As a young medical student in Bulgaria, Liana Apostolova was intrigued by diseases of the brain and decided early to specialize in neurology.
“I think the brain is the most fascinating organ and the one we know the least about,” she said.
Now, Apostolova will get the opportunity of her career to unlock one of the toughest riddles in modern medicine: how to treat a relatively rare form of Alzheimer’s disease in young people, an ailment that robs people of their memories, often while they are in the prime of their lives.
Apostolova, a researcher at the Indiana University School of Medicine, has won a five-year, $44.7 million grant to undertake a major study of early-onset Alzheimer’s disease, the university announced Thursday afternoon. The grant is the university’s largest-ever single award from the National Institutes of Health.
The grant follows a $7.6 million award last year that allowed IU to begin planning and other start-up activity for the study, bringing total federal support for the initiative to more than $52 million.
While Alzheimer’s disease is often considered an “old person’s disease,” the early-onset form strikes people younger than 65—often in their 40s or 50s, but sometimes even younger, Apostolova said.
“You can be very young—in your 20s even,” she said in an interview.
Early-onset Alzheimer’s disease is estimated to affect about 200,000 Americans, according to the Alzheimer’s Association.
The money will allow Apostolova’s research team, in conjunction with several other institutions, to follow and study hundreds of participants diagnosed with early-onset Alzheimer’s disease.
The program will enroll 400 early-onset Alzheimer’s patients, who have mild cognitive impairment or mild Alzheimer’s disease and who have been found in PET scans to have beta amyloid protein in the brain. The buildup of beta amyloid protein has been associated with the development of the disease.
The patients—along with 100 healthy “control” participants—will undergo comprehensive examinations including cognitive tests, MRI and PET scans, collection of spinal fluid and DNA testing. They will be tested again in 12 months and in two years.
“The data and insights from research into this unique population are crucial to build our understanding of Alzheimer’s, which is proving to be a very complex and challenging disease," Dr. Eliezer Masliah, director of the NIH’s Division of Neuroscience, said in written remarks.
Twenty institutions across the nation will participate in recruitment and analysis of the study. Researchers hope the study will point to new therapies for a disease that has yet to be fully understood.
“Alzheimer’s disease is a complex and insidious illness that robs people of their memories and their dignity,” IU President Michael McRobbie said in a media statement.
Apostolova has been researching Alzheimer’s for years, specializing in early detection and disease prognosis. She has examined genetic risk factors for the disease.
She graduated from the Medical University in Sofia, Bulgaria in 1988, and obtained her neurology and dementia training from the University of Iowa and UCLA, respectively. She joined the IU School of Medicine as professor of Alzheimer’s disease research in 2015.
Over the years, numerous pharmaceutical companies, including Indianapolis-based Eli Lilly and Co., have spent billions of dollars trying to develop treatments to slow or stop the diseases, but so far none have been successful.
“It’s frustrating to us as researchers,” Apostolova said, “because we still don’t understand all the mechanisms of Alzheimer’s disease and our treatments that have tried and failed.”