Sunday, July 31, 2011

Highlighting the Importance of Research, Recruitment of Human Subjects, and Technology

ARTICLE:  “Taking steps to prevent memory loss:  studyhopes to prove exercise could help many.”  MilwaukeeJournal Sentinel [Milwaukee]25 July 2011, E1-2.

TAKE HOME MESSAGE:  People who are passionate about their work deserve a boost.  Keep your eye open for opportunities to promote that passion by profiling good research.

Principal Investigator
1)  Are there collaborating universities you want me to mention in this article?

2)  Let's get clear the definition of mild cognitive impairment.

3)  How do you differentiate aMCI from non-Alzheimer's dementia?

4)  How do you differentiation non-Alzheimer's dementia from Alzheimer's?

      5)      I noticed that your exercised and non-exercised gropus had the APOE episilon 4 marker present. Must a genetic factor liek APOE e4 necessarily be present to participate in the study?

6)  How do you test for the presence of this allele?

7)      Can neuroimaging like PET or MRI show plaques and brain shrinking   characteristic of full blown Alzheimer's?

      8)      I want to be clear on the way in which on-going studies progress the work you published in Psychiatry Research this month.

      9)      You want to determine whether the caudate activation you observe with physical activity is compensatory or protective, how do your studies tease out this distinction?

      10)  I read with interest Verghese's 2006 article in Neurology focusing on the ability    of leisure activities such as reading, writing, crossword puzzles to lower risk of aMCI.  How did you control for instances when subjects were extremely mentally active in their daily lives?  Was it possible that these types of subjects were capable of skewing the results?

      11)  I also want to be clear on future implications of your findings:  do you imagine   that Alzheimer's can be staved in some way if exercise is increased after a diagnosis of aMCI?

      12)  Based on your findings so far, how much exercise is reasonably expected to delay Alzheimer's?

      13)  To qualify for the study, subjects also had to meet Petersen criteria for aMCI.  Can you describe some of these criteria?

Study Coordinator 
      1)  I understand the study’s major endpoint:  to measure blood flow in the caudate nucleus and semantic memory pre and post physical activity, but I want to clarify the ultimate goal of these studies:  is it to test the efficacy of exercise in staving off mild cognitive impairment or is it to stave off Alzheimers in people who have MCI or is it to keep blood flowing to a part of the aging brain that is involved in an important type of memory?

2)   Do you typically get study subjects who have been previously diagnosed with mild cognitive impairment?  Or are study participants typically people who have concerns about memory loss?  What do you think motivates your volunteers?

3)   The brochure says that participants need to be between 60-88 years old and able to walk on a treadmill.  Exclusion/inclusion criteria?  Are people with Alzhiemers excluded?

4)   Tell me about your screening process.

5)   Tell me about the famous name discrimination test of semantic memory administered to subjects who volunteer.  What do these results tell you about the subject?

6)   Have you started to collect data in control subjects (or perhaps the studies are blinded?).  How do you differentiate your controls from those who are cognitively impaired?

7)   Let me clarify the time commitment required for these studies:  4 d/wk, 30 min/day, 12 weeks.  This involves 46 visits to the patient by a trainer or lab staff? 

8)   Describe how the trainer works with study subjects to get them up to speed in terms of the exercise.

9)    Do you have any tips for study participants as far as coping with the confinement of the MRI machine?

10)  What have been the subjects’ impressions of the study?

Study Participant 
      Study participant was asked to describe her experience in the study and her motivation for participating.

Neuroimaging expert
1)  Would you be willing to describe that 1991 picture next to the MRI? 

2)  What has been your trajectory since that picture was taken?

      3)      What are some of the important advances in fMRI since you were a student in Milwaukee; what are still some of its limitations?

4)  Can you describe some of the work you’re doing in brain mapping?

Would you be willing to comment  on the significance or future directions, or perhaps the pitfalls of this type of research?