Neurology Central

DeKosky: Alzheimer’s, CTE and the silver screen

From leading the first prevention trial in Alzheimer’s disease, to a breakthrough in amyloid tracers, and, more recently, being portrayed in Hollywood blockbuster ‘Concussion’ for his role in the first identification of chronic traumatic encephalopathy in American football players, Steven DeKosky has certainly enjoyed a varied career.
Steven has made numerous contributions to neuroscience and neurology that have undoubtedly shaped the field as we know it, but what does he see as his most significant role? What are the biggest gaps yet to be addressed in our knowledge of neurodegenerative disease? And what happens when Hollywood decides to take a story of microscope slides to the Silver Screen? We spoke to Steven about his contributions to neurology, his thoughts on future directions for Alzheimer’s and TBI research, and what it was like to see himself portrayed on film.

As an established expert in the field of Alzheimer’s disease (AD) research and clinical practice, what do you believe has been your biggest contribution to AD research so far?

I believe I’ve had a number of contributions to the research but it is difficult to pick just one – I have been blessed with a long career and my work has moved from basic research in human and animal brains to clinical trials. My group was the first to demonstrate the correlation between numbers of synapses and cognition in living patients who underwent biopsy as part of a study. We were also able to show in this and several other studies the neuroplasticity of the Alzheimer’s brain, despite the neurodegenerative changes taking place. We went on to describe this in mild cognitive impairment (MCI) in the cholinergic system. As the principal investigator, I oversaw a great team when we did the first prevention trial in AD using Ginkgo biloba – a double-blind placebo-controlled trial that took 8 years. We learned a great deal about how to do prevention trials in the future, and demonstrated that Ginkgo does not have an effect on progression of MCI or AD in later life, but also that it was quite safe.

Certainly a high-point of my research career was holding the position of Principle Investigator in the Investigational New Drug clinical trials of Pittsburgh Compound-B, or PiB, invented by two of my colleagues at the University of Pittsburgh (PA, USA), Chester Mathis and William Klunk. PiB was the first amyloid imaging compound developed, and we showed that it could identify presymptomatic presence of amyloid plaques, differentiate difficult dementia cases and identify prodromal AD – that is, MCI due to AD versus MCI not due to AD. It was the breakthrough that led to several other amyloid tracers and now, tau tracers, and we hope the methods can be used to find tracers for most, if not all, of the proteins deposited in different neurodegenerative disorders such as Parkinson’s disease and ALS.

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