Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Dublin Brain Bank

DUBLIN BRAIN BANK 
FURTHERING NEUROLOGICAL RESEARCH
 

 

The need for an Irish Brain Bank

Ireland is the only European country that does not have a national Brain Bank. We are developing a Brain Bank initially in Dublin, but later growing to become The National Irish Brain Bank. In collaboration with US researchers, Irish neuroscientists have been at the forefront of pioneering dementia research. Having a local brain bank will significantly advance this research. Objectives of the brain bank include facilitation of brain donation through an ethically approved programme of informed consent and the provision of accurate diagnosis for relatives of brain donors according to the best international practice.

We will ensure the dissemination of high quality brain tissue to neuroscience researchers in Ireland and elsewhere and through a tissue advisory board will respond to requests for tissue without prejudice. We will ensure that relatives of donors are kept fully informed about all aspects of brain banking and about progress in dementia research in particular. Through our newly developed web site and at public lectures, we will disseminate and promote knowledge of brain banking. We will encourage neuroscientists to visit and to work in the brain bank and also in the adjacent neuropathology laboratory. Through multi-disciplinary meetings we will foster collaboration between clinicians, neuroscientists and neuropathologists. We will strive to maintain excellence in our practice and will always be mindful of our positions as custodians of these valuable human resources. We will collaborate with colleagues in other similar brain banks in the best interests of patient care and in the best interests of our own scientific growth.

Background and relevance to Health Services in Ireland

Early diagnosis and treatment of cardiovascular disease, stroke and cancer has resulted in prolongation of the normal life expectancy, but increased longevity also increases the risk for development of dementia. For example, predictions indicate that the numbers of people with Alzheimer disease (AD) will double every 20 years reaching a worldwide total of 81.1 million in 2040 [1]. There are currently approximately 38,000 people living with dementia in the Republic of Ireland and it is predicted that this will rise to 70,115 in 2026 and 10 years later will reach 103,998 [2]. The socio-economic impact of this disease burden will be enormous. The disability weight for dementia is higher than for all medical conditions with the exception of spinal cord injury and terminal cancer [3]. The major challenges in dementia and specifically AD are early detection and implementation of scientifically based treatment strategies. Irish neuroscientists at the forefront of AD research have identified the key proteins involved in early neuronal degeneration and are now turning their attention to the mechanisms whereby these proteins impair neuronal function [4-6]. Ireland is one the few countries country in the EU, which does not have a national brain bank. A significant impediment to neuroscience research in Ireland is the lack of human brain tissue for study.

Strategic relevance

Development of a national Brain Bank (BB) to harvest tissues from patients with Alzheimer's, Parkinson's, Epilepsy, Motor Neurone Disease, Multiple Sclerosis and Neuropsychiatric disorders, together with rare but important conditions such as Creutzfeldt Jacob Disease along with healthy tissues from normal aged patients, is perhaps the most important research resource required to advance world class neuroscience research in Ireland. For instance, a key strategy in the treatment of AD is early recognition, which must rely on a combination of biomarkers supplemented with neuropsychological and imaging investigations. The validity or otherwise of biomarker based diagnosis in early AD can only be determined by comprehensive prospective studies of large populations over several years with subsequent pathologic confirmation. Already, archived brain tissues from the existing Beaumont Brain bank has been critical in identifying the pathologic amyloid species involved in early AD [7].

A similar strategy lies at the heart of Parkinson's Disease (PD) research where availability of human tissues will allow characterisation of protein interactions which are fundamental in selective neuronal degeneration [8,9]. The existing brain bank has already received a significant number of voluntary donations from patients who have attended the Mater Hospital movement disorder clinic.

In epilepsy, the search for the genetic and molecular basis of anti-epileptic drug resistance is crucial and readily lends itself to large scale genetic testing which is most likely to be informative if carried out on brain tissues resected from patients whose epilepsy is resistant to drugs [10]. Additionally, the genetic basis for epilepsy susceptibility may be addressed using similar precious human tissue resources. The epilepsy core in a BB will underpin the large pharmacogenomics research programme at Beaumont Hospital [11].

Current MS research is focussing on axonal injury as an early and important determinant of long-term outcome. Animal models offer only a limited opportunity to study this phenomenon. Ireland has already played a major role in MS research over the past 20 years with much of the work based on the study of human tissues collected by the Northern Ireland MS brain bank [12]. But given Northern Ireland's smaller population base it has proven increasingly difficult to maintain and restock the NI MS Brain Bank. An All - Ireland brain bank including samples from both Northern Ireland and the Republic of Ireland would provide a much larger population base of over 5 million people and would facilitate replenishment of important tissue stocks in the Northern Ireland Brain Bank. When established in Dublin, it is our intention to broaden the scope of the brain bank to all of Ireland basis.

Irish psychiatrists have been at the forefront of international research in the structural basis of schizophrenia but have had to rely on the importation of human tissues from the US [13,14]. Easy availability of well-characterised brain tissue from deceased Irish patients with neuropsychiatric disease is seen as an essential step in advancing this exciting area of neuroscience research.
Facilities & Management

The Brain bank storage unit is currently located in the Neuropathology Department at Beaumont Hospital, but will be transferred to a 1000 square foot benched and shelved laboratory space when construction of the new RCSI Clinical Research Building is completed in 2009. The facility will include freezers, storage racks for tissue sections, computers, and associated software. 1 full time scientist, 1 part-time nurse specialist and 1 clerical assistant will staff the facility.

A neuropathologist [Dr. M. Farrell or Dr. F.Brett] will be responsible to the management committee for the day to day running of the brain bank. Quarterly meetings of the management committee will take place and minutes will be circulated to the RCSI Ethics committee. The management committee will include a member of public; senior neuroscientist [Dr. Dominic Walsh] neuropathologist [Dr. M. Farrell or Dr. F.Brett]; neurologist [Dr. Timothy Lynch], Psychiatrist [Professor Brian Lawlor]; Alzheimer Society representative [Mr. Maurice O'Connell],a medico-legal expert [to be determined] and a medical ethicist who will be nominated by and represent the RCSI Ethics committee.

In addition, a Scientific Advisory Board (including 3 experts who head or have directed brain banks ) have agreed to serve on this committee: Harry Vinters (UCLA), Francoise Gray [Immediate past-president of the International society of Neuropathology (Hopital Lariboisier, Paris) and Dr. James Nicholl UK, will meet once yearly and oversee publication of an annual report documenting the NBB's activities. The Scientific Advisory Board will have the power to make binding recommendations on the operation of the NBB.

Tissue Advisory Board (TAB)

Should the situation arise where a member of the management committee requests tissue for their own research purposes, this will be seen to cause a conflict of interest for both the management committee and the requesting member. In this case the chair (or if necessary, the deputy chair) of the management committee and the chair of the SAB will constitute a separate tissue advisory board (TAB) established specifically to review requests made by management committee members. Where appropriate the TAB will have the power to request external review of applications for tissue. The management committee will conduct monitoring of tissue usage.

Goals

We hope to have an all-Ireland Brain bank that will serve the needs of Irish neuroscience researchers fully operational within the next 3 years. We also expect to be integrated into the European network of brain banks [15] in the very near future.

The staff at the Dublin Brain Bank will be happy to answer any questions you may have regarding donation or research so please do not hesitate to contact us using the following details:

CONTACT INFORMATION

DUBLIN BRAIN BANK

Teresa Loftus
Project Coordinator
Dublin Brain Bank
NEUROPATHOLOGY DEPT
BEAUMONT HOSPITAL
DUBLIN 9
IRELAND

E-mail: brainbank@rcsi.ie  
Website: www.brainbank.ie

24 hour messaging service number 01 7974757