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The idea is that the cleaning system removes more proteins during deep sleep and therefore decreases the risk of brain haemorrhages
Researchers from the Leiden University Medical Center (LUMC) will use a grant from the Brain Foundation to investigate whether and how the brain can better remove harmful proteins. The idea is that this reduces the risk of brain haemorrhages. They want to achieve this by stimulating deep sleep and by activating a particular nerve.
“As we age, the protein amyloid beta builds up in our brains,” says neurologist and sleep doctor Rolf Fronczek. “This makes the blood vessels brittle and can lead to brain haemorrhages.” This is one of the leading causes of brain haemorrhage in the elderly and is also known as CAA. The hereditary variant of this condition, the Katwijk disease, owes its name to the village where many families with this disease live. In this study, Fronczek and colleagues will investigate two ways to cleanse the brain of this harmful protein.
Natural cleaning system
“It was recently discovered that the brain already naturally removes harmful proteins. This is done by the so-called glymphatic system. What is special is that this system is much more active during deep sleep.” This is why in this study 20 patients were prescribed GHB for three months. GHB works well in narcolepsy patients, among other things, because it promotes deep sleep. The idea is that the cleaning system removes more proteins during deep sleep and therefore decreases the risk of brain haemorrhages. Fronczek works together with the medical head of the SEIN Sleep-Wake Center, Gert Jan Lammers.
In addition, the functioning of the cleaning system seems to be negatively influenced by electrical discharges from brain cells. Fronczek: “We know from our research into cerebral infarctions that these discharges can be inhibited if a large nerve in the neck, the vagus nerve, is stimulated.” To see whether this treatment also works for CAA, a second group of 20 people will be given a device that they can use to stimulate the vagus nerve in the neck for a few minutes three times a day. Fronczek does this together with neurologist Marieke Wermer. A third group of 20 people will receive both treatments.
Cleaning system in pictures
In order to find out whether the cleaning system in the brain is actually stimulated, it must first be imaged. Because this system was discovered not very long ago, the knowledge about it is not yet complete. Coincidentally, MRI physicists Lydiane Hirschler and Thijs van Osch of Radiology conduct a great deal of research into this system at the LUMC. For example, special scanning techniques have recently been developed in the LUMC, which allow the cleaning system to be mapped with a 7-Tesla MRI. In addition, the participants’ cerebrospinal fluid will be examined for the removal of harmful proteins.
New fields of research
With the grant from the Brain Foundation, Fronczek and colleagues can realize this research. “I find it very fun and at the same time exciting to start this study. I wonder if we can indeed show that the glymphatic system becomes more active through deep sleep and nerve stimulation.” If this theory is correct, it will open fields of research for other neurological disorders in which harmful proteins accumulate, such as Alzheimer’s, Huntington’s and Parkinson’s.
The subsidy of 400,000 euros from the Brain Foundation comes from the call ‘Disease-modifying treatment’.
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- Name author and/or edited by: LUMC
- Photographer or photo agency: : INGImages
- Source for this article: : LUMC
- What is the URL for this resource?: https://www.lumc.nl/over-het-lumc/nieuws/2022/April/Verkleint-een-schoner-brein-de-kans-op-hersenbloedingen/
- Original title: Does a cleaner brain reduce the risk of brain haemorrhages?
- Target audience: Healthcare Professionals, Students
- Date: 2022-04-06