Dr. Reisa Sperling explains why she studies Alzheimer’s disease and memory loss. Sadly, her grandfather was affected by the disease, “so that was another motivation.” At the time of his decline, Reisa was 27 and contemplating giving up an acting career in New York City to return to medical school. “Alzheimer’s robs people of who they are, particularly memory, but it also causes changes in personality and eventually all cognitive domains,” she says. “From the science point of view, it was a window into understanding the parts of the brain that have always fascinated me.”
The tool: functional Magnetic Resonance Imaging (fMRI)People have been studying memory and other aspects of cognition for centuries. But only recently has state-of-the-art imaging technology been able to produce a dynamic “snapshot” of the brain in action. As Reisa points out about her decision to study neurology, “it was an incredibly fortuitous time to have this interest and a way of looking at it.”
The target: the hippocampusThroughout her medical school and residency, she was struck by how many older people worried that they had Alzheimer’s—“even if they don’t call it by the A-word”—because they had trouble remembering names. All memory can be thought of as accumulating and linking our experiences, but the hippocampus plays a key role in forming new associations and is affected early on by Alzheimer’s. “That’s why our fMRI studies are aimed at watching people learn new information: because that’s what goes wrong first in Alzheimer’s,” the neurologist explains.
The test: face-name associationMatching names and faces is a particularly difficult task because it requires us to form new visual and verbal associations between inherently unrelated items. “So from both the neuroscience and clinical point of view, that task made sense,” Reisa says. First, she looked at how healthy young people performed at learning a total of 455 face-name pairs. “What really turned on in the brain when young subjects correctly learned the face-name pairs was the hippocampus.”
She then compared the face–name association abilities of 10 healthy young people, 10 healthy elderly people, and seven patients with mild Alzheimer’s disease. Sure enough, it showed that the hippocampus was indeed the part of the brain that wasn’t working in Alzheimer’s disease. “It was already known that the hippocampus shrinks in Alzheimer’s patients, but this one was one of the early papers that showed that it was functionally impaired,” Reisa explains.
The goal: better treatmentsAll brains contain a protein called amyloid, but in the brains of Alzheimer’s patients it accumulates in clumps and forms plaques. “We don’t know how these plaques and tangles translate into the behavioral and cognitive symptoms we see. Functional and structural imaging will teach us about those changes,” Reisa explains. “The other thing I’m excited about is using fMRI to establish when we have a drug that lowers amyloid, whether by decreasing its production, or by clearing it out of the brain. Is it hitting the right targets in the brain and changing brain function in a way that’s meaningful?”
She predicts that drug therapies will be found that will slow the progression of Alzheimer’s, and that advances in treatment will go hand-in-hand with better methods of diagnosis, because very early treatments would be the most effective. “Currently, there’s a lot of pathology by the time the disease is diagnosed, so we need procedures that are useful five or 10 years earlier.” However, in the early stages of the disease’s progression, it is harder to see whether the drugs are working, so better biological markers are needed. “We’re working on both sides of the problem simultaneously,” says the neurologist.
A passionate commitmentReisa readily confesses to thinking about her job a hundred hours a week, but when not in the lab she’s raising two small children with her husband, also a neurologist. “Neuroscience is very competitive and fast-moving, but it’s also wide open and very dynamic,” she points out, adding that a relative abundance of excellent role models help make it a good field for women. After all, she says with a smile, “It’s the coolest thing ever.”
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Name: Reisa Sperling
Born: August 29, 1959
Where I go to watch IMAX films: Science Museum in Boston
Job: Assistant professor of neurology, Harvard Medical School; director of clinical research, Memory Disorders Unit, Brigham and Women’s Hospital, Boston
Education: B.A.: Columbia University, New York City, M.D., M.MSc.: Harvard Medical School, Cambridge, MA
Book/s I'd want if I were stranded on a desert island: Everything by Henry James
Favorite place to visit: Fiji
Favorite food: Sushi
Favorite artist/kind of music: Beethoven
Biking experiences: I love to bike on islands near the sea, like Martha’s Vineyard.