Quicknotes

From the Summer 2014 edition of Vanderbilt Medicine Magazine

VICC debuts novel neuroendocrine tumor treatment

A retired elementary school principal has become the first patient at Vanderbilt-Ingram Cancer Center to receive an investigational cancer therapy for the treatment of his neuroendocrine tumor.

Harold (Cap) Caplan of Hilton Head, South Carolina received the first injection of a drug that delivers a high dose of radiation directly to the cancer cells in his tumor.

The therapy using the radionuclide Lutetium-177 (177Lu) is being tested in a Phase 3 clinical trial. Vanderbilt is the only medical center in a multi-state southern region participating in the trial, which is also being conducted at several centers in the United States and Europe.

Eric Liu, M.D., assistant professor of Surgery and Radiology and Radiological Sciences, is the principal investigator at Vanderbilt for the trial, dubbed NETTER-1.

“This is a very well-known therapy in Europe and until now we have been referring our patients there. One of the places that delivers it is the center where I trained in Uppsala, Sweden,” said Liu.

 

 

Study explores genetics behind Alzheimer’s resiliency

Autopsies have revealed that some individuals develop the cellular changes indicative of Alzheimer’s disease without ever showing clinical symptoms in their lifetime.

Vanderbilt University Medical Center memory researchers have discovered a potential genetic variant in these asymptomatic individuals that may make brains more resilient against Alzheimer’s.

“Most Alzheimer’s research is searching for genes that predict the disease, but we’re taking a different approach. We’re looking for genes that predict who among those with Alzheimer’s pathology will actually show clinical symptoms of the disease,” said principal investigator Timothy Hohman, Ph.D.

Analyzing a sample of 700 subjects from the Alzheimer’s Disease Neuroimaging Initiative, one genetic mutation (rs4728029) was found to relate to both ventricle dilation and cognition and is a marker of neuroinflammation.

“It appears that certain individuals with a genetic predisposition toward a ‘bad’ neuroinflammatory response have neurodegeneration. But those with a genetic predisposition toward no inflammatory response, or a reduced one, are able to endure the pathology without marked neurodegeneration,” he said.

 

 

Mapping brain circuitry

Common psychiatric disorders, such as anxiety and addiction, likely result from changes in brain circuitry. Understanding structural and functional brain connections—and how they change in psychiatric disorders—could lead to novel preventive and therapeutic strategies.

The bed nucleus of the stria terminalis (BNST) has been linked to both anxiety and addiction, but its circuitry in humans has not been described. Jennifer Blackford, Ph.D., assistant professor of Psychiatry, and colleagues used two neuroimaging methods—diffusion tensor imaging and functional MRI—to identify patterns of connectivity between the BNST and other brain regions in healthy individuals. The BNST showed connections to multiple subcortical brain regions, including limbic, thalamic and basal ganglia structures, which matched reported connections in rodents. The researchers also identified two novel BNST connections: to the temporal pole and to the paracingulate gyrus.

The findings, reported in NeuroImage, provide a map of BNST neurocircuitry and lay the foundation for future studies of the circuits that mediate anxiety and addiction.