What Makes Them Interesting: In the past year, Dr. Andre Machado and Dr. Imad Najm, two Cleveland Clinic clinicians and researchers, have embarked on one of the most ambitious studies of brain disease ever conducted. They hope their work transforms how neurological conditions such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, stroke and epilepsy are diagnosed. The two are leading a team that has begun collecting data on a planned sample of 200,000 participants. The dream is that these diseases can even be prevented altogether.
What Makes This Different: The Cleveland Clinic Brain Study is one of a kind in three considerations — the size of the sample, the time scale it’s following, and the significant thoroughness of the data collection. The study, which is on track to enroll its first 3,000 individuals next year, Najm says, includes comprehensive cognitive testing, brain scans, biomarker collection and eye imaging over a 20-year period to see how currently neurologically healthy adults' brains change. “You cannot predict the future. You can’t do it in health. You even really can’t do it in financial markets,” Machado says. “Most [participants] will age without an issue, but we know by the numbers that some will develop a disease. Once they bifurcate, some age healthy, some age sick. We can rewind the movie."
Prevention over Treatment: The hope is that this longitudinal trick can help determine what the early signs of neurological disorders are, years before onset. Most experts in the field, including Najm and Machado, believe that prevention of neurological diseases will prove more fruitful than a focus exclusively on treatment, when neuronal death has already occurred. “Everyone has been finding the same thing,” Najm says. “The damage is there. We want to do something that will give us insight on why things happen, detect them early, and get treatment started early."
Why Cleveland? The two study leaders are accidental Clevelanders. Both are immigrants, and they came for training at the Cleveland Clinic with the intention to move on after a year or two. Machado, originally from Brazil, joined Cleveland Clinic in 2004 to complete a fellowship after completing his residency with the University of São Paulo. “I was welcomed into this community like I couldn’t imagine. Our kids were born here, they are Clevelanders for life." He works as the chair of the Cleveland Clinic’s Neurological Institute.
Najm has a similar story. From Lebanon, he joined the clinic in 1991 for a neurology residency following a stint in California. He had a tough first day. "When I got to Cleveland from Los Angeles, the first thing I saw was a foot and a half of snow. The next day, I had to go to work very early. It took me almost an hour and a half to get through the snow.” Najm is the director of the Cleveland Clinic's Epilepsy Center.