First-of-its-kind primary prevention trial needs more older adults to help researchers determine if a specific type of computer training can reduce the risk of Alzheimer’s disease, other dementias

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The University of South Florida’s Preventing Alzheimer’s with Cognitive Training (PACT) study continues to seek participants for this first-of-its-kind primary prevention trial.  Funded by a $2.7 million National Institutes of Health grant, the study is examining whether a specific type of computerized brain training can reduce the risk of mild cognitive impairment, and dementias like Alzheimer’s disease, in older adults.

The Tampa Bay area has three PACT study training sites, one each in Hillsborough, Pinellas and Polk counties. For more information on site locations and phone numbers, please visit: pactstudy.org/tampa-bay/

Prevention research takes on increased urgency in the wake of recent failures of investigational Alzheimer’s drugs from major pharmaceutical companies to halt brain degeneration.

Research assistant Dorothy St. Pierre, center, chats with a PACT study participant Twyla Sampson in the USF Cognitive Aging Lab.

“Much of what we know about Alzheimer’s disease indicates that early intervention is absolutely critical,” said USF’s Aryn Harrison Bush, PhD, PACT study co-investigator who oversees the Polk County site. “Compelling preliminary evidence has shown that the specific form of adaptive, computer-based cognitive training we are studying decreased the risk of dementia by 29% to 48% compared to older adults who received no training.”

The researchers hope to enroll a total of 1,600 healthy adults age 65 or older, in Tampa Bay and Michigan.  Study participants cannot have dementia or other neurological disorders, but a family history of Alzheimer’s does not disqualify a person. They must commit to three initial visits at the training site, and then complete the remaining brain training sessions independently at home.

Lakeland PACT study participant John Peronto, 71, is the primary caregiver for his wife of 41 years Sue Peronto, diagnosed with Alzheimer’s disease in 2013.  The once vibrant woman, now bedridden, struggles to communicate. But Sue still recognizes and calls her husband by name, and John affectionately refers to his wife as “my Susie Q.”

“I became interested in this study because I’ve seen what this awful disease has done to my wife,” Peronto said. “I’m hoping it expands the knowledge about whether this type of cognitive training can help prevent or slow Alzheimer’s.  Right now only a few drugs are on the market, and all they do is provide some short-term relief of symptoms.”

The researchers hope to recruit a total of 1,600 volunteers — a diverse population of healthy adults age 65 or older — to test whether a specific type of computer brain exercises can reduce the risk of decline in cognitive abilities like thinking, remembering and reasoning.

The USF researchers want to broaden the scientific studies to a more diverse population than ever before to evaluate “whether it’s feasible and effective to ‘prescribe’ such brain training exercises at home,” said Jennifer Lister, PhD, PACT study co-investigator. “We’re enthusiastic about bringing the opportunity to participate in Alzheimer’s prevention research to our community.”

Principal investigator Jerri Edwards, PhD, emphasized the need for African-American and Latino volunteers as the Alzheimer’s Association reports they are populations at highest risk for Alzheimer’s disease and other dementias.

-Video and photos by Allison Long, USF Health Communications and Marketing

Dr. Cindy Munro will be among the first researchers in the United States to study an audio-recording system to reduce delirium in ICU patients.

Tampa, FL (Dec. 19, 2016) – The National Institutes of Nursing Research (NINR) has awarded more than $1.9 million to the University of South Florida College of Nursing to study an audio-recording reorientation intervention to prevent delirium in the intensive care unit (ICU).

Cindy Munro, PhD, professor and associate dean of research and innovation at USF College of Nursing, will lead a team of USF Health researchers to study whether the intervention, called Family Automated Voice Reorientation (FAVoR), can help minimize delirium among patients receiving treatment in ICUs.

FAVoR uses scripted audio messages from the patient’s family, and is played to the patient in the ICU every hour during daytime. The audio recording helps inform the patient about the ICU environment in general terms –in a familiar voice. The recording calls the patients by name and explains what’s happening — telling them, “you’re not able to talk, because you are in a breathing tube,” “you’re in the hospital,” and “we will visit you soon.” 

Cindy Munro, PhD

Dr. Munro and her team will study 178 critically ill and mechanically ventilated adult patients hospitalized at Tampa General Hospital. The researchers will also follow the patients’ progress for six months after they leave the hospital.

“People with delirium have a lot more trouble with recovery,” Dr. Munro said. “Their memory and their long-term quality of life is affected even after they’re discharged from the hospital. So, by doing this alteration to the environment, we’re hoping to help reduce delirium in the ICU, and improve patients’ lives when they go home.”

According to the ICU Delirium and Cognitive Impairment Study Group, 50 percent of critically ill and 80 percent of mechanically ventilated adult patients suffer from delirium. Delirium is a serious disorder that affects one’s mental abilities, environment awareness and thinking, and causes behavioral changes and emotional disturbances.

During this four-year study, Dr. Munro will work with USF College of Nursing’s Ming Ji, PhD, professor, and Zhan Liang, MSN, assistant professor. She will also collaborate with two physicians from USF Health Morsani College of Medicine’s Division of Pulmonary, Critical Care and Sleep Medicine: Karel Calero, MD, assistant professor, and W. Mcdowell Anderson, MD, professor and director of Sleep Medicine.  

“We’re happy to be the one of the first institutions in the nation to study delirium in the ICU,” said Donna Petersen, ScD, CPH, interim dean of the USF College of Nursing, senior associate vice president of USF Health and dean of the USF College of Public Health. “This research will help tackle an untapped health care issue such as delirium as well as help advance our college research mission.”      

The study is supported by NINR, part of National Institute of Health (NIH). NINR helps promote and improve the health of individuals, families and communities. NINR is part of NIH’s 27 institutes and centers that support and conduct clinical and basic science research on health and illness. For more information about NIH and NINR visit www.ninr.nih.gov.

-USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Physical Therapy and Rehabilitation Sciences, the Biomedical Sciences Graduate and Postdoctoral Programs, and the USF Physicians Group. USF Health is an integral part of the University of South Florida, a high-impact, global research university dedicated to student success. For more information, visit www.health.usf.edu

David Morgan plays a leading role in an ambitious national research movement to help stop Alzheimer’s disease by 2025

In a year’s time Alzheimer’s disease affects more Americans than cancer and heart disease, the country’s top two causes of death. And, according to a report by the Rand Corporation, the total economic costs of dementia – from $159 billion to $215 billion yearly — slightly surpass those of heart disease and exceed cancer care costs by 30 percent.  Yet, the federal government spends five times more on heart disease research than on Alzheimer’s research and eight times more on cancer research.

That’s why in addition to his roles as a senior administrator and researcher, David Morgan, PhD, chief executive officer of the USF Health Byrd Alzheimer’s Institute, dedicates time advocating for more Alzheimer’s research funding at the national and state levels. Dr. Morgan, is a founding member and lead representative of the ResearchersAgainstAlzheimer’s, a coalition focusing the energies of the research community on the aggressive goal of stopping Alzheimer’s by 2025.

David Morgan, PhD

  Listen to Dr. Morgan audio clip below.

“The major risk factor for Alzheimer’s disease is old age,” said Dr. Morgan, distinguished professor of molecular pharmacology and physiology at the Morsani College of Medicine. “As we see gains in longevity, due largely to success in treating other diseases, and as more baby boomers pass age 65, the financial impact of Alzheimer’s and related dementias on Medicare will overwhelm our country’s capacity to maintain the program.”

Dr. Morgan remains optimistic that translational research conducted in the laboratories and clinics at the Institute can contribute to discoveries leading to two things by 2025:  the tools to prevent Alzheimer’s in high-risk older adults not yet showing symptoms, and treatments to effectively slow progression of the memory-robbing neurodegenerative disease in those diagnosed.

“We don’t need breakthroughs to achieve these two goals. We need the public and private resources to do the hard work of proving the science is right,” Dr. Morgan said. “Without the investment, we won’t get there.”

Leading a translational center at forefront of Alzheimer’s research and care

During Dr. Morgan’s tenure, the Byrd Alzheimer’s Institute – combining laboratory research, patient clinics, drug trials, and caregiver/health professional/first responder education under one roof — continues to grow and strengthen.

When he was tapped to lead the Institute in 2009, four doctoral researchers occupied less than 30 percent of the partially shelled, seven-floor facility.  Today, nearly 30 basic science and clinical faculty members, primarily from the Morsani College of Medicine, have appointments at the translational research center, bolstered by another dozen associate members from across USF. The building is nearly fully built out and occupied.

Under Dr. Morgan’s leadership, the USF Health Byrd Alzheimer’s Institute – a translational research center at the forefront of Alzheimer’s disease research and care — continues to grow and strengthen.

Despite intense competition for reduced research funding, Byrd Institute investigators attracted more than $7.5 million in new research grants and contracts last fiscal year, largely from the National Institutes of Health (NIH) and private foundations. New and ongoing research focuses on understanding the pathophysiology of Alzheimer’s as well as testing whether treatments targeting amyloid (plaques) or tau (tangles) in the brain can halt or slow progression of the disease itself, not just alleviate some symptoms.

“In the first six months I directed this Institute I learned more about the clinical aspects of Alzheimer’s disease than I had in the 20 preceding years,” Dr. Morgan said. “Having physicians who see patients and conduct clinical studies in the same building helps motivate scientists working in the laboratories.  It greatly facilitates the rate at which the laboratory research findings are tested in the clinic.”

Harnessing the power of advanced brain imaging techniques for clinical research

One of Dr. Morgan’s early strategic decisions was to invest in a state-of-the-art positron emission tomography (PET) scanner.  The addition has begun to pay off with a steady increase in patients referred to the Institute’s PET imaging center for brain and oncology diagnostic services. In addition, more clinical studies funded by the NIH and pharmaceutical companies are using an FDA-approved amyloid imaging agent to detect and measure amyloid, a hallmark feature of Alzheimer’s in the brain.  Scientists now know that amyloid plaques begin building up in the brain years before the first signs of memory loss.

USF is home to one of few Alzheimer’s centers in the country to own a PET scanner, which is used with neuroimaging agents in studies looking to detect signs of Alzheimer’s in the brain before symptoms are displayed. Dr. Morgan, left, with Amanda Smith, MD, the Institute’s medical director, who oversees clinical trials supported by the NIH and pharmaceutical industry.

The Institute expects to be among the 200 sites participating in the recently announced national Imaging Dementia – Evidence for Amyloid Scanning (IDEAS) study to determine the clinical usefulness of amyloid PET scans in helping doctors accurately diagnose Alzheimer’s and other dementias in cases where the cause of cognitive impairment is uncertain. Dr. Morgan is optimistic that the comprehensive study will demonstrate the value of amyloid imaging and advance Medicare and other insurance carriers toward its reimbursement.

“As we run trials evaluating drugs to see if they can reduce amyloid or tau buildup in the brain, we can monitor how much is there before and after and determine if (the investigational therapy) hit the target,” Dr. Morgan said. “It is a very important biomarker for progression of the disease.”

He looks forward to the day when physicians will be able to use advanced brain imaging techniques to screen for Alzheimer’s much like they do now for heart disease, so that intervention can be started early before cell death in the brain becomes irreversible.

Merging interests in memory and age-related brain changes to tackle Alzheimer’s

Dr. Morgan’s 35-year career in neurosciences started at Northwestern University where he did his doctoral research on the neurochemistry of learning and memory. As a postdoctoral fellow at the University of Southern California School of Gerontology in the early 1980s, he investigated age-related changes in the brains of rodents and humans. During that period momentum began building for federal efforts to combat Alzheimer’s disease and researchers discovered a new cerebrovascular protein, beta amyloid, identified as a pathological hallmark of Alzheimer’s disease and prime suspect in triggering nerve cell damage.  Dr. Morgan seized the opportunity to apply his background in aging and brain function on finding drugs to treat Alzheimer’s dementia.

Dr. Morgan worked with colleagues at USF to develop a mouse genetically modified to develop Alzheimer’s symptoms early in life. He is an expert in using transgenic mouse models to test new immune therapies against both amyloid and tau — both considered pathological hallmarks of Alzheimer’s disease.

Arriving at USF in 1992, he collaborated with colleagues to create a mouse genetically modified to develop Alzheimer’s symptoms early in life (the APP+PS1 mouse model of Alzheimer’s disease).  Dr. Morgan’s impressive research portfolio includes studies to help determine how inflammation in the brain affects the Alzheimer’s disease process and to test gene therapy and immune therapy against the amyloid peptide. He currently leads a four-year, $1.75-million R01 grant from the National Institute of Neurological Disorders and Stroke, exploring antibodies to protect against the accumulation of neuron-killing tau tangles in a transgenic mouse model.

Dr. Morgan’s work has been published in many high-impact journals including Science, Nature and the Journal of Neuroscience, and he has consulted with both major pharmaceutical companies and small biotechnology firms on the development of Alzheimer’s therapeutics.

Dr. Morgan shares laboratory space at the Institute with senior scientist Marcia Gordon, PhD, professor of molecular pharmacology and physiology; Daniel Lee, PhD, and Maj-Linda Salenica, PhD, both assistant professors of pharmaceutical sciences; and Kevin Nash, PhD, assistant professor of molecular pharmacology and physiology. While he continues to seek out new research – he and Dr. Nash are teaming up to find ways to enhance anti-inflammatory activity of the protein fractalkine in the brain — lately he spends as much time mentoring junior faculty.

“I’ve reached a point in my career where I feel it’s critically important to help junior faculty improve the grant proposals they write so they can build their own track records as principal investigators,” Dr. Morgan said.

Early in his scientific career, Dr. Morgan seized the opportunity to apply his background in aging and brain function on finding drugs to treat Alzheimer’s dementia.

Building upon scientific discoveries to find effective treatments

The search for answers about the cause of Alzheimer’s has spanned many theories in the last several decades.

“There’s a broad consensus among most researchers today that a combination of amyloid and tau is needed to cause Alzheimer’s disease.  Amyloid alone is not enough,” Dr. Morgan said. “The accumulation of amyloid outside neurons may trigger abnormal inflammation in the brain, which in turn causes tau tangles to build up inside the neurons and that leads to neuron death.”

The exact cascade of events and amount of plaques and tangles resulting in full-blown Alzheimer’s pathology is still unknown, he added, and no doubt complex.

Dr. Morgan, who holds an undergraduate degree in philosophy, is philosophical about what the USF Health Byrd Alzheimer’s Institute is working toward under his leadership.

“I’m not coming to work because I think we’re going be awarded a patent for a drug that cures Alzheimer’s disease,” he said. “But I am confident that the things we discover at USF, when integrated with the larger community of scientific knowledge, will move us closer to a better understanding of this devastating neurodegenerative disease and result in meaningful treatments to benefit patients and their families.”

In addition to his roles as senior administrator, scientist and mentor, Dr. Morgan advocates for more Alzheimer’s research funding at the national and state levels.

An interdisciplinary team led by Dr. Cecile Lengacher will study whether mindfulness-based stress reduction reduces chemotherapy-induced cognitive impairment

Tampa, FL (July 14, 2015) –The National Cancer Institute (NCI) has awarded more than $2.8 million to the  University of South Florida College of Nursing to study memory and concentration among breast cancer survivors using a meditation-based stress reduction intervention.

Cecile Lengacher, PhD, professor and pre-doctoral fellowship program director at the USF College of Nursing, will lead a team of researchers from USF Health and Moffitt Cancer Center to study the “Efficacy of MBSR treatment of cognitive impairment among breast cancer survivors.” Dr. Lengacher and her team will study 300 breast cancer survivors from Moffitt Cancer Center and the USF Health Morsani Center for Advanced Healthcare.

Cecile Lengacher, PhD

During the five-year study, researchers will evaluate mindfulness-based stress reduction for breast cancer (MBSR (BC)) to determine if the intervention improves objective and subjective cognitive functioning among breast cancer survivors. This non-pharmacological stress reduction program involves group interaction and practice techniques, including sitting and walking meditation, yoga and body scan. Researchers will use a three-group randomized design to test the outcome and will deliver it in English and Spanish. Dr. Lengacher has used MBSR (BC) in a previous study, and preliminary data showed positive results.

Breast cancer survivors will participate in a six-week intervention and will be assessed at baseline, six weeks, 12 weeks and six months. The assessments will include clinical histories, demographics, objective neuropsychological and subjective cognitive tests, symptom measurements and blood samples.

“Breast cancer survivors who have undergone chemotherapy and radiation often experience a condition called chemo brain, which effects memory and concentration,” Dr. Lengacher said. “Our goal is to test MBSR (BC) in a randomized controlled trial to determine if the intervention is an effective treatment for memory and cognitive functioning. Positive results would increase quality of life for survivors and provide evidence for better, more effective and less costly treatment of this condition.”

According to American Cancer Society (ACS), there are currently about 14.5 million cancer survivors in the United States. More than 25 percent suffer from a “mental fog” or chemo brain. ACS shows that survivors may have cognitive impairment problems six months to 10 years after treatment.

Dr. Lengacher will conduct the study with a team of researchers from USF Health and Moffitt Cancer Center, including Kevin Kip, PhD, distinguished USF Health professor; Carmen Rodriguez, PhD, assistant professor at USF Nursing; Branko Miladinovic, PhD, assistant professor at the USF Health Morsani College of Medicine, Richard Reich, PhD, associate professor at USF Sarasota-Manatee; Hongdao Meng, PhD, associate professor at the USF School of Aging Studies; and Heather Jim, PhD, and Jong Park, PhD, researchers at Moffitt Cancer Center.

“We’re excited to receive this significant grant from NIH to study breast cancer survivors,” said Dianne Morrison-Beedy, PhD, senior associate vice president of USF Health and dean of the College of Nursing. “I’m proud to lead a college that’s transforming health care and transforming lives.”

The study is supported by NCI, part of National Institute of Health (NIH). NCI supports cancer research, training, health, and information dissemination. NCI is part of NIH’s 27 institutes and centers that support and conduct clinical and basic science research on health and illness. For more information about NIH and NCI visit http://www.cancer.gov/.

-USF Health-
USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities. For more information, visit www.health.usf.edu.

Media contact:
Vjollca “V” Hysenlika, College of Nursing Communications
(813) 974-2017, or vhysenli@health.usf.edu

Amyvid is the first and only FDA-approved diagnostic PET tracer for imaging beta amyloid plaques in the living brain

Tampa, FL – (Sept. 5, 2012) The USF Health Byrd Alzheimer’s Institute’s Eric Pfeiffer Imaging Center is one of only a limited number of PET imaging sites in Florida to offer Amyvid brain imaging.  Amyvid is a diagnostic PET (positron emission tomography) tracer to detect the presence or absence in the brain of significant amyloid plaques, a hallmark of Alzheimer’s disease, while patients are still alive.  The radiotracer allows physicians to see evidence of amyloid plaques in patients with cognitive impairment when providing clinical evaluation for Alzheimer’s disease and other causes of cognitive decline.

Alzheimer’s disease (AD) is one of many possible causes of dementia or cognitive impairment. Patients with symptoms of cognitive impairment can be misdiagnosed with Alzheimer’s disease, and up to one in five patients without AD pathology upon autopsy are clinically diagnosed with the neurodegenerative disease. In conjunction with clinical assessment, an imaging test or brain scan could detect the presence of neuritic, beta-amyloid plaques in the living brain.

An Amyvid PET scan is intended for use in adult patients with early stage dementia or memory problems. Amyvid is injected into the blood stream, where it binds to amyloid plaques in the living brain. An Amyvid PET scan is not a covered service under Medicare. For questions on payment and scheduling for Amyvid PET imaging, call (813) 396-0728.

 For more information about Amyvid, visit www.amyvid.com

 -USF Health-

USF Health’s mission is to envision and implement the future of health. It is the partnership of the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences and the School of Physical Therapy and Rehabilitation Sciences; and the USF Physician’s Group. The University of South Florida is a global research university ranked 50^th in the nation by the National Science Foundation for both federal and total research expenditures among all U.S. universities.

Media contact: