Thursday , August 11 2022

"We need their brains: donating in the brain in the search for the treatment of dementia" Science



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The rain is on Wednesday morning, while Dr. Andrew Affleck drives more carefully than usual on his way to the Neuroscience Research Australia building in Randvick.

They are not just dense, crowded roads that set the edge to his caution; in the trunk of his car, removed in several layers of protective containers and placed in ice, the brain is a human being who was alive only a few hours earlier.

It's not an ordinary brain – if any brain could be said to be plain – but the one who has a deadly secret is buried inside. A person who until recently was knitted within this mass of pink, gray and white tissue died of one of the neurodegenerative diseases that are increasingly the cause of death for our elderly population. Perhaps it was Alzheimer's disease that gradually robbed them of a relationship with reality or a frontotemporal dementia that transformed her personality, or Parkinson's disease that shook her body and mind.

Andrew Affleck.



Whatever he claims for his life, this body is on its way to Sydney Brain Bank.

***

"I really hope this will be a brain that will bring us across the line," Affleck says. In Sydney Brain Bank, located in NeuRA, it is hoped that scientists will be able to learn some new and vital insights from their tissue. Or maybe one day, that insight will lead to better understanding, better treatment or even healing.

"Every donation, bringing tissue back to the lab, I tell myself, I really hope this is the main point," says Affleck, a scientific associate at Sydney Brain Bank.

"It's really exciting and you want to do the best you can, not just for science, but for the family too."

Adele Lusson, research assistant, prepares a paraffinic section of tissue for coloring. Brain Bank is located in Randvick, NSV, Australia.



The interior of Sydney Brain Bank looks like a typical research facility: wallpaper glass-glazed offices and laboratories where every available space is filled with equipment, greenhouse and fascicles, but everything is clean and clean. There are no weights in bowls or hollywood decorations that can give the visitor any sense of 600 brains and some spinal wires that have passed through the hands of scientists here.

A few floors beneath glossy laboratories, in a basement that is usually accessed over the elevator, is a space of typical size. It is filled with mobile shelves that can be separated and moved by touching the button.

The shelves are covered with closed white plastic spoons, each containing half of the brain stored in formalin. Dr Claire Shepherd, director of Sydney Brain Bank, is almost apologized for this.

Dr Claire Shepherd.



"Baskets do not look very glamorous or scientific, but many years of experience have told us that they are the best means of keeping the brain," she explains.

The room is controlled by temperature at a pleasant warmth and is completely silent except for several electronic sound signals, because the power shelves move. It is a quiet place; as if in a room full of deep thresholds.

The other half of each of these preserved brains are stored in ultrasonic freezers at a temperature of -80 ° C.

Sydney Brain Bank is one of many such facilities throughout Australia and all over the world, the purpose of which is the collection of brain tissue and spinal cord from people affected by various diseases and conditions. This tissue is available to researchers looking for answers to questions about why these diseases occur, how they are progressing and what can be done to treat, stop or prevent them.

Focus Sydney Brain Bank is a neurodegenerative disease; especially dementia and movement disorders – such as Parkinson's disease, motor neuron disease, Huntington's disease, and progressive supranuclear paralysis.

The donation of the brain is a different organ donor beast, not least because it is one for transplantation while the other is for research.

"Many people just think they are on the donation card, and they ask me:" Can I donate my brain because I am a donor of the organ? "Shepherd says, but brain donation is far more complicated, because for scientists to get the most information from this donated tissue, they must know about the donor's life before they died.

Donors associated with Sidney Brain Bank are recruited through a network of special neurologists and clinics around Sydney, which collects standardized information about their patients, such as their history of the disease and the unique history and traits of their illness. These data include blood tests and regular images with technology such as MRI.

"Then, the value of the tissue is really enriched, because we do not own only the tissue, but we have all this information about how the individual looked alive, which is standardized information about cohorts of individuals," shepherd says.

Andrev Affleck, removal of tissue parts from an automated slider.



However, personal identity and donor life are hidden from staff and researchers working with tissue. It must be that way, not only because of privacy, but also because of the staff handling the donated brains.

Šćepar remembers the donor's family who died, who sent the Bank a home-made booklet on donor life and who they were. It seems that this shot of donor life was an intensely emotional experience for Shepherd, and that emotion is still very close to the surface.

"I'm a brain tissue keeper," she says. "That does not mean that I am insensitive to the person's personality, obviously, but I do not have that close relationship, and it would be dangerous if I thought it, because it will affect this level every day."

***

Time is an enemy of organ donations. The longer the organ – whether the heart, the kidney or the brain – remains inside a body that no longer supplies it with animal oxygen, the more tissue breaks and the worse the quality of the information can be drawn from it.

Andrev Affleck, removal of tissue parts from an automated slider.



Laboratory layers in the laboratory.



The staff of Sydney Brain Bank carries pager with them 24 hours a day, seven days a week, 365 days a year. When a donor dies, one of the first calls for family, carers or medical personnel is this service.

Things must happen quickly. Whoever is on the call then connects to the morgue in which the body and burial will be taken.

"One of the main things we intend to do is not really interfere with funeral arrangements for the family … we can best, we are trying to speed up the donation for them, so there is no delay," Affleck explains.

Removing the brain – and spinal cord if donated – is taking place in one of the few remaining operational morgues in Sydney. It's a relatively fast process, for at most a couple of hours, and then Aflek or whoever is on the call, return the tissue to Brain Bank.

When it arrives, the brain is divided into two hemispheres. One half is frozen, along with tissue samples that are cut out of the brain region that are of particular interest to the researchers. Frozen tissue can be studied under a microscope later, but more importantly, freezing protects DNA, proteins, and tissue biochemistry.

Adele Lusson, research assistant, prepares a paraffinic section of tissue for coloring.



The second half of the brain is immersed in formalin within two months, allowing the liquid preservative to penetrate the brain completely. Once this process is completed, this hemisphere is stored in 3mm sections layered on small acetate sheets, in white buckets that connect the basement shelves. At this point Brain Bank staff takes less samples or "blocks" from different parts of the brain that are of interest for further research.

"There may be softening or there is a change in the color of the tissue or there is something that really needs further research under the microscope," Affleck says. These smaller sectors also treat different stains that emphasize presence – or absence – of protein and structure.

The final step is a complete, standardized report that links what Brain Bank has noticed about the tissue with what is known about the life and disease of donors. This information is the starting point for researchers interested in the study of tissue. It may be somewhere in these folders, slide boxes, tissue samples, and data pages the answer they are looking for.

***

What about donors and their families? What are they looking for when they label this box and give their consent to remove their weakest personal body after death?

Lucille Bloch never heard of a brain donation until she attended a lecture by Professor John Hodges, who led a research group in NeuRA.

Lucille Bloch will leave her brain at Sydney Brain Bank. Her husband Keith Bloch, who died, also donated his brain.



Black and white photo of Lucille and Keith Bloch.



Keith Bloch, who died, also donated his brain.



"He said dementia is growing in number, we need to think about creating dementia drugs, and what we need is people with dementia, when they die, we need their brains," she recalls.

The face of Keith's Louley's husband was diagnosed with a frontotemporal dementia. After the lecture, the village told him what she learned with him.

"And, he said," Well, dear, at this moment we have four children, and two grandchildren, I will give my brain because I want to help if our children take it and other people [get it]. "

Keith died 10 years ago, but Lucille is still visiting NeuRA occasionally. "I am part of it," she says. Experience has made her advocate for the donation of the brain, and for greater awareness and understanding of dementia. When the time comes, she will donate her brain.

Lisa Webb's husband Bob died two years ago from what was diagnosed as the primary progressive aphasia-a gradual loss of linguistic abilities. However, this is actually a symptom of Parkinson's disease, a diagnosis that has not been discovered until death.

Shortly after Bob's diagnosis, the topic of brain donation came during a visit to NeuRA tests.

"For him, the brain was just part of the body, he was always happy to donate organs, and the brain is just another organ," Liza says. "I suppose I have the same attitude; I looked and thought if we could do something to help other people not to go through this, then we do it."

He thinks Bob's tissue is somewhere in Sydney Brain Bank and helps researchers to give it a sense of comfort.

"There is that little moment that goes there, in fact, it really does not exist, as if it still works well, and it's really a nice thing to keep."

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