Tell me about yourself and how you are involved with the Cleveland Alzheimer’s Disease Research Center (CADRC).
My primary appointment is in the Cleveland Clinic Division of Nuclear Medicine, where we perform a full range of clinical nuclear medicine services. A significant portion of our studies are brain PET scans, for patient care as well as for research and clinical trials. We collaborate with the CADRC to perform PET scans to evaluate participants for biomarkers related to Alzheimer’s dementia (AD).

What are your main activities and goals as they relate to brain health?
I serve as a co-director of the CADRC NeuroImaging Core, focusing on PET scans and image analysis. PET differs from other types of brain imaging (MRI, CT) in that a tiny amount of an injected tracer is imaged, which reveals the biochemical status of the brain. For example, one type of PET scan reveals the local metabolism of brain cells, which can assist with planning epilepsy surgery or diagnosing frontal-temporal dementia. Other types of PET scan reveal the presence or absence of certain proteins in the brain associated with AD, years before symptoms may occur.

Can you please tell us about the new CLARiTI project and your role in the project within the CADRC?
“ATN” imaging of amyloid protein, tau protein, and neurodegeneration is widely recognized to be highly valuable for AD research. However, support for ATN imaging (amyloid PET, tau PET, and MRI scans) in Alzheimer’s Disease Research Centers (ADRCs) has been limited. CLARiTI is an NIH-funded project supporting ATN imaging at all 35 ADRCs nationwide. Imaging includes longitudinal ATN scans, two years apart, to better understand how these imaging biomarkers change over time. My role in CLARiTI is as Cleveland Clinic principal investigator. Together with Dr. Brian Appleby, who serves as the University Hospitals principal investigator, we direct CLARiTI activities at CADRC.

What is the focus of your research currently, and where do you see your work going in the next two-five years?
Much of my work for the CADRC has involved quantitative analysis of amyloid PET images. Accurately quantifying the degree of amyloid protein accumulation in the brain is highly valuable for tracking pre-symptomatic progression of AD, which is a focus area of CADRC. AD researchers have developed the Centiloid score as a standardized measure of brain amyloid protein. A recent success is that Centiloid scoring is now available to physicians with commercial software and is starting to be used in routine patient amyloid PET scans. In comparison, quantitative analysis of tau PET images is much less developed and standardized. CADRC is now acquiring tau PET scans on participants co-enrolled in the CLARiTI project. We are implementing quantitative analysis of tau protein burden to provide CADRC investigators an additional tool for tracking longitudinal progression of AD.

How do you see research in brain health/Alzheimer’s Disease/dementia evolving in the next 2-5 years?
The recent approval of amyloid-lowering drugs is very exciting since their clinical trials demonstrated slower progression of AD. Further clinical trials are in progress to better understand the benefits versus risk and cost of current and future amyloid-lowering drugs.

Do you have any suggestion or recommendations for students or young researchers who wish to get more involved in brain health research?
Brain health research teams such as the CADRC consist of highly motivated members with a broad range of skills and experiences. Many fields of study can lead to a career in brain health research.