A Cholesterol Test for the Brain
What are biomarkers, and how do they relate to neurodegenerative disease? Dr. Richard Isaacson, neurologist and world-renowned Alzheimer’s prevention researcher, explains.
Have you heard the term “biomarkers” but aren’t quite sure what they are or how they relate to neurodegenerative disease? Well, if you’ve ever had your blood drawn and tested, a care provider has used a blood-based biomarker as an indicator of your health. For example, blood glucose is a key biomarker for diabetes that can be used to diagnose the condition and provide critical information about how to manage it (depending on whether blood sugar levels are too high or too low). Another common blood test, referred to as a lipid panel or a complete cholesterol test, measures four types of fats in the blood: total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides.
These four fats serve as biomarkers of vascular health, with high levels indicating an increased risk of atherosclerotic cardiovascular disease, heart attack, and stroke. Measuring and tracking cholesterol is a quick, affordable, and precise strategy to managing heart health. If your cholesterol is high, your healthcare provider will likely prescribe a shift in diet, a boost in exercise frequency, and perhaps a statin medication. Another lipid panel ordered at your next appointment would then reveal whether these efforts had resulted in improvements to your cholesterol and risk of disease, and in turn influence your care plan.
Blood tests can provide a great deal of insight into the health of your heart, liver, kidneys, thyroid, metabolism, and more, but researchers have yet to create a comprehensive equivalent test that can provide insight into your brain health and risk of developing a neurodegenerative disease. Fortunately, Dr. Richard Isaacson and his team at the Institute for Neurodegenerative Diseases are working to change that.
Dr. Isaacson shares:
"We're trying to develop the cholesterol test for the brain where we're not just able to diagnose and assess risk, but [also] understand trajectory of change over time. If I'm going to tell someone to exercise on a regular basis and manage their diabetes and high blood pressure better, and take this vitamin, or take this supplement, or take this medication . . . We can then use biomarkers to…evaluate the effectiveness of the treatments that are personalized for that patient. And then we can understand if that person's on the right path."
Switching to a Mediterranean-style diet and taking up regular exercise can lend to better results on your cholesterol test, indicating improvements to your vascular health. But how can we quantify the impact of those lifestyle changes on your brain health? Dr. Isaacson’s goal is to create a panel of blood-based biomarkers that will provide that information in the relatively near future. In addition to the commonly studied neurodegenerative culprit proteins, amyloid-beta and tau (which make up damaging plaques and tangles in the brain, respectively), Dr. Isaacson and his team are studying over 120 markers in order to develop the most effective and cost-efficient blood test.
In fact, they’re even working on developing tests that can be done right at home using finger prick cards to collect a small amount of blood, an advancement that would reduce cost and increase access to these tests across the world. These innovations would bring us leaps and bounds further than where we are currently when it comes to clinical Alzheimer’s diagnostics.
Today, if an individual presents with symptoms of dementia, they may receive a lumbar puncture, a painful procedure which entails a needle being inserted into the spine to remove cerebrospinal fluid for measurements of amyloid and tau levels. Alternatively, a positron emission tomography (PET) scan, a brain imaging test, could be conducted to visualize the presence of amyloid or tau in the brain. While both of these tests can provide useful information, they are expensive, time-consuming, associated with side-effects, and often geographically inaccessible. As a result, these tests cannot be widely delivered as routine health screenings. The ease of an accurate blood-test for monitoring neurodegenerative disease risk would allow for early detection and early diagnosis of neurodegenerative disease before symptoms.
Dr. Isaacson explains:
"The earlier we can understand and diagnose a person, the more likely we are to have success in treating. You know, neurodegenerative diseases start in the brain decades before the first symptom begins, whether it’s a motor symptom like slowness of movement or tremor, or a cognitive symptom like memory loss . . . And using blood-based biomarkers to try to diagnose brain disease is something that you probably haven’t heard too much about in the past, but you’re going to be hearing a lot about it in the future."
To learn more about IND’s work on developing the equivalent of a cholesterol test for the brain, watch our conversation with Dr. Richard Isaacson in the video above.
By Alicia J. Barber, PhD
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