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Banking on the future; Exploring the mysteries of the brain
By Christopher A. Szechenyi, Boston.com Staff, 08/03/00
BELMONT - Stephen Vincent's beeper woke him up at home at 5:10 a.m. on Monday, the beginning of another not-so-routine day in the life of a man who helps
run the largest brain bank in the world. Yes, brain bank.
|
 Brains bank
Brain links
Donate yours
Check out this photo gallery of brains donated to science.
 Photos
How to donate your brain to science:
To begin the process of brain donation, call 1-800-BRAINBANK
(1-800-272-4622) at the time of impending death or immediately after the
death of a donor. If you are interested in a brain donation, McLean Hospital recommends that your family discuss the subject and inform your physician about the decision.
After calling, you can register the planneddonation, and you will receive a wallet-sized donor card to facilitate the process. (A regular organ donor card does not list the brain, so a separate registration process is necessary.) All donor information is kept strictly confidential.
Harvard Brain Tissue Resource Center:
www.brainbank.mclean.org:8080
National Alliance for the Mentally Ill, Massachusetts Chapter:
www.namimass.org
National Institute for Mental Health:
www.nimh.nih.gov
Danada Foundation:
www.dana.org
Whole Brain Atlas, by Dr. Keith A. Johnson:
www.med.harvard.edu:80/
AANLIB/home.html
Virtual Hospital:
www.vh.org/
Providers/Textbooks/
BrainAnatomy/html
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The beep came from a family at a nursing home in Pennsylvania. They wanted
to donate the brain of a loved one, who had suffered from Huntington's
disease and had chosen to help scientists find a cure.
"I had to deal with the nuts and bolts of things," recalled Vincent, a man
who clearly relishes his unusual job. "I needed to make sure the body was
brought to refrigeration. I assured the family that we would be in touch
with the pathology service to make sure things happened according to plan."
Within 24 hours, the two-pound, five-ounce brain arrived by courier service
at Harvard's Brain Tissue Center, a federally-funded brain bank located on
the sprawling grounds of McLean Hospital.
With more than 5,000 brains stored in freezers and formaldehyde, the brain
bank serves as a national resource for scientists who want to obtain tissues
from the brains of those with troubling disorders such as Alzheimer's
disease.
Each year, the center ships more than 4,000 tissue samples to some
100 scientists around the world.
"We're constantly in awe of brains here," said Vincent, a neuroscientist who
has seen hundreds of brains in his 12 years at McLean as a scientist and more recently as associate director of the
brain bank.
"We don't get tired of it. It's such an amazing part of nature's
machinery."
A team of researchers on three floors at McLean are trying to decipher the
way that machinery works at the cellular level in people afflicted
with schizophrenia, manic depression, Alzheimer's, autism and a wide range
of other complex syndromes.
The researchers here are on the front lines of an evolution in understanding mental illness. Twenty years ago, the relationship between the symptoms
of mental disease and brain disorders was much less clear.
"It was impossible to understand these disorders at a fundamental level. We
were flying blind," said Dr. Joseph Coyle, chief of the consolidated
psychiatry department at Harvard Medical School.
But with the discovery of the connection between a lack of dopamine, a
chemical messenger, and the development of Parkinson's disease, in the
1960s, the science took on a new head of steam. "That laid the foundation,"
Coyle said.
The brain bank was set up at McLean in 1978 by Dr. Ted Bird to encourage
further research. Since then, scientists have discovered fundamental
causes of such neurological disorders as Huntington's, Parkinson's and
Alzheimer's diseases.
But there is still much work to be done, especially on mental illnesses like
schizophrenia.
Dr. Sabina Berretta has been preparing an experiment for three years to
unravel the mysteries of the disease. She has been accumulating enough
tissue to compare how certain regions in the brain of schizophrenic patients
affect each other.
"The question is whether they are all affected or is one part affecting
another," Berretta said. "I'm lucky enough to receive whole regions of the
brain from patients with schizophrenia. I'm lucky because in most cases,
scientists are unable to get whole regions of the brains."
Such painstaking work has given hope to people like Katie Eaves, who donated
the brain of her 26-year-old son, Jason, after he committed suicide in 1998.
The young man had been diagnosed three years earlier with schizophrenia, a
debilitating mental illness characterized by delusions and disorganized
behavior.
"We believed as a family that this is something we should do," said
Eaves, a resident of Westford, near the New Hampshire
border. Like other families facing from mental illness in a loved one,
Eaves and her husband Gene heard about the brain research program
at McLean by word of mouth.
They saw their son slowly degenerate from an artistic college
student to someone who was nervous, depressed and had hallucinations.
When he died, "We were very numb," Eaves recalled. "We didn't
really think about the next step."
It was Jason's brother, Ethan, who called the brain bank. "We know that's where a treatment or a cure will be found," Eaves said. "We hope that this will give us some answers. We would like to
know what happened to my son."
Once a brain arrives at the center, it is cut in half. A neuropathologist
slices one of its hemispheres into pieces. Then Tim Wheelock, a pathology
technician, takes those pieces and shaves them into paper-thin wafers,
stains them and takes photos of them with a digital camera. Each photo is
stored in a computer and available for viewing via the Internet.
"It gives
the researchers the ability to participate in the selection process,"
Vincent said.
A pathologist then examines the slides with the brain tissue to see whether
the clinical diagnoses of a patient, made by a doctor before death, was
indeed correct. About 70 percent of doctors' diagnoses are
verified in the lab.
The other half of the brain is dissected into regions and rapidly frozen at 160 degrees below zero centigrade. The organs are kept in huge freezers, backed up with
CO2 gas in case of an emergency.
Each of the tens of thousands of tissue samples is carefully marked by a
number and the entire inventory is tracked in a computer. Some of the brain
tissues at McLean are 15 years old and remain in a state of suspended
animation.
Staffed by eight full-time employees on call 24 hours a day, the center
receives about 325 brains each year. But there is still a shortage of
tissue. "We need normal, non-diseased brains," Vincent said, noting that
scientists use them for comparative research.
At McLean, which also serves as a Harvard teaching hospital, some of the leading brain
researchers in the world are using tissue from the brain bank. Dr.
Coyle, the psychiatry department chairman, said that researchers have
learned that the brain is "constantly changing over the course of an
individual's lifetime, much like the Internet itself, though the brain has
the hard wired infrastructure."
Scientists have also learned that the brain functions by means of more than
100 chemical messengers called neurotransmitters. It is the chemical
imbalances among some of those substances that cause the symptoms of
Alzheimer's and Huntington's diseases and mental illnesses such as
schizophrenia and manic depression.
In his laboratory, Coyle has focused on the role of glutamate, a major
neurotransmitter, which is found in the food additive, Accent, to enhance
flavors. Among other researchers, his team has found a link between the
dysfunction in the brain's use of glutamate and schizophrenia. "It will help
us develop treatment strategies," Coyle said.
Another researcher at McLean, Dr. Francine Benes, the director of the brain
bank, is looking for alterations in the wiring of the brains of patients
with schizophrenia. Her team has examined more than 80 brains during the
past 19 years.
"It's a complex problem. The brains of schizophrenic patients looks
relatively normal," she said. "But there are very small alterations in the
wiring of their brains that render the individual abnormal."
She has identified a specific neurotransmitter, called GABA, that may
contribute to schizophrenia when it's produced by the body in insufficient
quantities. "Eventually we may able to identify people who are at risk of
developing schizophrenia and potentially give them treatment before they
develop the disease," Benes said.
Another neuroscientist, Dr. Anne Cataldo, is examining the brains of
Alzheimer's patients and has found inter-cellular abnormalities that may
contribute to the disease. Among others, she's pinpointed a substance,
called A-beta, which forms large protein clumps in patients' brains.
As research continues to contribute to the understanding of a number of
diseases, a donation arrives nearly once a day at the brain bank. It is
Vincent's job to explain to families the benefits of their decisions and to make
the arrangements to receive them.
"We deal with death a lot," Vincent said. "We deal with people who are
grieving. But that's balanced out with pursuing the frontiers of brain
research. Ultimately, this is very fulfilling."
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