Newswise — October 5, 2020—(BRONX, N.Y)— Joe Verghese, M.B.B.S., M.S., an international leader in aging and cognition research at Albert Einstein College of Medicine and Montefiore Health System, has received two grants from the National Institutes of Health totaling $13.8 million to conduct studies on pre-dementia and Alzheimer’s disease.
The first grant totals $7.6 million over five years and will fund a study of a pre-dementia condition called motoric cognitive risk syndrome (MCR) in 11,000 older adults living in six countries. The second five-year grant of $6.2 million will enable researchers to evaluate the effectiveness of a non-invasive brain stimulation technique intended to alleviate symptoms of Alzheimer’s disease and improve brain function.
"Approximately 50 million adults worldwide have dementia, which puts an enormous burden on individuals, their families and caretakers, and the healthcare system," said Dr. Verghese, director of the Montefiore Einstein Center for the Aging Brain. "Our ultimate goal is to develop treatments that can prevent or treat Alzheimer’s disease, which is the most common form of dementia."
Dr. Verghese is chief of the integrated divisions of cognitive and motor aging and of geriatrics at Einstein and Montefiore. He also is the Murray D. Gross Memorial Faculty Scholar in Gerontology, director of the Resnick Gerontology Center, and professor in the Saul R. Korey Department of Neurology and of medicine at Einstein.
Exploring the Biology of Pre-Dementia
Dr. Verghese first identified and described MCR, a condition in which older adults have an abnormally slow gait and cognitive complaints, in a 2014 study. He found that MCR affects almost one in 10 older adults and those diagnosed were twice as likely as other older adults to develop dementia within 12 years.
The first grant will allow Dr. Verghese and his colleagues to investigate the biological roots of MCR and identify biomarkers for the condition. Researchers will establish a consortium of eight ongoing studies of aging, evaluate biological and genetic data from the participants, and track their structural and functional brain changes over time. Hundreds of participants will be enrolled from current studies at Einstein, including the LonGenity Study, the Central Control of Mobility and Aging, and the Einstein Aging Study.
"We’ve already uncovered clues about the biological pathways and brain structures implicated in MCR, which appear distinct from other pre-dementia conditions, and now we can dig deeper to refine our understanding of this syndrome," said Dr. Verghese. "The large number of study participants will give power to our findings and, we hope, help us to identify new ways to prevent or treat MCR and slow or stop its progression to Alzheimer’s." Einstein-Montefiore collaborators on the grant include Nir Barzilai, M.D., Helena Blumen, Ph.D., M.S., Carol Derby, Ph.D., and Richard Lipton, M.D.
Studying a Novel Non-Invasive Approach for Treating Alzheimer’s
Dr. Verghese’s second grant will focus on treatment, specifically, the at-home use of transcranial direct current stimulation (tDCS) therapy, delivered with a bathing-cap style head covering. The randomized, double-blind study will evaluate the effects of six months of at-home tDCS on improving cognitive performance and selected symptoms in 100 patients with mild-to-moderate Alzheimer’s disease. The co-primary investigator on the grant is Helena Knotkova, Ph.D., D. Phil., associate professor of medicine at Einstein and director of clinical research and analytics at the MJHS Institute for Innovation in Palliative Care.
Study participants or their caregivers will be trained to use the headgear and a companion telehealth tablet. Participants will receive either placebo or actual tDCS treatments for 30 minutes, five times a week, over six months. Researchers will use established tests and surveys to measure cognitive performance, attention, and mood. Immediately after the six-month period, and again at two later dates, investigators will assess functional and structural brain changes using functional magnetic resonance imaging (fMRI).
"There is a compelling need for new, low-risk treatment approaches for Alzheimer’s disease," said Dr. Verghese. "Transcranial direct current stimulation has been effective in animal research and in some limited human studies, and there appear to be very few side effects. If we can demonstrate the effectiveness of this treatment, it could potentially become an important part of dementia care."
The first grant, titled, “The Biological Underpinnings of Motoric Cognitive Risk Syndrome: A Multi-Center Study," was awarded by the National Institute on Aging (NIA), part of the NIH (1R01AG057548-01A1). The second grant, titled “Non-Invasive Home Neurostimulation for Mild to Moderate Alzheimer’s Disease: Double-Blind, Sham Controlled Randomized Clinical Trial," also was awarded by the NIA (1R01AG068167-01).
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About Albert Einstein College of Medicine
Albert Einstein College of Medicine is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2019-20 academic year, Einstein is home to 724 M.D. students, 158 Ph.D. students, 106 students in the combined M.D./Ph.D. program, and 265 postdoctoral research fellows. The College of Medicine has more than 1,800 full-time faculty members located on the main campus and at its clinical affiliates. In 2019, Einstein received more than $178 million in awards from the National Institutes of Health (NIH). This includes the funding of major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Einstein runs one of the largest residency and fellowship training programs in the medical and dental professions in the United States through Montefiore and an affiliation network involving hospitals and medical centers in the Bronx, Brooklyn and on Long Island. For more information, please visit www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook, and view us on YouTube.
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1R01AG057548-01A1; 1R01AG068167-01