Photo Courtesy of WVU Medicine
MORGANTOWN — World-leading brain experts at West Virginia University’s Rockefeller Neuroscience Institute are celebrating the historic breakthrough Alzheimer patients around the globe have been awaiting.
“For Alzheimer’s, there’s not that many treatments available, despite hundreds of clinical trials over the past two decades and billions of dollars spent,” said Dr. Ali R. Rezai, a neurosurgeon at WVU who led the team of investigators that successfully performed a phase II trial using focused ultrasound to treat a patient with early stage Alzheimer’s.
The WVU team tested the innovative treatment in collaboration with INSIGHTEC, an Israeli medical technology company. Earlier this year, INSIGHTEC was approved by the U.S. Food and Drug Administration to begin a phase II clinical trial of the procedure, and selected the WVU Rockefeller Neuroscience Institute as the first site in the United States for that trial.
Last summer, researchers at Sunnybrook Health Sciences Centre in Toronto reported the results of a phase I safety trial showing they could reversibly open the blood-brain barrier in Alzheimer’s patients.
The procedure in West Virginia involved the use of ultrasound waves focused through a specialized helmet with more than 1,000 probes targeting a precise spot in the brain, Rezai explained, coupled with microscopic bubbles.
“And when we put a different frequency of ultrasound on the bubbles, they start osculating,” he said.
The reaction opens up the brain-blood barrier — a nearly impenetrable shield between the brain’s blood vessels and cells that make up brain tissue.
“It’s protected on one end for us to function but also prevents larger molecules or chemotherapy or medications or anti-bodies or immune system cells or amino therapy or stem cells to get in,” he said.
In this case, the West Virginia team targeted the hippocampus and the memory and cognitive centers of the brain that are impacted by plaques found in patients with Alzheimer’s.
“Plaques are these clusters of proteins that accumulate and they block-up the brain’s connectivity,” he said. “In animal studies it showed that these plaques are cleared with ultrasound technology.
The first patient, a person Rezai called a pioneer and hero, is West Virginia health care worker and former WVU Children’s Hospital Neonatal Intensive Care Unit nurse Judi Polak.
“I think that with Alzheimer’s there’s so much in the unknown and I’ve been with Health Science for a long time and I understand that we need to be able to step forward and look into the future,” Polak said.
But getting to this point was a long journey beginning five years ago when she was first diagnosed with early-onset Alzheimer’s.
When we have a relative or someone close to us suffering from a health issue it can be hard to find the right words to say. You want to be encouraging and positive but also sympathetic. You may feel nervous about saying the wrong thing.
Here are six things you should NOT say and six things to say instead:
1. Bringing up God or faith: When Michelle Pierce’s daughter, Ali, was diagnosed with stomach cancer and liver disease at 15, Pierce was shocked by a local pastor’s statement. “He told me we were going through this because of my lack of faith,” said the 42-year-old Mountain Home, Ark. resident.
“Blaming is hurtful,” said Lipson. “You really have to be careful about bringing up religion. Whether you should do so depends on your personal relationship with them [the people in a health crisis].”
What to say instead: Lipson suggested asking the person, “How do you feel about what happened to you?” or “What do you think is going on?” She also said do not say, “Everything happens for a reason” or “God doesn’t give us more than we can handle.”
2. Asking a person his or her prognosis or telling stories of people who have had the same condition who didn’t have a positive outcome: “I think it’s human nature to do that, to tell stories,” said Sal Raichbach, a psychologist in Jupiter, Fla. “Every person deals with adversity and pain, but try to avoid comparisons.”
What to say instead: Lipson said the most important thing to do is to make the person feel he or she hasn’t lost any power. “Empower the person to believe in positive strength,” said Lipson. She added it’s OK to ask, “How’s it going?” or “How are you feeling?” And if you know of specialists and the person hasn’t begun treatment, you can offer a referral to a specialist.
3. Making negative statements about appearance: In addition to not saying “you look like you’re wasting away,” avoid uttering that the person looks tired or “washed out.” Raichbach said: “People know what they look like. The more you say, the worse it’s going to come out.”
What to say instead: Lipson points out that commenting on appearance is tricky. “You don’t want to ignore the problem, but you can say something in a way that isn’t cruel,” she said. “If the person makes a comment about their appearance first, telling them, ‘I see it’s been hard on you’ is acceptable and then ask if there’s anything you can do for them.”