Ride For Life: University of Alabama expanding neurology research

UAB is aiming for the brain with a big expansion of its neurological research and treatment capabilities. The ambitious effort is being built upon a foundation of discoveries about the fundamental nature of diseases such as Alzheimer's and Parkinson's.

"You name it, we want to grow in those areas," said Dr. Ray Watts, who last year became chairman of the University of Alabama at Birmingham's Department of Neurology.

Watts is leading an effort to give UAB one of the top 10 academic neurology departments in the nation within five years.

"You've got to aim high," said Watts, who came to UAB from Emory University in Atlanta.

The plan calls for the department to double the size of its faculty to about 50 doctors and researchers. The enlarged department is expected to eventually occupy the entire Sparks Building, Watts said.

Working with other departments, neurology will expand upon or create research programs into chronic diseases such as Parkinson's, Alzheimer's, multiple sclerosis, Lou Gehrig's, myasthenia gravis and epilepsy.

Watts said the expansion is being driven by basic research that has provided new insights into how the brain functions and possible ways to prevent degenerative diseases.

"We are in a period of exponential growth and knowledge, and neuroscience is at the leading edge of that, which is leading us to an explosion in treatment opportunities," Watts said.

Research into Parkinson's disease is a good example of the recent leap in knowledge, he said. A nationally respected authority on Parkinson's, Watts said doctors now understand much more about the disease, which often is marked by tremors, rigidity and a shuffling walk.

New approaches:

Parkinson's has received much attention in recent years, since it struck former U.S. Attorney General Janet Reno and actor Michael J. Fox.

At the root of Parkinson's, researchers have found 10 genetic abnormalities that make some people susceptible to brain damage, sometimes from toxins such as pesticides, Watts said. Parkinson's develops when brain cells that produce dopamine are damaged.

"There are a dozen ways you can insult and damage these dopamine cells," Watts said.

When about 70 percent of dopamine-producing cells are disabled, people begin experiencing the classic symptoms of Parkinson's disease, Watts explained.

For decades the main treatment for Parkinson's disease was L-dopa, a medicine that increased production of dopamine. But the therapy was based upon increasing doses and did nothing to stop progression of the disease.

"You have to give more and more and more, and the side effects begin to be an issue," Watts said. "If we could stop somebody with mild, early Parkinson's right where they are, we could treat them fine the rest of their lives."

Learning just how Parkinson's develops has allowed scientists to produce the disease in laboratory animals and then develop treatments to slow or even reverse it, he said.

There are two approaches that excite Watts, although other medicines and procedures are being developed, too.

The coenzyme Q-10 is a nutrient that energizes cells. In laboratory animals and a small study of 90 patients, it has slowed Parkinson's disease. Now, researchers are moving on to the next phase of drug trials and increasing dosages to see if they can increase Q-10's power, Watts said.

Strategy of finesse:

Even more interesting is the development of a protein that stimulates nerve growth, he said. It's called glial cell line-derived neurotrophic factor, or GDNF. It appears to not only protect dopamine-producing cells from damage, but it can actually cause them to grow back healthier than they were.

"I call it biological Miracle Grow for dopamine cells," Watts said.

The National Institutes of Health is sponsoring multi-center GDNF trials after early successes in animals and small groups of people.

Still, Watts believes there will be no single cure for Parkinson's and other degenerative diseases of the brain.

"There will be multiple approaches that may lead to a cure," he said. "That's how we cure certain cancers now. It's unusual to cure cancer with a single agent or approach."

Already, that drug cocktail strategy can be seen emerging to fight Alzheimer's disease. Recent studies have shown that combining the newly approved drug memantine, also known as Namenda, with the long-time standard donepezil, also known as Aricept, produces significant gains in mental functioning for some patients.

Watts calls this the strategy of "finesse, rather than brute force."

"With brute force, you may break the front door down, but you'll blow up the house at the same time," he said.