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Photo: iStockphoto
Photo: iStockphoto

Memory and the ageing brain

Neuroscientists have failed to scale up new treatments for memory deficits due to the lack of qualification-matched research administration in medical institutes

The challenges posed by an ageing population have financial implications for the treatment and management of memory-related disorders, which constitute the major chunk of brain ageing. While the term ‘memory deficit’ is interchangeably used with Alzheimer’s disease, such deficits are known to occur in other brain disorders too. Even though neuropsychologists have devised modules to diagnose memory deficits, neuroscientists have failed to scale up new treatments due to the absence of qualification-matched research administration in medical institutes where clinicians and scientists need to collaborate in a goal-oriented manner.

Artificial disruption of neurons in a defined area of a mouse brain helps to model memory deficits in mice so that it matches the human spectrum of disease seen in hospitals. Such efforts lead to useful insights, not only by giving us an understanding of the brain but also by ascribing function to genes, the environment and growth factors responsible for learning and memory. In 2000, Eric Kandel won the Nobel Prize for showing that there is a biochemical basis of learning and memory, driven by protein synthesis and the activation of certain genes.

In the absence of a cure for human memory disorders, various experimental tools are used by neuroscientists which include the famous behavioural paradigm, Morris Water Maze. Discovered by Richard G. Morris in 1981, the behavioural test employs the swimming skills of mice, trained to identify a submerged platform in a circular pool, using spatial cues in the room by recording the time taken to reach the platform, as a marker of learning. Expectedly, the normal mice learn faster with successive days of training, while the memory deficit mice or genetically engineered mice (in which a gene is deleted to ascribe its function in learning and memory) are unable to perform the task in the required time frame. The test mice are administered the drug or herbal extract under investigation or exposed to exercise or other experimental conditions, hypothesized to increase memory, and the effect is analysed by mapping the reduction in time taken to reach the platform.

In several such experiments, Neuroscience Research Lab at Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, has shown that brahmi extract, when administered to experimental mice, is able to reverse memory deficits. The group recently showed the memory enhancing effects of human cord blood-derived stem cells, pitching for establishment of public cord banks from where such stem cells could be provided to poor patients for free, if therapies are validated in future.

Overwhelming retrospective evidence points out that a Mediterranean diet, comprising vegetables, fish and eggs or Omega 3, delays or prevents development of Alzheimer’s disease. However, this does not include studies from India. Many scientists hypothesize that early life exposure to certain drugs, mobile phones or toxins could play a critical role in developing memory disorders in late life. However, the research data remains conflicting at best. The genetic predisposition of brain ageing disorders led the (Barack) Obama administration in the US to commit a special brain fund under the leadership of Nick Spitzer, a renowned neuroscientist. A battery of cheap neurogenetic tests were simultaneously launched in PGIMER so that expensive investigations could be avoided with early detection of disease. Because private genetic testing is widely believed to be a potential source of data loss, academicians argue against these tests being sent to private labs. This data could be useful in pre-marital counselling, pre-natal testing, pre-implantation manipulation (in some countries) or launch of new clinical trials in memory research. Therefore, a poor patient’s right to access his/her own genetic data, regardless of treatment outcome, must be protected. In contrast, international neuroscientists have begun to offer their patients samples for cheaper genetic testing as there is a huge cost difference in price.

Integration of knowledge from genetic understanding of the disease with re-emerging therapies can provide answers to whether stem cell mobilization to the damaged brain is possible or not. This needs to be supported by policies that fund research integration of ayurveda with modern medicine. The inclusion of AYUSH (department of ayurveda, yoga and naturopathy, unani, siddha and homoeopathy) directors in the governing bodies of PGIMER and All India Institute of Medical Sciences is a step in that direction.

Similarly, Chinese traditional medicine is an integral part of medical schooling in China. This is where India needs to acquire leadership in the face of failed memory drug trials. In the absence of memory and ageing centres (read neurogeriatrics) in Indian medical institutes, the knowledge and skills of biomedical scientists should be exploited. The entire PhD research cadre of such medical institutes, in collaboration with patient support groups, can be used to valorize the molecular effects of re-emerging therapies for worldwide human application. Some experts even advocate opening yoga centres or departments of complementary medicine within medical institutes, much like the Jawaharlal Institute of Postgraduate Medical Education and Research in Puducherry, Harvard or Johns Hopkins in the US. This can be done by resurrecting a Defence Research and Development Organization-style of research management in medical institutes.

The opinions expressed here are the author’s personal reflections and not that of the government or the journal he works for.

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