Dr. Snyder’s quest to slow the disease
Peter J. Snyder’s CV boasts such institutions as Michigan State University and Long Island Jewish Medical Center of Albert Einstein College of Medicine – and those are just the colleges he attended. He also has taught at The University of Connecticut, Yale School of Medicine and The Warren Alpert Medical School of Brown University, where he currently works as professor of neurology, in addition to being the chief research officer for The Lifespan hospital system. Why should you care about this man’s accomplishments? He can make a significant contribution to Alzheimer’s research – with your help.
For the past fifteen years, Snyder has been immersed in developing novel treatments for Alzheimer’s disease. During that time, scientists have begun to understand the biology of the disease more clearly than ever. And it’s a timely shift since, according to Snyder, we desperately need apt therapeutics to slow the progression of the disease.
Every day, 10,000 people reach the age of 65 in the United States; the imminent repercussions of the aging baby boom generation require attention. Snyder thinks that, if scientists don’t come up with some answers soon, we will hit a crisis point in a couple of decades. To slow Alzheimer’s, doctors need to intervene before the patient’s quality of life has been impaired. It’s crucial that the disease is aggressively treated at this point because, by the time the symptoms present themselves, it is too late.
It’s hard for doctors to figure out who will best benefit from taking experimental drugs, testing in the clinic or even receiving the therapy once it’s approved by the FDA unless they can first determine who the high-risk individuals are – after all, these people are not expressing any symptoms. The goal is to find a way of identifying real risk and vulnerability and, ultimately, to make the discovery of new therapeutics easier and faster.
Any new therapy will not be for everybody – in addition to being expensive, it will carry some risks and side effects. Snyder is guardedly optimistic that, within the next decade, a drug will slow progression of Alzheimer’s. He undercuts that expectation by pointing out that, when the new therapy becomes available, doctors will still be faced with the problem of being unsure whom to treat if they want to intervene early enough in the disease. Enter his study.
Snyder is enrolling people who are still healthy but have at least one parent who has had Alzheimer’s disease and are beginning to exhibit subtle changes – their memory or ability to learn and recall new information is altering more than what is typical for their age. With their help, Snyder is creating a cognitive stress test to identify people who are going to start showing the Alzheimer’s symptoms in 15 or so years.
Accomplishing that goal requires stressing the system to see the signal that predicts risk. To increase the sensitivity of his cognitive test, he is using a low dose of a very safe drug called Scopolamine that’s often administered for nausea and sea sickness. A tiny injection of it changes the person’s chemical system in the brain for a couple of hours, after which it completely wears off. During that time, people who are at true risk will have more of a response to the drug. Snyder measures the subjects’ reaction by looking at the scans of their brains and at the genetic material from saliva. If he is successful, he promises that “the public health implications could be really huge.”
What else is huge is the power of this common drug. Scopolamine is generic medicine that costs less than a dollar per dose. Snyder can create a diagnostic test that can be used anywhere in the world to predict risk without accumulating massive expenses. Anticipating difficulties third-world countries might encounter due to lack of pricy equipment, Snyder employs the sophisticated technology of the U.S. to create a much less expensive and easier point of care technique – a stress test that can be done in an outpatient office with a nurse, predicting what a CAT scan would show.
Snyder and his team analyzed a small portion of their preliminary data to make sure that they weren’t wasting their volunteers’ time. Much to their delight, the researchers found that the data looks highly promising. Right now, to prove that their technique really works, he is looking for more subjects – thirty older adults who have concerns about their memory and first-degree relatives with Alzheimer’s. He asks that those who are interested in helping with the research contact Christine Getter, Senior Clinical Research Associate, at 444-4464 or firstname.lastname@example.org.
Snyder says that older people often struggle in silence due to shame. During one-on-one interviews, many reveal that they have figured out strategies to work around the changes they’re struggling with. They are aware that they are less efficient and hide their problems, which are more than just age-related issues. Even their spouses are frequently unable to discern subtle transformations. Despite their normal outward appearance, these individuals are self-conscious – their ordeal is affecting their self-perception and their ego, often resulting in depression. Because very little help is available for them right now, many of Snyder’s subjects fly in to Providence on their own funding from various states.
Their data will lead to new treatment trials after Snyder identifies how to rationally select people for them. He is most interested in the trials of immunotherapies – drugs that boost the immune response and block the formation of a toxic protein in the brain that’s linked to the disease. He estimates that a vaccine, which slows the progression of the disease, will become available within the next ten years. While scientists now know that they have to intervene before the onset of the symptoms, they can’t accurately test an actual drug that’s supposed to slow down the disease without being sure that they are testing the right subjects – otherwise, they run the risk of having a failed trial because they tested on the wrong subjects, not because the drug was not working. This is precisely the type of huge mistake Snyder is trying to avoid.
To identify subjects, Snyder and his team often use a hidden-maze learning test that’s administered on an iPad. Subjects use a stylus (pen) to tap their way through the maze that’s hidden under a 10x10 grid of squares. Even though they don’t see the maze, they learn whether they are right or wrong every time they make a move and tap a square. If they are right, they stay on the path and look for their way out of the maze. If they are wrong, they have to go back and try a different way. The test measures the subjects’ ability to create and hold in their memory a maze and use it, from trial to trial, to get through the maze effectively. Snyder is thankful to all the people for their efforts: “We do compensate people for their time, but they’re giving a lot more to us than we’re giving back. We appreciate it tremendously.”
Editor’s note: This is one of a series of profiles of local businesses, some of which advertise in The Jewish Voice.