The Dementia Researcher, ISTAART PIA Relay Podcast is back for a second, 5-part series. Where the interviewee becomes the interviewer. With five leading researchers discussing their research, their field, and the work of the Alzheimer’s Association ISTAART Professional Interest Area they represent.
Part Four – Dr Betty Tijms [1] interviews Dr Claudio Babiloni [2].
Dr Betty Tijms is an Associate Professor at the Alzheimer center, department of Neurology, Amsterdam UMC in the Netherlands. Jennifer’s research focusses on better understanding interindividual differences in the early stages of Alzheimer’s disease that are related to developing dementia, through MR imaging and CSF proteomic analyses. She has recently, started work on cerebrospinal fluid proteomics as one of the most comprehensive measures to get more insight into interindividual differences in underlying pathophysiological processes. Betty is representing the Neuroimaging PIA.
Dr Claudio Babiloni is an Associate Professor of Physiology at Sapienza University of Rome. Claudio is investigating the brain rhythms underlying the regulation of vigilance and cognitive functions in aging, with a particular interest in the main progressive neurodegenerative diseases leading to dementia such as Alzheimer’s, Lewy body, and Parkinson’s diseases. The primary methods of this research are EEG and neuroimaging techniques. Claudio is representing the Electrophysiology PIA.
The Alzheimer’s Association International Society to Advance Alzheimer’s Research and Treatment (ISTAART) convenes the global Alzheimer’s and dementia science community. Members share knowledge, fuel collaboration and advance research to find more effective ways to detect, treat and prevent Alzheimer’s and other dementias. Professional Interest Areas (PIA) are an assembly of ISTAART members with common subspecialties or interests.
There are currently 27 PIA covering a wide range of interests and fields, from the PIA to Elevate Early Career Researchers to Biofluid Based Biomarkers and everything in between.
To sign-up to ISTAART and a PIA visit www.alz.org/istaart/ [3]
Voice Over:
Hello and thank you for listening to the second season of the ISTAART PIA Relay Podcast series brought to you by Dementia Researcher. ISTAART is a professional society and part of the Alzheimer’s Association representing scientists, physicians, and other dementia professionals active in researching and understanding the causes and treatments of Alzheimer’s disease and other dementias. In this five-part series, we once again asked members of the ISTAART professional interest areas to take turns interviewing their colleagues and being interviewed themselves with the interviewee going on to be the next episode’s interviewer. We’ll be releasing one of these podcasts each day in the build-up to the Alzheimer’s Association’s international virtual conference to showcase the work of ISTAART PIAs. Thank you for listening.
Dr Betty Tijms:
Hi, everyone, and thanks for joining us. I’m Betty Tijms, and I’m an associate professor at the Alzheimer’s Center in Amsterdam, the Netherlands, and I chair the neuro imaging PIA. And today it’s my pleasure to be talking with Claudio Babiloni about the electrophysiology PIA. So Claudio, can I start by asking you to introduce yourself and maybe tell us a bit about the PIA you’re involved in?
Dr Claudio Babiloni:
Yes. Thanks. I am professor of physiology at the Department of Physiology and Pharmacology in Sapienza University of Rome, and I chair the ISTAART electrophysiology professional interest area. And I am at the end of my role, and so in September, the elected chair, Professor [inaudible 00:02:20] will take the role of chair. Our PIA promotes electrophysiological research in Alzheimer’s disease and related dementias.
Dr Betty Tijms:
Okay. Thank you. And so maybe before we get into the PIAs a bit more, maybe you can start with telling us a bit about why you got involved in Alzheimer’s research, and maybe also why electrophysiology.
Dr Claudio Babiloni:
Yes. Okay. And I’m a psychology as a basic formation and also have a PhD in biomedical science. So I try to unit my interests in psychology and the neurobiology and the focus of my research is human mind and consciousness. I use electroencephalographic techniques to study the brain and investigate how the oscillations of brain activity can regulate the flow of vigilance and consciousness in humans. And these oscillations, these brain rhythms are the basis of also attention, memory, and the reasoning. Of course, in the course of the years, I was aware that there are more than 40 million of people with Alzheimer’s disease and related dementias. And most of them have disturbances of vigilance and consciousness. And these disturbances have a very dramatic impact on their life. And today we don’t have drugs to stop these diseases, but maybe we can improve our treatment to regulate the vigilance and improve the quality of life. Recently, my mother suffered from Alzheimer’s disease and died. And nowadays, even my father suffers from Alzheimer’s disease dementia. So now it’s not only a scientific interest, but it’s also a personal battle.
Dr Betty Tijms:
Yeah. It’s coming now very close to you, but I can also see why it’s logical for you to have moved into the dementia field with your prime interests in the individual ones and consciousness and awareness for electrophysiology. So what do you think are then the hot topics at the moment in your field?
Dr Claudio Babiloni:
Yes. And electrophysiology PIA is formed by researchers and the people from industries and the companies which want to explore it, the study of brain electrical activity, to understand that the model of Alzheimer’s disease and the related dementias and also the way to regulate and the normalized the brain electrical activity in patients with Alzheimer’s disease from early stages to dementia. So the hot topics are in the field of human clinical trials, testing the effect of a symptomatic and disease modifying drugs on brain activity of patients from early stages of the disease when there are no cognitive impairments or behavioural deficits to the stages of my cognitive impairment and dementia. And the idea is to use electrophysiological measures obtained by EEG recordings in the resting state quiet wakefulness or during cognitive tasks as end points to test the effect of the intervention. On the other hand, there was also the hot topic of the investigation of electrophysiology and brain electrical activity in animal models of Alzheimer’s disease for example to-
Dr Betty Tijms:
[crosstalk 00:07:16] Yeah. So then you can really probe what’s going on. So I always wonder how there’s this thick skull, right, that’s kind of interfering with your electrodes in the brain activity. So I can imagine that that’s a very hot topic to look into animals so that you can come through the skull and understand better what’s happening.Dr Claudio Babiloni:
Yeah. Yes. Yes. Exactly. The idea is that you can test a panel of candidate drugs for the patients, and you can test this panel in, for example, mice with some mutations producing the accumulation of a beta amyloid in the brain or [inaudible 00:08:08] in the brain. And you can have a competition between different candidate drugs to select the best one in the normalization of brain activity in these mouse models, for example, to move on the best drugs to human clinical trials. And you know they are really expensive.
Dr Betty Tijms:
Yeah. And I think it’s also striking that you say that one of the hot topics is that people are moving to focus on the earlier stages of the disease, like preclinical AD. What do you think about that in terms of electrophysiology? I can imagine that if you don’t have impairments in cognition yet that maybe that’s because your brain succeeds in having these normal brain activation patterns in spite of the amyloids.
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. Yeah. You are right. That this is an hot topic also in the relation to the idea that you may, of course, treat the brain to remove amyloid deposition [inaudible 00:09:30] or you can slow down the accumulation, but you can also prevent the accumulation of a beta amyloid. So the interest of many researchers is on the preclinical stages of the disease when you have a relatively good cognitive performance even if you are a positive to biomarkers, diagnostic biomarkers of a [inaudible 00:09:57] disease in terms of a beta accumulation in the brain or a slight neurodegenerative process.
Dr Claudio Babiloni:
And in this sense, electrophysiology can be used to put in evidence some abnormalities in the brain oscillations in the resting state condition, for example, an increase of slow waves in the EEG activity or other alterations in the shape of EEG traces. And the, for example, your institution in Amsterdam gave really great contributions in this field also showing the abnormalities in the functional brain connectivity derived from EEG activity. And the, for example, there is an important project called Inside in Paris. They recorded EEG and also neuroimaging data from hundreds of people without the cognitive deficits. Some of them were positive to accumulation of amyloid in the brain and different groups could demonstrate abnormalities in the EEG activity in these patients.
Dr Betty Tijms:
And so, yeah, it’s not because you maintain normal brain activity that that’s the reason that you have normal cognition. It’s already altering. Yeah. That’s fascinating. And so what would be your favorite research topic to focus on if you could be free for the next month and only dedicate your time on research? What would you do?
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. I really think that there is a bias in the research. The focus of Alzheimer’s disease research in patients is on measurement of amyloid accumulation in the brain or [inaudible 00:12:25] in the brain and the effect of neuro-degeneration in terms of atrophy in the cerebral cortex of hippocampus in relation to memory. And this is really important, of course, to understand the disease and also to understand the effect of the disease modifying drugs, but a lot of Alzheimer’s disease patients suffer from the incapacity to maintain the vigilance during daylight.
Dr Claudio Babiloni:
So they cannot have a good conversation with other people. They can not follow TV programs because they fall asleep. And so I think that this is a part of the research that should be developed on the brain correlates of vigilance and sleep wake cycle in patients with Alzheimer’s disease in order to understand why they fall asleep very quickly or they cannot have a steady vigilance and try to use the drugs we have in the pharmacy to improve vigilance in this patients in order to add on these drugs together with other symptomatic. And recently, also this is modifying drugs for Alzheimer’s disease.
Dr Betty Tijms:
Yeah. Wow. I can see that you would want to do that. Probably it will take more than a month.
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. Yeah. Absolutely. Absolutely.
Dr Betty Tijms:
It will be a good start.
Dr Claudio Babiloni:
Yeah.
Dr Betty Tijms:
And so what I was wondering, in a way, this is kind of a nasty question, in a way electrophysiology is also neuro imaging. So why are you a separate PIA?
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. Yeah. This is a very interesting question, but I can say immediately that in ISTAART, there are several PIAs a lot of PIAs now, but there is a strong interaction between PIAs in the sense, for example, that we recently developed a common joint symposium with sub-cortical neuro-modulatory system PIA, which is interested in the Alzheimer’s disease neuropathology in the brain stem and the [inaudible 00:15:12] for brain in relation to sleep and vigilance. So we put together our interest in a joint symposium, and also we have developed proposals for the international conference of Alzheimer’s disease with sleep and circadian rhythms PIA.
Dr Claudio Babiloni:
And in order to put together the results of our members and the members of the sleep PIA to better understand that the neurophysiological correlates of Alzheimer’s disease in terms of regulation of vigilance and sleep wake cycle. And the moreover we organize common joint symposium with cognitive perioperative and delirium PIA, which is interested in the cognitive deficits appearing immediately after neurosurgery and showing the sum neurodegenerative diseases latent before the neurosurgery. And we discuss together and the plan lectures on the use of EEG during the neurosurgery or in the resting state condition to have an early biomarkers of Alzheimer’s disease. So electrophysiology PIA is a separate PIA because the focus is on brain electrical activity in Alzheimer’s disease and related dementia, but ISTAART allows a very strong and continuous interaction with other PIAs.
Dr Betty Tijms:
Yeah. And I have to admit that all the different imaging techniques in neuroimaging. They all require their own expertise as well. So it makes sense to have a dedicated subgroup, but it’s not the same as MRI and so on. Okay. So that’s a lot of interesting collaborations and really fits also with your own personal focus on what you find important in research. And so do you have other activities also with your PIA that you support your own fields?
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. Yeah. Yeah. Absolutely. I stand to electrophysiology PIA and my role that I could be in touch with leaders in the field of Alzheimer’s disease, clinical trials, people originally not part of the community of a clinical neuro-physiologists and experts of electrophysiology, but thanks to ISTAART PIA events, I could be in touch and start some discussion. For example, it was very important for my research and also the activities of electrophysiology PIA, the cooperation with the Lewy body dementia PIA, because you know that also your center in Amsterdam gave important evidence that there are abnormalities in the EEG oscillations in patients with Lewy body dementia. And for example, the EEG biomarkers are supportive biomarkers in the diagnosis of patients with the Lewy body dementia.
Dr Claudio Babiloni:
So it was very useful to discuss with members of Lewy body dementia PIA in order to discuss how to bring EEG biomarkers in the guidelines for the assessment of Alzheimer’s disease patients and the how to move the EEG biomarkers from supportive to indicative biomarkers of Lewy body dementia. So indicative means that you can, if you see some abnormalities in the EEG in those patients, you can have an evidence of the disease.
Dr Betty Tijms:
Yeah. And so to support the Lewy body diagnosis.
Dr Claudio Babiloni:
Yeah. Exactly.
Dr Betty Tijms:
That’s interesting. Is that our dose normality is really different between the neurodegenerative disorders. Do you see very specific alterations or abnormalities?
Dr Claudio Babiloni:
Yeah. Yeah. In the sense that in the research of my group, but also other independent teams, we see that there are some differences in the frequency of oscillations, of EEG activity, different abnormalities in different frequencies of the oscillations in the patients with Alzheimer’s disease, Parkinson’s disease, with dementia and the Lewy body dementia. And so there is an interesting discussion about the extent to which these different frequencies are related to dopaminergic systems or a [inaudible 00:21:08] systems, which are differently impaired in Alzheimer’s disease and Parkinson’s disease and Lewy body dementia. And it’s a something to be developed farther, and there is a discussion in place with the Lewy body dementia PIA.
Dr Betty Tijms:
Yeah. This sounds like a very exciting part. So in the collaboration with other PIAs as well. About your PIA, if there are any early career researchers listening, how could they become involved in the activities?
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. This is one of the goal of our electrophysiology PIA to attract new scientists, new researchers, early stage researchers to electrophysiology PIA. And we have used in the past the webinars with experts of electrophysiology PIA in investigations, in animal models. So Alzheimer’s disease, but also in clinical trials in patients, and we have planned some discussions about how these fields can have a lot of opportunities for early stage researchers. In our PIA we have two young members, Francesca Farina from Ireland and Susanna Lopez from Italy, which are members of the steering committee. And they are about 30 year old. So they are really young. [crosstalk 00:23:04].
Dr Betty Tijms:
They’re real [crosstalk 00:23:06].
Dr Claudio Babiloni:
Yeah. Yeah. Yeah.
Dr Betty Tijms:
[crosstalk 00:23:06] early career.Dr Claudio Babiloni:
Yeah. But, but, but, yeah. Yeah. But they are excellent scientists with a lot of publications in the field and they are able to communicate to other early stage researchers.
Dr Betty Tijms:
So you have two young steering committee members, so that’s nice. And can you tell a bit more about how the rest of the committee is organized?
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. We had the new election of the members of the steering committee in May this year and the old steering committee will remain in place until September. In September this year, we will have the electrophysiology PIA day in which we will have a scientific session. And this year we will deal with the use of brain stimulation to modulate the brain oscillations and the cognitive functions in patients. But we will have also a business meeting. And I invite all people interested in electrophysiology PIA to register in ISTAART, to click on electrophysiology PIA domain, and participate to the business meeting. We will discuss the goals for the future, but also what we did in the past year. And there will be the change of the steering committee. They elected the chair is [inaudible 00:25:07], as I said before, who is a very smart scientist in the field of preclinical electrophysiology in Alzheimer’s disease.
Dr Claudio Babiloni:
And there will be also a new position of new members and they cover USA and Turkey and three continents. And the, for example, we will have [inaudible 00:25:46] who is a professor of neurology in [inaudible 00:25:51], Turkey, [inaudible 00:25:53] who is another professor of University of Istanbul in Turkey. And they were expert of EEG activity during cognition in patients with Alzheimer’s disease. And we will have also professor [inaudible 00:26:16] based in USA and expert of neuroimaging and electrophysiology in Alzheimer’s disease. The early stage researchers are Francesca Farina from Dublin Trinity College and the Susanna [inaudible 00:26:36] from University of Roma Sapienza. And we will have a really, really great time in the coming months.
Dr Betty Tijms:
Yeah. And it sounds like a nice diverse group. So one last question because we’re nearing the end already of this interview is what kind of advice would you give a new researcher who wants to move in to the dementia field?
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. Absolutely. My suggestion is to focus on biomarkers of Alzheimer’s disease, because we really need to view dementia as a symptom, and we really need to distinguish between the neuro-biological causes of a different kind of dementias. Dementia is a term similar to fever or a schizophrenia, but we really need to go over the concept of the symptom and the move to the neurophysiological and the neuro-biological model of the disease at the basis of cognition of the behavior on the effectivity And so on. We really need to understand these model with biomarkers related to biochemistry and molecular interactions, but also neurophysiological electrical activity of the neurons of the neural populations, and then the connectivity between different populations and the measures of [inaudible 00:28:41] with the neuroimaging or accumulation of a beta amyloid or tau by neuroimaging and so on. So this is my suggestion for them.
Dr Betty Tijms:
Yeah. And then find new biomarkers or work on those that are already there.
Dr Claudio Babiloni:
Yeah. Yeah. Yeah. I see that there is space for blood biomarkers, so a beta amyloid tau and also some proteins related to neural-synaptic transmission. So of course, also for example, a new ways to understand the connectivity in the brain from a structural point of view or functional point of view. So there is really a big space to complete the puzzle of the neuro-biological and neurophysiological and neuroanatomical model of the disease.
Dr Betty Tijms:
Yeah. I agree. It’s a combination of [inaudible 00:29:47] so try to work with what we know and try to integrate it a bit more as well while trying to find new things to better understand how cognition declines and how patients differ. Yeah. Thank you so much. It was a nice conversation and yeah, I think this is the end of the interview.
Dr Claudio Babiloni:
Thank you to you for your kind, kind handling of this interview.
Voice Over:
Thank you for listening. You can find profiles on today’s panelists and information on how to become involved in ISTAART on our website at DementiaResearcher.NIHR.ac.uk, and also at ALZ.org/ISTAART. we’ll be back tomorrow with the next recording in our ISTAART PIA Relay Podcast series. Finally, please remember to like, subscribe, and leave a review of our podcast. You can do this on our website and in your podcast app. Thank you.
Voice Over:
Brought to you by DementiaResearcer.NIHR.ac.uk in association with Alzheimer’s research UK and Alzheimer’s Society supporting early career researchers across the world.
Voice Over:
Hello. This is Adam Smith. I’m just dropping into the podcast stream to ask you a favor. Dementia Researcher has been nominated for a People’s Choice Podcast award, and it would be fantastic if you would take a moment to vote for us. You’ll find the link in the text below the podcast. And if you visit PodcastAwards.com, register an account, and you’ll find Dementia Researcher in the science and medicine category. Choose us, hit submit, job done. Dementia Researcher is a real passion of mine. I so enjoy producing the podcast and occasionally hosting as well. All of our guests give up their time freely, and I think this would be a fantastic way to recognize their contribution and to help put important dementia research on the map. So please, if you have a moment, it would be fantastic if you could take the time to vote. Thank you very much for listening and again, click the link in the text below, or go to PodcastAwards.com by the 31st of July. Thank you.
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