lifestyle and diet.”

When it comes to medication, Grotta tells patients to schedule and keep telehealth appointments with their healthcare providers or stroke specialists and to not let their prescriptions lapse. “Don’t let your blood pressure or anticoagulant medication prescription run out. Blood pressure is the single most important risk factor for stroke. Don’t run out of your medications,” he cautions.

While COVID-19 is going to change the way strokes are managed in the hospital and by prehospital providers, Dr. Grotta assures patients that at most places in the country, there is plenty of capability to care for both COVID-19 and stroke.

The American Brain Foundation was founded to bring researchers and donors together in the fight against brain disease. We believe that when we cure one disease, we will cure many. Learn more about stroke and other brain diseases or help us in our mission by giving today.