A magazine for friends of the Warren Alpert Medical School of Brown University.

Windows Into Alzheimer’s

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Retinas may help doctors identify the disease long before the onset of symptoms.

Mark Wolff wanted to know. To him, the thought of suffering through Alzheimer’s disease the way his father did—without knowing, and without his family knowing, what he was up against until late in its progression—is worse than learning, even while he’s still perfectly healthy, that a possible precursor of the disease has gained a toehold.

“I’m not a worrier by nature,” Wolff says. “I just don’t want to wind up like my dad. It was just a nightmare what happened to him. He didn’t get the medical attention he needed and his quality of life could have been better.”

So Wolff, a lighting company executive from Bristol, RI, enrolled in a trial at Butler Hospital and found out through a positron emission tomography (PET) scan of his brain that he has early signs of amyloid plaque. The presence of plaque, a tangle of proteins that could eventually cause the neurodegeneration of Alzheimer’s disease, is a risk factor. Wolff might never develop the disease, or if he does, it might not affect him for a decade or more.

The trial, being conducted at both Butler and Rhode Island Hospital, is led by Stephen Salloway, MD, MS, a professor of neurology and of psychiatry and human behavior at the Warren Alpert Medical School and director of Butler’s Memory and Aging Program. It has two goals: One is to test whether the drug solanezumab will prevent or delay memory loss and slow amyloid plaque buildup in people at increased risk for Alzheimer’s. The other, via a sub-study launched at Butler, is to test whether a retinal scan can monitor that progress as well as the much more expensive PET scans.

Salloway is working on the larger trial with Brian Ott, MD, a professor of neurology and director of the Alzheimer’s Disease and Memory Disorders Center at Rhode Island Hospital. Inspired in large part by research led by Peter Snyder, PhD, a professor of neurology and ophthalmology and senior vice president and chief research officer at Lifespan, Salloway and Ott believe that the retina may provide a reliable reflection of early but significant Alzheimer’s disease risk in the brain.

If so, that could vastly expand the number of people around the world who receive an early risk assessment and could save tremendous amounts of money compared to $5,000 PET scans, Snyder says.

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