A Brain Repair Centre Knowledge Translation grant is allowing Dr. Alon Friedman to pioneer a new technology using retinal imaging to identify early signs of brain disease.

Dr. Friedman and his collaborators are developing sophisticated new algorithms for ultra-high-field fluorescein angiography (UHFFA), an imaging technique used for diagnosing and monitoring diabetic retinopathy by tracing the leakage of blood components from tiny vessels in the retina into the surrounding tissues.

“The new algorithms dramatically increase the ability of fluorescein angiography to detect and quantify even the most subtle degrees of damage to the micro vessels of the retina,” says Dr. Friedman, who joined Dalhousie from Israel’s Ben-Gurion University in 2014, as Dennis Chair in Epilepsy Research and professor in the departments of Medical Neuroscience and Pediatrics. “This feeds into our work not only to develop a diagnostic clinical tool, but also to evaluate the efficacy of old and new therapies for restoring the integrity of the vasculature in the retina and brain.”

As Dr. Friedman explains, leaks in the blood-retinal barrier often indicate similar leaks in the blood-brain barrier. These, as he has discovered and published widely, lead to a host of neurological diseases, from epilepsy to encephalopathy to dementia.

He has started a company, EMAGIX Inc., to commercialize the patented algorithms, which will provide clinicians with a sensitive and quantitative means of evaluating the integrity of the blood-retinal barrier, as a proxy for assessing small-vessel pathology in the brain. This will enable non-invasive, inexpensive diagnosis of early brain pathology, so measures can be taken to slow down the damage.

One strategy Dr. Friedman has proven successful is to use medications already approved for treating high blood pressure to reduce the leakage and protect the brain by limiting the amount of inflammation-causing foreign proteins passing through the blood-brain barrier. He and his team are also working with a California company to test experimental small molecules targeting the TGF-β (transforming growth factor-beta) pathway.

“TGF-β induces a signaling cascade that is associated with inflammation that further makes the blood vessel wall permeable,” says Dr. Friedman, who has also explored the role of TGF-β in post-traumatic epilepsy and other brain diseases. “We are evaluating which molecules best block this pathway to moderate inflammation and preserve the integrity of small blood vessels in the retina and the brain.”

The researchers are not only looking into the eye to validate their findings. Dr. Friedman is also working with Dalhousie colleagues, neurosurgeon Dr. David Clarke, critical care specialist Dr. Rob Greene, radiologist Dr. Matthias Schmidt, psychiatrist Dr. Cynthia Calkin and the Biomedical Translational Imaging Centre (BIOTIC), to develop new algorithms for assessing blood vessel damage in the brain using high-field magnetic resonance imaging (MRI).

According the Dr. Friedman, Halifax offers an ideal environment for his research. “It’s a small city, people get to know each other well, and the Brain Repair Centre provides a very important venue for collaborative research,” he says. “People here make themselves available, they listen to your needs and ideas and they want to help. I’m really making progress.”

In addition to his BRC KT grant, Dr. Friedman hold grants from the Canadian Institutes of Health Research, Nova Scotia Health Research Foundation, Canada Foundation for Innovation, National Institutes of Health, Israeli Science Foundation, German Science Foundation, CURE Epilepsy Foundation, and others.

Wednesday the 28th. © 2018. All rights reserved.. Bridgewater Media Services