November is Alzheimer's Awareness Month, when we bring attention to this devastating disease and show support for the millions of people affected by it. Let’s first discuss the difference between Alzheimer’s disease and dementia. Dementia is an overall term for a group of symptoms that include difficulties with memory, language, problem-solving, and other thinking skills. These symptoms reflect changes in the brain. Alzheimer’s disease is a neurodegenerative disorder clinically characterized by dementia. So, Alzheimer’s is one type of dementia. Other types include vascular and mixed dementia.
Q: What do we know about Alzheimer’s disease?
Scientists don’t yet fully understand what causes Alzheimer’s disease, but it is likely the result of several factors. Changes in the brain can begin years before the first symptoms appear. We know a bit about the risk factors, however, which include age, naturally, because symptoms usually appear after age 60, and the risk increases with age. A family history of the disease and an unhealthy lifestyle may also increase the chances of getting Alzheimer’s. Studies have shown that adequate physical activity, a good diet, limited alcohol consumption, and not smoking may reduce the chances of getting Alzheimer’s disease.
Q: How is Alzheimer’s disease diagnosed and then treated?
Doctors base Alzheimer’s diagnoses on medical history, physical exams, diagnostic tests, and the characteristic symptoms of certain brain changes. As for treatments, certain therapies can remove beta-amyloid, one of the hallmarks of Alzheimer’s disease, from the brain. This can reduce or slow cognitive and functional decline, but not stop it altogether. Certain drugs, too, can help reduce or control the cognitive and behavioral symptoms of Alzheimer’s.
An understanding of neuroscience — the study of the human nervous system — is essential to understanding Alzheimer’s disease, the most common type of dementia. The disease is caused by damaged neurons (nerve cells) in the brain, which are needed for thinking, walking, talking, and all other human activity. Alzheimer’s disrupts communication among neurons, resulting in loss of function and cell death. People with Alzheimer’s disease gradually lose the ability to live and function independently. There is no known cure for Alzheimer’s, but some treatments may change disease progression.
Neuroscience encompasses other brain issues, as well. We recently had the opportunity to talk with Dr. Darren Ó hAilín, a lecturer and module lead for neuroscience at American University of the Caribbean School of Medicine (AUC), United Kingdom (AUC UK Track). He is also on the faculty at the University of Central Lancashire (UCLan), where AUC’s UK Track program is based. Dr. Ó hAilín holds a doctorate in biology, a master’s in neuroscience, and a bachelor’s in psychology and sociology. He is a member of the Anatomical Society and the British Neuroscience Association.
Q: You’ve researched other brain issues, including FOXG1 syndrome. What can you tell us about that?
A: FOXG1 syndrome is a severe genetic disorder affecting development of the brain. Patients usually suffer from seizures, movement abnormalities, intellectual disability, sleep disturbances, and impairments in communication and language. The disorder is very rare. Only about a thousand cases have been confirmed worldwide, but it’s highly likely that the prevalence is higher as it is often misdiagnosed. Diagnoses have been steadily rising as we have greater access to sequencing techniques and clinicians are becoming more knowledgeable of the disorder.
Q: Does an understanding of FOXG1 syndrome help doctors and scientists better understand Alzheimer’s disease?
A: Most of the research into FOXG1 syndrome links it to autistic spectrum disorders rather than dementia, but we do know that the FOXG1 gene is implicated in the development and function of an area of the brain known as the hippocampus, which is severely affected in people with Alzheimer’s disease. This connection is unlikely to lead to a major breakthrough in Alzheimer’s research, but it may play some small part in mapping function and dysfunction of the brain in general.
Q: You’ve also done research on glioblastoma brain tumors. What are they?
A: Glioblastoma is a type of highly malignant tumor affecting the brain and sometimes the spinal cord. It most often occurs after the sixth decade of life but can affect people of any age. Our current treatment strategies are palliative, as the disease is unfortunately fatal.
Can you tell us about some areas of glioblastoma research that may help develop treatments?
A: Clinicians are increasingly recognising that glioblastoma is less a single type of tumor, but more likely a group of molecularly distinct subtypes. In other words, two seemingly identical glioblastoma tumors may have different genetic profiles, which may influence how they respond to treatment. A promising area of research looks to leverage these differences in molecular profile to target specific vulnerabilities in a given tumor, so that each patient’s treatment would be tailored to the gene expression of their own tumor rather than to a broad diagnosis. The complexity of glioblastoma unfortunately means we may be decades away from new effective treatments, but advances in sequencing technology give us reason to be optimistic.
Q: Can you fill us in on another of your areas of interest, epigenetic modification?
A: Broadly speaking, epigenetic modifications are changes in what genes do without changing the actual DNA sequence. This most often means turning a gene on or off. These modifications are an integral part of embryonic development, learning and memory, and even in the division of cells that occurs in our bodies every day. Some of these changes are heritable, but they also can be influenced by the environment. A person’s gene expression today, for example, could be influenced by the food eaten by their grandparents before they were born.
Q: What drew you to neuroscience?
A: Teaching about or researching the human brain means delving into a whole spectrum of disciplines under the “neuroscience” umbrella. Pursuing a career in neuroscience, particularly in a teaching role, allowed me to engage with everything from how molecules interact within a cell to how people interact within a society.
Q: Did your interest in neuroscience develop from your undergraduate work in psychology?
A: My undergraduate in psychology was mostly from an arts and humanities perspective, but I found myself drawn more to the hard sciences at an early point in my degree. I took as many neuro-adjacent electives as I could, such as neuropsychology, cognitive sciences, etc. This gave me a decent foundation to become a research assistant on neuroimaging projects and eventually bridge into a general neuroscience postgraduate. Studying neuroscience without a background in biology was tough, but it opened new avenues of research for me.
For more on Alzheimer’s disease, visit the United States National Institute on Aging and check out the in-depth Alzheimer’s Association report, 2023 Alzheimer’s Disease Facts and Figures. The Alzheimer’s Foundation of America has more information on Alzheimer’s Awareness Month. Also visit the International FOXG1 Foundation, the American Association of Neurological Surgeons for more info on glioblastoma, and the Centers for Disease Control and Prevention page on epigenetics.
At AUC School of Medicine, we’re training future neurologists and other specialist physicians. Our 2022–2023 MD graduates achieved a 97% first-time residency attainment rate*, and are now beginning their post-graduate training across 24 specialties. Learn more about AUC and its MD program, as well as Dr. Ó hAilín and the rest of our faculty and staff. Thank you, Dr. Ó hAilín, for sharing some time with us. Sláinte!
*Percentage of students attaining a 2023–2024 residency position out of all graduates or expected graduates in 2022–2023 who were active applicants in the 2023 NRMP match or who attained a residency position outside the NRMP match.