After decades of research, cautious optimism on Alzheimer’s disease – interview with Dr. Scott Small

Dr. Scott Small, Director of the Alzheimer’s Disease Research Center at Columbia University, is using advanced MRI technology to pinpoint the area of the brain affected by Alzheimer’s, in the quest for a cure.

What makes Alzheimer’s Disease (AD) AD, as opposed to normal cognitive decline and memory loss? The answer to this question is at the heart of decades of research in the lab of Dr. Scott Small, Director of the Alzheimer Disease Research Center at Columbia University. “One way to understand what causes AD is to pinpoint what part of the brain is most affected by it,” explains Dr. Small.

Advanced MRI technology – functional magnetic resonance imaging or fMRI – has enabled Dr. Small and his team to narrow down the location of AD to a particular area in the hippocampus.  Their research has shown that the entorhinal cortex is the area affected by AD, whereas the dentate gyrus is the area of the hippocampus affected by normal aging.  “Once we established this dissociation, we asked ‘what is the molecular mechanism that links the anatomical dissociation of AD and normal aging?’. This is the ‘where’ part of the investigation.  The ‘how’ is the novel therapeutic drug interventions which can then provide treatment and relief to patients.”

Dr. Scott Small

Dr. Scott Small

Dr. Small’s quest for a cure to Alzheimer’s is inspired by his work as a practicing clinician, treating Alzheimer’s patients at Columbia medical center, where he sees the ravages of the disease on a daily basis. “All diseases are bad, but Alzheimer’s is one of the most feared disorders, because it robs us of ourselves,” he says.

What has enabled the recent advances in Alzheimer’s research? “The developments of the last 20 years in MRI imaging has laid the groundwork for the work we’re doing now,” explains Dr. Small, who has developed MRI variants which will enable early detection of AD. “The cure is going to come from an understanding of the fundamental mechanisms of the disease.  We have the tools, and in 5-10 years we will be able to detect the disease at the very early stages, before the onset of symptoms.  Then we will be able to treat and hopefully provide a cure.”

“Dr. Small’s breakthroughs are a clear example of how advanced technologies, in this case MRI, are making possible the development of therapies and drugs that were not possible 10 years ago,” says Miri Polachek, Executive Director of Israel Brain Technologies (IBT).  “This intersection of technology and clinical research is where we believe the breakthroughs will continue to emanate from.  The BrainTech conference, where Dr. Small will be presenting, is one platform we’ve created to bring together the entire BrainTech ecosystem – researchers, entrepreneurs, investors, clinicians – to foster more cooperation and more breakthroughs.”

Dr. Small will be presenting at BrainTech 2017 on “Neurodegeneration and Aging – Zooming in to Alzheimer’s and aging, a roadmap to therapeutics.”


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