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Scientists are using bioelectronic medicine to treat inflammatory diseases, an approach that capitalizes on the ancient "hardwiring" of the nervous system.
- Bioelectronic medicine is an emerging field that focuses on manipulating the nervous system to treat diseases.
- Clinical studies show that using electronic devices to stimulate the vagus nerve is effective at treating inflammatory diseases like rheumatoid arthritis.
- Although it's not yet approved by the US Food and Drug Administration, vagus nerve stimulation may also prove effective at treating other diseases like cancer, diabetes and depression.
The nervous system’s ancient reflexes<p>You accidentally place your hand on a hot stove. Almost instantaneously, your hand withdraws.</p><p>What triggered your hand to move? The answer is <em>not</em> that you consciously decided the stove was hot and you should move your hand. Rather, it was a reflex: Skin receptors on your hand sent nerve impulses to the spinal cord, which ultimately sent back motor neurons that caused your hand to move away. This all occurred before your "conscious brain" realized what happened.</p><p>Similarly, the nervous system has reflexes that protect individual cells in the body.</p><p>"The nervous system evolved because we need to respond to stimuli in the environment," said Dr. Tracey. "Neural signals don't come from the brain down first. Instead, when something happens in the environment, our peripheral nervous system senses it and sends a signal to the central nervous system, which comprises the brain and spinal cord. And then the nervous system responds to correct the problem."</p><p>So, what if scientists could "hack" into the nervous system, manipulating the electrical activity in the nervous system to control molecular processes and produce desirable outcomes? That's the chief goal of bioelectronic medicine.</p><p>"There are billions of neurons in the body that interact with almost every cell in the body, and at each of those nerve endings, molecular signals control molecular mechanisms that can be defined and mapped, and potentially put under control," Dr. Tracey said in a <a href="https://www.youtube.com/watch?v=AJH9KsMKi5M" target="_blank">TED Talk</a>.</p><p>"Many of these mechanisms are also involved in important diseases, like cancer, Alzheimer's, diabetes, hypertension and shock. It's very plausible that finding neural signals to control those mechanisms will hold promises for devices replacing some of today's medication for those diseases."</p><p>How can scientists hack the nervous system? For years, researchers in the field of bioelectronic medicine have zeroed in on the longest cranial nerve in the body: the vagus nerve.</p>
The vagus nerve<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYyOTM5OC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NTIwNzk0NX0.UCy-3UNpomb3DQZMhyOw_SQG4ThwACXW_rMnc9mLAe8/img.jpg?width=1245&coordinates=0%2C0%2C0%2C0&height=700" id="09add" width="1245" height="700" data-rm-shortcode-id="7b0919cad274445520414149b25edd2e" data-rm-shortcode-name="rebelmouse-image" />
Electrical signals, seen here in a synapse, travel along the vagus nerve to trigger an inflammatory response.
Credit: Adobe Stock via solvod<p>The vagus nerve ("vagus" meaning "wandering" in Latin) comprises two nerve branches that stretch from the brainstem down to the chest and abdomen, where nerve fibers connect to organs. Electrical signals constantly travel up and down the vagus nerve, facilitating communication between the brain and other parts of the body.</p><p>One aspect of this back-and-forth communication is inflammation. When the immune system detects injury or attack, it automatically triggers an inflammatory response, which helps heal injuries and fend off invaders. But when not deployed properly, inflammation can become excessive, exacerbating the original problem and potentially contributing to diseases.</p><p>In 2002, Dr. Tracey and his colleagues discovered that the nervous system plays a key role in monitoring and modifying inflammation. This occurs through a process called the <a href="https://www.nature.com/articles/nature01321" target="_blank" rel="noopener noreferrer">inflammatory reflex</a>. In simple terms, it works like this: When the nervous system detects inflammatory stimuli, it reflexively (and subconsciously) deploys electrical signals through the vagus nerve that trigger anti-inflammatory molecular processes.</p><p>In rodent experiments, Dr. Tracey and his colleagues observed that electrical signals traveling through the vagus nerve control TNF, a protein that, in excess, causes inflammation. These electrical signals travel through the vagus nerve to the spleen. There, electrical signals are converted to chemical signals, triggering a molecular process that ultimately makes TNF, which exacerbates conditions like rheumatoid arthritis.</p><p>The incredible chain reaction of the inflammatory reflex was observed by Dr. Tracey and his colleagues in greater detail through rodent experiments. When inflammatory stimuli are detected, the nervous system sends electrical signals that travel through the vagus nerve to the spleen. There, the electrical signals are converted to chemical signals, which trigger the spleen to create a white blood cell called a T cell, which then creates a neurotransmitter called acetylcholine. The acetylcholine interacts with macrophages, which are a specific type of white blood cell that creates TNF, a protein that, in excess, causes inflammation. At that point, the acetylcholine triggers the macrophages to stop overproducing TNF – or inflammation.</p><p>Experiments showed that when a specific part of the body is inflamed, specific fibers within the vagus nerve start firing. Dr. Tracey and his colleagues were able to map these relationships. More importantly, they were able to stimulate specific parts of the vagus nerve to "shut off" inflammation.</p><p>What's more, clinical trials show that vagus nerve stimulation not only "shuts off" inflammation, but also triggers the production of cells that promote healing.</p><p>"In animal experiments, we understand how this works," Dr. Tracey said. "And now we have clinical trials showing that the human response is what's predicted by the lab experiments. Many scientific thresholds have been crossed in the clinic and the lab. We're literally at the point of regulatory steps and stages, and then marketing and distribution before this idea takes off."<br></p>
The future of bioelectronic medicine<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTYxMDYxMy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjQwOTExNH0.uBY1TnEs_kv9Dal7zmA_i9L7T0wnIuf9gGtdRXcNNxo/img.jpg?width=980" id="8b5b2" width="2000" height="1125" data-rm-shortcode-id="6682370b5a6471bf3d8b42ca3c508519" data-rm-shortcode-name="rebelmouse-image" />
Vagus nerve stimulation can already treat Crohn's disease and other inflammatory diseases. In the future, it may also be used to treat cancer, diabetes, and depression.
Credit: Adobe Stock via Maridav<p>Vagus nerve stimulation is currently awaiting approval by the US Food and Drug Administration, but so far, it's proven safe and effective in clinical trials on humans. Dr. Tracey said vagus nerve stimulation could become a common treatment for a wide range of diseases, including cancer, Alzheimer's, diabetes, hypertension, shock, depression and diabetes.</p><p>"To the extent that inflammation is the problem in the disease, then stopping inflammation or suppressing the inflammation with vagus nerve stimulation or bioelectronic approaches will be beneficial and therapeutic," he said.</p><p>Receiving vagus nerve stimulation would require having an electronic device, about the size of lima bean, surgically implanted in your neck during a 30-minute procedure. A couple of weeks later, you'd visit, say, your rheumatologist, who would activate the device and determine the right dosage. The stimulation would take a few minutes each day, and it'd likely be unnoticeable.</p><p>But the most revolutionary aspect of bioelectronic medicine, according to Dr. Tracey, is that approaches like vagus nerve stimulation wouldn't come with harmful and potentially deadly side effects, as many pharmaceutical drugs currently do.</p><p>"A device on a nerve is not going to have systemic side effects on the body like taking a steroid does," Dr. Tracey said. "It's a powerful concept that, frankly, scientists are quite accepting of—it's actually quite amazing. But the idea of adopting this into practice is going to take another 10 or 20 years, because it's hard for physicians, who've spent their lives writing prescriptions for pills or injections, that a computer chip can replace the drug."</p><p>But patients could also play a role in advancing bioelectronic medicine.</p><p>"There's a huge demand in this patient cohort for something better than they're taking now," Dr. Tracey said. "Patients don't want to take a drug with a black-box warning, costs $100,000 a year and works half the time."</p><p>Michael Dowling, president and CEO of Northwell Health, elaborated:</p><p>"Why would patients pursue a drug regimen when they could opt for a few electronic pulses? Is it possible that treatments like this, pulses through electronic devices, could replace some drugs in the coming years as preferred treatments? Tracey believes it is, and that is perhaps why the pharmaceutical industry closely follows his work."</p><p>Over the long term, bioelectronic approaches are unlikely to completely replace pharmaceutical drugs, but they could replace many, or at least be used as supplemental treatments.</p><p>Dr. Tracey is optimistic about the future of the field.</p><p>"It's going to spawn a huge new industry that will rival the pharmaceutical industry in the next 50 years," he said. "This is no longer just a startup industry. [...] It's going to be very interesting to see the explosive growth that's going to occur."</p>
Being a leader is about more than the job title. You have to earn respect.
- What does it take to be a leader? For Northwell Health president and CEO Michael Dowling, having an Ivy League degree and a large office is not what makes a leader. Leadership requires something much less tangible: influence.
- True leaders inspire people to follow and believe in them and the organization's mission by being passionate, having humility, and being a real part of the team. This is especially important in a field like health care, where guidance and teamwork save lives.
- Authenticity is also key. "Don't pretend, be real," says Dowling. "Accept your vulnerabilities, accept your weaknesses, know where your strengths are, and get people to belong."
From making their own swabs to staying in constant communication across the board, Northwell Health dove headfirst into uncharted waters to take on the virus and save lives.
- Preparing for a pandemic like COVID-19 was virtually impossible. Northwell Health president and CEO Michael Dowling explains how, as the largest healthcare provider in New York, his team had to continuously organize, innovate, and readjust to dangerous and unpredictable conditions in a way that guaranteed safety for the staff and the best treatment for over 128,000 coronavirus patients.
- From making their own supplies when they ran out, to coordinating with government at every level and making sense of new statistics and protocols, Northwell focused on strengthening internal and external communication to keep the ship from sinking.
- "There was no such thing as putting up the white flag," Dowling says of meeting the pandemic head on and reassuring his front line staff that they would be safe and have all the resources they needed to beat the virus. "It's amazing how innovative you can be in a crisis."
In the future, you might voluntarily share your social media data with your psychiatrist to inform a more accurate diagnosis.
- About one in five people suffer from a psychiatric disorder, and many go years without treatment, if they receive it at all.
- In a new study, researchers developed machine-learning algorithms that analyzed the relationship between psychiatric disorders and Facebook messages.
- The algorithms were able to correctly predict the diagnosis of psychiatric disorders with statistical accuracy, suggesting digital tools may someday help clinicians identify mental illnesses in early stages.
Identifying psychiatric disorders<p>The goal was for the algorithms to analyze patterns in these datasets, then predict which group participants belonged to: schizophrenia spectrum disorders (SSD), mood disorders (MD), or healthy volunteers (HV). The results were promising, showing that the algorithms correctly identified:</p><ul><li>The SDD group with an accuracy of 52% (chance was 33%)</li><li>The MD group with an accuracy of 57% (chance was 37%)</li><li>The HV group with an accuracy of 56% (chance was 29%)</li></ul><p>The study also showed interesting differences in Facebook activity among the groups, such as:</p><ul><li>The SSD group was more likely to use language related to perception (hear, see, feel).</li><li>The MD and SSD groups were far more likely to use swear words and anger-related language.</li><li>The MD group was more likely to use language related to biological processes (blood, pain).</li><li>The SSD group was more likely to express negative emotions, use second-person pronouns and write in netspeak (lol, btw, thx).</li><li>The MD group was more likely to post photos containing more blues and less yellows.</li></ul><p>These differences tended to become more apparent in the months before a patient was hospitalized. But even 18 months before hospitalization, the results revealed signals that hinted participants might be on the path to developing a psychiatric disorder. That's where these tools may someday help improve early-identification efforts.</p><p>"In psychiatry, we often get a snapshot of somebody's life, for 30 minutes once a month or so," he said. "There's the potential to get much greater granularity with some of these new assessment tools. Facebook, for example, can allow us to understand somebody's thoughts and behaviors in a more real-time, longitudinal fashion, as opposed to cross-sectional moments in time."</p><p>Dr. Birnbaum noted that everyone has a unique style of <a href="https://www.northwell.edu/behavioral-health/news/insights/digital-activity-provides-more-clues-to-its-impact-on-mental-health" target="_blank">online behavior</a> and that certain behavioral changes may contain clues about mental health.</p><p>"The way that we're understanding this is that everybody has a digital baseline, a way they typically act and behave on social media and the internet," he said. "So, ultimately here we would want to identify this baseline for each individual—a fingerprint—and then monitor for changes over time, and identify which changes are concerning, and which are not."</p><p>Using digital tools to better identify psychiatric conditions could someday reduce the number of people who suffer without treatment.</p><p>"There's an alarming gap between the number of people who experience mental illness and those who receive care," said Michael Dowling, president and CEO of Northwell Health. "It's especially troubling when you consider that the health disparity between people with mental illness and those without is larger than disparities attributable to race, ethnicity, geography or socioeconomic status."<a href="#_msocom_1" target="_blank"></a></p>
A step toward the future of psychiatry<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTU1NzkzNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzMjMyNTU2OX0.EP0V-l7aldnzNJKupUq4otg8r3UIE_f7vH7M4Pdisg4/img.jpg?width=980" id="6c141" width="2000" height="1125" data-rm-shortcode-id="9b2303ef4ce0c88f0669e2d72a04b63d" data-rm-shortcode-name="rebelmouse-image" />
Credit: Jewel Samad/AFP via Getty Images<p>Although previous research has examined the relationship between online activity and psychiatric disorders, the new study is unique because it paired online behavior with clinically confirmed cases of psychiatric disorders.</p><p>"The vast majority of the data thus far has been extracted from anonymous, or semi-anonymous individuals online, without any real way to validate the diagnosis or confirm the authenticity of the symptoms," Dr. Birnbaum said.</p><p>But before clinicians can use these kinds of digital approaches, researchers have more work to do.</p><p>"I think that we need much larger datasets," Dr. Birnbaum said. "We need to repeat these findings. We need to better understand how demographic differences, like age, ethnicity and gender, can play a role."</p><p>Privacy is another consideration. Dr. Birnbaum emphasized that these kinds of approaches would only be conducted on a voluntary basis, and that the Facebook data used in the recent study was anonymized, and the algorithms examined only individual words, not the context or meaning of sentences.</p><p>"This isn't about surveillance, or that Facebook should somehow be monitoring us," Dr. Birnbaum said. "It's about giving the power to the patient. I imagine a world where patients could come into the doctor's office and express their concerns, but also provide some additional clinically meaningful information that they own."</p><p>Dr. Birnbaum said the long-term goal isn't for algorithms to make official diagnoses or replace physicians, but rather to serve as supplementary tools. He added that these tools would be used only for people seeking help or information about their risk of developing a psychiatric condition, or suffering a relapse.</p><p>"Hopefully one day, we'll be able to incorporate this and other information to inform what we do, the same way you go to a doctor and you get an X-ray or a blood test to inform the diagnosis," he said. "It doesn't make the diagnosis, but it informs the doctor. That is where psychiatry is heading, and hopefully this is a step in that direction."</p>
Clinical trials at the Feinstein Institutes for Medical Research focus on stabilizing cognitive loss and alleviating the psychotic symptoms that change our loved ones.
- Alzheimer's is a neurodegenerative disease that is estimated to affect twice as many Americans by 2050, making it a troubling eventuality for many young adults.
- There's currently no cure for Alzheimer's, but clinical trials of immunotherapy approaches show promise.
- Immunotherapies may also alleviate the psychotic symptoms of Alzheimer's, like agitation, aggression, and paranoia.
What causes Alzheimer’s disease?<p>While the costs of Alzheimer's are clear, its exact causes remain frustratingly mysterious. Currently, there's no cure for the disease, nor treatments that stop its progression.</p><p>"Alzheimer's is this brain problem, and everyone sort of knows what's probably causing the problem, but nobody's been able to do anything about it," said Dr. Jeremy Koppel, a geriatric psychiatrist and co-director of the Litwin-Zucker Alzheimer Research Center.</p><p>But in recent decades, researchers have zeroed in on likely contributors to the disease. The brains of Alzheimer's patients reliably show two abnormalities: build-ups of proteins called abnormal tau and beta-amyloid. As these proteins accumulate in the brain, they disrupt healthy communication between neurons. Over time, neurons get injured and die, and brain tissue shrinks.</p><p>Still, it's unclear exactly how these proteins, or other factors such as <a href="https://feinstein.northwell.edu/news/the-latest/alzheimer-s-drug-cuts-hallmark-inflammation-related-to-metabolic-syndrome-by-25-percent" target="_blank">inflammation</a>, may drive Alzheimer's.</p><p>"We are dealing with very complicated components," said Dr. Philippe Marambaud, a professor at the Feinstein Institutes and co-director of the Litwin-Zucker Alzheimer Research Center. "The actual culprit is not clearly defined. We know there are three possible culprits [tau, beta-amyloid, inflammation]. They're working in concert, or maybe in isolation. We don't know precisely."</p><p>Many Alzheimer's researchers have spent years developing therapies that target beta-amyloid, which can accumulate to form plaques in the brain. The Alzheimer's Association <a href="https://www.alz.org/national/documents/topicsheet_betaamyloid.pdf" target="_blank" rel="noopener noreferrer">writes</a>:</p><p style="margin-left: 20px;">"According to the amyloid hypothesis, these stages of beta-amyloid aggregation disrupt cell-to-cell communication and activate immune cells. These immune cells trigger inflammation. Ultimately, the brain cells are destroyed."</p><p>Unfortunately, clinical trials of therapies that target beta-amyloid haven't been effective in treating Alzheimer's.</p>
Anti-tau immunotherapies: The holy grail of Alzheimer’s?<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTUzMzQ5NS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0MDk2Nzg0NH0.8pYVGXtj3bc_qEf2jHkttvLrnli8_w9K8e2rvu72WHU/img.jpg?width=980" id="a287d" width="3873" height="3873" data-rm-shortcode-id="8e3f157a2fa4857c2867abe1a27b4a95" data-rm-shortcode-name="rebelmouse-image" />
In brains with Alzheimer's disease, tau proteins lose their structure and form neurofibrillary tangles that block communication between synapses.
Credit: Adobe Stock<p>At the Feinstein Institutes, Dr. Marambaud and his colleagues have been focusing on the lesser-explored Alzheimer's component: abnormal tau.</p><p>In healthy brains, tau plays several important functions, including stabilizing internal <a href="https://www.brightfocus.org/alzheimers-disease/infographic/progression-alzheimers-disease" target="_blank">microtubules</a> in neurons. But in the brains of Alzheimer's patients, a process called phosphorylation changes the structure of tau proteins. This blocks synaptic communication.</p><p>Dr. Marambaud said there are good reasons to think anti-tau therapies may effectively treat Alzheimer's.</p><p>"The main argument around why [anti-tau therapies] could be more beneficial is that we've known for a very long time that tau pathology in the brain of the Alzheimer's patient correlates much better with the disease progression, and the loss of neuronal material in the brain," compared to beta-amyloid, Dr. Marambaud said. </p><p>"The second strong argument is that there are inherited dementias, called tauopathies, which are caused by mutations in the gene coding for the tau protein. So, there is a direct genetic link between dementia and tau pathology."</p><p>To better understand how this protein interacts with Alzheimer's, Dr. Marambaud and his colleagues have been <a href="https://pubmed.ncbi.nlm.nih.gov/30134961/" target="_blank" rel="noopener noreferrer">developing immunotherapies that target abnormal tau</a>.</p><p>Immunotherapies, such as vaccines, typically target infectious diseases. But it's also possible to use the body's immune system to prevent or treat some non-infectious diseases. Scientists have recently succeeded in treating certain forms of cancer with immunotherapies, for example.</p><p>"We have developed a series of monoclonal antibodies, which are basically the therapeutics that are required when you want to do immunotherapy," Dr. Marambaud said.</p>
Alzheimer’s and psychosis<img class="rm-lazyloadable-image rm-shortcode" type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNTUzMzQ4My9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NDc5MzUzN30.riUe5nW2qpCqI54cWxLVnpklZoTpOtWoaVCiIOAWHMY/img.jpg?width=980" id="5482a" width="1313" height="875" data-rm-shortcode-id="dec0418d58b14540690b3093b0a31f2a" data-rm-shortcode-name="rebelmouse-image" />
Credit: Getty Images<p>When most people think of Alzheimer's, they tend to focus on the erosion of memory. But the darkest effects of the disease are often psychotic symptoms like agitation, aggression and paranoia, according to Dr. Koppel, who, in addition to researching Alzheimer's, spent decades treating Alzheimer's patients as a clinician.</p><p>"My research focus comes out of 20 years of sitting with Alzheimer's families and listening to what the primary issue is," said Dr. Koppel. "It's never memory. It starts out with memory as a diagnostic issue. But the real suffering comes from the changes that happen in the personality and the belief system that make Alzheimer's patients" ostracized or even become violent toward their loved ones.</p><p>At the Feinstein Institutes, Dr. Koppel's research focuses on alleviating Alzheimer's-related psychotic symptoms through anti-tau immunotherapies. </p><p>"It's our hypothesis that abnormal tau proteins in the brain somehow, downstream, impact the way that people think," Dr. Koppel said. "And the impact that it has is this paranoid, agitated, psychotic phenotype."</p><p>Supporting this hypothesis is research on <a href="https://www.northwell.edu/news/insights/what-we-need-to-know-about-cte" target="_blank" rel="noopener noreferrer">chronic traumatic encephalopathy (CTE)</a>, a degenerative disease that involves the accumulation of abnormal tau. CTE, common among professional football players, also causes psychotic symptoms like agitation, aggression and paranoia.</p><p>What's more, <a href="https://pubmed.ncbi.nlm.nih.gov/25151619/" target="_blank" rel="noopener noreferrer">research shows</a> that as Alzheimer's patients accumulate more abnormal tau in their brains, as measured through cerebrospinal fluid, they exhibit more psychotic symptoms, and are more likely to die sooner than patients with less abnormal tau.</p><p>Given these strong connections between psychosis and abnormal tau, Dr. Koppel and his colleagues hope that anti-tau immunotherapies will alleviate psychosis in Alzheimer's patients, who currently lack safe and effective treatment options and are often given medication that is meant to alleviate psychosis in people with schizophrenia.</p><p>"We are giving medications to Alzheimer's patients that hasten their cognitive decline and lead to bad outcomes, like stroke and sudden death," Dr. Koppel said. "Nonetheless, the schizophrenia medications do treat some of the psychotic symptoms and aggressive behavior related to Alzheimer's disease, and for many families this is crucial. We just don't have many options, and we desperately need more."</p><p>Beyond treating Alzheimer's patients, anti-tau immunotherapies may shed light on other mental illnesses.</p><p>"Alzheimer's may give us a window into what happens in the brain that makes people psychotic," Dr. Koppel said. "Once you have a biologic treatment for psychosis that gets at an underlying pathophysiology, believe me, you could look at schizophrenia in new ways. Maybe it's not going to be tau, but it may be a paradigm for treating mental illness."</p>
The future of Alzheimer’s treatments<p>Dr. Marambaud said the long-term goal of anti-tau immunotherapies is to prevent Alzheimer's. But that's currently impossible because scientists lack the biomarkers and diagnostic tools needed to detect the disease before cognitive symptoms appear. It could take decades before prevention becomes possible, if it ever does.</p><p>In the short term, stabilizing Alzheimer's is a more realistic goal.</p><p>"Our hope is that the treatments will be aggressive enough so that we can at least stabilize the disease in patients identified to be already affected by dementia, with cognitive tests that can be done by the clinicians," Dr. Marambaud said. "And even better, maybe reduce the cognitive impairments."</p><p>Dr. Marambaud said he encourages the public not to lose faith.</p><p>"Be patient. It's a very complicated disease," he said. "A lot of labs are really committed to making a difference. Congress has also realized that this is a huge priority. In the past five years, [National Institutes of Health] funding has increased tremendously. So the scientific field is working very hard. The politicians are behind us in funding this research. And it's a complicated disease. But we will make a difference in the years to come."</p><p>In the meantime, the Alzheimer's Association <a href="https://www.alz.org/alzheimers-dementia/research_progress/prevention" target="_blank">notes</a> that physical activity and a healthy diet can reduce the chances of developing Alzheimer's, though more large-scale studies are needed to better understand how these factors interact with the disease.</p><p>"Many of these lifestyle changes have been shown to lower the risk of other diseases, like heart disease and diabetes, which have been linked to Alzheimer's," the association wrote. "With few drawbacks and plenty of known benefits, healthy lifestyle choices can improve your health and possibly protect your brain."</p>
Northwell Health has built an elaborate data system to track and fight COVID-19. If this system goes global, it could prevent a future pandemic.
- This coronavirus pandemic is very much still ongoing, but now is the time to discern its lessons so that we are more prepared for the next one. Michael Dowling, president and CEO of Northwell Health, shares how their health system is collecting and utilizing vast amounts of health data to best care for patients and to quickly identify and manage COVID-19 surges.
- "I would say that we probably had the most elaborate dashboard of any health system dealing with this crisis," says Dowling. Northwell Health has also developed a "local surveillance tracking system" which has allowed them to react to COVID spikes early. Dowling hopes that these systems will be adopted by and improved upon by other networks.
- In addition to improvements to New York State's illness surveillance system, Dowling hopes to see a more global approach to fighting the pandemic where infection data is tracked shared between nations and warning signs can be acted on early enough to avoid another crisis.