Gad A. Marshall, MDBACK

Instructor in Neurology, Associate Neurologist, Brigham and Women's Hospital

Amyloid Deposition and Frontally Mediated Symptoms in MCI

Patients with mild cognitive impairment (MCI), often a precursor to Alzheimer's disease (AD), may present with apathy (loss of interest, lack of motivation and social withdrawal) and executive dysfunction (impairment in complex attention, working memory, organization, and reasoning) that leads to impairment in instrumental activities of daily living (IADLs). IADL impairment includes difficulties in preparing meals, handling finances, using transportation, shopping, and many other everyday activities. Symptoms of MCI are thought to be caused by dysfunction in the frontal regions of the brain. Recent advances in brain imaging now allow tracking of amyloid development, thought to be a main cause of AD. The goal of Dr. Marshall's research is to understand the biological underpinnings of apathy and executive dysfunction in relation to IADL impairment in MCI and mild AD, focusing on amyloid deposition and frontal and parietal nerve cell connection dysfunction. This could improve the clinical characterization of MCI subjects for clinical trials and develop more sensitive tests for disease progression. It may also offer the opportunity to differentiate between patients whose MCI will progress to AD and intervene with disease-modifying agents targeting amyloid, thus attacking the disease at its earliest stages.