Battling the brain146;s enemies

The human brain is a powerful and resilient organ. But it has many enemies and a dramatic vulnerability.

The human brain is a powerful and resilient organ. But it has many enemies and a dramatic vulnerability. When under attack8212;from ischemic stroke, head trauma or degenerative diseases8212;a small cluster of affected brain cells basically commits suicide and, in so doing, releases toxins that kill off neighboring cells in droves. Neurons tumble like dominoes to their death in a process that can take hours in a stroke or a head trauma or years in Alzheimer8217;s or Parkinson8217;s disease.

The physical symptoms of that cell death may vary from disease to disease, but the result is the same: disability that can make the simplest of human tasks difficult or impossible.

The medical profession has struggled to combat each of the brain8217;s enemies separately and limit the damage and disability they wreak. But prevention is hard, and cures are elusive. It has been a war with few successes. But what if there were a simple way to fortify human neurons against the brain8217;s enemies? What if some safe, readily available compound, taken before or just after a stroke or injury or even long before a neurodegenerative disease takes hold, could protect the brain against insults and injuries?

This idea is called neuroprotection. Although the quest for it has a history of disappointment, some glimmers of hope are on the horizon. 8220;It8217;s a little bit like the search for the Holy Grail,8221; says Dr. Walter Koroshetz, deputy director of the National Institute of Neurological Disease and Stroke. 8220;But I don8217;t think there8217;s anybody who doesn8217;t believe eventually we8217;re going to be able to do this8230; We need a success that we can build on.8221;

To that end, the US government launched a nationwide trial in March to investigate whether creatine8212;a dietary supplement safely taken by bodybuilders at lower doses than those being tested8212;can slow the die-off of neurons in early-stage Parkinson8217;s disease. A second promising neuroprotectant, the dietary supplement co-enzyme Q10, is set to enter clinical trials next year for early-stage Parkinson8217;s disease, as well.

This summer, the National Institute of Neurological Diseases and Stroke is expected to fund a national clinical trial to see if high doses of progesterone8212;the hormone that surges during pregnancy but is present in all human brains8212;can help disrupt the rapid death of brain cells in head trauma. Scientists at the University of California, Los Angeles, are studying whether magnesium sulfate8212;long used to stave off early labor and delivery 8212; can break the chain of destruction that leaves stroke patients disabled. And a common antibiotic, minocycline, is being tested in humans as a way to slow Lou Gehrig8217;s disease and Huntington8217;s disease, a degenerative genetic disorder.

8220;The biology of the neuroprotection has just exploded. It8217;s just amazing,8221; Koroshetz says. 8220;There are so many different pathways people have identified that could potentially save brain cells from dying, it really piques your interest.8221;

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Researchers are wary. They have been here before and come up empty-handed. 8220;The graveyard of neuroprotectants is absolutely full. It8217;s depressing,8221; says Dr. David Wright, a professor of medicine at Emory University Medical School in Atlanta and a leader in testing progesterone for head injury. But his hopes have been buoyed by studies suggesting that quickly elevating levels of progesterone, a steroid, may help save many with traumatic head injury and improve their outcomes.
Melissa Healy, Los Angeles Times