The underlying cause of many brain diseases – including epilepsy, mild to severe cognitive impairment, and Parkinson’s disease – could be a leaky blood-brain barrier. Dr. Alon Friedman is one of the world’s leading researchers studying how damage to this delicate protective sheath, which lines every blood vessel in the brain, leads to the development of neurological diseases.

“The blood-brain barrier selectively allows oxygen and essential nutrients into the brain, while blocking proteins and chemicals that shouldn’t be there,” explains Dr. Friedman, who joined Dalhousie from Israel’s Ben-Gurion University in July 2014. “But if the blood-brain barrier is damaged and these proteins and chemicals get out of the bloodstream and into the brain, they can trigger inflammation that damages nerve tissue.”  

Head injury is a common cause of leaky blood-brain barrier—so is stroke, high blood pressure and excessive exposure to chemicals and drugs. Dr. Friedman wants to learn more about the causative factors and detailed consequences of damage to the blood-brain barrier, and develop methods of detecting and treating this damage before it leads to neurological and/or cognitive problems.

He’s well on his way to an effective detection method. With colleagues at Ben-Gurion, Dr. Friedman has developed a new MRI algorithm called Dynamic-Contrast Enhanced (DCE) MRI, which the researchers used to identify significant blood-brain barrier pathologies in football players (compared to track and field athletes). The results were published in November, 2014 by the Journal of the American Medical Association in JAMA Neurology.

Dr. Friedman will continue to refine the DCE-MRI technology in Halifax, in collaboration with researchers at the Biomedical Translational Imaging Lab (BIOTIC) at the IWK and QEII.

“My first priority is to test the algorithm on epilepsy patients, to see what is the state of their blood-brain barriers and how pathologies there might be related to the course of their disease and their resistance to medication,” notes Dr. Friedman. He is also looking forward to studying the vasculature of brains donated to the Maritime Brain Tissue Bank, located just down the hallway from his lab at Dalhousie Medical School.

“The brain bank will allow us to compare clinical histories of donors with the pathologies of their brains, to see how blood-brain-barrier damage was involved and what other specific brain pathologies it is associated with,” he says. “We want to identify mechanisms to target in early stages to prevent further deterioration.”

One of Dr. Friedman’s goals is to identify agents with the potential to repair the blood-brain barrier. “Blood vessels can be repaired, perhaps more easily than neurons,” he notes. Repairing the blood vessels would prevent the leakage of further damaging substances into the brain, effectively derailing the disease process before symptoms emerge.




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