It is a brick building, with a simple plaque indicating “biological resource platform”. At the heart of 13e district of Paris, the Pitié-Salpêtrière hospital houses a center unique in France: a “biobank” of brains. In about ten gray freezers, kept at – 80°C, 750 cerebral hemispheres of donors wait.
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Co-managed by Paris hospitals and patient associations, this biobank is used for research on neurodegenerative diseases: Alzheimer’s and Parkinson’s, but also cerebellar syndromes, multiple sclerosis, fronto-temporal lobar degeneration, and lateral sclerosis amyotrophic (Charcot’s disease). “The donations are only used for research on these diseases, nothing else”explains Marie-Claire Artaud-Botté, scientific coordinator of the centre.
Diagnose better
Researchers can request samples here to validate their hypotheses on the mechanisms involved in these pathologies. Since 2009, nearly 200 research projects have been carried out thanks to the brains of the biobank. “Some teams are working on cultured cells or animal models, but the human brain cannot be completely replaced. Alzheimer’s disease, for example, only affects humans “, explains Maï Panchal, scientific director of the Vaincre Alzheimer foundation.
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If no treatment directed against Alzheimer’s is currently available in France, research is progressing. “We now know that almost half of cases can be avoided by acting on risk factors, such as a sedentary lifestyle, alcohol, smoking and others, she recalls. Above all, we know how to accurately diagnose the disease. »
Where Alzheimer was rather a hypothesis after eliminating other possible cognitive disorders, medicine now uses brain imaging and biomarkers to confirm the suspicion. Brain lesions specific to Alzheimer’s can be seen fifteen to twenty years before the first symptoms. In France, more than 200,000 new cases are detected each year.
A sample taken within 48 hours of death
At the Pitié-Salpêtrière, the glass plate slipped under the microscope reveals colored brown clusters, a sign of the disease. To better understand Alzheimer’s and other neurodegenerative pathologies, researchers work by comparing patients and healthy people of the same age. In addition to those of sick donors, the freezers therefore also contain “control” brains, from people who died without brain problems.
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“We have more brains of sick people than control brainssays Marie-Claire Artaud-Botté. Between the registration of a young and healthy donor, often relatives of patients, and his death, the brain can be the victim of pathologies. » Not necessarily Alzheimer’s or similar for that matter; a major stroke is enough to prevent the brain from being used for research.
In the event of a donation, the sample must be taken within forty-eight hours after the death, in one of the fourteen partner centers across France. The deceased is then returned to his family. “We can’t see anything from the sample, it leaves a thin scar on the back of the skull which is covered by the hair”whispers a visitor whose late wife was a donor.
Revocable consent
At the biobank, it is easy to recognize that brain donation is fraught with symbolism and that the process requires special acceptance by families, much more than organ donation to save lives. Consent is revocable at any time, by the person or by their family after death. “But in general, we see a real momentum among patients and their loved ones to help develop treatments”notes Mai Panchal.
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Unlike organ donation, which is for therapeutic purposes, brain donation is used for research and is framed differently. “It’s not like donating your body to medicine either.explains Marie-Claire Artaud-Botté. All our procedures go through a committee for the protection of persons and donations and their uses are very legally regulated. Applications from researchers are examined by a scientific committee. »
The center keeps the samples for ten years, anonymously but with the health history. A necessary detail to be able to take into account, for example, the effects of smoking. And hope, one day, to overcome neurodegenerative diseases.
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No treatment for Alzheimer’s
There is currently no treatment capable of stopping or reversing Alzheimer’s disease that is authorized in France. Most research in the field focuses on immunotherapy, in order to mobilize the patient’s immune defenses to fight against the pathology.
The United States authorized, in 2021, aducanumab, a molecule which makes it possible to slow down the evolution of the disease, but not to cure it. In France, this treatment has not been authorized because the results of clinical trials were not sufficiently robust, and the side effects can be significant (cerebral microhemorrhages).