Joe Verghese, MBBS, MS

"The population itself is growing older. It is essential that we conduct these studies, in terms of identifying new treatments, rigorously testing and throwing out treatments that don’t work.”

The ultimate goal for the treatment of Alzheimer disease, and numerous of other neurological disorders, is prevention. Although, achieving prevention takes time and is often a multi-step process that requires an immense understanding of the disease before reaching precision medicine aimed at clinical regression. Joe Verghese, MBBS, MS, director, Montefiore Einstein Center for the Aging Brain, feels as though every positive study is a step closer to prevention or treatment.

He was recently awarded a grant from the National Institutes of Health to conduct 2 studies, 1 of which will focus on a pre-dementia condition called motoric cognitive risk (MCR) syndrome, and the other will look at the at-home use of transcranial direct current stimulation (tDCS) therapy. Both of the studies will focus on separate issues but could ultimately have lasting results for the same patient population.

Verghese stressed the clinical utility of MCR, stating it can easily be applied to patient populations and is derived from current mild cognitive impairment (MCI) criteria. In an interview with 

, Verghese provides additional context on how these methods can be used as complimentary treatment approaches, and why they can push the needle closer to the ultimate goal of prevention.

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The director of the Montefiore Einstein Center for the Aging Brain provided insight on how his studies may bring Alzheimer disease 1 step closer to prevention.

Joe Verghese, MBBS, MS: Bridging the Gap to Alzheimer Disease Prevention

"It’s non-invasive. You don’t have to do an intervention or surgical procedure to implant that like you would do with other brain stimulators. It also has a very low side effect profile and is very safe to use.”

In October, the National Institutes of Health awarded 2 grants, totaling $13.8 million to Joe Verghese, MBBS, MS, to conduct studies on pre-dementia and Alzheimer disease (AD). The second of the 2 will focus on treatment, specifically, the at-home use of transcranial direct current stimulation (tDCS) therapy, delivered with a bathing-cap head covering.

Across a 6-month trial period, 100 patients with mild-to-moderate AD will receive either placebo or actual tDCS treatments for 30 minutes, 5 times a week in the randomized, double-blind study. Verghese, director of the Montefiore Einstein Center for the Aging Brain, and Helena Knotkova, PhD, DPhil, associate professor of medicine, Einstein College of Medicine, and director of clinical research and analytics at the Metropolitan Jewish Health System (MJHS) Institute for Innovation in Palliative Care, will lead the study and examine whether the non-invasive brain stimulation technique can alleviate symptoms of AD and improve brain function.

, Verghese discussed the current evidence that exists to support further examination of brain stimulation in AD, as well as the advantages the therapy may bring to the patient community.

The director of the Montefiore Einstein Center for the Aging Brain discussed the advantages of non-invasive brain stimulation and what has been previously observed in patients with Alzheimer disease.

Joe Verghese, MBBS, MS: Advantages of Non-Invasive Brain Stimulation in Alzheimer Disease

“We are trying to see if the impairments in these pathways would lead to developing MCR, which in turn would increase risk for dementia.”

Joe Verghese, MBBS, MS, first identified and described motoric cognitive risk syndrome (MCR), a condition in which older adults have an abnormally slow gait and cognitive complains, in a 2014 study. He found that MCR affects almost 1 in 10 older adults and those diagnosed were twice as likely as other older adults to develop dementia within 12 years. After receiving a grant from the National Institutes of Health (NIH), Verghese plans to investigate the biological roots of MCR and identify biomarkers for the condition. 

Verghese currently serves as the director of the Montefiore Einstein Center for the Aging Brain. He also is the Murray D. Gross Memorial Faculty Scholar in gerontology, director of the Resnick Gerontology Center, and professor in the Saul R. Korey Department of Neurology and of medicine at Albert Einstein College of Medicine. He told NeurologyLive that the study will be centered on the pathogenesis of MCR and the brain substrates within it. 

The study will use a combination of data from 6 different studies, including hundreds of patients enrolled from current studies such as the LonGenity study, the Central Control of Mobility and Aging, and the Einstein Aging study. Verghese sat down with NeurologyLive to provide more detail on his work, and some of the specific measures he and his colleagues will examine in their further exploration into MCR.

The director of the Montefiore Einstein Center for the Aging Brain discussed the details of his study that will evaluate motoric cognitive risk syndrome.  

Joe Verghese, MBBS, MS: Understanding the Pathology of Motoric Cognitive Risk Syndrome  

"This is based on the criteria for mild cognitive impairment syndrome, the only difference being that we’ve substituted slow gait for objective cognitive testing, thus making it more accessible in many settings.”

Recently, Joe Verghese, MBBS, MS, was awarded 2 grants from the National Institutes of Health, totaling $13.8 million, to conduct studies on pre-dementia and Alzheimer disease (AD). The first grant totals $7.6 million over 5 years and will fund a study of motoric cognitive risk syndrome (MCR), a pre-dementia condition, in 11,000 older adults. Verghese, who is the director of the Montefiore Einstein Center for the Aging Brain, and colleagues will use the grant to investigate the biological roots of MCR and identify biomarkers for the condition.

The origins of MCR date back to 2014, where Verghese first identified and described the condition, which is often characterized in older adults who have abnormally slow gait and cognitive complaints. Results from that study showed that MCR affects almost 1 in 10 older adults, with a 2-fold increased risk of developing dementia within 12 years of the diagnosis.

Verghese, who also is the Murray D. Gross Memorial Faculty Scholar in gerontology, director of the Resnick Gerontology Center, and professor in the Saul R. Korey Department of Neurology and of medicine at Albert Einstein College of Medicine, sat down with 

to discuss how MCR is characterized and what unique symptoms those with the condition present.

The director of the Montefiore Einstein Center for the Aging Brain detailed the symptoms of motoric cognitive risk syndrome and how they compare to more typical mild cognitive impairment. 

Joe Verghese, MBBS, MS

Articles

Joe Verghese, MBBS, MS: Bridging the Gap to Alzheimer Disease Prevention

Joe Verghese, MBBS, MS: Advantages of Non-Invasive Brain Stimulation in Alzheimer Disease

Joe Verghese, MBBS, MS: Understanding the Pathology of Motoric Cognitive Risk Syndrome

Joe Verghese, MBBS, MS: Characteristics of Motoric Cognitive Risk Syndrome