TMC PULSE

t m c » p u l s e | m ay 2 0 1 7 14 Insight into Alzheimer's Researchers are looking for signs of the disease in retina tissue S andra Devall stood by the window at Alvin Community College, looking for her husband's pickup truck. In her haste to get to watercolor class, she had left home without some of her art supplies. "He doesn't mind bringing them to me," Devall said. "My husband is used to me calling about something that I've forgotten." Forgetting things has steadily become Devall's norm since 2013, when she was diagnosed with early-onset Alzheimer's disease. But taking water- color class two days a week and being a master gardener help maintain her social engagement skills. By the time she was officially diagnosed, Devall, 75, knew what was causing her memory deficiency. The retired graphic arts teacher at College of the Mainland had noticed the same symptoms while taking care of her mother, who also had Alzheimer's. Devall's mother was diagnosed at age 70, two years after she had moved in with Devall and her husband following her own husband's death. "She had watched two sisters go through it, and I knew she was very afraid of having it," Devall said. "Ironically, I don't think she was ever aware she had it. She lived only two years after that." Prior to her mother's diagno- sis, Devall recalls not being able to pinpoint any symptoms that might have led them to think her mother had Alzheimer's or the eventual multi- infarct dementia caused by the dis- ruption of blood flow to the brain. All she knew was whatever was going on was challenging for everyone in the household—herself, her husband and her mother. "My mother had been such a kind, easygoing woman," Devall said. "Now she was frightened, and she would not leave my side. By the time I got her to a doctor, it was obvious to him just being around her. I hated to talk about Alzheimer's in front of her because, in her time, you just didn't do that. But the doctor told me, 'Sandra, look at her and tell me if you think she knows what we are talking about.'" So four years ago, when Devall began forgetting things, she knew what her doctor was going to tell her. Key could be early detection Researchers at The University of Texas Medical Branch at Galveston are study- ing Alzheimer's disease to determine what can be done to diagnose it earlier. A recent UTMB study sheds light on how Alzheimer's disease begins within the brain. Researchers found a rela- tionship between inflammation, a toxic protein, and the onset of the disease. They also identified a way that doctors can detect early signs of Alzheimer's by looking at the backs of patients' eyes. UTMB researchers have previously found evidence that tau oligomers, which are abundant in the central nervous system, may be present in the early stages of Alzheimer's. Brain cells depend on tau protein to form high- ways for the cells to receive nutrients and get rid of waste, said Rakez Kayed, Ph.D., an associate professor in UTMB's department of neurology and one of the authors of the recent study. In some neurodegenerative diseases, including Alzheimer's, the tau protein changes into a toxic form known as a tau oligo- mer and begins clumping into neuro- fibrillary tangles, he added. "They cause havoc in a brain cell and are super toxic because the nervous system doesn't recognize it," Kayed said. When those proteins stick together, molecular nutrients can no longer move to where they are needed, which leads to the eventual death of the brain cells. In a paper published in the Journal of Alzheimer's Disease, the authors pro- vide evidence "that tau oligomers are present in the retina and are associated with inflammatory cells … These results suggest that there may be a toxic relationship between tau oligomers and inflammation." Imaging the brain for evidence of tau oligomers is a complicated pro- cedure, but an eye exam is not, Kayed said. Researchers are also looking at tau levels in spinal fluid as an indicator of Alzheimer's, he added. "The problem with Alzheimer's is that the genetic component is limited—a small number of people have genetic risk factors for the disease," Kayed said. "If we could test spinal fluid, the eyes and eventually blood, it could tell us the best therapy. If we do this early enough, we could possibly halt the progress of Alzheimer's." Little tests Devall wishes an eye exam could have given her an earlier Alzheimer's diagno- sis, but she is hopeful that researchers will be able to help others with this discovery. She volunteers for Alzheimer's research and testing at UTMB. B y C h r i s t i n e H a l l Sandra Devall, who has Alzheimer's disease, attends a watercolor class at Alvin Community College to keep up her social and physical skills.

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