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Brains matter

Sun, Dec 01, 2013

Randy Woltjer ’81 works at a bank. At his building, there are regular deposits and withdrawals. And these transactions increase the chance for cures of some of the most pernicious diseases—Alzheimer’s, Parkinson’s and ALS.

Woltjer manages the , affiliated with the in Portland. The bank is a human tissue repository for brain research studies.

The Oregon Brain Bank is one of about 25 similar facilities across the country, many—but not all—connected to Alzheimer’s research centers.

There are two ways in which people interact with the bank. One group consists of families who wish to donate the brain of a loved one for research—and perhaps also have a brain autopsy done to learn more about the nature of the disease. The other is brain researchers who ask for tissue samples for research; Woltjer recently sent 200 different samples to one such project. At any given time, 50 or so research efforts are supported.

Originally, the Brain Bank was established to collect tissue from patients enrolled in research studies or who had died of unexplained brain illnesses. However, these were limited in number initially.

“In its early years, a ‘family interest’ function was added, whereby essentially any family could request a brain autopsy,” said Woltjer. “For a variety of reasons, that assistance was halted, but when I arrived in 2006, I reinstated the program. Today, about half of our donated tissue comes from these families.”

Grant money sponsors brain autopsies for patients in research; philanthropic contributions support all other autopsies. Currently, the Brain Bank provides its services free to families and to scientists in order to make the barriers to brain study as low as possible. Most patients come from Oregon or neighboring states, but the bank has collected brain tissue from families from coast to coast, where there was not a local institution to help.

Woltjer has conducted thousands of brain autopsies and understands the desire for families to know more about a deceased loved one’s condition—and if there are implications for future family members.

“Even with the modern scans used today, a diagnosis is sometimes unclear and often incomplete,” he said. “In an elderly person, what is normal aging and what is disease starts to overlap. Often, more than one disease is present.”

With an average life expectancy in the United States at 78 years—and because of how that average is skewed, many people are living longer than the average—Woltjer sees an increasing demographic problem looming.

Americans already spend $200 billion a year  on Alzheimer’s-related treatment and care, even in the absence of a cure. He expects that dollar figure to increase fivefold in the next 25 to 30 years if trends continue.

“There’s an impetus to do something and pressure to find cures,” Woltjer said. And he sees hopeful signs.

“I would say that we are making progress. Alzheimer’s has been cured in mice many times over, but mice and mouse models of disease don’t have the complexity of what you find in the human brain,” he said. “Yet some key processes have been modeled, and some interesting strategies to target these have been developed. There is widespread expectation of new drugs that may show some success in the next 10 years or so.”

Woltjer began his studies at Calvin in , switched to , and late in his time on campus added biology and pre-med coursework. He took a year off after Calvin as he applied to medical school, picking up a master’s at Michigan State in, surprisingly, English.

“I developed a love of Shakespeare,” he said, adding with a chuckle: “Going to med school, I thought I’d never have the chance to read anything else ever again, but that hasn’t been the case. Plus, themes from the plays keep coming up in real life all the time.”

Woltjer earned his PhD and MD degrees at Vanderbilt, moving from cancer research to brain studies. He did a pathology residency and received a grant related to Alzheimer’s research that he began at the University of Washington. In that work, he collaborated with the Oregon Brain Bank and became an obvious choice to become its director when the position opened.

How can people keep their brains healthy? “There is something to the idea of ‘cognitive reserve,’” he said. “It is inevitable that the brain will age, as the rest of our bodies do, but staying intellectually, socially and physically active can slow impairment. What we most need is a change in our society to promote good habits that include healthy eating and living—and to start teaching these right away to our children.”