Organ donations not only save lives, they’re also key to helping science. This is chiefly the case for brain donations. Diseases such as Parkinson’s, Huntington’s, epilepsy, and Alzheimer’s have not yet been studied sufficiently because it’s hard to find donors of brains that can be analyzed. This also delays the creation of medication for treating these conditions.
José Luna Muñoz has dedicated 35 years of his life to the task of obtaining brains and analyzing them. Although it’s been an uphill struggle, it is beginning to bear fruit. “Donation by patients has been a little slow, but people are responding very well,” says the neuroscientist, a former coordinator of the brain bank at the IPN Center for Research and Advanced Studies, and director and founder of the National Dementia Biobank (Biobanco Nacional de Demencias, BND).
In order to convince patients with mental disease and their families to donate their brains after death, the BND has created a special protocol. The patient fills out a series of forms to give express consent to donation and then members of staff explain that the procedure consists of a surgery that takes one and a half hours, the body is preserved, and biobank staff later transport it for the funeral service.
What’s more, Luna has woven an extensive network to obtain brain donations and perform more in-depth research into Parkinson’s, Huntington’s, epilepsy, and Alzheimer’s. “The National Institute of Neurology and other institutions have supported us. We sometimes receive donations of up to 56 brains per month,” says Luna. “We do transfers every three months on average, and sometimes receive 26 brains.”
From the front line, Luna is also working to overturn the idea that mental diseases are part of the aging process, as this is an obstacle to studying the brain. “When people with dementia died in the past, it was usually said that they had senile dementia, which was indicated as a normal process of memory loss. The International Alzheimer’s Association has started a campaign to remove that concept from clinical vocabulary, because it leads to the belief that Alzheimer’s is a normal process of aging and that’s not true,” emphasizes Luna.
This researcher has managed to make the BND part of the Latin American Network of Brain Banks and his work has inspired research in other countries to ensure that these diseases are treated properly. “We’re stopping people from calling them ‘senile dementia’. They now have to diagnose a neurodegenerative disease and its clinical characteristics. This has helped their relatives not only to donate for research but also gives them an answer about what their relative really had,” he says.
In this race to beat the clock, Luna has received support from the Mexican Alzheimer’s Federation, which last July organized marches to raise awareness of brain donation in Sonora. BND’s network now extends to 20 of the states in Mexico, and although the new coronavirus pandemic has delayed meetings, work has not stopped in the laboratory and in webinars on the culture of brain donation.
However, studying brains is not enough. The BND team receives blood, saliva, cerebrospinal fluid, and other organs such as the liver and pancreas to do more detailed analysis that gives clues on the origin of these diseases and making earlier diagnosis. “The hypothesis I’m working on at the moment is that there may be some changes in the intestine prior to those alterations of the brain, which possibly occur due to some modification of the gut flora,” suggests Luna.
Studying the organs of people who had certain diseases in life is crucial to tackling a crisis that threatens humanity: rapid aging of the global population. According to figures from the World Health Organization (WHO), 22% of the population will be over 60 by 2050. “Neurodegenerative diseases such as Alzheimer’s, progressive supranuclear palsy, Parkinson’s disease, Huntington’s disease, and others appear at advanced ages. These are the primary causes of disability and dependency,” explains Daisy Acosta, founder of the National Brain Bank in the Dominican Republic.
Proposals for drugs to address the mental diseases of the coming years are multi-million-dollar investments that in many cases do not receive approval. “Since memantine was released in 2003, there hasn’t been another drug on the market. That’s not due to a lack of interest. Lilly has invested billions of dollars in treatments for Alzheimer’s, but it doesn’t have a single successful drug to show for it,“ says Acosta.