Scientists are short of brains.
Not that they lack smarts. Rather, they need more tissue they can study to better understand -- and maybe, someday, treat -- diseases of the mind as well as head injuries.
As dementia diagnoses rise, more athletes get concussions and more soldiers return from war with trauma, the drive to find treatments has taken on new urgency. Researchers’ demand for tissue is increasing, and brain banks are working to spur donations. While it’s easier to persuade donors who live with neurological ailments and want to help find cures, their brains must be compared in studies with healthy ones -- and banks need more of both.
“It’s never enough,” said Thor Stein, an assistant professor at Boston University who studies Alzheimer’s and chronic traumatic encephalopathy, known to affect boxers and others with repeated brain trauma. “In terms of brain supply, we’re always in the red.”
By studying brain cells scientists have discovered deficiencies in the brain chemical dopamine in Parkinson’s patients, leading to therapy that boosts levels and improves motor control. That’s also how they found the brain plaques in Alzheimer’s that are now the focus of drug development. Doctors are gathering in Copenhagen this week to discuss the latest research on the memory-robbing disease.
“Looking at the brains of people with a disease is like looking at the scene of a crime,” said David Dexter, scientific director of the Parkinson’s UK Brain Bank at Imperial College London. “Without having brain banks, we’re not going to cure Alzheimer’s or Parkinson’s.”
In the U.K., only 730 Britons donated their brains for research last year. The potential pool was much larger: About 60,000 deaths are directly related to dementia each year in the U.K. There are no statistics for brain donations in the U.S., though researchers say the numbers needed to keep pace with demand fall far short.
There’s a reluctance to part with the organ that has long been seen as the seat of the soul.
The U.S. Department of Defense set up a brain bank last year to help researchers explore the injuries of returning soldiers with trauma. Months later, the National Institutes of Health established a tissue-sharing network to speed research on schizophrenia and multiple sclerosis. One donation can yield as many as 250 tissue blocks that can be used in research projects, according to the Parkinson’s UK bank.
There’s no substitute for looking at actual cells, said Daniel Perl, who oversees the Defense Department brain bank.
“We’ve attempted to look at high-resolution imaging, which doesn’t require someone to die, but it doesn’t tell you that much,” Perl said in an interview. “It doesn’t get down to what’s happening at the cellular level, which is what you want to know.”
Donating your brain or body to science is a different process than donating a kidney, heart or lung to save a life, which is generally a matter of registering with a government donor registry. Bodies and brains for science, where supply can’t meet demand, require written and witnessed consent.
The NIH encourages the five tissue banks in its fledgling NeuroBioBank network to boost efforts to draw donations. So far, it looks like they will each meet their goal of collecting 100 brains a year, according to the National Institute of Mental Health in Bethesda, Maryland.
After the brain bank at Imperial College was set up 12 years ago, Dexter visited branches of the bank’s affiliated Parkinson’s UK charity to drum up donations. The effort is just now beginning to bear fruit, with about 200 donations a year coming in for both the Parkinson’s bank and an affiliate focused on multiple sclerosis, said Dexter, a professor of neuropharmacology at Imperial College.
The main problem for brain banks is the dearth of donations from people with no signs of illness. Only 10 percent of donations come from healthy people, known as controls in scientific parlance.
“Every brain bank I know of has an issue with control brains,” Perl said. Dexter is more direct: “They’re really the ones holding up research.”
Scientists need healthy brains so they can see the changes brought on by disease.
And then, there’s what Art Caplan calls the “yuck factor.”
“When you talk about donating your brain, it creeps people out,” said Caplan, director of medical ethics at NYU Langone Medical Center in New York. “When there’s a disease present, they get it. When they’re an ordinary citizen, they say ’yuck.’”
In some cases, there are religious concerns, triggered by the belief that a person’s body must remain intact after death to ensure entry to the afterlife.
There’s a different kind of afterlife for donors, said Steve Gentleman, a professor of neuropathology at Imperial College who works with Dexter at the Parkinson’s brain bank. “If you donate, you live forever,” he said.