Conference report

INTERNATIONAL CONFERENCE ON BRAIN DISORDERS  & TREATMENTS

16-18 November 2015

Faculty Hall, Indian Institute of Science Bangalore

What is dementia and how is it caused?

The underlying genetic bases of Alzheimer’s disease

Can we prevent the onset of dementia in Alzheimer’s disease?

These are some of the key areas that will come under the lens at the international conference: “Neurodegenerative Diseases: Pathogenesis to Therapy” conference, which will be held between 16-18 November 2015 at the Faculty Hall, Indian Institute of Science, Bangalore. The conference is being organised by the Centre for Brain Research, an autonomous centre at the IISc. Scientists from various national and international research institutes and Universities will present their studies and findings during these three days and explore novel therapies. The main focus will be on neurological disorders related to age: their causes, mitigation and possible treatments.

Dementia refers to a range of symptoms that includes the loss of memory and decline in mental abilities like thinking, problem solving and language, caused due to brain degeneration. It is a common symptom of Alzheimer’s disease (AD) and has been noted in people in their mid-60s. Research suggests the onset of dementia could be delayed, and that there are treatments for the symptoms of the disease which can slow down the progression of dementia.

The degeneration of the brain as we age is primarily a medical problem. But, with the increasing ageing population across the world, it has now become an economic issue also. “Age related neurological  disorders have been a cause for public health concern in developed countries. In the near future, India and China will see the largest increase in new cases of dementia. So, there is growing global concern about ageing disorders, in general and dementia, in particular”, said Professor Vijayalakshmi Ravindranath, chairman, Centre for Neuroscience, IISc, Bangalore.

The first day of the conference will focus on Alzheimer disease- its causes, symptoms and possible therapy of its primary symptom – dementia. The day’s talks include

  • John C. Morris, a lifetime achievement award winner from the Alzheimer’s Association for his contributions to this field, currently at the Washington University School of Medicine will speak about delaying the onset of dementia in AD and the ongoing trials.
  • Yves Joanette, University of Montreal, Canada, will talk about the challenge that dementia poses and the collaborative efforts at a global level to understand the origins of the diseases causing dementia.
  • Arthur Toga, founder of the Laboratory of NeuroImaging, University of California, Los Angeles, describing his work on making data from various laboratories accessible, and using a wide range of instruments and different protocols, to discover meaningful patterns.
  • Sudha Seshadri from Boston University School of Medicine, will present the genetic aspect of Alzheimer disease research.
  • The possible links between Dementia and type 2 diabetes will be discussed by Prof. Velandai Srikanth, a geriatrician at the Monash medical centre, Monash University, Melbourne.
  • Suvarna Alladi, Nizam Institute of medical Sciences, Hyderabad, will address the possible role of multilingualism in the delay of onset of dementia.
  • Mary Ganguli, University of Pittsburgh will speak about the relationship of brain’s function and dysfunction to the overall population as opposed to an individual.
  • Murali Krishna will present his research from populations of Mysore and how nutrition and growth in early life and socio-economic adversities affect cognition in individuals.

The second day will be a range of topics on factors and mitigation of neurodegeneration due to age, how lifestyle factors and other diseases can influence brain damage owing to AD, Parkinson, Lafora disease or Amylotrophic Lateral Sclerosis. Dr. Ana Ines Ansaldo from University of Montreal, Canada, will talk about mitigation of neurodegenerative symptoms. Dr. Rosalyn Moran from Virginia Tech Carilion Research Institute, will present a mathematical predictive model to examine the impact of life experiences in aging neurobiology. Dr. Stanley Fahn, Columbia University Medical centre, followed by Dr. Uday Muthane’s, (Parkinson aging and research foundation, Bangalore) talk on Parkinson’s disease and mitigation probabilities.

 

The last day will be a presentation by Dr. Sangram Sisodia from University of Chicago, on genetic mutations causing Alzheimer followed by Dr. M. M. Panicker’s (NCBS, Bangalore) research on stem cell modelling on late onset of the disease. Prof. Colin Masters, University of Melbourne, will speak on possible gene therapy in Alzheimers before the concluding session of the conference – a panel discussion on dementia.

 

 

Day 1

16-18 November 2015

Faculty Hall, Indian Institute of Science Bangalore

“By 2050, more than 50% of the ageing population will be in South East Asia”, said Prof Yves Joanette, during the first session of the International Conference ‘Neurodegenerative Diseases: Pathogenesis to Therapy’ at the IISc today. “Globally, about 30% of the population would be 60+ very soon”, she added.

This immediately implies an increase in incidence of dementia. With an increasing aged population, dementia is becoming more of an economic problem, rather than a medical problem.

“India will contribute to dementia research both within the country and globally”, said Joanette, pointing out to the Rs 225 crore grant provided by Kris Gopalakrishnan to IISc. During his speech at the inauguration, Gopalakrishnan said “Understanding the human brain would help us improve the condition of people whose lives are affected by these diseases. There is a huge avenue for computational research, where India can really provide inputs”.

Dementia refers to a range of symptoms that includes the loss of memory and decline in mental abilities like thinking, problem solving and language, caused due to brain degeneration. It is a common symptom of Alzheimer’s disease (AD) and has been noted in people in their mid-60s. Dementia is also caused by other factors, said Joanette. “We need to examine the cascade of events that end up in dementia”, she said.

“We also need to find ways to deal with dementia-affected population – their quality of life and strengthening services for caregivers and families”, she added.

AD, first diagnosed in 1906, is a disease where neurons in the brain die and the brain wastes away as a result. Dr John Morris from the Washington University in St Louis called it a ‘global epidemic’. “The first stage of the disease is generally silent, and cannot be detected by current diagnosis methods”, he said. “The second phase is characterised by dementia and cognitive impairment. We currently have no therapy for the underlying cause of AD – the neuronal degeneration”, he added.

“We need population level studies to complement clinical ones”, said Dr Mary Ganguli from the University of Pittsburgh. Human beings are hetergenous subjects, not uniform like lab rats, she said. “It is crucial to examine the external factors from the population around a patient. Such data is lacking from countries like India”.

Ganguli has developed an India-specific questionnaire which can be used for population level dementia surveys. Neuro-physiological tests, the usual norm for diagnosis, were not feasible with illiterate people. She found an incidence of 1.17% in a population in Haryana, as opposed to 8% at a locality in the US. “The study needs to be expanded to other socio-economic classes, and across the country”, she said.

Dr Sudha Seshadri, an alumnus of CMC Vellore who is now at Boston University, has been “looking at new genes or new targets for understanding the biology of AD, which would help discover new drugs and therapeutic approaches”. She suggested genome-wide surveys to look at possible targets for gene therapy.

Murali Krishna, an Early Career Wellcome Trust-DBT fellow from Mysore, examined the hypothesis that a smaller birth weight, because of a smaller head, increases chances of dementia when the person ages. Examining more than 1000 people born in a particular hospital in Mysore, he was able to establish that low birth weight, combined with low socio-economic status, increased the prevalence of dementia and cardiometabolic disorders.

Suvarna Alladi of Nizam’s Institute of Medical Sciences, Hyderabad, said that India was ideal to test the hypothesis of whether speaking more than one language maintains cognitive functions better. “Switching between languages maintains higher cognitive functioning”, she said. “Irrespective of literacy, being multi-lingual helps to delay dementia. Illiterate but skilled workers like artisans, potters and weavers had heightened cognitive abilities and hence late onset of dementia”, she added.

 

http://cbr.iisc.ernet.in/conference.php

Prof. John C. Morris http://neuro.wustl.edu/aboutus/facultybiographies/morris

Mary Ganguli http://www.wpic.pitt.edu/research/dementia_epidemiology/

Murali Krishna http://wellcomedbt.org/fellowsprofile/dr-murali-krishna-125

 

 

Day 2

17 November 2015

Faculty Hall, Indian Institute of Science Bangalore

“Sitting is the new smoking. Eight hours of sitting does similar damage to what smoking does to you”, said Manjari Tripathi, a Professor of Neurology at the All India Institute of Medical Sciences, New Delhi. Life expectancy in India has shot up in the last 50 years, thanks to better medical facilities.

“Soon, India will have the third largest ageing population following the US and China”, she said. “One in six women beyond 55 are likely to develop dementia. However, the factors leading to dementia are still an enigma”. Tripathi has initiated a study that will monitor the health of a rural and an urban group, over the next couple of decades.

Dementia refers to a range of symptoms that includes the loss of memory and decline in mental abilities like thinking, problem solving and language, caused due to brain degeneration. It is a common symptom of Alzheimer’s disease (AD) and has been noted in people in their mid-60s.

Can we remodel the brain after it has aged? At a very interesting talk during the second day of the International Conference ‘Neurodegenerative Diseases: Pathogenesis to Therapy’ at the IISc today, Ana Ines Ansaldo from the University of Montreal discussed brain remodelling as a therapy for Alzheimer’s Disease.

The brain is capable of some degree of plasticity, or remodelling. With age, this ability typically decreases. Ansaldo has found that engaging the brain in novel, complex tasks provides it with an ‘enriched environment’ that delays onset of brain degeneration. Therapy induced plasticity can potentially prove beneficial for Alzheimer’s patients, her research has shown.

Stanley Fahn from Columbia University spoke on the symptoms and pathogenesis of Parkinson’s Disease. The disease is caused due to degeneration of neurons, and it progresses slowly in most people; the person’s brain slowly stops producing dopamine, a neurotransmitter – a chemical used to communicate between neurons. Hirsch Etienne from the Brain and spine institute, Paris, spoke on the unmet therapeutic needs in Parkinson’s disease. K P Mohan Kumar spoke on the specific protein Prohibitin and its relation with Parkinson’s.

Jean-Pierre Julien from Laval university, Canada, spoke on possible therapies for the disease Amylotrophic Lateral Sclerosis (ALS). The disease affects motor neurons, the brain and spinal cord, causing muscle weakness and paralysis.

Rosalyn Moran from Virginia Tech spoke about her research on the mathematical modelling of the brain, which can help predict long term ageing patterns and propensity for disease.

LINKS

http://cbr.iisc.ernet.in/conference.php

Ana Ines Ansaldo: http://www.laboansaldo.com/ana_ines_e.html

Manjari Tripathi: http://www.aiims.edu/aiims/departments/spcenter/nsc/neurology/manjari-t.htm

K P Mohan Kumar: http://iicb.res.in/divisionwiselistofscientists/cbp/kpmohankumar.html

 

 

Day 3

18 November 2015

Faculty Hall, Indian Institute of Science Bangalore

The last day of the International Conference ‘Neurodegenerative Diseases: Pathogenesis to Therapy’ was packed with discussions regarding the latest research about Alzheimer’s and dementia, especially detection and therapy.

A panel discussion in the afternoon discussed the Dementia Network – designed to improve the system of care for individuals with Alzheimer’s Disease and dementia. Stanley Fahn from Columbia University stressed the need for collaboration among institutes, and among different streams – doctors, nurses, academicians, caregivers and families of affected people. Such a network can be used to establish common protocols and assessments for diagnosis, treatment and data collection.

Sangram Sisodia from the University of Chicago stressed the need for scientists to network together and use technology to the best possible extent. Yves Joanette from the University of Montreal stressed on the need for Big Data; and the need for large international collaborations to generate Big Data. Narahari from IISc stressed further on the need for complex algorithms that can handle the kind of data needed to understand neurological diseases. He spoke of the need to complement crowdsourced data with expert data, to get a good picture.

Upinder Bhalla from the National Centre for Biological Sciences said that the Centre for Brain Research established at IISc was an excellent starting point to setup the Dementia Network in India. Mathew Varghese from NIMHANS also stressed the same – when setting up the network was discussed 6 years ago, he said “research into Alzheimer’s Disease was in its infancy”.

In other talks, Sisodia from the University of Chicago has been working on the function of presenilin, a protein that is involved in the generation of beta-amyloid, which accumulates to form the ‘amyloid plaques’ typical of Alzheimer’s Disease. Deepak Nair from the Centre for Neurosciences, IISc has been studying the Amyloid Precursor Protein, which generates the beta-amyloid that leads to plaques. Vijayalakshmi Ravindranath studies how the plaques accumulate.

Balaji Jayaprakash from the Centre for Neurosciences, IISc has been studying mice affected by Alzheimer’s Disease to test memory and how it disappears with time.

Using laboratory strains of patient cells, Mitradas Panicker from the National Centre for Biological Sciences has developed a ‘gene map’ of the neural cells, which can help in earmarking the genes responsible for Alzheimer’s Disease.

Interviews

Prof. John Morris is the Harvey A. and Dorismae Hacker Friedman Distinguished Professor of Neurology, Professor of Pathology and Immunology, Professor of Physical Therapy, and Professor of Occupational Therapy at Washington University. He also is the Director and Principal Investigator of the Charles F. and Joanne Knight Alzheimer’s Disease Research Center. He studies various aspects of Alzheimer disease.

Based on your experience in dementia research in the western world, what would be you suggestions to Indian researchers or researchers focussing on dementia in India?

In the US, the only area where we have done really well in approaching the issue of dementing illness is a combination of clinical research in following patients and healthy control people to see how the disease progresses in them in conjunction with basic science. So the two work together and not separately. In IISc, there is tremendous basic research but no or very little clinical research. In the US, we have exclusive Alzheimer’s research centres that are funded by national institute of health which started in 1984 and since then they have brought clinical and basic science people together. It’s not a tradition in India but I would say that is the only way to advance research in dementia here.

Do you think that lifestyle changes in Indians could help curb the rising number of dementia affected people here?

No one knows the answer yet but it might be possible. That makes India a wonderful place for this kind of research because of the diverse populations, cultures and lifestyles – diet, aging, obesity etc. factors can be checked for their links to dementia. India makes for a perfect laboratory to check for these questions and examine them in clinical cohorts. There will be a lot of challenges to that. Also the population above 65 is much lower in India as opposed to the US or Japan but the existing number is huge and it is only going to get bigger. Hence there is an imperative to do this research.

Available drugs have failed to stop or delay dementia. The ongoing genetic research in that direction is also in its nascent stages. Is there any other alternative that can help deal with dementia in the present situation?

Two paths that we haven’t tried –

  1. Administering past failed drugs during the earlier course of the disease, right when the symptoms show up. The research has just begun in that aspect.
  2. Using combination of drugs- each drug attacking a different mechanism leading to dementia. This is yet to start.

 

 

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