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>> OKAY.

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GOOD MORNING.

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I'M WALTER KOROSHETZ THE 

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DIRECTOR OF THE INSTITUTE OF 

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DISORDERS AND STROKE AND THIS IS

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THE ALZHEIMER'S DISEASE-RELATED 

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DIMENTIAS SUMMIT FOR 2025.

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CAN EVERYBODY HEAR ME OKAY?

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THUMBS UP, GREAT.

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I WANT TO THANK THE PEOPLE WHO 

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DID ALL THE WORK INCLUDING 

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PEOPLE HERE AT NINDS AND 

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NATIONAL INSTITUTE OF AGING AND 

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PARTICULARLY THE WORKING GROUPS 

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YOU'LL HEAR FROM TODAY WHO 

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BROUGHT TO YOU RESEARCH 

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RECOMMENDATIONS FOR YOUR 

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CONSIDERATION AND FOR INPUT AND 

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THESE WILL THEN BE PRESENTED TO 

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THE NINDS COUNCIL FOR FORMAL 

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ADOPTION AND THANKS TO DR. POZEN

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SHORE CHAIRING THE WORK GROUPS 

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THAT LED UP TO THE SUMMIT.

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SO THIS IS THE SLIDE THAT JUST 

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REINFORCES WHAT WE ALL KNOW THAT

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THE PUBLIC BURDEN AND SUFFERING 

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DUE TO DEMENTIA IS INCREASING 

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AROUND THE WORLD AND THIS IS 

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FROM THE DISEASE STUDY AND THE 

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INCREASE IN BURDEN OF DISEASE IS

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PRIMARILY DRIVEN BY THE AGING OF

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THE POPULATION.

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SO IF YOU LOOK AT THE AGE 

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STANDARD PREVALENCE IT'S FAIRLY 

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FLAT, SOME INCREASE BUT PRETTY 

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FLAT AND IF YOU LOOK ON THE 

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RIGHT-HAND SIDE YOU SEE THE 

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NUMBERS OF PEOPLE AFFECTED OVER 

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TIME AS THE POPULATION AGES.

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SO, THAT'S TRUE GLOBALLY AND 

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CERTAINLY TRUE IN THE UNITED 

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STATES AND WHY ADDRESSING 

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ALZHEIMER'S DISEASE AND RELATED 

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DEMENTIA IS A NATIONAL PRIORITY.

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THE NATIONAL PLAN TO ADDRESS 

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THIS BURDEN OF ILLNESS WAS 

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ORIGINALLY RELEASED IN 2012.

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IT'S UPDATED ANNUALLY.

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IT CALLS FOR ACTION TO 

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ACCELERATE RESEARCH AND IMPROVE 

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CARE IN SERVICES FOR PEOPLE 

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LIVING WITH DEMENTIA AND THAT'S 

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DEFINED FOR THESE PURPOSE AS 

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ALZHEIMER'S DISEASE, VASCULAR 

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COGNITIVE IMPAIRMENT AND LEWY 

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BODY DEMENTIA WHICH IS THE 

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CONDITION THAT AFFECTS PEOPLE 

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WITH PARKINSON'S WHO THEN 

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DEVELOP DEMENTIA.

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SOME PEOPLE WITH THIS DISEASE 

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DEVELOP DEMENTIA EVEN BEFORE THE

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PARKINSON'S SYMPTOMS AND FRONTAL

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TEMPORAL DEMENTIA AND THE BURDEN

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OF ILLNESS FALLS CLEARLY ON THE 

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PEOPLE AFFECTED BUT ALSO ON THE 

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FAMILIES WHO CARE FOR THESE 

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FOLKS.

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THE NATIONAL ALZHEIMER'S ACT WAS

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AUTHORIZED IN 2011 AND HELD BY 

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HEALTH AND HUMAN SERVICES AND IN

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EVALUATION WITH NIH AND OTHER 

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AGENCIES CONTRIBUTING AND 

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INCLUDES SIX KEY GOALS COVERING 

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RISK REDUCTION, WHICH IS ALWAYS 

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THE ONE THAT'S GOING TO GIVE YOU

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THE GREATEST PUBLIC HEALTH 

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IMPACT IN TERMS OF PREVENTION, 

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TREATMENT CARE SUPPORT AND 

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PUBLIC AWARENESS.

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THE ADVISORY COUNCIL ON 

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ALZHEIMER'S RESEARCH CARE AND 

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SERVICES MEETS REGULARLY.

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IT HAS 12 PUBLIC MEMBERS 

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REPRESENTING PATIENT ADVOCATES, 

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CAREGIVERS, PROVIDERS, STATE AND

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LOCAL GOVERNMENT REPS, 

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RESEARCHERS, VOLUNTARY HEALTH 

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ASSOCIATION REPRESENTATIVES AND 

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CHAIRED CURRENTLY BY DR. MIMS 

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AND IT'S BEEN A PLEASURE TO WORK

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WITH ADRIAN OVER THE YEARS.

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YOU SEE ON THE RIGHT SIDE THE 

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NUMBER OF FEDERAL AGENCIES 

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INVOLVED IN THE ADVISORY COUNCIL

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ON ALZHEIMER'S RESEARCH CARE AND

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SERVICES AND FOR EACH THERE'S A 

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SUBCOMMITTEE THAT WORKS AS A 

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COMMITTEE AND PREVENTION 

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COMMITTEE AND RISK REDUCTION 

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COMMITTEE.

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WHAT WE DO IS SAID THE ADRD 

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MILESTONES AND WE DO THAT 

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THROUGH PEOPLE WORKING BEHIND 

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THE SCENES TO DEVELOP 

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RECOMMENDATIONS THAT ARE THEN 

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VETTED AT SUMMITS SUCH AS THE 

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ONES WE'RE TALKING ABOUT.

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THERE ARE RESEARCH SUMMITS ON 

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CARE AND SERVICES FOR PERSONS 

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WITH DEMENTIA AND THEIR 

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CAREGIVERS AND THEY'RE RAN BY 

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THE NATIONAL INSTITUTES OF AGING

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AN ALZHEIMER'S RESEARCH SUMMIT 

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AGAIN RAN BY THE NATIONAL 

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INSTITUTE OF AGING AND NINDS 

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RUNS THE ONE WE'RE TALKING ABOUT

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TODAY WHICH IS ALZHEIMER'S 

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DISEASE RELATED RESEARCH SUMMIT.

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THE SUMMITS REFLECT CRITICAL 

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SCIENTIFIC PRIORITIES AS BROUGHT

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TO THE FOREFRONT BY WORKING 

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GROUPS THAT INCLUDE SCIENTISTS, 

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CAREGIVERS AND HEALTH CARE 

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PROVIDERS.

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LEADING UP TO THE SUMMIT 

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SUBCOMMITTEES WORK ON 

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PARTICULARLY DEEP DIVES INTO 

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AREAS THOUGHT TO BE ESPECIALLY 

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IMPORTANT IN THEIR SUMMITS AND 

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STARTING TODAY THOSE PRIORITIES 

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FOR THE ALZHEIMER'S DISEASE 

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RELATED SUMMIT WILL BE REPORTED 

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OUT FOR YOUR INPUT AND 

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CONSIDERATION.

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THIS PROFESSIONAL -- THESE PLANS

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ALL GO INTO DEVELOPING THE 

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ANNUAL ADRD PROFESSIONAL 

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JUDGMENT BUDGET AS WELL AS THE 

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2024 ADRD PROGRESS REPORT.

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THAT PROFESSIONAL JUDGMENT 

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BUDGET GOES STRAIGHT TO HHS AND 

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THEN IS CONSIDERED BY THE 

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CONGRESS AND SET BY 

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APPROPRIATION OF CONGRESS AND 

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THEY ESTIMATE THE ANNUAL BUDGET 

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FUNDING NEEDED TO LEVERAGE 

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SCIENTIFIC OPPORTUNITIES IN 

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DEMENTIA RESEARCH AND THE 

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CONGRESS HAS BEEN EXTREMELY 

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GENEROUS IN TERMS OF INVESTING 

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IN THE FUTURE OF THIS RESEARCH 

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OVER THE LAST SIX OR SEVEN 

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YEARS.

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I WOULD SAY THE ANNUAL REPORT IS

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NOW AVAILABLE ON THE WEBSITE.

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IN TERMS OF ALZHEIMER'S 

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DISEASE-RELATED DIMENTIAS WHAT 

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WE CONCENTRATE ON ARE THE 

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VASCULAR CONTRIBUTIONS AND WEAR 

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AND TEAR ON THE BLOOD VESSELS IN

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THE BRAIN CAUSING ISSUES SUCH AS

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STROK

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STROKES MANY TURN OUT TO BE SUB 

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CLINICAL AND THEY SEEM TO BE 

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RELATED TO DEVELOPING RISK OF 

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COGNITIVE IMPAIRMENT DIM EN IS 

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THAT OF AGING.

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THERE'S ALSO A VERY INTERESTING 

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CONDITION THAT'S EXTREMELY 

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COMMON WE CALL WHITE MATTER 

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DISEASE.

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THIS IS USUALLY ASSOCIATED WITH 

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CHANGES IN THE BLOOD VESSELS BUT

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THE WHITE MATTER ARE THE C

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CONNECTIONS BETWEEN THE BRAIN 

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AREAS AND WE SEE ABNORMALITIES 

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IN THE AREAS THAT COMPOSE THE 

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WIRES.

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WE DON'T UNDERSTAND EXACTLY WHAT

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CAUSES THE CHANGES TO OCCUR BUT 

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ALSO ASSOCIATED WHITE MATTER 

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DISEASE WITH HYPERTENSION AND 

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LEAD TO COGNITIVE IMPAIRMENT.

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LEWY BODY DEMENTIA ARE THE 

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PATHOLOGICAL HALLMARK ARE LEWY 

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BODIES AN AGGREGATE OF SINUCLEIN

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AND THEY DEVELOP MOTOR TROUBLE 

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AND THE AREA OF LEWY BODY 

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DIMENSION.

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FRONTAL TEMPORAL DEMENTIA AND 

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OCCUR YOUNGER AND AFFECTS PEOPLE

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IN THEIR 50s AROUND 60s.

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CAUSES SOCIAL DECLINE IN 

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BEHAVIOR AND LANGUAGE AND 

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THEY'LL PRESENT TO A 

196
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PSYCHIATRIST FIRST BECAUSE OF 

197
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CHANGES IN THEIR BEHAVIOR AND 

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ALSO SEEN IN AMYOTROPHIC LATERAL

199
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SCLEROSIS AND CORRELATION IN THE

200
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GENETIC FORMS AND IN THE OTHER 

201
00:09:32,576 --> 00:09:33,644
FORMS OF FTD.

202
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A BIG AREA OF INVESTIGATION IS 

203
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AROUND MIXED DEMENTIAS.

204
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WHEN SOMEONE LOOKS IN THE BRAIN 

205
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OF PEOPLE WHO HAVE DIED WHO HAD 

206
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DEMENTIA, THE OLDER YOU ARE THE 

207
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MORE LIKELY YOU WILL HAVE A MIX 

208
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OF MULTIPLE DIFFERENT CONDITIONS

209
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GOING ON TO CAUSE DEMENTIA AND 

210
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THAT REALLY GETS THINGS 

211
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COMPLICATED BECAUSE TREATMENTS 

212
00:09:57,167 --> 00:09:58,569
WILL HAVE TO AFFECT ALL OR WILL 

213
00:09:58,569 --> 00:10:00,170
HAVE TO HAVE SPECIFIC TREATMENTS

214
00:10:00,170 --> 00:10:02,139
FOR EACH OF THE DIFFERENT 

215
00:10:02,139 --> 00:10:05,175
ETIOLOGIES THAT GO ON TO CREATE 

216
00:10:05,175 --> 00:10:08,645
THE TROUBLE FOR THE PEOPLE AS 

217
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THEY AGE.

218
00:10:14,384 --> 00:10:16,620
THAT'S A BIG AREA OF CONCERN AND

219
00:10:16,620 --> 00:10:25,896
WE'LL TALK MORE ABOUT THAT.

220
00:10:25,896 --> 00:10:28,732
WE'LL LOOK AT THE MECHANISMS 

221
00:10:28,732 --> 00:10:29,633
CAUSALLY RELATED TO THE 

222
00:10:29,633 --> 00:10:31,535
COGNITIVE IMPAIRMENT OF DEMENTIA

223
00:10:31,535 --> 00:10:33,337
BY THIS TIME OF BASIC RESEARCH.

224
00:10:33,337 --> 00:10:34,738
WE UNDERSTAND WHY WE CAN 

225
00:10:34,738 --> 00:10:39,076
INTERVENE TO TRY TO REVERSE THE 

226
00:10:39,076 --> 00:10:41,778
PROCESS THAT LEADS TO COGNITIVE 

227
00:10:41,778 --> 00:10:42,312
IMPAIRMENT AND DEMENTIA.

228
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THAT'S ONE OF OUR BIG AREAS OF 

229
00:10:45,115 --> 00:10:46,817
FOCUS AT THE NIH.

230
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BUT THE JOB IS NOT TO PUBLISH A 

231
00:10:50,354 --> 00:10:52,656
LOT OF PAPERS AND END IT THERE.

232
00:10:52,656 --> 00:10:55,459
THE JOB IS TO MOVE FROM THE 

233
00:10:55,459 --> 00:10:57,461
DISCOVERY IN THE LABORATORIES TO

234
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THE DEVELOPMENT OF THERAPEUTICS 

235
00:11:00,264 --> 00:11:02,332
AND THAT REQUIRES UNDERSTANDING 

236
00:11:02,332 --> 00:11:03,800
WHAT ARE TARGETS THAT COME FROM 

237
00:11:03,800 --> 00:11:07,104
THE BASIC MECHANISMS OF DISEASE 

238
00:11:07,104 --> 00:11:10,073
THAT COULD BE DRUGGABLE.

239
00:11:10,073 --> 00:11:11,308
INCLUDES DEVELOPMENT OF 

240
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BIOMARKERS THAT CAN IDENTIFY 

241
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PEOPLE WITH PARTICULAR 

242
00:11:15,145 --> 00:11:16,413
ETIOLOGIES AS WE MENTIONED 

243
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BEFORE.

244
00:11:17,915 --> 00:11:19,383
THERE MAY BE MULTIPLE 

245
00:11:19,383 --> 00:11:19,683
ETIOLOGIES.

246
00:11:19,683 --> 00:11:20,918
WE NEED THE BIOMARKERS TO 

247
00:11:20,918 --> 00:11:24,555
IDENTIFY WHO IS GOING TO RESPOND

248
00:11:24,555 --> 00:11:26,623
TO WHAT TYPE OF TREATMENT 

249
00:11:26,623 --> 00:11:27,891
DEPENDING ON WHAT THE TARGET OF 

250
00:11:27,891 --> 00:11:30,727
THAT TREATMENT IS.

251
00:11:30,727 --> 00:11:35,599
IN ADDITION BECAUSE DEMENTIA 

252
00:11:35,599 --> 00:11:37,100
OCCURS SLOWLY OVER TIME A STUDY 

253
00:11:37,100 --> 00:11:39,469
TO DEFINE A TREATMENT CANNOT 

254
00:11:39,469 --> 00:11:41,905
RELY ON SAY LOOKING FOR SEVEN TO

255
00:11:41,905 --> 00:11:43,373
10 YEARS DOWN THE ROAD TO SEE 

256
00:11:43,373 --> 00:11:44,341
HOW IT WORKS.

257
00:11:44,341 --> 00:11:47,311
WE NEED TO MAKE DECISIONS MUCH 

258
00:11:47,311 --> 00:11:49,680
MORE QUICKLY IN TERMS OF WHAT 

259
00:11:49,680 --> 00:11:52,549
TYPE OF DRUGS, SAY, FOR INSTANCE

260
00:11:52,549 --> 00:11:53,917
NEED TO GO INTO THOSE LONGER 

261
00:11:53,917 --> 00:11:56,587
TRIALS AND THERE WE NEED 

262
00:11:56,587 --> 00:11:58,255
BIOMARKERS WE CALL TARGET 

263
00:11:58,255 --> 00:11:59,856
ENGAGEMENT TO KNOW THE DRUG IS 

264
00:11:59,856 --> 00:12:03,560
DOING WHAT YOU WANT IT TO DO.

265
00:12:03,560 --> 00:12:05,162
AND THAT IS REALLY CRUCIAL 

266
00:12:05,162 --> 00:12:06,763
PARTICULARLY NOW BECAUSE WE HAVE

267
00:12:06,763 --> 00:12:08,665
SO MANY DIFFERENT TARGETS THAT 

268
00:12:08,665 --> 00:12:10,634
HAVE BEEN IDENTIFIED IN THE 

269
00:12:10,634 --> 00:12:12,235
BASIC SCIENCE.

270
00:12:12,235 --> 00:12:13,837
THE BOTTLENECK IS OFTEN 

271
00:12:13,837 --> 00:12:14,705
IDENTIFYING WHICH ONES ARE 

272
00:12:14,705 --> 00:12:15,939
ROBUST ENOUGH THEY CAN REALLY 

273
00:12:15,939 --> 00:12:17,407
MAKE A DIFFERENCE IN PEOPLE AND 

274
00:12:17,407 --> 00:12:20,243
THIS IS WHERE WE NEED THE 

275
00:12:20,243 --> 00:12:22,145
BIOMARKERS TO MAKE THOSE EARLY 

276
00:12:22,145 --> 00:12:25,482
TYPE OF DECISIONS GO, NO-GO 

277
00:12:25,482 --> 00:12:26,316
DECISIONS BEFORE ENTERING THE 

278
00:12:26,316 --> 00:12:27,250
LONG CLINICAL TRIALS.

279
00:12:27,250 --> 00:12:31,154
BUT THE CLINICAL TRIALS ARE 

280
00:12:31,154 --> 00:12:34,992
CLEARLY THE END GAME HERE IS TO 

281
00:12:34,992 --> 00:12:37,327
SHOW IN A RIGOROUS WAY WHETHER A

282
00:12:37,327 --> 00:12:38,862
TREATMENT IS WORKING OR NOT AND 

283
00:12:38,862 --> 00:12:40,497
WHAT IS THE AFFECT SIZE OF THAT 

284
00:12:40,497 --> 00:12:43,133
TREATMENT, WHAT ARE THE RISKS 

285
00:12:43,133 --> 00:12:46,203
AND BENEFITS AND THEREFORE TO 

286
00:12:46,203 --> 00:12:48,538
INFORM THE PUBLIC ON HOW THEY 

287
00:12:48,538 --> 00:12:50,507
SHOULD MOVE FORWARD WITH 

288
00:12:50,507 --> 00:12:58,882
THEIRSELVES  -- THEMSELVES OR 

289
00:12:58,882 --> 00:12:59,583
LOVED ONES.

290
00:12:59,583 --> 00:13:01,885
THE RESEARCH SYNERGIZES WITH 

291
00:13:01,885 --> 00:13:04,254
OTHER NEUROLOGICAL DISORDERS.

292
00:13:04,254 --> 00:13:11,228
WE MENTIONED VASCULAR COGNITIVE 

293
00:13:11,228 --> 00:13:14,131
IMPAIRMENT AS A KEY FEATURE OF 

294
00:13:14,131 --> 00:13:16,700
THE ADRDs AND THERE'S INFORMED 

295
00:13:16,700 --> 00:13:18,568
BY WORK ON STROKE AND 

296
00:13:18,568 --> 00:13:20,070
CARDIOVASCULAR DISEASE IN THE 

297
00:13:20,070 --> 00:13:22,239
LAST 50 YEARS.

298
00:13:22,239 --> 00:13:24,107
SIMILARLY YOU'LL HEAR ABOUT 

299
00:13:24,107 --> 00:13:26,043
INFLAMMATION INVOLVED IN THE 

300
00:13:26,043 --> 00:13:28,111
DAMAGE THAT OCCURS IN THE 

301
00:13:28,111 --> 00:13:30,013
NEUROGENERATIVE DISEASES AND SO 

302
00:13:30,013 --> 00:13:32,549
RESEARCH OVER THE LAST 50 YEARS 

303
00:13:32,549 --> 00:13:34,284
WE LEARNED A LOT AND IN NO 

304
00:13:34,284 --> 00:13:35,318
INSTANCE HAVE WE LEARNED 

305
00:13:35,318 --> 00:13:38,021
EVERYTHING BUT WE LEARNED A LOT 

306
00:13:38,021 --> 00:13:41,291
ABOUT THE INFLAMMATORY RESPONSES

307
00:13:41,291 --> 00:13:43,493
IN THE BRAIN AND THESE ARE ALL 

308
00:13:43,493 --> 00:13:44,795
CRITICALLY IMPORTANT NOW AS 

309
00:13:44,795 --> 00:13:46,263
FOUNDATIONS TO UNDERSTAND HOW TO

310
00:13:46,263 --> 00:13:48,832
DEVELOP TREATMENTS FOR THESE 

311
00:13:48,832 --> 00:13:51,835
DISORDERS.

312
00:13:51,835 --> 00:13:53,637
SO, THE SLIDE JUST BASICALLY 

313
00:13:53,637 --> 00:13:57,374
INDICATES HOW COMPLICATED THE 

314
00:13:57,374 --> 00:13:59,376
SITUATION IS.

315
00:13:59,376 --> 00:14:01,578
PARTICULARLY WHEN YOU ARE 

316
00:14:01,578 --> 00:14:04,247
DEALING WITH MULTI-ETIOLOGY DIM 

317
00:14:04,247 --> 00:14:12,456
EN -- DEMENTIAS YOU HAVE THE 

318
00:14:12,456 --> 00:14:19,396
SIGNATURE OF NEURO DEGENERATIVE 

319
00:14:19,396 --> 00:14:22,065
DISEASES AND TAU IS A PROTEIN 

320
00:14:22,065 --> 00:14:24,568
THAT AGGREGATES INSIDE THE CELLS

321
00:14:24,568 --> 00:14:26,470
AND COMES LATER AND SEEMS TO BE 

322
00:14:26,470 --> 00:14:27,871
ASSOCIATED WITH DEATH OF THE 

323
00:14:27,871 --> 00:14:29,940
CELLS OPPOSED TO AMYLOID ITSELF.

324
00:14:29,940 --> 00:14:34,244
TAU IS ALSO A PROTEIN THAT ONE 

325
00:14:34,244 --> 00:14:44,755
SEES IN THE FRONTAL DEMENTIAS 

326
00:14:58,435 --> 00:15:04,274
AND PEOPLE ARE DIAGNOSED WITH 

327
00:15:04,274 --> 00:15:05,142
ALZHEIMER'S DISEASE AND SIMILAR 

328
00:15:05,142 --> 00:15:08,645
WE'LL SEE IN MANY PEOPLE WHO 

329
00:15:08,645 --> 00:15:13,350
HAVE DEMENTIA DIAGNOSES DISEASE 

330
00:15:13,350 --> 00:15:21,825
HAS EVIDENCE OF SYNUCLEIN 

331
00:15:21,825 --> 00:15:22,759
AGGREGATION AND THIS HAPPENS 

332
00:15:22,759 --> 00:15:25,962
OVER TIME AND WHY SOME PEOPLE 

333
00:15:25,962 --> 00:15:28,064
ARE RESILIENT AND HAVE THE 

334
00:15:28,064 --> 00:15:29,900
PATHOLOGIES BUT COGNITIVELY 

335
00:15:29,900 --> 00:15:30,967
NORMAL ARE INTERESTING QUESTION 

336
00:15:30,967 --> 00:15:31,902
TO PURSUE.

337
00:15:31,902 --> 00:15:34,771
ARE THERE THINGS IN PHYSICAL 

338
00:15:34,771 --> 00:15:36,540
ACTIVITY, DIET OR ALCOHOL OR 

339
00:15:36,540 --> 00:15:39,810
DRUG USE OR ENVIRONMENTAL 

340
00:15:39,810 --> 00:15:44,214
FACTORS, PSYCHOSOCIAL FACTORS, 

341
00:15:44,214 --> 00:15:46,516
METABOLIC FACTORS THAT GO ON TO 

342
00:15:46,516 --> 00:15:48,652
INFLUENCE THE PROGRESSION OF 

343
00:15:48,652 --> 00:15:49,619
THESE DISEASES ARE AREAS OF 

344
00:15:49,619 --> 00:15:54,891
GREAT INTEREST AT THIS TIME.

345
00:15:54,891 --> 00:15:59,329
HERE IS JUST A SLIDE TO SHOW IN 

346
00:15:59,329 --> 00:16:04,267
THE STUDY A RELIGIOUS ORDER 

347
00:16:04,267 --> 00:16:06,236
STUDY OUT OF CHICAGO.

348
00:16:06,236 --> 00:16:08,638
ONE CAN SEE AND IF YOU LOOK AT 

349
00:16:08,638 --> 00:16:14,110
PEOPLE WHO ARE ELDERLY, FEW OF 

350
00:16:14,110 --> 00:16:18,181
THEM HAVE ALZHEIMER'S ALONE.

351
00:16:18,181 --> 00:16:20,951
AD VASCULAR IS COMMON AND FOR 

352
00:16:20,951 --> 00:16:24,020
OTHER DEMENTIAS ALSO VERY 

353
00:16:24,020 --> 00:16:24,654
COMMON.

354
00:16:24,654 --> 00:16:26,656
FOR THE MAJORITY OF FOLKS WILL 

355
00:16:26,656 --> 00:16:31,027
HAVE A MIX OF PATHOLOGIES IN THE

356
00:16:31,027 --> 00:16:31,828
ELDERLY STATE.

357
00:16:31,828 --> 00:16:33,463
SOME FOLKS DEVELOP DEMENTIA 

358
00:16:33,463 --> 00:16:35,165
EARLIER ON AND THEY'RE LIKELY TO

359
00:16:35,165 --> 00:16:39,903
HAVE A PURER FORM OF ONE OF 

360
00:16:39,903 --> 00:16:42,339
THESE TYPES OF DEMENTIAS BUT THE

361
00:16:42,339 --> 00:16:44,074
PUBLIC HEALTH ISSUE IS IN OUR 

362
00:16:44,074 --> 00:16:44,875
AGING POPULATION AND THERE WE 

363
00:16:44,875 --> 00:16:48,845
HAVE TO LEARN HOW TO BEST 

364
00:16:48,845 --> 00:16:53,450
APPROACH THE ISSUE OF 

365
00:16:53,450 --> 00:16:55,285
MULTIETIOLOGY DEMENTIAS.

366
00:16:55,285 --> 00:16:56,720
I MENTIONED BIOMARKERS AND THIS 

367
00:16:56,720 --> 00:17:07,264
IS AN EXAMPLE OF THE SYNUCLEIN 

368
00:17:12,402 --> 00:17:15,872
BIOPSIES AND YOU CAN SEE IN THE 

369
00:17:15,872 --> 00:17:18,975
SPINAL FLUID AND THEY BECOME 

370
00:17:18,975 --> 00:17:22,345
ABNORMAL POTENTIALLY 10 YEARS 

371
00:17:22,345 --> 00:17:23,280
BEFORE ANYONE SHOWS SIGNS OF 

372
00:17:23,280 --> 00:17:29,686
THEIR NEUROLOGICAL TROUBLES.

373
00:17:29,686 --> 00:17:31,087
ON ONE HAND IT'S VERY 

374
00:17:31,087 --> 00:17:33,123
ENCOURAGING WE HAVE TREATMENTS 

375
00:17:33,123 --> 00:17:35,025
WE CAN IDENTIFY PEOPLE EVEN 

376
00:17:35,025 --> 00:17:36,660
BEFORE THEY GET SYMPTOMS AND IF 

377
00:17:36,660 --> 00:17:39,763
WE CAN INTERVENE EFFECTIVELY 

378
00:17:39,763 --> 00:17:41,598
THERE, THEN WE'RE BASICALLY CURE

379
00:17:41,598 --> 00:17:42,232
THE DISEASE.

380
00:17:42,232 --> 00:17:47,938
SO THAT'S KIND OF THE HOLY GRAIL

381
00:17:47,938 --> 00:17:52,275
WE'RE HOPING THESE BIOMARKERS 

382
00:17:52,275 --> 00:17:54,811
WHEN LINKED WITH EFFECTIVE 

383
00:17:54,811 --> 00:17:55,879
TREATMENT.

384
00:17:55,879 --> 00:17:59,316
THIS IS AN EXAMPLE OF A PHOSPHO 

385
00:17:59,316 --> 00:18:00,617
TAU BIOMARKER THAT AGGREGATES 

386
00:18:00,617 --> 00:18:03,053
INSIDE THE CELLS AND GENERALLY 

387
00:18:03,053 --> 00:18:05,388
THEN KILLS THE CELLS.

388
00:18:05,388 --> 00:18:08,625
THESE ARE BLOOD TESTS THE 

389
00:18:08,625 --> 00:18:12,362
SYNUCLEIN TEST OF SKIN OR SPINAL

390
00:18:12,362 --> 00:18:15,031
FLUID AND THESE ARE BLOOD TESTS 

391
00:18:15,031 --> 00:18:19,235
THAT CAN LOOK AT PHOSPHORO TAU 

392
00:18:19,235 --> 00:18:20,637
IN FOLKS AND YOU CAN SEE IF YOU 

393
00:18:20,637 --> 00:18:22,806
HAVE A LOW LEVEL, THEN YOU'RE 

394
00:18:22,806 --> 00:18:23,907
LIKELY TO HAVE NORMAL COGNITION 

395
00:18:23,907 --> 00:18:28,645
OVER TIME AND IF YOU HAVE A HIGH

396
00:18:28,645 --> 00:18:32,115
LEVEL, THEN YOU'RE AT RISK FOR 

397
00:18:32,115 --> 00:18:32,682
DECLINING OVER TIME.

398
00:18:32,682 --> 00:18:35,685
SO THIS IS STARTING WITH PEOPLE 

399
00:18:35,685 --> 00:18:39,055
WHO ARE COGNITIVELY NORMAL AND 

400
00:18:39,055 --> 00:18:44,627
SHOWING THIS IS A MARKER OF 

401
00:18:44,627 --> 00:18:46,796
DECLINE TOWARDS DEMENTIA.

402
00:18:46,796 --> 00:18:48,631
THERE ARE NEW BIOMARKERS THAT 

403
00:18:48,631 --> 00:18:51,835
HAVE RECENTLY BEEN DISCOVERED 

404
00:18:51,835 --> 00:18:53,436
AND YET TO BE VALIDATED AND HAVE

405
00:18:53,436 --> 00:18:55,138
GONE TO A COMMERCIAL PROCESS AS 

406
00:18:55,138 --> 00:18:57,040
SOME OF THE ABETA AND TAU 

407
00:18:57,040 --> 00:18:59,175
BIOMARKERS HAVE ALREADY DONE.

408
00:18:59,175 --> 00:19:03,380
THIS IS A STUDY SHOWING THAT 

409
00:19:03,380 --> 00:19:08,184
THERE ARE TWO PROTEINS.

410
00:19:08,184 --> 00:19:13,690
THEY HAVE FUNNY NAMES, YWHHA IS 

411
00:19:13,690 --> 00:19:17,394
ONE AND THE OTHER IS MPTX2.

412
00:19:17,394 --> 00:19:20,630
THE OTHER TENDS TO GO UP WITH 

413
00:19:20,630 --> 00:19:24,634
DEMENTIA AND THE SECOND GOES 

414
00:19:24,634 --> 00:19:25,101
DOWN.

415
00:19:25,101 --> 00:19:28,405
SO THE RATIO OF WHAT THEY'RE 

416
00:19:28,405 --> 00:19:29,773
MEASURING NOW IS SHOWING -- WE 

417
00:19:29,773 --> 00:19:32,642
COMPARE IT TO AMYLOID AND TAU BY

418
00:19:32,642 --> 00:19:36,179
ITSELF AND THIS IS MUCH MORE OF 

419
00:19:36,179 --> 00:19:37,914
A ROBUST MARKER.

420
00:19:37,914 --> 00:19:41,918
BUT IT IS A SPINAL FLUID TEST.

421
00:19:41,918 --> 00:19:44,621
JUST AN EXAMPLE OF HOW THESE 

422
00:19:44,621 --> 00:19:46,923
FIELDS ARE PROGRESSING AND 

423
00:19:46,923 --> 00:19:50,226
VALUABLE BIOMARKERS, BLOOD AND 

424
00:19:50,226 --> 00:19:52,529
SPINAL FLUID AND ACTUALLY I 

425
00:19:52,529 --> 00:19:56,399
SHOULD MENTION THE RATIO IS ALSO

426
00:19:56,399 --> 00:19:58,902
ABNORMAL IN THE BLOOD AS WELL.

427
00:19:58,902 --> 00:20:03,973
BUT TIME AND STUDIES IN THOUSAND

428
00:20:03,973 --> 00:20:06,142
OF PEOPLE NOW VALIDATING THE 

429
00:20:06,142 --> 00:20:09,012
BIOMARKERS WHICH WILL BE HIGHLY 

430
00:20:09,012 --> 00:20:09,312
PREDICTIVE.

431
00:20:09,312 --> 00:20:15,351
THE AREA OF COGNITIVE IMPAIRMENT

432
00:20:15,351 --> 00:20:17,687
DUE TO DUE TO VASCULAR DISEASE.

433
00:20:17,687 --> 00:20:18,588
THERE'S VASCULAR CHANGES THAT 

434
00:20:18,588 --> 00:20:22,525
OCCUR DUE TO DEMENTIA DUE TO THE

435
00:20:22,525 --> 00:20:25,195
BREAD AND BUTTER TYPE OF SEVERAL

436
00:20:25,195 --> 00:20:25,929
VASCULAR DISEASE.

437
00:20:25,929 --> 00:20:27,997
WE SEE THE HYPERTENSION IN AGING

438
00:20:27,997 --> 00:20:30,366
AND ALZHEIMER'S ITSELF IS 

439
00:20:30,366 --> 00:20:32,602
ASSOCIATED WITH CHANGES AND HOW 

440
00:20:32,602 --> 00:20:33,903
BLOOD FLOWS FROM THE BRAIN AND 

441
00:20:33,903 --> 00:20:39,209
HOW OXYGEN IS SUPPLIED.

442
00:20:39,209 --> 00:20:40,543
ONE OF THE MAJOR PROGRAMS FROM 

443
00:20:40,543 --> 00:20:44,581
THE ADRD IS LOOKING AT THE 

444
00:20:44,581 --> 00:20:47,550
CHANGES IN THE BLOOD VESSELS IN 

445
00:20:47,550 --> 00:20:49,986
PEOPLE WHO HAVE THIS WHAT WE 

446
00:20:49,986 --> 00:20:51,121
CALL SMALL VESSEL DISEASE OR 

447
00:20:51,121 --> 00:20:53,022
WHITE MATTER DISEASE I MENTIONED

448
00:20:53,022 --> 00:20:53,323
EARLIER.

449
00:20:53,323 --> 00:20:55,592
AND WE CAN SEE HERE WE'RE 

450
00:20:55,592 --> 00:21:01,598
WORKING TO DEVELOP A MARKER THAT

451
00:21:01,598 --> 00:21:04,834
WE CAN MEASURE AND CORRELATE 

452
00:21:04,834 --> 00:21:09,772
WITH THIS AMOUNT OF MRI 

453
00:21:09,772 --> 00:21:16,546
ABNORMALITY WE SEE AS WELL AS 

454
00:21:16,546 --> 00:21:19,315
THE COGNITIVE IMPAIRED AND THIS 

455
00:21:19,315 --> 00:21:21,551
SHOWS HOW BLOOD FLOW CHANGES 

456
00:21:21,551 --> 00:21:24,154
WHEN THE BRAIN IS ACTIVATED OR 

457
00:21:24,154 --> 00:21:27,657
THE BLOOD VESSELS ARE STRESSED 

458
00:21:27,657 --> 00:21:30,627
TO DILATE IS ABNORMAL IN FOLKS 

459
00:21:30,627 --> 00:21:34,264
AS THEY DEVELOP COGNITIVE 

460
00:21:34,264 --> 00:21:36,633
IMPAIRMENT AND THIS IS SHOWING 

461
00:21:36,633 --> 00:21:39,068
THE GRAPHS IN MULTIPLE DIFFERENT

462
00:21:39,068 --> 00:21:40,637
INSTITUTIONS INDICATING IT'S A 

463
00:21:40,637 --> 00:21:42,972
FAIRLY ROBUST FINDING THAT CAN 

464
00:21:42,972 --> 00:21:44,641
BE REPRODUCED AT MULTIPLE 

465
00:21:44,641 --> 00:21:47,110
DIFFERENT PLACES.

466
00:21:47,110 --> 00:21:48,878
THESE ARE THE KINDS OF THINGS WE

467
00:21:48,878 --> 00:21:52,549
DEVELOP TREATMENTS TO TRY TO 

468
00:21:52,549 --> 00:21:53,917
IMPROVE.

469
00:21:53,917 --> 00:21:58,521
KTB43 IS ANOTHER PROTEIN THAT 

470
00:21:58,521 --> 00:22:01,758
AGGREGATES IN SIDE THE NEURONS 

471
00:22:01,758 --> 00:22:03,860
IN FOLKS WITH ALZHEIMER'S 

472
00:22:03,860 --> 00:22:04,093
DISEASE.

473
00:22:04,093 --> 00:22:07,964
AS WELL AS THE FRONTAL DEMENTIAS

474
00:22:07,964 --> 00:22:09,132
AND ALS.

475
00:22:09,132 --> 00:22:13,269
OF NOTE, THIS PROTEIN IS 

476
00:22:13,269 --> 00:22:16,439
INVOLVED IN THE SPLICING OF 

477
00:22:16,439 --> 00:22:17,674
MESSENGER RNA.

478
00:22:17,674 --> 00:22:18,875
MESSENGER RNA IS MADE FROM THE 

479
00:22:18,875 --> 00:22:23,746
DNA AND PROTEINS ARE MADE OFF OF

480
00:22:23,746 --> 00:22:24,714
THE INSTRUCTIONS IN THE 

481
00:22:24,714 --> 00:22:26,716
MESSENGER RNA AND MESSENGER RNA 

482
00:22:26,716 --> 00:22:30,420
IS BROKEN UP INTO PIECES TO 

483
00:22:30,420 --> 00:22:34,257
CAUSE THE RIGHT AMOUNT OF AMINO 

484
00:22:34,257 --> 00:22:40,530
ACIDS IN YOUR PROTEINS.

485
00:22:40,530 --> 00:22:43,199
TDP-43 IS INVOLVED IN THE 

486
00:22:43,199 --> 00:22:44,500
SPLICING FUNCTION AND WHEN IT 

487
00:22:44,500 --> 00:22:46,202
AGGREGATES, IT CAN'T DO THAT.

488
00:22:46,202 --> 00:22:50,240
SO ONE SEES PROTEINS THAT HAVE 

489
00:22:50,240 --> 00:22:52,508
THICK -- HAVE PIECES IN IT THAT 

490
00:22:52,508 --> 00:22:54,310
SHOULD BE SPLICED OUT BUT 

491
00:22:54,310 --> 00:22:56,446
THEY'RE NOT BECAUSE OF THE 

492
00:22:56,446 --> 00:22:58,548
TPD-43 DYSFUNCTION AND THESE ARE

493
00:22:58,548 --> 00:23:00,316
CALLED CRYPTIC PROTEINS AND 

494
00:23:00,316 --> 00:23:01,684
THESE ARE POTENTIALLY GOING TO 

495
00:23:01,684 --> 00:23:04,854
BE VERY GOOD MARKERS OF TDP-43 

496
00:23:04,854 --> 00:23:06,956
IMMIGRATION IN THE BRAIN OF 

497
00:23:06,956 --> 00:23:08,992
PEOPLE WITH FRONTAL TEMPORAL 

498
00:23:08,992 --> 00:23:16,532
DEMENTIA AND PARKINSON'S AND 

499
00:23:16,532 --> 00:23:18,635
ALZHEIMER'S AND ALS.

500
00:23:18,635 --> 00:23:20,370
AND THERE'S INTERESTING 

501
00:23:20,370 --> 00:23:23,406
TECHNOLOGIES ON THE RIGHT OF THE

502
00:23:23,406 --> 00:23:24,707
SLIDE PEOPLE ARE USING 

503
00:23:24,707 --> 00:23:26,542
SOPHISTICATED GENOMIC TECHNIQUES

504
00:23:26,542 --> 00:23:30,213
TO BASICALLY GET RID OF THE PATH

505
00:23:30,213 --> 00:23:31,314
LOGIC ABNORMALITIES.

506
00:23:31,314 --> 00:23:36,653
SO IN THIS CASE THERE'S A GROUP 

507
00:23:36,653 --> 00:23:39,055
WORKING WITH A PARTICULAR 

508
00:23:39,055 --> 00:23:41,491
ARTIFICIAL GENE THAT CAN GET IN 

509
00:23:41,491 --> 00:23:42,592
THE NEURONS BUT IT'S ONLY GOING 

510
00:23:42,592 --> 00:23:44,961
TO BE ACTIVE IN THE NEURONS THAT

511
00:23:44,961 --> 00:23:49,265
HAVE TDP-43 WHERE THEY GO SPLICE

512
00:23:49,265 --> 00:23:55,805
OUT A CRYPTIC PEPTIDE AND IN 

513
00:23:55,805 --> 00:23:58,474
THOSE NEURONS THE PEPTIDE 

514
00:23:58,474 --> 00:24:01,244
ARTIFICIAL GENE WILL BE ACTIVE 

515
00:24:01,244 --> 00:24:07,050
AND NORMALIZE THE CRYPTIC 

516
00:24:07,050 --> 00:24:08,251
SPLICING OF THE ABNORMALITY AND 

517
00:24:08,251 --> 00:24:10,320
PEOPLE CAN USE GENOMIC 

518
00:24:10,320 --> 00:24:11,921
TECHNIQUES IN THE LABORATORY AND

519
00:24:11,921 --> 00:24:13,323
ANIMAL MODELS THAT HOPEFULLY CAN

520
00:24:13,323 --> 00:24:14,791
MOVE INTO PEOPLE.

521
00:24:14,791 --> 00:24:17,226
THE POWER OF THESE IS COMPARED 

522
00:24:17,226 --> 00:24:18,695
TO DRUGS THEY'RE ONLY ACTIVE 

523
00:24:18,695 --> 00:24:19,595
EXACTLY WHERE YOU WANT THEM TO 

524
00:24:19,595 --> 00:24:21,064
BE ACTIVE.

525
00:24:21,064 --> 00:24:24,334
SO LIKELY WE CAN GET BIG EFFECT 

526
00:24:24,334 --> 00:24:24,867
SIZES WITH VERY FEW SIDE 

527
00:24:24,867 --> 00:24:27,170
EFFECTS.

528
00:24:27,170 --> 00:24:35,478
AND THAT'S CERTAINLY THE TRICK.

529
00:24:35,478 --> 00:24:36,746
IN TERMS OF THE GENETIC TRICKS 

530
00:24:36,746 --> 00:24:40,249
THE OTHER ONE IS GENE EDITING.

531
00:24:40,249 --> 00:24:43,619
IN WHICH AN ABNORMAL PROTEIN CAN

532
00:24:43,619 --> 00:24:51,260
BE ACTUALLY NORMALIZED BY 

533
00:24:51,260 --> 00:24:52,528
BASICALLY GOING IN AND CUTTING 

534
00:24:52,528 --> 00:24:57,433
OUT THE ABNORMAL PIECE IN AN 

535
00:24:57,433 --> 00:25:00,636
ALZHEIMER'S MODEL IN CUT OUT THE

536
00:25:00,636 --> 00:25:02,939
AMYLOID PRECURSOR PROTEIN THAT 

537
00:25:02,939 --> 00:25:04,407
PREVENTS IT FROM BECOMING 

538
00:25:04,407 --> 00:25:04,707
PATHOLOGIC.

539
00:25:04,707 --> 00:25:07,510
WE'LL SEE MORE OF THESE.

540
00:25:07,510 --> 00:25:09,746
THIS IS VERY EARLY IN 

541
00:25:09,746 --> 00:25:12,648
DEVELOPMENT STAGE IN TERMS OF 

542
00:25:12,648 --> 00:25:14,350
GENE EDITING.

543
00:25:14,350 --> 00:25:15,385
THERE'S A COMMON FUND PROGRAM 

544
00:25:15,385 --> 00:25:18,154
WE'RE INVOLVED WITH WHICH IS 

545
00:25:18,154 --> 00:25:19,622
BASICALLY WORKING TO GET GENE 

546
00:25:19,622 --> 00:25:21,157
EDITING TO THE PEOPLE IN 

547
00:25:21,157 --> 00:25:22,191
DIFFERENT CONDITIONS.

548
00:25:22,191 --> 00:25:24,660
AGAIN, A REALLY EXCITING WAY OF 

549
00:25:24,660 --> 00:25:29,732
GETTING VERY PRECISE TREATMENTS 

550
00:25:29,732 --> 00:25:32,635
TO RECTIFY GENETIC ABNORMALITIES

551
00:25:32,635 --> 00:25:34,570
FOR HEALTH.

552
00:25:34,570 --> 00:25:36,606
I MENTIONED EARLIER THERE ARE 

553
00:25:36,606 --> 00:25:42,111
SOME REAL INTERESTING CLUES WHEN

554
00:25:42,111 --> 00:25:43,546
WE LOOK AT PEOPLE TO BE VERY 

555
00:25:43,546 --> 00:25:47,250
LATE AGE AND DO NOT HAVE 

556
00:25:47,250 --> 00:25:52,555
COGNITIVE IMPAIRMENT AND THESE 

557
00:25:52,555 --> 00:25:57,293
ARE EXAMPLES THAT ARE REALLY 

558
00:25:57,293 --> 00:26:00,396
APPRECIATION IN THE SENSE THAT 

559
00:26:00,396 --> 00:26:02,265
WHEN YOU FIND OUT WHAT IT IS 

560
00:26:02,265 --> 00:26:04,133
THAT'S PROTECTING THEM, IF YOU 

561
00:26:04,133 --> 00:26:06,469
CAN THEN DEVELOP A DRUG OR 

562
00:26:06,469 --> 00:26:12,408
GENOMIC THERAPY TO MIMIC THAT 

563
00:26:12,408 --> 00:26:15,144
PROTECTION, YOU CAN THEN PROTECT

564
00:26:15,144 --> 00:26:18,915
PEOPLE WHO HAVE ALL DIFFERENT 

565
00:26:18,915 --> 00:26:20,650
FORMS OF THE DISEASE.

566
00:26:20,650 --> 00:26:23,386
SO, BY STUDYING THE FOUR 

567
00:26:23,386 --> 00:26:25,254
POPULATIONS, YOU CAN FIND 

568
00:26:25,254 --> 00:26:26,422
TREATMENTS THAT CAN BE 

569
00:26:26,422 --> 00:26:28,624
GENERALIZED TO BIG POPULATIONS.

570
00:26:28,624 --> 00:26:33,329
THE TWO MENTIONED HERE ARE 

571
00:26:33,329 --> 00:26:36,065
REELIN A CERTAIN ISOFORM OF 

572
00:26:36,065 --> 00:26:38,801
REELIN FIND PEOPLE WHO HAVE A 

573
00:26:38,801 --> 00:26:40,636
GENETIC MUTATION THAT SHOULD 

574
00:26:40,636 --> 00:26:41,504
GIVE THEM ALZHEIMER'S BUT 

575
00:26:41,504 --> 00:26:44,040
THEY'RE COGNITIVELY NORMAL.

576
00:26:44,040 --> 00:26:47,910
SOMEHOW THE REELIN ISOFORM IS 

577
00:26:47,910 --> 00:26:51,547
PROTECTING THEM AND THE APOE 3 

578
00:26:51,547 --> 00:26:54,917
IS DOING SOMETHING SIMILAR.

579
00:26:54,917 --> 00:27:05,428
THE IDEA TO FIND OUT WHAT THE 

580
00:27:05,928 --> 00:27:09,031
APOE 3 IS DOING AND FIND PEOPLE 

581
00:27:09,031 --> 00:27:09,932
AT RISK FOR ALZHEIMER'S DISEASE 

582
00:27:09,932 --> 00:27:13,803
AND SIMILARLY WITH THE REELIN 

583
00:27:13,803 --> 00:27:14,036
ISOFORM.

584
00:27:14,036 --> 00:27:16,439
THESE ARE CLOSE TO BEING 

585
00:27:16,439 --> 00:27:22,478
FOLLOWED UP FOR NEW TREATMENTS.

586
00:27:22,478 --> 00:27:24,647
THE OTHER THING TO MENTION, I 

587
00:27:24,647 --> 00:27:28,618
BRIEFLY HIT ON THIS EARLIER IS 

588
00:27:28,618 --> 00:27:34,357
THAT IN ALL THE 

589
00:27:34,357 --> 00:27:36,058
NEURODEGENERATIONS THERE'S AN 

590
00:27:36,058 --> 00:27:36,592
INFLAMMATORY REACTION.

591
00:27:36,592 --> 00:27:38,628
WE THINK OF INFLAMMATION WITH 

592
00:27:38,628 --> 00:27:41,364
INFECTION, SAY, FOR INSTANCE, 

593
00:27:41,364 --> 00:27:43,266
WHERE THE INFLAMMATION COMES AND

594
00:27:43,266 --> 00:27:46,636
IT CONTROLS THE BACTERIA OR THE 

595
00:27:46,636 --> 00:27:49,372
VIRUS THAT'S CAUSING YOUR 

596
00:27:49,372 --> 00:27:50,106
INFECTION.

597
00:27:50,106 --> 00:27:52,375
BUT IT TURNS OUT IN THE NERVOUS 

598
00:27:52,375 --> 00:27:53,843
SYSTEM, THE IMMUNE SYSTEM IS 

599
00:27:53,843 --> 00:27:56,646
ACTIVE ALL THE TIME IN RESHAPING

600
00:27:56,646 --> 00:27:58,781
THE SYNAPSES BETWEEN THE CELLS 

601
00:27:58,781 --> 00:28:02,585
AND IN PROTECTING THE BRAIN 

602
00:28:02,585 --> 00:28:03,586
AGAINST BACTERIA AND VIRUSES.

603
00:28:03,586 --> 00:28:08,257
BUT IN SOME INSTANCES IN 

604
00:28:08,257 --> 00:28:09,392
NEURODEGENERATION IT APPEARS THE

605
00:28:09,392 --> 00:28:10,660
IMMUNE SYSTEM BECOMES OVER 

606
00:28:10,660 --> 00:28:12,461
ACTIVE AND MAY CONTRIBUTE TO THE

607
00:28:12,461 --> 00:28:12,695
DAMAGE.

608
00:28:12,695 --> 00:28:14,530
SO SO THERE'S A NUMBER OF 

609
00:28:14,530 --> 00:28:16,299
EXAMPLES.

610
00:28:16,299 --> 00:28:19,569
THIS IS ONE OF THEM WHERE IT'S 

611
00:28:19,569 --> 00:28:24,640
BEEN FOUND THAT KEY CELLS WHICH 

612
00:28:24,640 --> 00:28:26,108
ARE INFLAMMATORY CELLS CAN 

613
00:28:26,108 --> 00:28:32,648
INVADE THE SURFACE OF THE BRAIN 

614
00:28:32,648 --> 00:28:36,652
SUBSTANCE CALLED THE DURA MATTER

615
00:28:36,652 --> 00:28:39,655
AND PRODUCE IL17 WHICH CREATES 

616
00:28:39,655 --> 00:28:42,825
MACROPHAGES WHICH IS ANOTHER 

617
00:28:42,825 --> 00:28:44,860
MORE AGGRESSIVE INFLAMMATORY 

618
00:28:44,860 --> 00:28:47,863
CELL THAT CAN THEN INJURY 

619
00:28:47,863 --> 00:28:51,534
ADJACENT CELLS AND GIVE RISE TO 

620
00:28:51,534 --> 00:28:55,037
LOSS OF NEURONS AND SYNAPSES.

621
00:28:55,037 --> 00:28:58,207
SO TARGETING THESE TYPES OF 

622
00:28:58,207 --> 00:29:01,444
CELLS IS PARTICULAR INFLAMMATORY

623
00:29:01,444 --> 00:29:04,614
CELLS MIGHT BE PROTECTIVE.

624
00:29:04,614 --> 00:29:08,651
AND THIS EXAMPLE AS I MENTIONED 

625
00:29:08,651 --> 00:29:12,655
IS ACTUALLY DRIVEN BY THE 

626
00:29:12,655 --> 00:29:14,924
VASCULAR ABNORMALITIES ONE SEES 

627
00:29:14,924 --> 00:29:15,391
IN VASCULAR COGNITIVE 

628
00:29:15,391 --> 00:29:18,060
IMPAIRMENT.

629
00:29:18,060 --> 00:29:20,630
THERE'S ALSO RECENT STUDIES 

630
00:29:20,630 --> 00:29:22,632
ABOUT APOE 4 WHICH IS ONE OF THE

631
00:29:22,632 --> 00:29:24,667
HIGHEST RISK FACTORS FOR 

632
00:29:24,667 --> 00:29:27,903
ALZHEIMER'S DISEASE AND 

633
00:29:27,903 --> 00:29:30,339
PROGRESSION OF ALZHEIMER'S 

634
00:29:30,339 --> 00:29:31,474
DISEASE.

635
00:29:31,474 --> 00:29:35,277
AND THIS STUDY SHOWS THAT IN 

636
00:29:35,277 --> 00:29:39,015
APOE 4, MICE ONE SEES AN 

637
00:29:39,015 --> 00:29:41,217
ABNORMALITY IN CHOLESTEROL 

638
00:29:41,217 --> 00:29:43,552
METABOLISM AND CHOLESTEROL 

639
00:29:43,552 --> 00:29:48,658
ACCUMULATES INSIDE THE CELLS 

640
00:29:48,658 --> 00:29:54,030
THAT RESULTS IN INHIBITION OF 

641
00:29:54,030 --> 00:29:56,032
MYELIN BASED PROTEIN WHICH IS 

642
00:29:56,032 --> 00:29:57,800
THE PROTEIN NEEDED TO COVER THE 

643
00:29:57,800 --> 00:30:00,636
WIRES THAT I MENTIONED EARLIER 

644
00:30:00,636 --> 00:30:04,073
THAT CONNECT TO DIFFERENT BRAIN 

645
00:30:04,073 --> 00:30:04,306
REGIONS.

646
00:30:04,306 --> 00:30:06,409
THERE'S A CONNECTION BETWEEN THE

647
00:30:06,409 --> 00:30:10,546
APOE 4 GENE WHICH IS A REAL BAD 

648
00:30:10,546 --> 00:30:12,648
ACTOR IN ALZHEIMER'S AND 

649
00:30:12,648 --> 00:30:13,649
VASCULAR COGNITIVE IMPAIRMENT OR

650
00:30:13,649 --> 00:30:15,584
WHITE MATTER DISEASE.

651
00:30:15,584 --> 00:30:18,454
FINALLY, I WANTED TO MENTION THE

652
00:30:18,454 --> 00:30:21,824
WORK YOU'LL BE HEARING ABOUT AND

653
00:30:21,824 --> 00:30:24,226
I DESCRIBED GOES ON AROUND 

654
00:30:24,226 --> 00:30:26,162
UNIVERSITIES ACROSS THE COUNTRY.

655
00:30:26,162 --> 00:30:28,264
WE ARE INDEBTED SO THE PATIENTS 

656
00:30:28,264 --> 00:30:31,500
AND THE SUBJECTS AND THE 

657
00:30:31,500 --> 00:30:33,202
CAREGIVERS WHO TAKE TIME AND 

658
00:30:33,202 --> 00:30:36,238
ENERGY TO PARTICIPATE IN THESE 

659
00:30:36,238 --> 00:30:36,639
STUDIES.

660
00:30:36,639 --> 00:30:40,342
AND IT'S ONLY THROUGH THIS 

661
00:30:40,342 --> 00:30:41,343
COMMUNITY THAT WE HAVE BUILT 

662
00:30:41,343 --> 00:30:43,512
OVER THE YEARS AND CONTINUE TO 

663
00:30:43,512 --> 00:30:45,748
NURTURE THAT WE'RE GOING TO MAKE

664
00:30:45,748 --> 00:30:46,816
ADVANCES.

665
00:30:46,816 --> 00:30:48,584
SIMILARLY ACROSS THE COUNTRY WE 

666
00:30:48,584 --> 00:30:52,288
ALSO HAVE A PROGRAM HERE ON THE 

667
00:30:52,288 --> 00:30:56,192
BETHESDA BUTS THE CENTER FOR 

668
00:30:56,192 --> 00:30:57,193
ALZHEIMER RELATED DEMENTIAS 

669
00:30:57,193 --> 00:30:59,929
USING SOME REALLY INNOVATIVE 

670
00:30:59,929 --> 00:31:03,766
TECHNOLOGIES PARTICULARLY USING 

671
00:31:03,766 --> 00:31:09,171
HUMAN CELLS TAKEN FROM PEOPLE 

672
00:31:09,171 --> 00:31:13,008
SAY THE SKIN BIOPSY AND 

673
00:31:13,008 --> 00:31:14,643
DEVELOPED INTO STUDY THE ROLE OF

674
00:31:14,643 --> 00:31:19,648
FACTORS IN THE PATHOLOGY THAT WE

675
00:31:19,648 --> 00:31:22,818
SEE IN THE CELLS OF PEOPLE WITH 

676
00:31:22,818 --> 00:31:26,655
NEUROGET

677
00:31:26,655 --> 00:31:29,525
NEUROGET  -- NEURODEGENERATIVE 

678
00:31:29,525 --> 00:31:32,094
DISEASES AND AN INTERESTING 

679
00:31:32,094 --> 00:31:33,696
STUDY AT THE CAMPUS.

680
00:31:33,696 --> 00:31:38,934
ANOTHER AREA I THINK IS 

681
00:31:38,934 --> 00:31:40,369
INCREDIBLY IMPORTANT NOW IS 

682
00:31:40,369 --> 00:31:43,539
UNDERSTANDING HOW TO IDENTIFY 

683
00:31:43,539 --> 00:31:47,710
PEOPLE EARLY ON AS THEY DEVELOP 

684
00:31:47,710 --> 00:31:49,411
NEURODEGENERATION AND THE 

685
00:31:49,411 --> 00:31:50,880
EARLIER SIGNS OF COGNITIVE 

686
00:31:50,880 --> 00:31:51,180
IMPAIRMENT.

687
00:31:51,180 --> 00:31:53,749
THE GENERAL RULE THAT WE SEE 

688
00:31:53,749 --> 00:31:56,051
ASCRIBE TO IS THAT AS THIS 

689
00:31:56,051 --> 00:31:59,722
PROCESS GOES ON AND ON IT GETS 

690
00:31:59,722 --> 00:32:02,191
VERY HARD TO STOP IT.

691
00:32:02,191 --> 00:32:04,460
THE BEST CHANCE OF MAKING A BIG 

692
00:32:04,460 --> 00:32:08,631
DIFFERENCE IS GOING TO BE IN 

693
00:32:08,631 --> 00:32:16,472
EARLY INTERVENTIONS.

694
00:32:16,472 --> 00:32:18,007
THE BIOMARKER FIELD HAS 

695
00:32:18,007 --> 00:32:20,376
PROGRESSED WHERE SOME WILL BE 

696
00:32:20,376 --> 00:32:22,311
TURNING POSITIVE VERY EARLY ON 

697
00:32:22,311 --> 00:32:23,145
EVEN BEFORE SYMPTOMS.

698
00:32:23,145 --> 00:32:25,447
SO THAT'S VERY ENCOURAGING.

699
00:32:25,447 --> 00:32:30,186
WE ALSO NEED WAYS IN WHICH WE 

700
00:32:30,186 --> 00:32:37,927
CAN IDENTIFY PEOPLE IN 

701
00:32:37,927 --> 00:32:38,227
COGNITION.

702
00:32:38,227 --> 00:32:48,470
THIS IS THE STUDY CALLED T THE 

703
00:32:48,470 --> 00:32:54,443
TECH PROGRAM TO DEVELOP A METHOD

704
00:32:54,443 --> 00:32:56,846
WHEREBY PRIMARY CARE PHYSICIANS 

705
00:32:56,846 --> 00:32:59,215
HAVE THEIR FAMILY DOCTOR AND 

706
00:32:59,215 --> 00:33:01,450
THAT WILL BE THE POINT TO WHERE 

707
00:33:01,450 --> 00:33:03,352
THE PROBLEMS WILL BE FIRST ABLE 

708
00:33:03,352 --> 00:33:04,587
TO BE DETECTED.

709
00:33:04,587 --> 00:33:08,524
AND SO WE NEED METHODS AND THIS 

710
00:33:08,524 --> 00:33:10,559
IS ONE OF THEM WHICH WAS QUITE 

711
00:33:10,559 --> 00:33:11,694
SUCCESSFUL AT HELPING IN THE 

712
00:33:11,694 --> 00:33:15,598
PRIMARY CARE SETTING TO IDENTIFY

713
00:33:15,598 --> 00:33:16,599
PEOPLE WITH COGNITIVE 

714
00:33:16,599 --> 00:33:17,733
IMPAIRMENT.

715
00:33:17,733 --> 00:33:20,636
IN THIS CASE IT SHOWED IT LED TO

716
00:33:20,636 --> 00:33:23,272
IMPROVED DEMENTIA CARE.

717
00:33:23,272 --> 00:33:26,008
SO EVEN WOULD THIS IDEA OF 

718
00:33:26,008 --> 00:33:27,509
IDENTIFYING PEOPLE FOR THESE NEW

719
00:33:27,509 --> 00:33:31,714
TREATMENTS OF THE FUTURE, THESE 

720
00:33:31,714 --> 00:33:33,816
DIAGNOSTIC CRITERIA CAN BE 

721
00:33:33,816 --> 00:33:34,416
HELPFUL IN THE IMMEDIATE TIME 

722
00:33:34,416 --> 00:33:36,252
FRAME.

723
00:33:36,252 --> 00:33:40,823
SO WHAT WE TRY TO DO IS THINK 

724
00:33:40,823 --> 00:33:45,194
ABOUT THE PROBLEMS THAT PEOPLE 

725
00:33:45,194 --> 00:33:49,999
ARE SUFFERING WITH 

726
00:33:49,999 --> 00:33:50,833
ALZHEIMER-RELATED DEMENTIAS AT 

727
00:33:50,833 --> 00:33:53,269
EVERY COMPONENT OF THESE 

728
00:33:53,269 --> 00:33:55,504
CONDITIONS, WE TRY TO DEVELOP 

729
00:33:55,504 --> 00:33:58,807
RESEARCH THAT CAN ADVANCE THEIR 

730
00:33:58,807 --> 00:34:00,976
TREATMENT, PREVENTION AND CARE.

731
00:34:00,976 --> 00:34:02,511
I'M REALLY LOOKING FORWARD TO 

732
00:34:02,511 --> 00:34:04,647
HEARING FROM THE RECOMMENDATIONS

733
00:34:04,647 --> 00:34:07,449
OF THE WORKING GROUPS AS THEY 

734
00:34:07,449 --> 00:34:09,385
HAVE REALLY TAKEN ON THE 

735
00:34:09,385 --> 00:34:12,054
CHALLENGE OF LOOKING AT A VERY 

736
00:34:12,054 --> 00:34:14,223
COMPLICATED BUT VERY IMPORTANT 

737
00:34:14,223 --> 00:34:16,625
AREA OF SCIENCE.

738
00:34:16,625 --> 00:34:26,969
THANK YOU VERY MUCH.

739
00:34:34,910 --> 00:34:40,349
NOW I'LL HAND IT OVER TO AC BER 

740
00:34:40,349 --> 00:34:43,118
MCCARTNEY LEADING THE SUMMIT 

741
00:34:43,118 --> 00:34:43,419
FROM NINDS.

742
00:34:43,419 --> 00:34:46,255
>> THANK YOU, WALTER.

743
00:34:46,255 --> 00:34:54,964
-- AMBER MCCARTNEY.

744
00:34:54,964 --> 00:34:59,268
>> AMBER: THIS SUMMARIZES
THE 

745
00:34:59,268 --> 00:34:59,902
PLAN TO ADDRESS ALZHEIMER'S 

746
00:34:59,902 --> 00:35:00,135
DISEASE.

747
00:35:00,135 --> 00:35:02,805
I WANT TO MAKE ONE POINT, THAT'S

748
00:35:02,805 --> 00:35:04,506
PLEASE FOCUS YOUR ATTENTION AT 

749
00:35:04,506 --> 00:35:06,008
THE BOTTOM OF THE SLIDE.

750
00:35:06,008 --> 00:35:09,345
HERE YOU CAN SEE UNDER THE FIRST

751
00:35:09,345 --> 00:35:10,646
PROFESSIONAL PLAN THERE'S AN 

752
00:35:10,646 --> 00:35:12,548
ACTION ITEM FOR US WHICH DIRECTS

753
00:35:12,548 --> 00:35:16,652
US TO REGULARLY CONVENE A SUMMIT

754
00:35:16,652 --> 00:35:17,619
ON ADRD RESEARCH.

755
00:35:17,619 --> 00:35:20,923
THE SUMMIT THE PURPOSE IS TO 

756
00:35:20,923 --> 00:35:23,892
REVIEW PROGRESS ON 

757
00:35:23,892 --> 00:35:25,928
RECOMMENDATIONS AS APPROPRIATE 

758
00:35:25,928 --> 00:35:26,829
BASED ON RECENT SCIENTIFIC 

759
00:35:26,829 --> 00:35:30,799
DISCOVERIES AND THIS IS WHAT 

760
00:35:30,799 --> 00:35:32,267
WE'RE HERE TO DO TODAY.

761
00:35:32,267 --> 00:35:34,370
TODAY WE WANT YOUR INPUT ON THE 

762
00:35:34,370 --> 00:35:35,371
DRAFT RECOMMENDATIONS PRESENTED 

763
00:35:35,371 --> 00:35:37,106
AND I WANT YOU TO KNOW WE TAKE 

764
00:35:37,106 --> 00:35:39,441
THIS VERY SERIOUSLY AND 

765
00:35:39,441 --> 00:35:41,410
ENCOURAGE YOU TO STAY INVOLVED 

766
00:35:41,410 --> 00:35:44,646
THROUGHOUT THE MULTI-DAY EVENT.

767
00:35:44,646 --> 00:35:46,782
IN THE AGENDA YOU'LL SEE TIME 

768
00:35:46,782 --> 00:35:48,650
DEDICATED PUBLIC INPUT IN EACH 

769
00:35:48,650 --> 00:35:51,653
SESSION AND WHERE WE ENCOURAGE 

770
00:35:51,653 --> 00:35:53,055
YOU TO PROVIDE INPUT AND 

771
00:35:53,055 --> 00:35:56,859
FEEDBACK ON THE RECOMMENDATIONS.

772
00:35:56,859 --> 00:36:00,629
HERE IS AN AGENDA FOR THE THREE 

773
00:36:00,629 --> 00:36:01,964
DAYS AND FOR EACH SESSION YOU'LL

774
00:36:01,964 --> 00:36:04,900
SEE THE NAME OF THE SESSION AND 

775
00:36:04,900 --> 00:36:08,637
I'VE INDICATED THE NUMBER OF 

776
00:36:08,637 --> 00:36:09,438
RECOMMENDATIONS EACH SESSION 

777
00:36:09,438 --> 00:36:10,672
WILL PRESENT.

778
00:36:10,672 --> 00:36:13,375
AS IN PREVIOUS YEARS, 

779
00:36:13,375 --> 00:36:15,110
CROSS-CUTTING SECTION SUCH AS 

780
00:36:15,110 --> 00:36:19,481
THE DISEASE SPECIFIC SESSION, 

781
00:36:19,481 --> 00:36:21,650
EACH HAVE EIGHT RECOMMENDATIONS 

782
00:36:21,650 --> 00:36:23,986
AND HAVE PRIORITY LEVELS 1-4.

783
00:36:23,986 --> 00:36:25,754
THEY HAVE TWO NUMBER ONE AND TWO

784
00:36:25,754 --> 00:36:27,856
NUMBER TWO PRIORITIES AND TWO 

785
00:36:27,856 --> 00:36:29,291
NUMBER THREE PRIORITIES AND TWO 

786
00:36:29,291 --> 00:36:29,625
NUMBER FOUR.

787
00:36:29,625 --> 00:36:31,727
THE SPECIAL TOPIC SESSIONS EACH 

788
00:36:31,727 --> 00:36:33,562
HAVE FOUR RECOMMENDATIONS WITH 

789
00:36:33,562 --> 00:36:34,863
PRIORITY LEVELS 1-4.

790
00:36:34,863 --> 00:36:40,736
ALL PRIORITIES PRESENTED ARE 

791
00:36:40,736 --> 00:36:43,772
HIGHEST PRIORITIES FOR THE 

792
00:36:43,772 --> 00:36:43,972
FIELD.

793
00:36:43,972 --> 00:36:46,875
YOU'LL HEAR MORE IN THE FIRST 

794
00:36:46,875 --> 00:36:51,046
SESSION LED BY DR. POSSIN.

795
00:36:51,046 --> 00:36:52,548
THEY DECIDED TO SPLIT INTO TWO 

796
00:36:52,548 --> 00:36:55,884
SUBCOMMITTEES AND START OFF DAYS

797
00:36:55,884 --> 00:36:58,387
ONE AND TWO.

798
00:36:58,387 --> 00:37:01,490
THE FIRST SESSION WILL START 

799
00:37:01,490 --> 00:37:06,562
WITH INFLAMMATION AND THE SECOND

800
00:37:06,562 --> 00:37:09,765
DAY IS RESEARCH.

801
00:37:09,765 --> 00:37:11,867
COMBINED THEY PRESENT THE EIGHT 

802
00:37:11,867 --> 00:37:15,604
EXISTING RECOMMENDATIONS FOR THE

803
00:37:15,604 --> 00:37:17,139
ETIOLOGY DEMENTIA SESSION FROM 

804
00:37:17,139 --> 00:37:17,339
2022.

805
00:37:17,339 --> 00:37:20,442
I WANT TO POINT OUT IN ADDITION 

806
00:37:20,442 --> 00:37:24,646
TO EACH SESSION, ENDING WITH 

807
00:37:24,646 --> 00:37:34,256
DEDICATED MICRO PHOTI AND I'LL 

808
00:37:34,256 --> 00:37:37,459
TALK ABOUT THE CONTEXT AND 

809
00:37:37,459 --> 00:37:40,629
WHAT'S INVOLVED.

810
00:37:40,629 --> 00:37:43,365
SO PLANNING STARTED SIX, SEVEN 

811
00:37:43,365 --> 00:37:46,001
MONTHS AGO AND THE COMMITTEES 

812
00:37:46,001 --> 00:37:50,339
INVOLVED OVER 120 SCIENTISTS, 

813
00:37:50,339 --> 00:37:51,440
PHYSICIANS, PEOPLE WITH LIVED 

814
00:37:51,440 --> 00:37:54,376
EXPERIENCE AND ADMINISTRATORS 

815
00:37:54,376 --> 00:37:57,212
AND PARTNERS AND I'LL INTRODUCE 

816
00:37:57,212 --> 00:37:58,480
DR. POSSIN.

817
00:37:58,480 --> 00:38:01,783
SHE'LL SPEAK AFTER ME AND HOLDS 

818
00:38:01,783 --> 00:38:06,488
THE JOHN DOUGLAS FRENCH ENDOWED 

819
00:38:06,488 --> 00:38:07,189
PROFESSORSHIP IN THE DEPARTMENT 

820
00:38:07,189 --> 00:38:10,058
OF NEUROLOGY AT THE UNIVERSITY 

821
00:38:10,058 --> 00:38:12,094
OF CALIFORNIA SAN FRANCISCO AND 

822
00:38:12,094 --> 00:38:14,663
PREVIOUSLY SHARED THE MULTIPLE 

823
00:38:14,663 --> 00:38:16,665
ETIOLOGY DEMENTIA SESSION FOR 

824
00:38:16,665 --> 00:38:18,000
TWO PREVIOUS SESSION AND THE 

825
00:38:18,000 --> 00:38:21,403
LEADER IN DETECTION OF ATAXIA 

826
00:38:21,403 --> 00:38:22,905
I.D. AND YOU HEARD WALTER TALK 

827
00:38:22,905 --> 00:38:24,907
ABOUT THE PROGRAM AND A LEADER 

828
00:38:24,907 --> 00:38:27,309
IN NATIONAL AND INTERNATIONAL 

829
00:38:27,309 --> 00:38:28,644
EFFORTS TO ADDRESS DEMENTIA IN 

830
00:38:28,644 --> 00:38:31,180
EVERYDAY CLINICAL STUDIES WE 

831
00:38:31,180 --> 00:38:33,549
HAVE AN ESTEEMED STEERING 

832
00:38:33,549 --> 00:38:35,751
COMMITTEE OF CHAIRS AND 

833
00:38:35,751 --> 00:38:37,986
PROMINENT LEADERS IN THE FIELD 

834
00:38:37,986 --> 00:38:39,021
AND HERE AT THE SESSION AND 

835
00:38:39,021 --> 00:38:46,662
MEETING GOALS.

836
00:38:46,662 --> 00:38:48,630
THIS SLIDE SHOWS THE NIH 

837
00:38:48,630 --> 00:38:50,132
RESEARCH SPENDING FOR 

838
00:38:50,132 --> 00:38:52,935
ALZHEIMER'S DISEASE AND 

839
00:38:52,935 --> 00:38:54,269
ALZHEIMER'S DISEASE RELATED 

840
00:38:54,269 --> 00:38:55,637
DEMENTIA RESEARCH HAS INCREASED 

841
00:38:55,637 --> 00:38:56,405
IN THE PAST DECADE.

842
00:38:56,405 --> 00:38:58,507
THIS IS NOT A BUDGETING SLIDE 

843
00:38:58,507 --> 00:38:59,942
BUT ACTUAL DOLLARS SPENT ON THE 

844
00:38:59,942 --> 00:39:01,476
CATEGORIES OF RESEARCH AND IF 

845
00:39:01,476 --> 00:39:02,911
YOU'RE INTERESTED IN DETAILS FOR

846
00:39:02,911 --> 00:39:05,614
THESE NUMBERS, PLEASE GO TO THE 

847
00:39:05,614 --> 00:39:06,949
NIH REPORTER WEBSITE THE ADDRESS

848
00:39:06,949 --> 00:39:08,917
IS FOUND AT THE BOTTOM OF THE 

849
00:39:08,917 --> 00:39:12,387
SLIDE.

850
00:39:12,387 --> 00:39:16,625
THE POINT I WANT TO MAKE IS THE 

851
00:39:16,625 --> 00:39:20,629
RELATED DEMENTIAS STUDIES HAVE 

852
00:39:20,629 --> 00:39:27,703
INCREASED AS WELL.

853
00:39:27,703 --> 00:39:30,205
NINDS LEADS THE ALZHEIMER'S 

854
00:39:30,205 --> 00:39:33,208
DISEASE RELATED DEMENTIAS AND 

855
00:39:33,208 --> 00:39:35,177
WORK IN CLOSE PARTNERSHIP WITH 

856
00:39:35,177 --> 00:39:36,912
THE NATIONAL INSTITUTE ON AGES 

857
00:39:36,912 --> 00:39:39,615
AND THROUGH THE CONGRESSIONAL 

858
00:39:39,615 --> 00:39:40,916
PARTNERSHIP FUNDS ARE AVAILABLE 

859
00:39:40,916 --> 00:39:41,817
TO FUND RESEARCH.

860
00:39:41,817 --> 00:39:43,452
WE USE THE ADDED FUNDS FOR 

861
00:39:43,452 --> 00:39:45,120
ACTIVITIES THAT RESPOND TO THE 

862
00:39:45,120 --> 00:39:46,922
MILESTONES IN THE NATIONAL PLAN.

863
00:39:46,922 --> 00:39:48,790
THE MILESTONES THAT COME FROM 

864
00:39:48,790 --> 00:39:50,125
THESE SUMMITS.

865
00:39:50,125 --> 00:39:51,593
IN PARTICULAR ADDED FUNDS ARE 

866
00:39:51,593 --> 00:39:54,630
USED FOR INCREASED INVESTIGATOR 

867
00:39:54,630 --> 00:39:56,632
INITIATED RESEARCH AND RESEARCH 

868
00:39:56,632 --> 00:39:58,400
THAT'S RESPONSIVE TO NINDS, ADRD

869
00:39:58,400 --> 00:40:03,472
FUNDING OPPORTUNITIES.

870
00:40:03,472 --> 00:40:09,144
THIS SLIDE IS A SUMMARY AND I 

871
00:40:09,144 --> 00:40:10,879
JUST WANT TO JUMP TO THE NEXT 

872
00:40:10,879 --> 00:40:14,616
SLIDE SO WE CAN MOVE FORWARD AND

873
00:40:14,616 --> 00:40:15,317
GET TIME BACK.

874
00:40:15,317 --> 00:40:16,652
BEFORE WE GET INTO SESSIONS I 

875
00:40:16,652 --> 00:40:21,890
WANT TO GIVE YOU A QUICK GUIDE 

876
00:40:21,890 --> 00:40:24,726
TO THE DRAFT RECOMMENDATIONS.

877
00:40:24,726 --> 00:40:26,628
YOU CAN SEE HERE THE 

878
00:40:26,628 --> 00:40:28,063
RECOMMENDATION IS AN EXAMPLE AND

879
00:40:28,063 --> 00:40:31,333
YOU CAN SEE IT HAS A NUMBER AND 

880
00:40:31,333 --> 00:40:34,069
PRIORITY AND THE PRIORITY THAT'S

881
00:40:34,069 --> 00:40:36,271
IN THE BOX IS FOLLOWED BY TEXT 

882
00:40:36,271 --> 00:40:40,909
AND THAT TEXT IS THE TOP LEVEL 

883
00:40:40,909 --> 00:40:41,276
RECOMMENDATION.

884
00:40:41,276 --> 00:40:43,045
SO THE DATE AT THE END IS THE 

885
00:40:43,045 --> 00:40:46,882
ESTIMATED YEAR TO COMPLETE OR 

886
00:40:46,882 --> 00:40:47,549
FULLY IMPLEMENT THE 

887
00:40:47,549 --> 00:40:52,554
RECOMMENDATION IF IT WERE 

888
00:40:52,554 --> 00:40:52,921
STARTED IN 2026.

889
00:40:52,921 --> 00:40:55,057
SO THE NEXT SLIDE IS WHEN I HAND

890
00:40:55,057 --> 00:40:57,025
IT OFF TO DR. POSSIN.

891
00:40:57,025 --> 00:40:58,994
THANK YOU VERY MUCH FOR TODAY 

892
00:40:58,994 --> 00:41:02,564
AND PLEASE DO PARTICIPATE IN THE

893
00:41:02,564 --> 00:41:05,033
DISCUSSION SESSIONS.

894
00:41:05,033 --> 00:41:06,435
AND I THINK I'LL HAND IT OFF TO 

895
00:41:06,435 --> 00:41:09,137
DR. POS SCRIN.

896
00:41:09,137 --> 00:41:12,641
-- DR. POSSIN.

897
00:41:12,641 --> 00:41:12,908
THANK YOU.

898
00:41:12,908 --> 00:41:17,379
>> DR. POSSIN: GOOD
MORNING I'M 

899
00:41:17,379 --> 00:41:19,681
PLEASED TO KICK OFF THE ADRD 

900
00:41:19,681 --> 00:41:19,981
SUMMIT.

901
00:41:19,981 --> 00:41:23,285
>> KATE, ARE YOU GOOD?

902
00:41:23,285 --> 00:41:30,425
>> DR. POSSIN: YES, CAN
YOU HEAR

903
00:41:30,425 --> 00:41:31,026
ME OKAY?

904
00:41:31,026 --> 00:41:31,927
ALL RIGHT, GOOD.

905
00:41:31,927 --> 00:41:34,596
I HAVE NO FINANCIAL CONFLICTS TO

906
00:41:34,596 --> 00:41:34,963
REPORT.

907
00:41:34,963 --> 00:41:37,632
AND WE ARE HERE TODAY FOR GOOD 

908
00:41:37,632 --> 00:41:37,866
REASON.

909
00:41:37,866 --> 00:41:42,204
A LARGE AND GROWING NUMBER OF 

910
00:41:42,204 --> 00:41:42,838
AMERICANS HAVE DEMENTIA.

911
00:41:42,838 --> 00:41:45,674
DEMENTIA AFFECTS MORE THAN 6 

912
00:41:45,674 --> 00:41:47,876
MILLION AMERICANS TODAY AND 13 

913
00:41:47,876 --> 00:41:50,912
MILLION ARE PROJECTED TO HAVE 

914
00:41:50,912 --> 00:41:52,948
DEMENTIA BY 2060.

915
00:41:52,948 --> 00:41:54,282
THE RISK FOR DEVELOPING DEMENTIA

916
00:41:54,282 --> 00:41:55,717
FOR PEOPLE WHO LIVE INTO OLDER 

917
00:41:55,717 --> 00:41:58,153
AGE IS HIGH WITH ESTIMATES 

918
00:41:58,153 --> 00:42:01,823
RANGING BETWEEN 20% TO 40%.

919
00:42:01,823 --> 00:42:03,658
AS SHOWN HERE IN THE RECENT 

920
00:42:03,658 --> 00:42:06,094
STUDY PUBLISHED IN NATURE AND 

921
00:42:06,094 --> 00:42:08,296
MEDICINE, THE RISK IS HIGHER FOR

922
00:42:08,296 --> 00:42:09,965
WOMEN, FOR BLACKS AND WHITES AND

923
00:42:09,965 --> 00:42:15,337
FOR PEOPLE WITH AN APOE 4 

924
00:42:15,337 --> 00:42:16,972
ALLELE, PARTICULARLY FOUR 

925
00:42:16,972 --> 00:42:18,306
ALLELES BUT IT'S HIGH FOR ALL 

926
00:42:18,306 --> 00:42:19,307
AMERICANS WHO LIVE INTO OLDER 

927
00:42:19,307 --> 00:42:24,179
AGE FROM ALL WALKS OF LIFE.

928
00:42:24,179 --> 00:42:34,723
AND MANY ARE UNPAID CAREGIVERS.

929
00:42:43,198 --> 00:42:45,567
DEMENTIA IS EXPENSIVE AND WILL 

930
00:42:45,567 --> 00:42:46,868
IMPOSE A FAST GROWING ECONOMIC 

931
00:42:46,868 --> 00:42:49,171
BURDEN IN THE COMING DECADES.

932
00:42:49,171 --> 00:42:51,840
USING DATA FROM THE HEALTH AND 

933
00:42:51,840 --> 00:42:53,975
RETIREMENT STUDY, COLLEAGUES 

934
00:42:53,975 --> 00:42:55,677
ESTIMATED ANNUAL FORMAL CARE 

935
00:42:55,677 --> 00:42:57,546
COSTS, THAT IS CARE THAT'S 

936
00:42:57,546 --> 00:43:00,816
PURCHASED IN THE MARKETPLACE IS 

937
00:43:00,816 --> 00:43:02,918
CURRENTLY $200 BILLION PER YEAR.

938
00:43:02,918 --> 00:43:04,619
THIS IS JUST IN THE UNITED 

939
00:43:04,619 --> 00:43:06,621
STATES.

940
00:43:06,621 --> 00:43:08,623
THESE FORMAL CARE COSTS ARE 

941
00:43:08,623 --> 00:43:11,293
PROJECTED TO REACH $1.4 TRILLION

942
00:43:11,293 --> 00:43:12,494
BY YEAR 2060.

943
00:43:12,494 --> 00:43:16,097
IF THE COST OF INFORMAL 

944
00:43:16,097 --> 00:43:17,666
CAREGIVING SUCH AS FOREGONE 

945
00:43:17,666 --> 00:43:20,202
WAGES BY THE CAREGIVER THE COST 

946
00:43:20,202 --> 00:43:20,635
HIGHER.

947
00:43:20,635 --> 00:43:23,071
WHILE THE PROJECTIONS ARE 

948
00:43:23,071 --> 00:43:24,573
ECONOMICALLY DEVASTATING THEY'RE

949
00:43:24,573 --> 00:43:26,408
NOT SET IN STONE.

950
00:43:26,408 --> 00:43:28,543
INVESTMENTS IN RESEARCH AND 

951
00:43:28,543 --> 00:43:30,245
SYSTEMS OF CARE COULD MITIGATE 

952
00:43:30,245 --> 00:43:33,949
THIS ECONOMIC BURDEN BY 

953
00:43:33,949 --> 00:43:35,383
PREVENTING OR DELAYING ONSET AND

954
00:43:35,383 --> 00:43:36,618
CHANGES IN LIFE AND TREATMENTS 

955
00:43:36,618 --> 00:43:40,622
THAT MODIFY THE DISEASE PROCESS 

956
00:43:40,622 --> 00:43:42,257
AND SMART SYSTEMS OF CARE.

957
00:43:42,257 --> 00:43:44,626
THAT SUPPORT THE PERSON LIVING 

958
00:43:44,626 --> 00:43:51,166
WITH DEMENTIA AND CAREGIVERS AND

959
00:43:51,166 --> 00:43:52,634
LOWER TOTAL COST AND IT WILL 

960
00:43:52,634 --> 00:43:55,370
REQUIRE SMART AND EFFECTIVE 

961
00:43:55,370 --> 00:43:56,338
COORDINATION AND COLLABORATION 

962
00:43:56,338 --> 00:43:58,940
BETWEEN SCIENTISTS AND FEDERAL 

963
00:43:58,940 --> 00:44:03,545
AGENCIES IN THE PRIVATE CENTER.

964
00:44:03,545 --> 00:44:06,481
THERE HAVE BEEN IMPORTANT RECENT

965
00:44:06,481 --> 00:44:07,482
BREAKTHROUGHS IN ADRD SCIENCE.

966
00:44:07,482 --> 00:44:09,918
YOU HEARD OF SOME THIS MORNING 

967
00:44:09,918 --> 00:44:10,952
FROM DR. KOROSHETZ.

968
00:44:10,952 --> 00:44:12,254
I HAVE THE PLEASURE OF 

969
00:44:12,254 --> 00:44:13,922
SUMMARIZING SOME OF THE 

970
00:44:13,922 --> 00:44:14,990
BREAKTHROUGHS IN THE AREA OF 

971
00:44:14,990 --> 00:44:16,958
PREVENTION, DIAGNOSIS, TREATMENT

972
00:44:16,958 --> 00:44:27,135
AND CARE.

973
00:44:28,436 --> 00:44:32,807
WE CAN PREVENT DATA THROUGH 

974
00:44:32,807 --> 00:44:34,943
LIFESTYLE AND THERE'S EVIDENCE 

975
00:44:34,943 --> 00:44:37,812
UNTREATED VISION LOSS AND HIGH 

976
00:44:37,812 --> 00:44:40,048
HDL CHOLESTEROL ARE RISK FACTORS

977
00:44:40,048 --> 00:44:40,715
FOR DEMENTIA.

978
00:44:40,715 --> 00:44:43,518
THESE IMPORTANT RISK FACTORS 

979
00:44:43,518 --> 00:44:44,786
COMBINED WITH THOSE THEY 

980
00:44:44,786 --> 00:44:46,087
MODELLED PREVIOUSLY ACCOUNT FOR 

981
00:44:46,087 --> 00:44:50,926
45% OF DEMENTIA RISK.

982
00:44:50,926 --> 00:44:52,561
WE'VE ALSO LEARNED ADDRESSING 

983
00:44:52,561 --> 00:44:54,429
MODIFIABLE RISK FACTORS IN 

984
00:44:54,429 --> 00:44:58,266
AT-RISK INDIVIDUALS CAN SLOW OR 

985
00:44:58,266 --> 00:45:00,635
PREVENT COGNITIVE DECLINE.

986
00:45:00,635 --> 00:45:02,737
AGGRESSIVE BLOOD PRESSURE 

987
00:45:02,737 --> 00:45:03,271
MANAGEMENT REDUCES MILD 

988
00:45:03,271 --> 00:45:05,040
COGNITIVE IMPAIRMENT RISK.

989
00:45:05,040 --> 00:45:08,643
IN THE FINGERS TRIAL, AN 

990
00:45:08,643 --> 00:45:10,712
INTERVENTION THAT TARGETED DIET,

991
00:45:10,712 --> 00:45:12,380
EXERCISE, COGNITIVE AND SOCIAL 

992
00:45:12,380 --> 00:45:14,115
STIMULATION AND VASCULAR RISK 

993
00:45:14,115 --> 00:45:16,885
MONITORING IN AT-RISK 

994
00:45:16,885 --> 00:45:18,420
INDIVIDUALS HAD SIGNIFICANT 

995
00:45:18,420 --> 00:45:19,754
IMPROVEMENTS IN COGNITIVE 

996
00:45:19,754 --> 00:45:20,021
FUNCTION.

997
00:45:20,021 --> 00:45:22,324
THE U.S. POINTER IS EXTENDING 

998
00:45:22,324 --> 00:45:24,459
THE WORK BY TESTING A 

999
00:45:24,459 --> 00:45:25,327
POTENTIALLY SCALABLE 

1000
00:45:25,327 --> 00:45:28,163
INTERVENTION IN A LARGE GROUP OF

1001
00:45:28,163 --> 00:45:29,464
AMERICANS ACROSS THE UNITED 

1002
00:45:29,464 --> 00:45:29,698
STATES.

1003
00:45:29,698 --> 00:45:33,435
AND TRIAL RESULTS ARE EXPECTED 

1004
00:45:33,435 --> 00:45:38,006
THIS YEAR.

1005
00:45:38,006 --> 00:45:43,078
WORLDWIDE FINGERS DEMENTIA 

1006
00:45:43,078 --> 00:45:44,613
TRIALS TO TEST STRATEGIES ACROSS

1007
00:45:44,613 --> 00:45:50,018
DIVERSE POPULATIONS.

1008
00:45:50,018 --> 00:45:52,621
BREAKTHROUGH NUMBER TWO, WE CAN 

1009
00:45:52,621 --> 00:45:53,455
IDENTIFY DISEASE IN LIVING 

1010
00:45:53,455 --> 00:45:56,224
PEOPLE WITH INEXPENSIVE AND 

1011
00:45:56,224 --> 00:45:58,627
NON-INVASIVE TESTS.

1012
00:45:58,627 --> 00:46:00,762
PREVIOUSLY, WE COULD ONLY 

1013
00:46:00,762 --> 00:46:02,030
IDENTIFY ALZHEIMER'S DISEASE IN 

1014
00:46:02,030 --> 00:46:02,897
LIVING PEOPLE USING EXPENSIVE 

1015
00:46:02,897 --> 00:46:07,836
AND INVASIVE TESTS, HEAD IMAGING

1016
00:46:07,836 --> 00:46:10,005
AND SPINAL TAPS.

1017
00:46:10,005 --> 00:46:12,574
IN THE STUDIES HERE IN SWEDEN, 

1018
00:46:12,574 --> 00:46:16,444
WHEN THE AD PLASMA BIOMARKER TAU

1019
00:46:16,444 --> 00:46:20,615
217 WAS AVAILABLE, THE ACCURACY 

1020
00:46:20,615 --> 00:46:24,252
OF DEMENTIA SPECIALISTS SHOWN IN

1021
00:46:24,252 --> 00:46:26,287
BLUE AND PRIMARY CARE PROVIDERS 

1022
00:46:26,287 --> 00:46:29,057
IN A AND B WERE IDENTIFYING 

1023
00:46:29,057 --> 00:46:32,327
ALZHEIMER'S DISEASE PATHOLOGY 

1024
00:46:32,327 --> 00:46:34,596
IMPROVED SUBSTANTIALLY TO 91%.

1025
00:46:34,596 --> 00:46:36,631
YOU HEARD FROM DR. KOROSHETZ HOW

1026
00:46:36,631 --> 00:46:37,699
SUBSTANTIAL BREAKTHROUGH BEING 

1027
00:46:37,699 --> 00:46:39,601
MADE IN BIOMARKERS FOR 

1028
00:46:39,601 --> 00:46:41,936
PARKINSON'S DISEASE AND LEWY 

1029
00:46:41,936 --> 00:46:44,239
BODY DEMENTIA.

1030
00:46:44,239 --> 00:46:46,341
ALPHA SYNUCLEIN CAN BE MEASURED 

1031
00:46:46,341 --> 00:46:50,078
IN BLOOD, SALIVA AND SKIN AND 

1032
00:46:50,078 --> 00:46:51,446
PLASMA AND OTHER SCALABLE 

1033
00:46:51,446 --> 00:46:53,815
BIOMARKERS EXTEND ACCESS TO 

1034
00:46:53,815 --> 00:46:56,151
ACCURATE DIAGNOSIS AND HAVE 

1035
00:46:56,151 --> 00:46:58,453
FACILITATED A MOVEMENT TOWARDS 

1036
00:46:58,453 --> 00:47:00,622
BIOLOGICAL STAGING OF DISEASE.

1037
00:47:00,622 --> 00:47:02,190
THESE ADVANCES PROVIDE 

1038
00:47:02,190 --> 00:47:02,824
GROUNDBREAKING NEW OPPORTUNITIES

1039
00:47:02,824 --> 00:47:05,960
TO IMPROVE CARE AND FIND CURES.

1040
00:47:05,960 --> 00:47:09,698
BUT NEXT WE NEED TO MOVE TOWARDS

1041
00:47:09,698 --> 00:47:12,333
STANDARDIZED DIAGNOSTIC PATHWAYS

1042
00:47:12,333 --> 00:47:14,602
THAT INCORPORATE THESE MARKERS 

1043
00:47:14,602 --> 00:47:16,171
WITH OTHER CLINICAL DATA.

1044
00:47:16,171 --> 00:47:17,572
WE NEED TO REDUCE VARIABILITY 

1045
00:47:17,572 --> 00:47:19,574
DUE TO HOW THE SAMPLES ARE 

1046
00:47:19,574 --> 00:47:22,811
HANDLED AND PROCESS AND ADJUST 

1047
00:47:22,811 --> 00:47:24,412
RESULTS BASED ON PATIENT 

1048
00:47:24,412 --> 00:47:26,314
COMORBIDITIES THAT IMPACT 

1049
00:47:26,314 --> 00:47:26,548
RESULTS.

1050
00:47:26,548 --> 00:47:29,117
AND THE NEXT POINT WILL BE A BIG

1051
00:47:29,117 --> 00:47:30,318
FOCUS OF THE SUMMIT.

1052
00:47:30,318 --> 00:47:32,287
WE NEED TO ADVANCE BIOMARKERS TO

1053
00:47:32,287 --> 00:47:36,624
THE OTHER BIOLOGICAL MARKERS OF 

1054
00:47:36,624 --> 00:47:43,364
ADRD INCLUDING SYNUCLEIN AND 

1055
00:47:43,364 --> 00:47:45,834
THERE'S A MULTI-SITE NATIONAL 

1056
00:47:45,834 --> 00:47:51,206
CONSORTIUM TO CONSOLIDATE AND 

1057
00:47:51,206 --> 00:47:52,040
IDENTIFY BIOMARKERS USED IN 

1058
00:47:52,040 --> 00:47:52,674
DEMENTIA CLINICAL TRIALS.

1059
00:47:52,674 --> 00:47:55,810
THE BIOMARKERS HAVE UNDER GONE 

1060
00:47:55,810 --> 00:47:57,278
INSTRUMENTAL VALIDATION AND NOW 

1061
00:47:57,278 --> 00:48:01,883
UNDERGOING CLINICAL VALIDATION.

1062
00:48:01,883 --> 00:48:04,886
BREAKTHROUGH NUMBER THREE, WE 

1063
00:48:04,886 --> 00:48:06,988
CAN IMPROVE DIAGNOSIS OF 

1064
00:48:06,988 --> 00:48:08,556
DEMENTIA IN PRIMARY CARE.

1065
00:48:08,556 --> 00:48:11,092
YOU HEARD A BIT OF THIS FROM 

1066
00:48:11,092 --> 00:48:15,163
DR. KOROSHETZ.

1067
00:48:15,163 --> 00:48:16,331
AND THERE'S BEEN FUNDING WHERE 

1068
00:48:16,331 --> 00:48:18,333
PAIR DIMES HAVE BEEN DEVELOPED 

1069
00:48:18,333 --> 00:48:19,334
AND IMPLEMENTED IN PRIMARY CARE 

1070
00:48:19,334 --> 00:48:23,104
AND IMPROVED DETECTION AND 

1071
00:48:23,104 --> 00:48:23,371
DIAGNOSIS.

1072
00:48:23,371 --> 00:48:25,940
THREE LARGE PRAGMATIC CLUSTER 

1073
00:48:25,940 --> 00:48:28,476
TRIALS ARE UNDERWAY WITH RESULTS

1074
00:48:28,476 --> 00:48:29,811
EXPECTED IN 2027.

1075
00:48:29,811 --> 00:48:31,613
I ALSO HIGHLIGHT ON THE SLIDE 

1076
00:48:31,613 --> 00:48:35,049
OTHER IMPORTANT INITIATIVES WITH

1077
00:48:35,049 --> 00:48:40,655
THE SAME GOAL THIS IS SO 

1078
00:48:40,655 --> 00:48:41,656
IMPORTANT.

1079
00:48:41,656 --> 00:48:44,225
IF WE DON'T DETECT AND DIAGNOSIS

1080
00:48:44,225 --> 00:48:47,228
PEOPLE EARLY IN CARE WE CAN'T 

1081
00:48:47,228 --> 00:48:48,263
CHANGE CARE.

1082
00:48:48,263 --> 00:48:50,765
AND TWO AMYLOID THERAPIES ARE 

1083
00:48:50,765 --> 00:48:51,566
APPROVED FOR ALZHEIMER'S 

1084
00:48:51,566 --> 00:48:51,966
DISEASE.

1085
00:48:51,966 --> 00:48:54,502
WHEN WE LAST HELD THE SUMMIT IN 

1086
00:48:54,502 --> 00:48:56,671
2022, OUR FIELD DID NOT HAVE ANY

1087
00:48:56,671 --> 00:48:58,006
DISEASE MODIFYING THERAPIES TO 

1088
00:48:58,006 --> 00:48:59,440
OFFER PATIENTS.

1089
00:48:59,440 --> 00:49:01,342
NOW, TWO THERAPIES THAT TARGET 

1090
00:49:01,342 --> 00:49:04,579
AMYLOID ARE APPROVED FOR THE 

1091
00:49:04,579 --> 00:49:07,582
TREATMENT OF EARLY STAGE 

1092
00:49:07,582 --> 00:49:12,654
ALZHEIMER'S DISEASE.

1093
00:49:12,654 --> 00:49:13,888
PATIENTS MUST BE DIAGNOSED AT 

1094
00:49:13,888 --> 00:49:15,156
THE EARLY STAGE TO QUALIFY.

1095
00:49:15,156 --> 00:49:19,527
THE DECLINE IN FUNCTION IS ABOUT

1096
00:49:19,527 --> 00:49:20,829
27% TO 40% SLOWER WHEN ON 

1097
00:49:20,829 --> 00:49:22,997
TREATMENT WHICH MEANS PATIENTS 

1098
00:49:22,997 --> 00:49:24,532
CAN STAY INDEPENDENT AND HOLD ON

1099
00:49:24,532 --> 00:49:27,135
TO WHAT MATTERS MOST TO THEM FOR

1100
00:49:27,135 --> 00:49:28,670
SEVERAL MONTHS LONGER THAN THEY 

1101
00:49:28,670 --> 00:49:33,908
COULD WITHOUT THE TREATMENT.

1102
00:49:33,908 --> 00:49:36,678
HOWEVER THIS TREATMENT AFFECT IS

1103
00:49:36,678 --> 00:49:40,648
MODEST AND THE TREATMENT POSES A

1104
00:49:40,648 --> 00:49:43,618
RISK AND EXTENSIVE SCREENING IS 

1105
00:49:43,618 --> 00:49:44,619
REQUIRED TO DETERMINE IF THE 

1106
00:49:44,619 --> 00:49:45,620
PATIENT IS APPROPRIATE FOR THE 

1107
00:49:45,620 --> 00:49:47,222
TREATMENT AND MOST DO NOT 

1108
00:49:47,222 --> 00:49:49,424
QUALIFY.

1109
00:49:49,424 --> 00:49:52,427
WE NEED TO MOVE TOWARDS MORE 

1110
00:49:52,427 --> 00:49:54,028
EFFECTIVE AND PERSONALIZED 

1111
00:49:54,028 --> 00:49:56,598
TREATMENT FOR PATIENTS TAILORED 

1112
00:49:56,598 --> 00:49:58,867
TO EACH PATIENT'S RISKS AND 

1113
00:49:58,867 --> 00:50:02,670
BIOMARKERS AND PROGRESS IS BEING

1114
00:50:02,670 --> 00:50:05,940
MADE AND TAU THERAPIES IS 

1115
00:50:05,940 --> 00:50:09,043
EXCITING AND TAU AGGREGATION IS 

1116
00:50:09,043 --> 00:50:10,478
MORE LINKED TO COGNITIVE 

1117
00:50:10,478 --> 00:50:11,179
DECLINE.

1118
00:50:11,179 --> 00:50:13,781
PROMISING GENE THERAPY APPROACH 

1119
00:50:13,781 --> 00:50:18,253
OR REDUCING THE IMPACT OF APOE 4

1120
00:50:18,253 --> 00:50:20,488
GENE AND INCREASING THE 

1121
00:50:20,488 --> 00:50:21,556
PROTECTIVE VARIANT AND REDUCING 

1122
00:50:21,556 --> 00:50:24,359
THE PRODUCTION OF AMYLOID BETA.

1123
00:50:24,359 --> 00:50:26,294
WE KNOW THERE'S MULTIPLE 

1124
00:50:26,294 --> 00:50:28,963
PATHOLOGIES IN MOST PATIENTS AND

1125
00:50:28,963 --> 00:50:29,497
WE'LL BE MOVING TOWARDS 

1126
00:50:29,497 --> 00:50:32,533
COMBINATION THERAPIES.

1127
00:50:32,533 --> 00:50:33,534
IN SUMMARY, TO THE TREATMENT 

1128
00:50:33,534 --> 00:50:36,671
AFFECT OF THE ANTIAMYLOID 

1129
00:50:36,671 --> 00:50:38,006
THERAPIES IS MODEST BUT 

1130
00:50:38,006 --> 00:50:39,107
REPRESENT AN IMPORTANT STEP 

1131
00:50:39,107 --> 00:50:40,675
FORWARD AND WE MUST KEEP OUR 

1132
00:50:40,675 --> 00:50:43,278
FOOT ON THE GAS TO HAVE MORE 

1133
00:50:43,278 --> 00:50:47,181
TREATMENTS AVAILABLE FOR 

1134
00:50:47,181 --> 00:50:50,752
PRECISION TREATMENT OF ADRD.

1135
00:50:50,752 --> 00:50:52,120
NIH FUNDS A WIDE RANGE OF 

1136
00:50:52,120 --> 00:50:53,988
CLINICAL TRIALS FOCUSSED ON THE 

1137
00:50:53,988 --> 00:50:55,924
TREATMENT OF ADRD.

1138
00:50:55,924 --> 00:51:00,428
THERE'S BEEN A SHIFT FROM 36% OF

1139
00:51:00,428 --> 00:51:02,196
CLINICAL TRIALS WITH 

1140
00:51:02,196 --> 00:51:03,965
PHARMACOLOGIC AGENTS TARGETING 

1141
00:51:03,965 --> 00:51:10,972
AMYLOID IN 2013 TO 2023, 15%.

1142
00:51:10,972 --> 00:51:14,208
ALSO YOU CAN SEE THERE'S BEEN 

1143
00:51:14,208 --> 00:51:18,413
SUBSTANTIAL INVESTMENT IN WILL 

1144
00:51:18,413 --> 00:51:20,648
NON-PHARMACOLOGIC APPROACHES.

1145
00:51:20,648 --> 00:51:22,016
BREAKTHROUGH NUMBER 5, WE HAVE 

1146
00:51:22,016 --> 00:51:23,718
DEMENTIA CARE THAT ADDRESSES 

1147
00:51:23,718 --> 00:51:27,488
PATIENT AND CAREGIVER NEEDS.

1148
00:51:27,488 --> 00:51:28,656
MEDICARE'S GUIDE PAYMENT MODEL 

1149
00:51:28,656 --> 00:51:32,627
RELEASED IN 2024 IS MEDICARE'S 

1150
00:51:32,627 --> 00:51:34,128
FIRST PAYMENT MODEL THAT 

1151
00:51:34,128 --> 00:51:37,332
INCLUDES SERVICES AND SUPPORTS 

1152
00:51:37,332 --> 00:51:39,133
FOR THE CAREGIVER.

1153
00:51:39,133 --> 00:51:40,835
A TRUE BREAKTHROUGH.

1154
00:51:40,835 --> 00:51:43,237
THERE'S A COLLABORATIVE CARE 

1155
00:51:43,237 --> 00:51:44,405
MODEL SPECIFICALLY DESIGN FOR 

1156
00:51:44,405 --> 00:51:44,672
DEMENTIA.

1157
00:51:44,672 --> 00:51:48,609
YOU SEE IN THE INFOGRAPHIC FROM 

1158
00:51:48,609 --> 00:51:52,447
CMS THE REQUIRED COMPONENTS AND 

1159
00:51:52,447 --> 00:51:53,281
WHEN DEMENTIA CARE ADDRESSES NOT

1160
00:51:53,281 --> 00:51:55,850
ONLY THE MEDICAL AND SOCIAL 

1161
00:51:55,850 --> 00:51:58,353
NEEDS OF THE PATIENT BUT ALSO 

1162
00:51:58,353 --> 00:52:00,521
THE SUPPORTS THE CAREGIVER, IT 

1163
00:52:00,521 --> 00:52:02,023
IMPROVES QUALITY OF LIFE FOR THE

1164
00:52:02,023 --> 00:52:03,758
PATIENT, REDUCES BURDEN ON THE 

1165
00:52:03,758 --> 00:52:06,728
CAREGIVERS AND SAVES MEDICARE 

1166
00:52:06,728 --> 00:52:09,263
MONEY BY PREVENTING UNNECESSARY 

1167
00:52:09,263 --> 00:52:09,597
EMERGENCIES.

1168
00:52:09,597 --> 00:52:11,966
WITH COLLABORATIVE CARE FAMILIES

1169
00:52:11,966 --> 00:52:14,135
SHIFT TOWARDS A MORE PROACTIVE 

1170
00:52:14,135 --> 00:52:16,070
AND STABLE EXPERIENCE OF 

1171
00:52:16,070 --> 00:52:16,337
DEMENTIA.

1172
00:52:16,337 --> 00:52:19,173
THIS BREAKTHROUGH HAS BEEN MADE 

1173
00:52:19,173 --> 00:52:20,641
POSSIBLE BY EFFECTIVE 

1174
00:52:20,641 --> 00:52:21,676
COORDINATION BETWEEN 

1175
00:52:21,676 --> 00:52:22,410
RESEARCHERS, POLICY LEADERS AND 

1176
00:52:22,410 --> 00:52:24,979
FEDERAL AGENCIES.

1177
00:52:24,979 --> 00:52:28,649
STILL, MUCH MORE WORK REMAINS TO

1178
00:52:28,649 --> 00:52:29,851
OPTIMIZE AND WIDELY IMPLEMENT 

1179
00:52:29,851 --> 00:52:34,822
QUALITY DEMENTIA CARE AND THE 

1180
00:52:34,822 --> 00:52:36,591
MECHANISMS OF ITS EFFECTIVENESS.

1181
00:52:36,591 --> 00:52:37,258
YOU'LL HEAR MORE IN THE NEXT 

1182
00:52:37,258 --> 00:52:39,927
SESSION TODAY.

1183
00:52:39,927 --> 00:52:43,164
SO NOW I WILL BRIEFLY SHARE WITH

1184
00:52:43,164 --> 00:52:45,299
YOU THE TOP PRIORITY 

1185
00:52:45,299 --> 00:52:47,635
RECOMMENDATIONS FROM EACH OF THE

1186
00:52:47,635 --> 00:52:48,636
SESSIONS.

1187
00:52:48,636 --> 00:52:51,873
STARTING WITH SESSIONS ON THREE 

1188
00:52:51,873 --> 00:52:53,174
CATEGORIES OF DISEASE.

1189
00:52:53,174 --> 00:52:56,044
FRONTAL TEMPORAL DEMENTIA, 

1190
00:52:56,044 --> 00:52:56,677
VASCULAR COGNITIVE IMPAIRMENT 

1191
00:52:56,677 --> 00:52:58,146
AND LEWY BODY.

1192
00:52:58,146 --> 00:53:02,083
TO HELP KEEP US ON TIME I WON'T 

1193
00:53:02,083 --> 00:53:04,652
READ THESE TO YOU AND URGE YOU 

1194
00:53:04,652 --> 00:53:12,560
TO SNAP A PICTURE.

1195
00:53:12,560 --> 00:53:14,228
THESE ARE THE TOP 

1196
00:53:14,228 --> 00:53:16,397
RECOMMENDATIONS AND TWO THAT ARE

1197
00:53:16,397 --> 00:53:17,832
TOP PRIORITY AND THE SESSION IS 

1198
00:53:17,832 --> 00:53:19,233
LED BY DR. KARCH AND IRWIN.

1199
00:53:19,233 --> 00:53:20,668
THEY'LL BE PRESENTING LATER 

1200
00:53:20,668 --> 00:53:24,338
TODAY.

1201
00:53:24,338 --> 00:53:25,073
VASCULAR COGNITIVE IMPAIRMENT 

1202
00:53:25,073 --> 00:53:28,076
AND DEMENTIA.

1203
00:53:28,076 --> 00:53:31,746
THIS SESSION LED BY DR. BASATI 

1204
00:53:31,746 --> 00:53:35,183
AND DR. LU.

1205
00:53:35,183 --> 00:53:41,155
NEXT, OUR SESSION ON LEWY BODY 

1206
00:53:41,155 --> 00:53:45,259
DISEASE ALSO HAS TWO PRIORITY 1 

1207
00:53:45,259 --> 00:53:48,663
RECOMMENDATIONS LED BY DR

1208
00:53:48,663 --> 00:53:52,767
DR. GALVIN AND POSTIN.

1209
00:53:52,767 --> 00:53:59,407
NEXT, WE HAVE THREE SESSIONS ON 

1210
00:53:59,407 --> 00:54:03,277
SPECIAL TOPICS AND POST DBI AND 

1211
00:54:03,277 --> 00:54:05,179
THESE ARE SESSIONS THAT WERE 

1212
00:54:05,179 --> 00:54:06,614
FIRST INTRODUCED IN 2019 AND 

1213
00:54:06,614 --> 00:54:08,649
CONTINUE TO BE FEATURED AT THE 

1214
00:54:08,649 --> 00:54:11,152
SUMMIT.

1215
00:54:11,152 --> 00:54:16,657
THEY EACH HAVE FOUR 

1216
00:54:16,657 --> 00:54:19,894
RECOMMENDAT

1217
00:54:19,894 --> 00:54:20,261
RECOMMENDATIONS.

1218
00:54:20,261 --> 00:54:22,897
AND THEN A SESSION ON THE 

1219
00:54:22,897 --> 00:54:23,831
EXPOSOME.

1220
00:54:23,831 --> 00:54:29,737
THIS HAS EVOLVED SINCE 2022.

1221
00:54:29,737 --> 00:54:33,374
WE HAD A SESSION POST-COVID.

1222
00:54:33,374 --> 00:54:34,308
DR. LOOKIN AND KIPNIS ARE THE 

1223
00:54:34,308 --> 00:54:39,881
CHAIRS.

1224
00:54:39,881 --> 00:54:42,216
WE ALSO HAVE THREE SESSIONS ON 

1225
00:54:42,216 --> 00:54:43,251
CROSS-CUTTING THEMES.

1226
00:54:43,251 --> 00:54:44,752
WE HAVE A BASIC ON BASIC AND 

1227
00:54:44,752 --> 00:54:45,887
CLINICAL DISCOVERY RESEARCH THAT

1228
00:54:45,887 --> 00:54:51,959
WILL KICK OFF OUR DAY TOMORROW.

1229
00:54:51,959 --> 00:54:58,466
THEY HAVE FOUR RECOMMENDA RECOM 

1230
00:54:58,466 --> 00:55:03,371
THIS ACAN CHAIRED BY DR. IADECOL

1231
00:55:03,371 --> 00:55:07,275
AND CARLSSON AND THOSE AT RISK 

1232
00:55:07,275 --> 00:55:10,311
LIVING WITH AD/ADRD YOU'LL HEAR 

1233
00:55:10,311 --> 00:55:12,580
THIS ON THE THIRD DAY CHAIRED BY

1234
00:55:12,580 --> 00:55:20,655
DR. GLYMOUR AND THEN THE CROSS 

1235
00:55:20,655 --> 00:55:23,291
CUTTING THEMES WILL BE NEXT IN 

1236
00:55:23,291 --> 00:55:33,534
JUST A MOMENT.

1237
00:55:59,860 --> 00:56:02,730
SO, I'LL JUMP IN I THINK.

1238
00:56:02,730 --> 00:56:04,865
WE'LL LAUNCH OUR FIRST SESSION 

1239
00:56:04,865 --> 00:56:06,734
OF THE ADRD SUMMIT, 2025 WITH 

1240
00:56:06,734 --> 00:56:09,937
THE SESSION ON MULTIPLE ETIOLOGY

1241
00:56:09,937 --> 00:56:11,239
DEMENTIA RESEARCH FOR 

1242
00:56:11,239 --> 00:56:12,673
IMPLEMENTATION OF DISCOVERIES 

1243
00:56:12,673 --> 00:56:13,574
INTO PRACTICE.

1244
00:56:13,574 --> 00:56:16,410
AND THIS IS A NEW SESSION FOR 

1245
00:56:16,410 --> 00:56:17,845
THE 2025 SUMMIT.

1246
00:56:17,845 --> 00:56:20,281
YOU'LL BE HEARING TODAY FROM MY 

1247
00:56:20,281 --> 00:56:22,183
CLOSE COLLEAGUES WHO WILL 

1248
00:56:22,183 --> 00:56:22,583
PRESENT WITH ME.

1249
00:56:22,583 --> 00:56:25,019
DR. WOOD WITH FROM THE AMERICAN 

1250
00:56:25,019 --> 00:56:28,389
ACADEMY OF FAMILY PHYSICIANS, 

1251
00:56:28,389 --> 00:56:29,690
DR. HAGERTY-LINGLER FROM THE 

1252
00:56:29,690 --> 00:56:32,026
UNIVERSITY OF PITTSBURGH AND 

1253
00:56:32,026 --> 00:56:35,263
DR. SNYDER FROM THE ALZHEIMER'S 

1254
00:56:35,263 --> 00:56:43,037
ASSOCIATION.

1255
00:56:43,037 --> 00:56:44,872
I'LL START BY SAYING AGAIN I 

1256
00:56:44,872 --> 00:56:52,647
HAVE NO FINANCIAL DISCLOSURES.

1257
00:56:52,647 --> 00:56:53,114
ALL RIGHT.

1258
00:56:53,114 --> 00:56:56,083
SO WE HAVE THIS NEW SESSION FOR 

1259
00:56:56,083 --> 00:57:00,821
THIS SUMMIT.

1260
00:57:00,821 --> 00:57:01,789
THIS IS CALLED RESEARCH FOR 

1261
00:57:01,789 --> 00:57:04,659
IMPLEMENTATION OF DISCOVERIES 

1262
00:57:04,659 --> 00:57:05,926
INTO PRACTICE.

1263
00:57:05,926 --> 00:57:09,030
THE FIRST GOAL OF THE NAPA 

1264
00:57:09,030 --> 00:57:12,667
NATIONAL PLAN IS TO PREVENT AND 

1265
00:57:12,667 --> 00:57:14,635
EFFECTIVELY TREAT AD/ADRD BY 

1266
00:57:14,635 --> 00:57:15,102
2025.

1267
00:57:15,102 --> 00:57:17,305
THIS IS A MOMENT TO REFLECT ON 

1268
00:57:17,305 --> 00:57:19,540
WHAT NEEDS TO BE DONE TO GET THE

1269
00:57:19,540 --> 00:57:22,310
BREAKTHROUGHS INTO PRACTICE TO 

1270
00:57:22,310 --> 00:57:23,244
BENEFIT PATIENTS, FAMILIES AND 

1271
00:57:23,244 --> 00:57:25,212
SYSTEMS OF CARE.

1272
00:57:25,212 --> 00:57:27,181
BECAUSE THE RECENT ADVANCES ARE 

1273
00:57:27,181 --> 00:57:28,082
NOT YET AVAILABLE TO MOST 

1274
00:57:28,082 --> 00:57:31,319
INDIVIDUALS AT RISK FOR OR 

1275
00:57:31,319 --> 00:57:32,687
LIVING WITH AD/ADRD.

1276
00:57:32,687 --> 00:57:35,523
SESSION 1 IS FOCUSSED ON 

1277
00:57:35,523 --> 00:57:36,657
IDENTIFYING KEY AREAS OF 

1278
00:57:36,657 --> 00:57:38,392
RESEARCH NEEDED TO CAPITALIZE ON

1279
00:57:38,392 --> 00:57:40,661
THE BREAKTHROUGHS AND ENSURE 

1280
00:57:40,661 --> 00:57:42,863
THEY REACH PATIENTS, FAMILIES, 

1281
00:57:42,863 --> 00:57:44,665
HEALTH CARE PROVIDERS AND HEALTH

1282
00:57:44,665 --> 00:57:51,472
SYSTEMS.

1283
00:57:51,472 --> 00:57:53,240
WE PRESENT FOR YOUR 

1284
00:57:53,240 --> 00:57:54,909
CONSIDERATION FOUR 

1285
00:57:54,909 --> 00:57:55,843
RECOMMENDATIONS THAT ARE 

1286
00:57:55,843 --> 00:57:56,644
IMPORTANT ACROSS ALL STAGES OF 

1287
00:57:56,644 --> 00:57:59,780
BRAIN HEALTH.

1288
00:57:59,780 --> 00:58:01,582
OUR PRIORITY 1 RECOMMENDATION IS

1289
00:58:01,582 --> 00:58:04,352
FOCUSSED ON IMPROVING DETECTION,

1290
00:58:04,352 --> 00:58:07,054
DIAGNOSIS AND LINKAGES TO CARE.

1291
00:58:07,054 --> 00:58:08,789
OUR PRIORITY 2 IS FOCUSSED ON 

1292
00:58:08,789 --> 00:58:11,192
IMPROVING ACCESS TO QUALITY CARE

1293
00:58:11,192 --> 00:58:14,128
WHICH IS PARTICULARLY IMPORTANT 

1294
00:58:14,128 --> 00:58:14,962
AROUND THE DIAGNOSIS AND INITIAL

1295
00:58:14,962 --> 00:58:18,799
TREATMENT PERIOD.

1296
00:58:18,799 --> 00:58:20,668
OUR PRIORITY 3 RECOMMENDATION IS

1297
00:58:20,668 --> 00:58:24,872
ON DEMENTIA CARE AND PRIORITY 4 

1298
00:58:24,872 --> 00:58:30,010
IS ON PRIMARY AND SECONDARY 

1299
00:58:30,010 --> 00:58:31,812
PREVENTION.

1300
00:58:31,812 --> 00:58:34,115
MOST THE RESEARCH THAT WE'RE 

1301
00:58:34,115 --> 00:58:35,950
RECOMMENDING USES THE METHODS OF

1302
00:58:35,950 --> 00:58:36,650
IMPLEMENTATION AND DISSEMINATION

1303
00:58:36,650 --> 00:58:40,154
SCIENCE WITH THE GOAL TO IMPROVE

1304
00:58:40,154 --> 00:58:41,722
PATIENT OUTCOMES AND ENHANCE 

1305
00:58:41,722 --> 00:58:42,590
CARE QUALITY.

1306
00:58:42,590 --> 00:58:45,192
THIS TYPE OF RESEARCH IS BEST 

1307
00:58:45,192 --> 00:58:46,660
CONDUCTED AS A COLLABORATION 

1308
00:58:46,660 --> 00:58:50,564
BETWEEN SCIENTISTS AND 

1309
00:58:50,564 --> 00:58:51,632
PRACTITIONERS WITH 

1310
00:58:51,632 --> 00:58:52,867
BI-DIRECTIONAL LEARNING 

1311
00:58:52,867 --> 00:58:53,434
THROUGHOUT THE INTEGRATION 

1312
00:58:53,434 --> 00:58:59,774
PROCESS.

1313
00:58:59,774 --> 00:59:02,910
PRIMARY CARE PLAYS A CRUCIAL 

1314
00:59:02,910 --> 00:59:04,578
ROLE IN THE RESEARCH RECOMMENDED

1315
00:59:04,578 --> 00:59:05,246
BY THE SESSION.

1316
00:59:05,246 --> 00:59:07,948
MOST PCPs FEEL THEY'RE IN THE 

1317
00:59:07,948 --> 00:59:09,950
FRONT LINES OF PROVIDING 

1318
00:59:09,950 --> 00:59:12,653
DEMENTIA CARE YET NOT PREPARED 

1319
00:59:12,653 --> 00:59:21,228
TO PROVIDE THIS CARE.

1320
00:59:21,228 --> 00:59:23,697
I WANT TO THANK MY INCREDIBLE 

1321
00:59:23,697 --> 00:59:24,632
COMMITTEE MEMBERS WORKING WITH 

1322
00:59:24,632 --> 00:59:26,133
ME TO PREPARE THE 

1323
00:59:26,133 --> 00:59:28,669
RECOMMENDATIONS WE PRESENT TODAY

1324
00:59:28,669 --> 00:59:33,107
FOR YOUR INPUT.

1325
00:59:33,107 --> 00:59:35,376
I'LL PRESENT NOW OUR 

1326
00:59:35,376 --> 00:59:36,644
RECOMMENDATION ON CARE.

1327
00:59:36,644 --> 00:59:39,513
WE RECOMMEND TO CONDUCT RESEARCH

1328
00:59:39,513 --> 00:59:42,683
TO ENHANCE THE EFFICIENCY AND 

1329
00:59:42,683 --> 00:59:44,018
EFFECTIVENESS OF EVIDENCE-BASED 

1330
00:59:44,018 --> 00:59:45,052
AND EVIDENCE-INFORMED 

1331
00:59:45,052 --> 00:59:46,520
COLLABORATIVE CARE MODELS THAT 

1332
00:59:46,520 --> 00:59:47,621
SUPPORT THE NEEDS OF PATIENTS 

1333
00:59:47,621 --> 00:59:52,059
AND CARE PARTNERS AT KEY POINTS 

1334
00:59:52,059 --> 00:59:54,829
IN THE AD/ADRD CARE JOURNEY FROM

1335
00:59:54,829 --> 00:59:56,664
DIAGNOSIS TO END OF LIFE 

1336
00:59:56,664 --> 00:59:58,098
INCLUDING POPULATIONS MOST AT 

1337
00:59:58,098 --> 01:00:08,542
RISK FOR POORER OUTCOMES.

1338
01:00:17,351 --> 01:00:19,153
AND A PATIENT SAID HIS HEART 

1339
01:00:19,153 --> 01:00:21,355
DISEASE WAS TOUGH BUT THINGS 

1340
01:00:21,355 --> 01:00:22,490
REALLY FELL A PART WHEN HIS 

1341
01:00:22,490 --> 01:00:24,091
MEMORY STARTED TO GO AND I FELT 

1342
01:00:24,091 --> 01:00:27,294
STUM IN HIS ENDLESS CYCLE ER 

1343
01:00:27,294 --> 01:00:28,662
VISITS AND HOSPITAL STAYS AND I 

1344
01:00:28,662 --> 01:00:30,231
WAS EXHAUSTED TRYING TO FIGURE 

1345
01:00:30,231 --> 01:00:31,866
IT OUT ON MY OWN WITH NO ONE 

1346
01:00:31,866 --> 01:00:32,833
HELPING ME FIGURE IT OUT.

1347
01:00:32,833 --> 01:00:35,369
I FELT ALONE JUST TRYING TO KEEP

1348
01:00:35,369 --> 01:00:42,343
MY DAD SAFE.

1349
01:00:42,343 --> 01:00:43,410
THIS SESSION'S RECOMMENDATION ON

1350
01:00:43,410 --> 01:00:45,212
CARE IS FOCUSSED ON 

1351
01:00:45,212 --> 01:00:48,782
COLLABORATIVE CARE FOR DEMENTIA 

1352
01:00:48,782 --> 01:00:51,252
THIS USES MULTI-DISCIPLINARY 

1353
01:00:51,252 --> 01:00:55,389
NEEDS TO MEET THE PSYCHOSOCIAL 

1354
01:00:55,389 --> 01:00:56,457
NEEDS AND EMPHASIZES CARE 

1355
01:00:56,457 --> 01:00:57,057
NAVIGATION AND SUPPORT.

1356
01:00:57,057 --> 01:00:58,993
THIS TYPE OF CARE HAS BEEN SHOWN

1357
01:00:58,993 --> 01:01:00,761
TO IMPROVE QUALITY OF LIFE FOR 

1358
01:01:00,761 --> 01:01:05,099
PEOPLE LIVING WITH DEMENTIA, 

1359
01:01:05,099 --> 01:01:08,402
CAREGIVER WELL BEING AND REDUCED

1360
01:01:08,402 --> 01:01:09,470
EMERGENCY ROOM VISIT AND REDUCED

1361
01:01:09,470 --> 01:01:10,638
TOTAL COST OF CARE AND REDUCING 

1362
01:01:10,638 --> 01:01:16,477
POLY PHARMACY.

1363
01:01:16,477 --> 01:01:18,779
THERE'S BEEN SUBSTANTIAL HARD 

1364
01:01:18,779 --> 01:01:19,914
WORK AND PROGRESS TOWARDS BETTER

1365
01:01:19,914 --> 01:01:27,154
DEMENTIA QUAR  -- CARE FOR ALL.

1366
01:01:27,154 --> 01:01:28,055
AND THERE WERE COLLABORATIVE 

1367
01:01:28,055 --> 01:01:30,224
DEMENTIA CARE MODELS.

1368
01:01:30,224 --> 01:01:33,694
THE 2019 ADRD SUMMIT INTRODUCED 

1369
01:01:33,694 --> 01:01:37,831
A RECOMMENDATION FOR ADVANCED 

1370
01:01:37,831 --> 01:01:39,533
DEMENTIA CARE AND NIH 

1371
01:01:39,533 --> 01:01:42,303
SUBMISSIONED REVIEWS TO EVALUATE

1372
01:01:42,303 --> 01:01:44,371
THE DEMENTIA CARE AND THE 

1373
01:01:44,371 --> 01:01:47,141
RESULTING WHITE PAPERS CONCLUDE 

1374
01:01:47,141 --> 01:01:50,177
THE EVIDENCE WAS SUFFICIENT TO 

1375
01:01:50,177 --> 01:01:51,779
IMPLEMENT COLLABORATIVE CARE 

1376
01:01:51,779 --> 01:01:55,149
MODELS IN WITH EVALUATION 

1377
01:01:55,149 --> 01:01:57,551
CONDUCTED TO CONTINUE EXPANDING 

1378
01:01:57,551 --> 01:01:59,119
THE EVIDENCE BASE.

1379
01:01:59,119 --> 01:02:01,522
THIS INSPIRED IMPORTANT POLICY 

1380
01:02:01,522 --> 01:02:02,823
WORK BY THE ALZHEIMER'S 

1381
01:02:02,823 --> 01:02:04,325
ASSOCIATION AND IMPACT MOVEMENT 

1382
01:02:04,325 --> 01:02:06,827
AND OTHERS WHICH LED TO THE 

1383
01:02:06,827 --> 01:02:07,861
COMPREHENSIVE CARE FOR 

1384
01:02:07,861 --> 01:02:09,730
ALZHEIMER'S ACT.

1385
01:02:09,730 --> 01:02:12,666
INTRODUCED IN THE HOUSE AND 

1386
01:02:12,666 --> 01:02:23,143
SENATE WITH STRONG BUY  -- 

1387
01:02:24,178 --> 01:02:25,412
BIPARTISAN SUPPORT AND WE HAVE 

1388
01:02:25,412 --> 01:02:27,348
THE MODEL AND THIS BRINGS US TO 

1389
01:02:27,348 --> 01:02:30,217
THE ADRD SUMMIT OF 2025 WHERE WE

1390
01:02:30,217 --> 01:02:31,619
RECOMMEND THE NEXT CRUCIAL STEPS

1391
01:02:31,619 --> 01:02:33,554
IN RESEARCH TO MOVE US TOWARDS 

1392
01:02:33,554 --> 01:02:36,690
BETTER DEMENTIA CARE FOR ALL.

1393
01:02:36,690 --> 01:02:38,125
THE SUBSTANTIAL PROGRESS TOWARDS

1394
01:02:38,125 --> 01:02:40,060
BETTER DEMENTIA CARE REFLECTS 

1395
01:02:40,060 --> 01:02:40,694
EFFECTIVE COORDINATION BETWEEN 

1396
01:02:40,694 --> 01:02:42,363
FEDERALLY FUNDED RESEARCH, 

1397
01:02:42,363 --> 01:02:46,967
POLICY WORK, FEDERAL AGENCIES 

1398
01:02:46,967 --> 01:02:48,769
AND BIPARTISAN LEGISLATORS BUT 

1399
01:02:48,769 --> 01:02:57,444
WE STILL HAVE A WAYS TO GO.

1400
01:02:57,444 --> 01:02:58,646
CHALLENGES REMAIN.

1401
01:02:58,646 --> 01:03:01,715
THE EFFECT SIZES ARE SMALL AND 

1402
01:03:01,715 --> 01:03:04,652
SOME TRIALS HAVE BEEN NEGATIVE.

1403
01:03:04,652 --> 01:03:06,220
AFFECT SIZES CAN VARY 

1404
01:03:06,220 --> 01:03:07,054
SUBSTANTIALLY FROM DIFFERENT 

1405
01:03:07,054 --> 01:03:08,656
TYPES OF PATIENTS AND CAREGIVERS

1406
01:03:08,656 --> 01:03:11,225
WHICH MAY HELP EXPLAIN THE SMALL

1407
01:03:11,225 --> 01:03:14,895
EFFECT SIZES WITHIN AND ACROSS 

1408
01:03:14,895 --> 01:03:15,462
STUDIES.

1409
01:03:15,462 --> 01:03:17,264
WE NEED TO █DO A BETTER JOB 

1410
01:03:17,264 --> 01:03:19,233
UNDERSTANDING THE RIGHT CARE FOR

1411
01:03:19,233 --> 01:03:20,501
THE RIGHT PATIENT AT THE RIGHT 

1412
01:03:20,501 --> 01:03:22,302
TIME AND NEED TO ADAPT CARE 

1413
01:03:22,302 --> 01:03:23,971
MODELS TO MEET THE NEEDS OF 

1414
01:03:23,971 --> 01:03:25,639
PATIENTS WHO LIVE ALONE OR 

1415
01:03:25,639 --> 01:03:29,176
WITHOUT AN ENGAGED CAREGIVER.

1416
01:03:29,176 --> 01:03:31,779
THE CARE MODELS TEND TO HAVE 

1417
01:03:31,779 --> 01:03:32,646
MANY COMPONENTS OF CARE JUST 

1418
01:03:32,646 --> 01:03:33,914
LIKE GUIDE BUT WE DON'T ALWAYS 

1419
01:03:33,914 --> 01:03:35,215
KNOW WHICH ARE THE COMPONENTS 

1420
01:03:35,215 --> 01:03:39,319
THAT DRIVE EFFECTIVENESS.

1421
01:03:39,319 --> 01:03:41,355
WE NEED TO ADAPT OUR CARE MODELS

1422
01:03:41,355 --> 01:03:44,124
TO MEET THE NEEDS OF PATIENTS 

1423
01:03:44,124 --> 01:03:46,627
DURING VULNERABLE POINTS IN 

1424
01:03:46,627 --> 01:03:48,562
THEIR JOURNEY AND CARE TEAMS 

1425
01:03:48,562 --> 01:03:51,498
IMPLEMENTING SCIENCE-BASED CARE 

1426
01:03:51,498 --> 01:03:53,033
MODEL FACING CHALLENGES 

1427
01:03:53,033 --> 01:03:54,735
INFIDELITY AND INTEGRATING THE 

1428
01:03:54,735 --> 01:03:56,370
MODELS WITH ROUTINE CARE.

1429
01:03:56,370 --> 01:03:58,205
THIS COULD BE ADDRESSED IN PART 

1430
01:03:58,205 --> 01:04:03,777
WITH A.I.-BASED TOOLS.

1431
01:04:03,777 --> 01:04:05,345
SO, THIS IS THE FULL TEXT OF 

1432
01:04:05,345 --> 01:04:05,946
THIS RECOMMENDATION.

1433
01:04:05,946 --> 01:04:08,315
WE WANT TO PUSH FORWARD RESEARCH

1434
01:04:08,315 --> 01:04:10,317
THAT ADDRESSES VULNERABLE POINTS

1435
01:04:10,317 --> 01:04:11,351
IN THE CARE JOURNEY.

1436
01:04:11,351 --> 01:04:15,723
WE WANT TO MEET THE NEEDS OF 

1437
01:04:15,723 --> 01:04:16,390
INDIVIDUALS IN THE HETEROGENEOUS

1438
01:04:16,390 --> 01:04:17,024
POPULATION INCLUDING PEOPLE WHO 

1439
01:04:17,024 --> 01:04:20,994
LIVE ALONE.

1440
01:04:20,994 --> 01:04:22,629
IN COOPERATE DECISION SUPPORT 

1441
01:04:22,629 --> 01:04:24,698
TOOLS, GENERATIVE A.I. 

1442
01:04:24,698 --> 01:04:25,966
APPROACHES TO DRIVE EFFICIENCIES

1443
01:04:25,966 --> 01:04:27,668
AND ADHERE TO BEST PRACTICES.

1444
01:04:27,668 --> 01:04:28,969
IDENTIFY THE CORE COMPONENTS OF 

1445
01:04:28,969 --> 01:04:31,872
CARE THAT DRIVE EFFECTIVENESS 

1446
01:04:31,872 --> 01:04:32,673
AND FOR WHOM.

1447
01:04:32,673 --> 01:04:35,275
AND ADVANCE WORK ON THE 

1448
01:04:35,275 --> 01:04:37,311
AVAILABILITY OF COMMON DATA 

1449
01:04:37,311 --> 01:04:38,679
ELEMENTS TO FACILITATE 

1450
01:04:38,679 --> 01:04:40,047
EVALUATION OF REAL-WORLD 

1451
01:04:40,047 --> 01:04:40,647
SETTINGS.

1452
01:04:40,647 --> 01:04:49,056
THANK YOU AND NEXT.

1453
01:04:49,056 --> 01:04:51,458
I'D LIKE TO INTRODUCE NOW JULIE 

1454
01:04:51,458 --> 01:04:53,360
WOOD WHO WILL SPEAK ON OUR NEXT 

1455
01:04:53,360 --> 01:04:59,366
RECOMMENDATION.

1456
01:04:59,366 --> 01:05:01,769
>> JULIE WOOD: THANK YOU
FOR 

1457
01:05:01,769 --> 01:05:02,836
JOINING US.

1458
01:05:02,836 --> 01:05:05,072
I'M JULIE WOOD A FAMILY 

1459
01:05:05,072 --> 01:05:05,739
PHYSICIAN AND JOINING FROM THE 

1460
01:05:05,739 --> 01:05:07,608
AMERICAN ACADEMY OF FAMILY 

1461
01:05:07,608 --> 01:05:08,909
PHYSICIANS THAT REPRESENTED 

1462
01:05:08,909 --> 01:05:10,277
ABOUT 28,000 FAMILY PHYSICIANS 

1463
01:05:10,277 --> 01:05:16,683
FROM ACROSS THE UNITED STATES.

1464
01:05:16,683 --> 01:05:20,254
MY -- I'M GOING TO COVER 

1465
01:05:20,254 --> 01:05:21,421
PRIORITY 1 A RECOMMENDATION ON 

1466
01:05:21,421 --> 01:05:21,688
DIAGNOSIS.

1467
01:05:21,688 --> 01:05:22,422
I DON'T HAVE ANYTHING TO 

1468
01:05:22,422 --> 01:05:28,328
DISCLOSE.

1469
01:05:28,328 --> 01:05:31,732
I'M GOING TO READ THIS FOR YOU 

1470
01:05:31,732 --> 01:05:32,432
AS WELL.

1471
01:05:32,432 --> 01:05:34,668
OUR RECOMMENDATION ON DIAGNOSIS,

1472
01:05:34,668 --> 01:05:37,638
CONDUCT IMPLEMENTATION AND 

1473
01:05:37,638 --> 01:05:38,605
DISSEMINATION RESEARCH ON 

1474
01:05:38,605 --> 01:05:40,674
EVIDENCE-BASED INTERVENTIONS TO 

1475
01:05:40,674 --> 01:05:41,809
DETECT AND DIAGNOSIS COGNITIVE, 

1476
01:05:41,809 --> 01:05:43,911
BEHAVIORAL OR FUNCTIONAL 

1477
01:05:43,911 --> 01:05:45,679
IMPAIRMENTS ASSOCIATED WITH 

1478
01:05:45,679 --> 01:05:47,181
AD/ADRD, COMMUNICATE RESULTS TO 

1479
01:05:47,181 --> 01:05:48,682
PATIENTS AND CARE PARTNERS AND 

1480
01:05:48,682 --> 01:05:50,350
LINK THEM TO QUALITY CARE IN 

1481
01:05:50,350 --> 01:05:57,791
PRIMARY HEALTH CARE SETTINGS.

1482
01:05:57,791 --> 01:06:00,627
SO ONE OF THE THINGS THAT WE 

1483
01:06:00,627 --> 01:06:03,597
WANTED TO EMPHASIZE IS WHY THIS 

1484
01:06:03,597 --> 01:06:05,732
IS SO IMPORTANT TO DIAGNOSIS 

1485
01:06:05,732 --> 01:06:08,669
MILD COGNITIVE IMPAIRMENT.

1486
01:06:08,669 --> 01:06:12,539
OFTEN THIS CAN DEMONSTRATE THAT 

1487
01:06:12,539 --> 01:06:13,473
WE CAN HELP TREAT SOMETHING 

1488
01:06:13,473 --> 01:06:15,342
THAT'S REVERSIBLE.

1489
01:06:15,342 --> 01:06:16,510
THIS MAY BE A CONDITION WHERE WE

1490
01:06:16,510 --> 01:06:18,178
TREAT SOMETHING LIKE A MEDICAL 

1491
01:06:18,178 --> 01:06:21,181
PROBLEM THAT IS ACTUALLY A 

1492
01:06:21,181 --> 01:06:22,783
REVERSIBLE PROBLEM.

1493
01:06:22,783 --> 01:06:25,986
WE CAN ALSO OPTIMIZE MEDICATION.

1494
01:06:25,986 --> 01:06:27,421
THIS CAN HELP INFORM TREATMENT 

1495
01:06:27,421 --> 01:06:28,655
DECISIONS FOR OTHER CONDITIONS 

1496
01:06:28,655 --> 01:06:31,325
THAT A PERSON MAY HAVE.

1497
01:06:31,325 --> 01:06:33,060
WE ALSO WANT TO HELP CONNECT 

1498
01:06:33,060 --> 01:06:34,528
PEOPLE TO OTHER SERVICES AS WELL

1499
01:06:34,528 --> 01:06:36,363
AS THE CAREGIVERS AND THIS IS 

1500
01:06:36,363 --> 01:06:37,831
MUCH OF WHAT THE GUIDE MODEL IS 

1501
01:06:37,831 --> 01:06:39,900
BASED ON YOU HEARD ABOUT 

1502
01:06:39,900 --> 01:06:40,167
EARLIER.

1503
01:06:40,167 --> 01:06:42,035
IT GIVES A PATIENT AND THEIR 

1504
01:06:42,035 --> 01:06:43,770
FAMILY THE OPPORTUNITY TO MAKE 

1505
01:06:43,770 --> 01:06:46,073
DECISIONS ABOUT PARTICIPATING IN

1506
01:06:46,073 --> 01:06:46,840
CLINICAL TRIALS OR OTHER 

1507
01:06:46,840 --> 01:06:47,708
RESEARCH THAT'S AVAILABLE.

1508
01:06:47,708 --> 01:06:49,943
AND A REALLY IMPORTANT ONE IS 

1509
01:06:49,943 --> 01:06:50,644
STARTING TO TALK ABOUT QUALITY 

1510
01:06:50,644 --> 01:06:51,712
OF LIFE AND GOALS FOR THE 

1511
01:06:51,712 --> 01:06:53,180
PATIENT AND THEIR FAMILY.

1512
01:06:53,180 --> 01:06:58,552
AND TALK ABOUT SAFETY ISSUES.

1513
01:06:58,552 --> 01:06:59,553
AND TALK TO THE PATIENT AND 

1514
01:06:59,553 --> 01:07:01,488
THEIR FAMILY ABOUT PLANNING 

1515
01:07:01,488 --> 01:07:03,757
AHEAD FOR THEIR CARE AND HAVING 

1516
01:07:03,757 --> 01:07:04,658
CONVERSATIONS ABOUT WHAT ARE THE

1517
01:07:04,658 --> 01:07:05,459
GOALS.

1518
01:07:05,459 --> 01:07:06,927
IMPORTANTLY, TALKING ESPECIALLY 

1519
01:07:06,927 --> 01:07:09,296
NOW AS YOU HEARD EARLIER TALKING

1520
01:07:09,296 --> 01:07:09,796
ABOUT NEW AND EMERGING 

1521
01:07:09,796 --> 01:07:19,973
THERAPIES.

1522
01:08:13,527 --> 01:08:15,195
IT'S IMPORTANT TO HAVE METHODS 

1523
01:08:15,195 --> 01:08:16,363
IN PLACE TO FIND PEOPLE EARLIER 

1524
01:08:16,363 --> 01:08:17,564
TO HELP WITH THE INTERVENTIONS 

1525
01:08:17,564 --> 01:08:21,335
THAT ARE SO IMPORTANT.

1526
01:08:21,335 --> 01:08:25,105
THERE'S ALSO DISPARITIES IN 

1527
01:08:25,105 --> 01:08:27,040
MEDICALLY UNDER SERVED 

1528
01:08:27,040 --> 01:08:28,842
COMMUNITIES AND MINORITIES, 

1529
01:08:28,842 --> 01:08:31,478
PEOPLE IN RURAL AREAS LIKE WHERE

1530
01:08:31,478 --> 01:08:36,650
I PRACTICE AND DIFFERENT SOCIAL 

1531
01:08:36,650 --> 01:08:38,852
DISADVANTAGES AND WE KNOW THE 

1532
01:08:38,852 --> 01:08:39,486
DIFFERENT RESOURCES ON THE SLIDE

1533
01:08:39,486 --> 01:08:49,596
BELOW.

1534
01:08:50,964 --> 01:08:52,666
SO IN PRIMARY CARE THERE'S A LOT

1535
01:08:52,666 --> 01:08:54,568
OF BARRIERS.

1536
01:08:54,568 --> 01:08:55,669
THERE'S A DEFINITE INTEREST 

1537
01:08:55,669 --> 01:08:57,004
AMONG PRIMARY CARE PHYSICIAN TO 

1538
01:08:57,004 --> 01:09:01,308
DO THIS BUT IT COULD BE A BIT 

1539
01:09:01,308 --> 01:09:01,641
OVERWHELMING.

1540
01:09:01,641 --> 01:09:04,578
TIME WAS GIVEN AS THE TOP 

1541
01:09:04,578 --> 01:09:04,811
FACTOR.

1542
01:09:04,811 --> 01:09:06,179
THERE WAS AN INTEREST AND A 

1543
01:09:06,179 --> 01:09:10,050
KNOWLEDGE OF THE NEED AND AS YOU

1544
01:09:10,050 --> 01:09:11,051
HEARD EARLIER FROM THE PREVIOUS 

1545
01:09:11,051 --> 01:09:14,154
PRESENTATION 82% OF PRIMARY CARE

1546
01:09:14,154 --> 01:09:17,391
DOCS CONSIDER THEMSELVES THE 

1547
01:09:17,391 --> 01:09:19,726
FRONT LINE.

1548
01:09:19,726 --> 01:09:20,660
HOWEVER, AN ALMOST EQUAL CONCERN

1549
01:09:20,660 --> 01:09:21,428
AND BARRIER.

1550
01:09:21,428 --> 01:09:23,463
ONE THING WE WANTED TO POINT OUT

1551
01:09:23,463 --> 01:09:25,899
IS THERE WAS A STUDY DONE BY THE

1552
01:09:25,899 --> 01:09:27,968
JOURNAL OF INTERNAL MEDICINE, 

1553
01:09:27,968 --> 01:09:29,369
GENERAL INTERNAL MEDICINE THAT 

1554
01:09:29,369 --> 01:09:33,073
CAME OUT IN 2022 THAT LOOKED AT 

1555
01:09:33,073 --> 01:09:36,643
TIME AND THEY ACTUALLY FOUND OUT

1556
01:09:36,643 --> 01:09:38,845
IF PRIMARY DOCS DID EVERYTHING 

1557
01:09:38,845 --> 01:09:40,113
RECOMMENDED IT WAS IMPORTANT FOR

1558
01:09:40,113 --> 01:09:42,649
ALL KINDS OF GUIDELINES IT WOULD

1559
01:09:42,649 --> 01:09:44,184
TAKE A PRIMARY CARE PHYSICIAN 

1560
01:09:44,184 --> 01:09:45,952
26.7 HOURS A DAY TO DO ALL 

1561
01:09:45,952 --> 01:09:46,353
THOSE.

1562
01:09:46,353 --> 01:09:47,788
WE WANT TO DO ALL THOSE AND 

1563
01:09:47,788 --> 01:09:49,389
PROVIDE GOOD CARE BUT THE KEY IS

1564
01:09:49,389 --> 01:09:51,158
WE HAVE TO FIND GOOD WAYS TO DO 

1565
01:09:51,158 --> 01:09:52,526
THAT AND HAVE THE RIGHT CARE AT 

1566
01:09:52,526 --> 01:09:56,663
THE RIGHT TIME SO WE CAN WORK IN

1567
01:09:56,663 --> 01:09:58,098
TEAMS AND A LOT OF OUR 

1568
01:09:58,098 --> 01:09:59,466
RECOMMENDATIONS TODAY ARE BASED 

1569
01:09:59,466 --> 01:10:01,435
ON THAT.

1570
01:10:01,435 --> 01:10:04,638
WE ALSO FOUND WITH SURVEYS 

1571
01:10:04,638 --> 01:10:08,008
INCLUDING ONE FROM MY 

1572
01:10:08,008 --> 01:10:09,743
ORGANIZATION AND -- 

1573
01:10:09,743 --> 01:10:14,548
>> YOU HAVE A TWO-MINUTE 

1574
01:10:14,548 --> 01:10:16,550
WARNING.

1575
01:10:16,550 --> 01:10:19,486
>> JULIE WOOD: THAT
GETTING 

1576
01:10:19,486 --> 01:10:20,554
CONFIDENCE IN TRAINING IS THE 

1577
01:10:20,554 --> 01:10:24,591
MOST IMPORTANT THING TO THEM AND

1578
01:10:24,591 --> 01:10:27,527
REDISCOVERED ORGANIZATIONS 

1579
01:10:27,527 --> 01:10:30,263
GETTING INFORMATION ON 

1580
01:10:30,263 --> 01:10:33,200
EVIDENCE-BASED CARE WAS KEY.

1581
01:10:33,200 --> 01:10:38,138
WE RECOMMEND TO GO WITH 

1582
01:10:38,138 --> 01:10:46,913
COGNITIVE SCREENING.

1583
01:10:46,913 --> 01:10:48,682
THIS IS AN EXAMPLE OF FACTORS 

1584
01:10:48,682 --> 01:10:50,517
THAT CAN CONTRIBUTE TO 

1585
01:10:50,517 --> 01:10:51,051
RISK-BASED SCREENING AND 

1586
01:10:51,051 --> 01:10:52,652
COGNITIVE CARE IN PRIMARY CARE 

1587
01:10:52,652 --> 01:10:54,254
CLINICS THAT CAN ALLOW IT TO GO 

1588
01:10:54,254 --> 01:10:58,525
MUCH QUICKER.

1589
01:10:58,525 --> 01:11:01,361
THE NEXT SLIDE IS A DIAGRAM THAT

1590
01:11:01,361 --> 01:11:04,664
WAS DONE AT A CONFERENCE OF 

1591
01:11:04,664 --> 01:11:07,167
MULTI-DISCIPLINARY SCIENTISTS ON

1592
01:11:07,167 --> 01:11:10,437
HOW THE RISK STRATIFICATION CAN 

1593
01:11:10,437 --> 01:11:12,005
OCCUR OFFSITE AND BUILD INTO THE

1594
01:11:12,005 --> 01:11:21,581
WELLNESS VISIT.

1595
01:11:21,581 --> 01:11:28,288
I WANTED TO MENTION IT'S VERY TO

1596
01:11:28,288 --> 01:11:29,723
KNOW THERE'S CLINICAL TRIALS 

1597
01:11:29,723 --> 01:11:31,892
ONGOING AND THE MILESTONE 

1598
01:11:31,892 --> 01:11:33,560
SHOWING THE PARADIGMS IS VERY 

1599
01:11:33,560 --> 01:11:35,729
IMPORTANT AND THERE'S RESEARCH 

1600
01:11:35,729 --> 01:11:36,296
ON THE WAY.

1601
01:11:36,296 --> 01:11:41,902
YOU HEARD ABOUT ONE OF THEM.

1602
01:11:41,902 --> 01:11:45,438
I WON'T REITERATE THAT BECAUSE 

1603
01:11:45,438 --> 01:11:52,712
WE HAD A GREAT SUMMARY BEFORE.

1604
01:11:52,712 --> 01:11:55,182
YOU SAW THE SLIDE OF SEVERAL 

1605
01:11:55,182 --> 01:11:55,448
MENTIONED.

1606
01:11:55,448 --> 01:11:59,152
THESE ARE BEING IMPLEMENTED IN 

1607
01:11:59,152 --> 01:12:00,654
PRIMARY CARE SETTINGS FOR EARLY 

1608
01:12:00,654 --> 01:12:10,997
DETECTION AND DIAGNOSIS.

1609
01:12:10,997 --> 01:12:13,833
SO, WE WANT TO MAKE SURE WE'RE 

1610
01:12:13,833 --> 01:12:16,369
HAVING SETTINGS AND FRAGMENTED 

1611
01:12:16,369 --> 01:12:16,970
RESEARCH CONTINUED AND THAT'S 

1612
01:12:16,970 --> 01:12:19,105
OUR RECOMMENDATION.

1613
01:12:19,105 --> 01:12:22,809
I WILL LEAVE IT THERE FOR YOU TO

1614
01:12:22,809 --> 01:12:25,845
SEE AND SINCE I'M OUT OF TIME, 

1615
01:12:25,845 --> 01:12:26,546
THANK YOU.

1616
01:12:26,546 --> 01:12:28,648
I READ THE BEGINNING.

1617
01:12:28,648 --> 01:12:29,716
THANK YOU FOR YOUR ATTENTION.

1618
01:12:29,716 --> 01:12:36,656
I'LL TURN IT OVER TO DR

1619
01:12:36,656 --> 01:12:38,792
DR. LINGLER.

1620
01:12:38,792 --> 01:12:41,428
>> DR. LINGLER: IT'S AN
HONOR TO

1621
01:12:41,428 --> 01:12:44,097
PRESENT ON BEHALF OF OUR WORKING

1622
01:12:44,097 --> 01:12:47,534
GROUP.

1623
01:12:47,534 --> 01:12:53,173
MY DISCLOSURES IS PAID 

1624
01:12:53,173 --> 01:12:54,674
COMPENSATION AND WE HAVE 

1625
01:12:54,674 --> 01:12:58,011
STRATEGIES TO IMPROVE ACCESS TO 

1626
01:12:58,011 --> 01:12:59,679
HIGH QUALITY AD/ADRD CARE 

1627
01:12:59,679 --> 01:13:01,948
INCLUDING DIAGNOSTIC EVALUATIONS

1628
01:13:01,948 --> 01:13:04,651
AND BIOMARKER TESTING, 

1629
01:13:04,651 --> 01:13:06,119
PHARMACOLOGIC AND 

1630
01:13:06,119 --> 01:13:08,655
NON-PHARMACOLOGIC TREATMENTS AND

1631
01:13:08,655 --> 01:13:13,493
PALLIATIVE CARE AND HOSPICE 

1632
01:13:13,493 --> 01:13:13,760
CARE.

1633
01:13:13,760 --> 01:13:16,730
RECOGNIZING THE EARLIEST PROCESS

1634
01:13:16,730 --> 01:13:18,431
INCLUDES STRATEGY TO INCREASE BE

1635
01:13:18,431 --> 01:13:20,667
OPPORTUNITIES FOR BRAIN HEALTH 

1636
01:13:20,667 --> 01:13:21,167
RESEARCH PARTICIPATION.

1637
01:13:21,167 --> 01:13:21,968
THE ACCESS RECOMMENDATION IS NEW

1638
01:13:21,968 --> 01:13:22,869
THIS YEAR.

1639
01:13:22,869 --> 01:13:25,972
IT'S GROUNDED IN A ROBUST BODY 

1640
01:13:25,972 --> 01:13:28,575
OF EVIDENCE SUGGESTING MANY 

1641
01:13:28,575 --> 01:13:29,542
BREAKTHROUGHS HIGHLIGHTED 

1642
01:13:29,542 --> 01:13:32,545
THROUGH THE INTRODUCTION ARE NOT

1643
01:13:32,545 --> 01:13:35,548
BENEFITING ALL FAMILIES IMPACTED

1644
01:13:35,548 --> 01:13:37,717
BY DEMENTIAS.

1645
01:13:37,717 --> 01:13:38,652
I'LL PROVIDE THE RATIONALE FOR 

1646
01:13:38,652 --> 01:13:40,520
THE RECOMMENDATION.

1647
01:13:40,520 --> 01:13:42,889
BEAR IN MIND THE RECOMMENDATION 

1648
01:13:42,889 --> 01:13:44,491
IS COMPREHENSIVE IN SCOPE 

1649
01:13:44,491 --> 01:13:47,160
SPANNING THE DIAGNOSTIC AND CARE

1650
01:13:47,160 --> 01:13:50,196
CONTINUUM SO VIEW THIS AS A HIGH

1651
01:13:50,196 --> 01:13:54,534
LEVEL OVERVIEW FOR CHALLENGES TO

1652
01:13:54,534 --> 01:13:58,171
HIGH QUALITY CARE ALONG A 

1653
01:13:58,171 --> 01:14:01,741
PERSON'S DEMENTIA TRAJECTORY.

1654
01:14:01,741 --> 01:14:03,710
A RECENT SYNTHESIS OF PUBLISHED 

1655
01:14:03,710 --> 01:14:06,946
LITERATURE SHOWS A PATTERN THAT 

1656
01:14:06,946 --> 01:14:14,387
THOSE WHO ARE FROM GROUPS NOBODY

1657
01:14:14,387 --> 01:14:15,922
TO EXPERIENCE MORE AD/ADRD TURN 

1658
01:14:15,922 --> 01:14:17,357
OUT TO BE THE LEAST LIKELY TO 

1659
01:14:17,357 --> 01:14:20,760
RECEIVE TIMELY AND ACCURATE 

1660
01:14:20,760 --> 01:14:22,796
DIAGNOSIS AND RECEIVE TREATMENT 

1661
01:14:22,796 --> 01:14:24,664
WITH INHIBITERS AS THE DISEASE 

1662
01:14:24,664 --> 01:14:29,035
PROGRESSES THE PATTERNS OF LOWER

1663
01:14:29,035 --> 01:14:32,405
QUALITY CARE PERSIST OFTEN IN 

1664
01:14:32,405 --> 01:14:34,941
THE FORMS OF CARE.

1665
01:14:34,941 --> 01:14:38,178
LET'S TAKE A CLOSER LOOK AT THE 

1666
01:14:38,178 --> 01:14:41,981
PATTERNS BEGINNING WITH 

1667
01:14:41,981 --> 01:14:42,716
DIAGNOSTICS.

1668
01:14:42,716 --> 01:14:44,117
YOU HEARD THE DIAGNOSES OF 

1669
01:14:44,117 --> 01:14:44,351
AD/ADRD.

1670
01:14:44,351 --> 01:14:46,920
ON THE PANEL TO YOUR LEFT WE 

1671
01:14:46,920 --> 01:14:48,855
HIGHLIGHT CLAIMS DATA 

1672
01:14:48,855 --> 01:14:52,659
DEMONSTRATING MISSES AND DEVIL 

1673
01:14:52,659 --> 01:14:58,198
RAYS IN DEMENTIA DIAGNOSES ARE 

1674
01:14:58,198 --> 01:15:00,967
PROGRAMATIC WITH DELAYS FOR 

1675
01:15:00,967 --> 01:15:02,836
HISPANIC INDIVIDUALS AND LONGER 

1676
01:15:02,836 --> 01:15:05,705
FOR THOSE IN THE HISPANIC AND 

1677
01:15:05,705 --> 01:15:07,540
NON-HISPANIC GROUPS.

1678
01:15:07,540 --> 01:15:09,275
A STUDY DOCUMENTED HIGHER 

1679
01:15:09,275 --> 01:15:11,678
PREVALENCE OF AD/ADRD AMONG 

1680
01:15:11,678 --> 01:15:15,115
RURAL POPULATIONS BUT NOTED 

1681
01:15:15,115 --> 01:15:17,584
CONSISTENT DELAYED DIAGNOSIS AND

1682
01:15:17,584 --> 01:15:20,153
LACK OF ACCESS TO PROFESSIONALS.

1683
01:15:20,153 --> 01:15:23,690
AND AS WAS ALLUDED TO, THE 

1684
01:15:23,690 --> 01:15:24,791
IMPLICATION MATTER TODAY BUT ARE

1685
01:15:24,791 --> 01:15:27,494
SALIENT WHEN WE CONSIDER THE 

1686
01:15:27,494 --> 01:15:28,395
ELIGIBILITY WINDOW FOR NOVEL AND

1687
01:15:28,395 --> 01:15:31,931
EMERGING THERAPEUTICS.

1688
01:15:31,931 --> 01:15:35,368
AS THE FIELD MOVES FORWARD TO AN

1689
01:15:35,368 --> 01:15:37,771
ERA OF BIOMARKER INFORMED 

1690
01:15:37,771 --> 01:15:38,872
DIAGNOSIS THERE'S EARLY EVIDENCE

1691
01:15:38,872 --> 01:15:41,007
IN THE ABSENCE OF THE DEDICATED 

1692
01:15:41,007 --> 01:15:43,643
EFFORT THOSE AT HIGHEST RISK 

1693
01:15:43,643 --> 01:15:45,545
FROM AD/ADRD MAY BE LESS LIKELY 

1694
01:15:45,545 --> 01:15:47,580
TO UNDER GO BIOMARKER TESTS.

1695
01:15:47,580 --> 01:15:51,518
HERE THE STUDY SHOWS ACCESS TO 

1696
01:15:51,518 --> 01:15:54,187
AMYLOID PET WAS UNEVEN ACROSS 

1697
01:15:54,187 --> 01:15:55,822
RACIAL AND ETHNIC GROUPS AND IF 

1698
01:15:55,822 --> 01:15:57,123
YOU PAN TO THE RIGHT, A REVIEW 

1699
01:15:57,123 --> 01:15:59,325
OF STUDIES ON THE TURN OF 

1700
01:15:59,325 --> 01:16:02,195
BIOMARKER TESTS RESULTS TO 

1701
01:16:02,195 --> 01:16:07,467
PATIENTS AND FAMILIES SHOWS A 

1702
01:16:07,467 --> 01:16:08,701
NEED OF PARTICIPANTS FROM BLACK 

1703
01:16:08,701 --> 01:16:13,139
AND BROWN COMMUNITIES SO IT 

1704
01:16:13,139 --> 01:16:15,008
INFORMS BEST PRACTICES FOR THE 

1705
01:16:15,008 --> 01:16:16,943
RESPONSIBLE RETURN OF THE 

1706
01:16:16,943 --> 01:16:24,050
SENSITIVE INFORMATION.

1707
01:16:24,050 --> 01:16:28,254
IN TERMS OF ACCESS TO PHARMACO 

1708
01:16:28,254 --> 01:16:30,423
THERAPIES IT'S ESSENTIAL TO NOTE

1709
01:16:30,423 --> 01:16:32,659
CARE ENCOMPASSES NOT ONLY THE 

1710
01:16:32,659 --> 01:16:36,663
TIMELY INITIATION OF FDA 

1711
01:16:36,663 --> 01:16:40,500
APPROACHED ANTI-DEMENTIA 

1712
01:16:40,500 --> 01:16:43,069
MEDICATIONS BUT EXTENDS TO 

1713
01:16:43,069 --> 01:16:44,537
INAPPROPRIATE PRESCRIBING FOR 

1714
01:16:44,537 --> 01:16:48,842
MOOD AND BEHAVIORAL SYMPTOMS AND

1715
01:16:48,842 --> 01:16:49,509
COMORBID SYMPTOMS.

1716
01:16:49,509 --> 01:16:50,743
AS HIGHLIGHTED INDIVIDUALS FROM 

1717
01:16:50,743 --> 01:16:52,645
RURAL COMMUNITIES ARE 

1718
01:16:52,645 --> 01:16:53,680
PARTICULARLY IMPACTED BY THE 

1719
01:16:53,680 --> 01:17:00,253
LATTER.

1720
01:17:00,253 --> 01:17:02,021
THE LAST EXAMPLES IDENTIFY 

1721
01:17:02,021 --> 01:17:04,057
STRATEGY TO IMPROIF ACCESS TO 

1722
01:17:04,057 --> 01:17:05,391
HIGH QUALITY CARE IN THE FINAL 

1723
01:17:05,391 --> 01:17:06,593
STAGES OF AD/ADRD.

1724
01:17:06,593 --> 01:17:08,094
AS THE TEXT ON THE LEFT 

1725
01:17:08,094 --> 01:17:10,263
HIGHLIGHTS MEDICARE 

1726
01:17:10,263 --> 01:17:11,698
BENEFICIARIES IDENTIFYING AS 

1727
01:17:11,698 --> 01:17:13,466
BLACK AND/OR HISPANIC RECEIVE 

1728
01:17:13,466 --> 01:17:14,534
MORE BURDENSOME AND COSTLY CARE 

1729
01:17:14,534 --> 01:17:15,635
AT THE END OF LIFE.

1730
01:17:15,635 --> 01:17:18,104
SIMILAR TO OTHER ASPECTS OF CARE

1731
01:17:18,104 --> 01:17:20,073
WE SEE OPPORTUNITIES TO IMPROVE 

1732
01:17:20,073 --> 01:17:23,543
ACCESS TO HIGH QUALITY CARE FOR 

1733
01:17:23,543 --> 01:17:26,479
LATER STAGE INDIVIDUALS WITH THE

1734
01:17:26,479 --> 01:17:27,347
PUBLICATION HIGHLIGHTING LOWER 

1735
01:17:27,347 --> 01:17:32,652
RATES OF DOCUMENTS GOALS OF CARE

1736
01:17:32,652 --> 01:17:35,121
INCLUDING DEMENTIA PATIENTS 

1737
01:17:35,121 --> 01:17:35,855
RECEIVING HOSPICE.

1738
01:17:35,855 --> 01:17:40,093
IN SUM, ADVANCES IN AD/ADRD CARE

1739
01:17:40,093 --> 01:17:42,228
FOR DIAGNOSTIC PRECISION TO END 

1740
01:17:42,228 --> 01:17:44,197
OF LIFE CARE HAVE NOT BENEFITTED

1741
01:17:44,197 --> 01:17:46,266
ALL WHO ARE IMPACTED BY THE 

1742
01:17:46,266 --> 01:17:47,700
CONDITIONS IT'S CRITICAL TO 

1743
01:17:47,700 --> 01:17:50,436
ACCELERATING THE TRANSITION OF 

1744
01:17:50,436 --> 01:17:53,673
EFFECTIVE DIAGNOSIS OF CARE AND 

1745
01:17:53,673 --> 01:17:57,010
REACHING REACH THOSE WITH WHO 

1746
01:17:57,010 --> 01:17:57,810
EXPERIENCE THE GREATEST BURDEN 

1747
01:17:57,810 --> 01:18:05,418
OF AD/ADRD.

1748
01:18:05,418 --> 01:18:07,353
THE WORK GROUP RECOMMEND TO 

1749
01:18:07,353 --> 01:18:08,488
IDENTIFY AND NAVIGATE PEOPLE TO 

1750
01:18:08,488 --> 01:18:11,124
QUALITY CARE WITH A FOCUS ON 

1751
01:18:11,124 --> 01:18:12,392
POPULATIONS EXPERIENCING HEALTH 

1752
01:18:12,392 --> 01:18:12,692
DISPARITIES.

1753
01:18:12,692 --> 01:18:14,460
THESE INTERVENTIONS SHOULD TAKE 

1754
01:18:14,460 --> 01:18:16,663
A SYSTEMS APPROACH AND 

1755
01:18:16,663 --> 01:18:20,033
APPROACHES SHOULD INCORPORATE 

1756
01:18:20,033 --> 01:18:20,700
PROVIDER EDUCATION AND TRAINING 

1757
01:18:20,700 --> 01:18:22,602
AND LINK PATIENTS WITH THE CARE 

1758
01:18:22,602 --> 01:18:24,637
THAT'S RIGHT FOR THEM.

1759
01:18:24,637 --> 01:18:27,206
AND LASTLY TO EXAMINE ETHICAL 

1760
01:18:27,206 --> 01:18:31,978
ISSUES AND EVALUATE PATHWAYS IN 

1761
01:18:31,978 --> 01:18:33,179
EVERYDAY CLINICAL SETTINGS AND 

1762
01:18:33,179 --> 01:18:34,514
SHOULD INCLUDE HELPING PROVIDERS

1763
01:18:34,514 --> 01:18:36,049
TO INTERPRET AND COMMUNICATE THE

1764
01:18:36,049 --> 01:18:37,951
RESULTS IN A WAY THAT OPTIMIZE 

1765
01:18:37,951 --> 01:18:40,520
AGENCY AND REDUCES POTENTIAL 

1766
01:18:40,520 --> 01:18:40,720
HARM.

1767
01:18:40,720 --> 01:18:42,622
WITH THAT I'LL TURN IT OVER TO 

1768
01:18:42,622 --> 01:18:47,193
DR. SNYDER AND LOOK FORWARD TO 

1769
01:18:47,193 --> 01:18:48,094
THE DISCUSSION.

1770
01:18:48,094 --> 01:18:50,997
>> DR. SNYDER: GOOD
MORNING, 

1771
01:18:50,997 --> 01:18:51,264
EVERYBODY.

1772
01:18:51,264 --> 01:18:52,665
I'M TRYING TO TURN ON MY CAMERA 

1773
01:18:52,665 --> 01:18:54,634
AND IT'S NOT LETTING ME SO I'LL 

1774
01:18:54,634 --> 01:18:55,635
KEEP GOING AND HOPEFULLY 

1775
01:18:55,635 --> 01:18:56,402
SOMEBODY CAN FIGURE THAT OUT.

1776
01:18:56,402 --> 01:18:58,404
IT'S A PLEASURE TO PRESENT ON 

1777
01:18:58,404 --> 01:19:00,907
BEHALF OF THE WORK GROUP AS WE 

1778
01:19:00,907 --> 01:19:04,944
THINK ABOUT THE FOURTH 

1779
01:19:04,944 --> 01:19:13,286
RECOMMENDATION.

1780
01:19:13,286 --> 01:19:17,957
AND THESE ARE MY DISCLOSURES.

1781
01:19:17,957 --> 01:19:22,729
AS WE GET TO BACK TO MIXED 

1782
01:19:22,729 --> 01:19:24,263
ETIOLOGY DEMENTIA THE PRIMARY 

1783
01:19:24,263 --> 01:19:25,498
AND SECONDARY PREVENTION IT'S 

1784
01:19:25,498 --> 01:19:27,934
ABOUT THE PREVENTION OF 

1785
01:19:27,934 --> 01:19:28,968
COGNITIVE DECLINE OR THE 

1786
01:19:28,968 --> 01:19:31,504
CONTINUED DECLINE OF AN 

1787
01:19:31,504 --> 01:19:32,372
INDIVIDUAL ONCE THEY'RE 

1788
01:19:32,372 --> 01:19:35,708
EXPERIENCING COGNITIVE CHANGES 

1789
01:19:35,708 --> 01:19:39,646
FOR THEMSELVES.

1790
01:19:39,646 --> 01:19:40,713
IN THINKING ABOUT PREVENTION, 

1791
01:19:40,713 --> 01:19:43,950
THIS GETS YOU TO OUR NEXT SLIDE 

1792
01:19:43,950 --> 01:19:46,319
RECOMMENDATION WHICH IS TO 

1793
01:19:46,319 --> 01:19:47,453
EVALUATE THE IMPLEMENTATION 

1794
01:19:47,453 --> 01:19:48,921
EFFECTIVENESS OF INTERVENTIONS 

1795
01:19:48,921 --> 01:19:50,690
THAT MITIGATE THE RISK OF 

1796
01:19:50,690 --> 01:19:52,025
COGNITIVE DECLINE IN PRIMARY 

1797
01:19:52,025 --> 01:19:53,359
CARE AND COMMUNITY SETTINGS.

1798
01:19:53,359 --> 01:19:56,629
THE IDEA OF ACCESS WITH A STRONG

1799
01:19:56,629 --> 01:19:59,265
FOCUS ON POPULATIONS 

1800
01:19:59,265 --> 01:20:01,567
EXPERIENCING DISPROPORTIONATE 

1801
01:20:01,567 --> 01:20:02,735
AD/ADRD BURDEN.

1802
01:20:02,735 --> 01:20:04,337
SO THE WORK GROUP TALKED ABOUT 

1803
01:20:04,337 --> 01:20:07,640
THE POTENTIAL AND EXAMPLES OF 

1804
01:20:07,640 --> 01:20:08,975
HOW IN PARTICULAR PRIMARY CARE 

1805
01:20:08,975 --> 01:20:09,676
COULD BE IMPLEMENTED.

1806
01:20:09,676 --> 01:20:11,310
THE IDEA AS WE THINK ABOUT THE 

1807
01:20:11,310 --> 01:20:13,112
NEED FOR RESEARCH THAT FOCUSES 

1808
01:20:13,112 --> 01:20:16,115
ON IMPLEMENTATION, STRATEGIES, 

1809
01:20:16,115 --> 01:20:17,517
PERSONALIZED INTERVENTIONS BASED

1810
01:20:17,517 --> 01:20:19,819
ON THE PATIENT'S RISK AND CAN BE

1811
01:20:19,819 --> 01:20:20,820
DELIVERED WITHIN PRIMARY CARE 

1812
01:20:20,820 --> 01:20:21,087
COMMUNITY.

1813
01:20:21,087 --> 01:20:23,456
WHAT YOU SEE HERE IS AN EXAMPLE 

1814
01:20:23,456 --> 01:20:25,925
THAT CAME FROM DR. WOOD WHO 

1815
01:20:25,925 --> 01:20:28,628
PREVIOUSLY SPOKE FROM THE AAFP 

1816
01:20:28,628 --> 01:20:31,097
THINKING ABOUT ALCOHOL USE AND 

1817
01:20:31,097 --> 01:20:32,832
SCREENING AND CESSATION PROGRAMS

1818
01:20:32,832 --> 01:20:34,667
DELIVERED IN PRIMARY CARE.

1819
01:20:34,667 --> 01:20:36,903
IN USING A SIMPLE BASIC 

1820
01:20:36,903 --> 01:20:37,503
SCREENING TOOL DELIVERED 

1821
01:20:37,503 --> 01:20:39,072
THROUGHOUT PRIMARY CARE, YOU CAN

1822
01:20:39,072 --> 01:20:42,041
SEE A SIGNIFICANT IMPACT ON BOTH

1823
01:20:42,041 --> 01:20:43,409
THE CONVERSATION HAPPENING IN 

1824
01:20:43,409 --> 01:20:44,644
PRIMARY CARE, AWARENESS OF THE 

1825
01:20:44,644 --> 01:20:46,813
THIS AS A POTENTIAL ISSUE AND A 

1826
01:20:46,813 --> 01:20:49,248
CHANGE IN BEHAVIOR.

1827
01:20:49,248 --> 01:20:50,450
AGAIN, REALLY LEADING TO IF WE 

1828
01:20:50,450 --> 01:20:52,218
CAN HAVE THE KINDS OF 

1829
01:20:52,218 --> 01:20:53,986
CONVERSATIONS AS IT APPLIES TO 

1830
01:20:53,986 --> 01:20:57,123
COGNITIVE DECLINE AND WE CAN 

1831
01:20:57,123 --> 01:20:59,559
IDENTIFY THE PRACTICES OR 

1832
01:20:59,559 --> 01:21:00,326
INTERVENTIONS FOR DELAYING OR 

1833
01:21:00,326 --> 01:21:03,463
SLOWING AN INDIVIDUAL'S RISK OF 

1834
01:21:03,463 --> 01:21:06,966
COGNITIVE DECLINE, THEN THIS MAY

1835
01:21:06,966 --> 01:21:08,601
ALLOW US TO MOVE FORWARD AND 

1836
01:21:08,601 --> 01:21:11,337
THINKING OF THE IDEA OF PRIMARY 

1837
01:21:11,337 --> 01:21:14,507
OR SECONDARY PREVENTION IN THE 

1838
01:21:14,507 --> 01:21:15,041
PRIMARY CARE OR IN THE 

1839
01:21:15,041 --> 01:21:21,481
COMMUNITY.

1840
01:21:21,481 --> 01:21:23,649
SO WE LOOK AT PHYSICIANS OR 

1841
01:21:23,649 --> 01:21:25,685
PRIMARY CARE PHYSICIANS, ONE OF 

1842
01:21:25,685 --> 01:21:29,288
THE THINGS WE HEAR AND THIS CAM 

1843
01:21:29,288 --> 01:21:30,690
CAME FROM THE ALZHEIMER'S 

1844
01:21:30,690 --> 01:21:33,693
ASSOCIATION S AND FIGURES IN 

1845
01:21:33,693 --> 01:21:38,664
2020, 71% PHYSICIANS SAY THEY'RE

1846
01:21:38,664 --> 01:21:40,133
ASKED ONCE A WEEK ABOUT DEMENTIA

1847
01:21:40,133 --> 01:21:42,635
AND IN THINKING ABOUT TOOLS AND 

1848
01:21:42,635 --> 01:21:44,537
IDENTIFYING WHERE AND WHEN WE 

1849
01:21:44,537 --> 01:21:45,938
MAY BE ABLE TO INTERVENE WE NEED

1850
01:21:45,938 --> 01:21:48,841
TO THINK ABOUT PREPARING OR 

1851
01:21:48,841 --> 01:21:49,976
SUPPORTING THESE CONVERSATIONS 

1852
01:21:49,976 --> 01:21:52,779
WITH INFORMATION, ACCURATE 

1853
01:21:52,779 --> 01:21:55,548
INFORMATION AND GOING INTO THE 

1854
01:21:55,548 --> 01:21:56,616
PRIOR THREE RECOMMENDATIONS THAT

1855
01:21:56,616 --> 01:21:58,017
WE'VE HEARD ABOUT IN THINKING 

1856
01:21:58,017 --> 01:21:59,786
ABOUT TREATMENT AND THINKING 

1857
01:21:59,786 --> 01:22:02,388
ABOUT DETECTION AND DIAGNOSIS IN

1858
01:22:02,388 --> 01:22:05,691
THE FACTS AND FIGURES REPORT 

1859
01:22:05,691 --> 01:22:07,493
PUBLISHED TODAY, 68% OF 

1860
01:22:07,493 --> 01:22:08,427
INDIVIDUALS TALK ABOUT THEIR 

1861
01:22:08,427 --> 01:22:09,829
DESIRE TO HAVE THIS INFORMATION 

1862
01:22:09,829 --> 01:22:12,632
IN THINKING ABOUT MAKING 

1863
01:22:12,632 --> 01:22:16,135
BEHAVIORAL CHANGES.

1864
01:22:16,135 --> 01:22:19,172
85% THAT OF INDIVIDUALS FIRST 

1865
01:22:19,172 --> 01:22:20,973
DIAGNOSED BY NON-DEMENTIA 

1866
01:22:20,973 --> 01:22:23,776
SPECIAL 

1867
01:22:23,776 --> 01:22:28,648
>> USISTS AND THEY THE 

1868
01:22:28,648 --> 01:22:32,351
INITIAL DEMENTIA DIAGNOSIS.

1869
01:22:32,351 --> 01:22:36,522
85% OF PERSONS DIAGNOSED WERE 

1870
01:22:36,522 --> 01:22:39,926
WERE DIAGNOSED BY A NON-DEMENTIA

1871
01:22:39,926 --> 01:22:41,828
SPECIALIST AND EVEN AFTER FIVE 

1872
01:22:41,828 --> 01:22:45,331
YEARS AROUND 23.5% OF 

1873
01:22:45,331 --> 01:22:50,736
BENEFICIARIES HAD A DIAGNOSIS OF

1874
01:22:50,736 --> 01:22:54,340
AN UNSPECIFIED DEMENTIA AND 

1875
01:22:54,340 --> 01:22:56,642
LOWER WITH THOSE WHO RECEIVED 

1876
01:22:56,642 --> 01:22:59,612
DEMENTIA SPECIALIST HEALTH CARE 

1877
01:22:59,612 --> 01:23:02,515
AND OVER FIVE YEARS LESS THAN 

1878
01:23:02,515 --> 01:23:04,650
HALF OF ALL PERSONS WITH 

1879
01:23:04,650 --> 01:23:07,653
DEMENTIA RECEIVED AN AD 

1880
01:23:07,653 --> 01:23:07,920
DIAGNOSIS.

1881
01:23:07,920 --> 01:23:11,791
AGAIN, IDENTIFYING THAT THROUGH 

1882
01:23:11,791 --> 01:23:13,893
PRIMARY CARE AND THERE'S A PATH 

1883
01:23:13,893 --> 01:23:15,294
IN THINKING ABOUT PRIMARY AND 

1884
01:23:15,294 --> 01:23:18,831
SECONDARY PREVENTION.

1885
01:23:18,831 --> 01:23:20,533
DR. POSSIN TALKED ABOUT THE 

1886
01:23:20,533 --> 01:23:21,434
LANCET COMMISSION REPORT IN 

1887
01:23:21,434 --> 01:23:23,069
THINKING ABOUT THE DEMENTIA RISK

1888
01:23:23,069 --> 01:23:26,839
AS A CONSOLATION OF ACCUMULATORS

1889
01:23:26,839 --> 01:23:28,641
ACROSS A PERSON'S LIFE AND BY 

1890
01:23:28,641 --> 01:23:29,809
UNDERSTANDING THAT THROUGH THE 

1891
01:23:29,809 --> 01:23:30,910
POTENTIAL CONTRIBUTORS TO A 

1892
01:23:30,910 --> 01:23:34,747
PERSON'S RISK, THIS CAN AID IN 

1893
01:23:34,747 --> 01:23:35,781
THE CONVERSATION WITH THE HEALTH

1894
01:23:35,781 --> 01:23:38,017
CARE PROVIDER.

1895
01:23:38,017 --> 01:23:40,553
AND AS WE THINK OF BUILDING OUT 

1896
01:23:40,553 --> 01:23:41,487
THE CONVERSATIONS AND TOOLS AND 

1897
01:23:41,487 --> 01:23:44,557
TESTS AND STUDIES THAT CAN ALLOW

1898
01:23:44,557 --> 01:23:45,558
US TO HAVE THE INFORMATION, 

1899
01:23:45,558 --> 01:23:47,793
THERE'S A NEED FOR US TO 

1900
01:23:47,793 --> 01:23:48,828
TRANSLATE THIS TYPE OF 

1901
01:23:48,828 --> 01:23:50,630
INFORMATION TO TOOLS THAT WILL 

1902
01:23:50,630 --> 01:23:52,598
IDENTIFY THOSE MOST AT RISK FOR 

1903
01:23:52,598 --> 01:23:55,434
TE DISEASE OR MOST AT RISK FOR 

1904
01:23:55,434 --> 01:23:56,836
COGNITIVE DECLINE IN A SCALABLE 

1905
01:23:56,836 --> 01:23:58,104
ACCURATE WAY.

1906
01:23:58,104 --> 01:23:58,604
>> TWO-MINUTE WARNING.

1907
01:23:58,604 --> 01:24:04,010
>> THANK YOU.

1908
01:24:04,010 --> 01:24:05,077
THERE'S A RESEARCH IN THINKING 

1909
01:24:05,077 --> 01:24:06,078
ABOUT DETECTION AND EARLY 

1910
01:24:06,078 --> 01:24:10,049
DETECTION IN SOME OF THESE 

1911
01:24:10,049 --> 01:24:10,316
EXAMPLES.

1912
01:24:10,316 --> 01:24:13,185
THESE ARE HIGH-LEVEL EXAMPLES.

1913
01:24:13,185 --> 01:24:16,656
WE HEARD A LITTLE BIT MORE ABOUT

1914
01:24:16,656 --> 01:24:19,725
THINKING ABOUT TAX AD AS 

1915
01:24:19,725 --> 01:24:21,427
EXAMPLES IN HOW TO DETECT THE 

1916
01:24:21,427 --> 01:24:22,028
EARLIEST CHANGES.

1917
01:24:22,028 --> 01:24:24,130
WHEN WE LOOK AT THIS IN THINKING

1918
01:24:24,130 --> 01:24:25,564
ABOUT THERE'S A NUMBER OF 

1919
01:24:25,564 --> 01:24:28,634
STUDIES THAT HAVE BEEN DONE IN 

1920
01:24:28,634 --> 01:24:30,603
DELIVERY OF SPECIFIC 

1921
01:24:30,603 --> 01:24:31,771
INTERVENTIONS WHETHER IT BE 

1922
01:24:31,771 --> 01:24:33,105
LOOKING AT EXERCISE IN A 

1923
01:24:33,105 --> 01:24:35,775
POPULATION OF PEOPLE THAT MAY BE

1924
01:24:35,775 --> 01:24:36,542
EXPERIENCING MILD COGNITIVE 

1925
01:24:36,542 --> 01:24:38,678
IMPAIRMENT OR COGNITIVE TRAINING

1926
01:24:38,678 --> 01:24:44,583
IN INDIVIDUALS ACROSS THE BOARD.

1927
01:24:44,583 --> 01:24:46,185
OR LOOKING AT THINGS TRYING TO 

1928
01:24:46,185 --> 01:24:47,453
UNDERSTAND THE UNDERLYING 

1929
01:24:47,453 --> 01:24:49,355
BIOLOGY IN AN INDIVIDUAL SO WE 

1930
01:24:49,355 --> 01:24:52,525
CAN EXPAND OUT THE TYPES OF 

1931
01:24:52,525 --> 01:24:52,992
INTERVENTIONS IN THE 

1932
01:24:52,992 --> 01:24:58,998
PERSONALIZED APPROACH.

1933
01:24:58,998 --> 01:25:01,767
OR LOOKING AT MULTIMODAL 

1934
01:25:01,767 --> 01:25:08,641
INTERVENTIONS LOOKING AT 

1935
01:25:08,641 --> 01:25:14,580
MULTIPLE RISK REDUCTION 

1936
01:25:14,580 --> 01:25:15,715
STRATEGIES AND THEY'RE TIED INTO

1937
01:25:15,715 --> 01:25:17,783
RESEARCH EFFORTS IN THINK ABOUT 

1938
01:25:17,783 --> 01:25:18,884
DISCOVERY VALIDATION AND 

1939
01:25:18,884 --> 01:25:20,753
IMPLEMENTATION ACROSS ALL THE 

1940
01:25:20,753 --> 01:25:24,190
SPECTRUMS OF DISCOVERY AND 

1941
01:25:24,190 --> 01:25:25,858
INTERVENTION IN CLINICAL CARE 

1942
01:25:25,858 --> 01:25:27,093
THAT CAN BE DELIVERED THROUGH 

1943
01:25:27,093 --> 01:25:28,494
PRIMARY CARE.

1944
01:25:28,494 --> 01:25:30,896
AND SO THINKING ABOUT THE 

1945
01:25:30,896 --> 01:25:32,298
SPECIFIC RECOMMENDATIONS OF OUR 

1946
01:25:32,298 --> 01:25:34,433
WORK GROUP AND EVALUATING THE 

1947
01:25:34,433 --> 01:25:35,768
IMPLEMENTATION AND EFFECTIVENESS

1948
01:25:35,768 --> 01:25:38,004
OF INTERVENTIONS THAT PROMOTE 

1949
01:25:38,004 --> 01:25:39,705
BRAIN HEALTH AND MITIGATE THE 

1950
01:25:39,705 --> 01:25:41,507
RISK OF PRIMARY CARE SETTINGS 

1951
01:25:41,507 --> 01:25:45,311
WITH A STRONG FOCUS ON 

1952
01:25:45,311 --> 01:25:47,680
POPULATIONS EXPERIENCING 

1953
01:25:47,680 --> 01:25:50,549
DISPROPORTIONATE AD/ADRD BURDEN 

1954
01:25:50,549 --> 01:25:52,318
AND TOOLS TO IDENTIFY HIGH RISK 

1955
01:25:52,318 --> 01:25:53,652
INDIVIDUALS AND THINKING OF 

1956
01:25:53,652 --> 01:25:55,821
PRIMARY AND SECONDARY 

1957
01:25:55,821 --> 01:25:56,922
INTERVENTIONS THAT ARE LOOKING 

1958
01:25:56,922 --> 01:25:58,824
AT THOSE DIFFERENT FACTORS, 

1959
01:25:58,824 --> 01:26:01,227
THINKING ABOUT PROMOTING BRAIN 

1960
01:26:01,227 --> 01:26:02,028
HEALTH, REDUCING RISK OF 

1961
01:26:02,028 --> 01:26:03,629
COGNITIVE DECLINE AND 

1962
01:26:03,629 --> 01:26:05,698
INTERVENTIONS THAT MAY INCLUDE 

1963
01:26:05,698 --> 01:26:06,866
GUIDANCE ON PERSONALIZED 

1964
01:26:06,866 --> 01:26:08,701
INTERVENTION STRATEGIES BASED ON

1965
01:26:08,701 --> 01:26:12,505
A PATIENT'S RISK PROFILE.

1966
01:26:12,505 --> 01:26:14,707
SO THIS BRINGS US TO THE SECTION

1967
01:26:14,707 --> 01:26:15,808
CLOSE WHERE WE'VE GONE THROUGH 

1968
01:26:15,808 --> 01:26:17,576
THE FOUR RECOMMENDATIONS THAT 

1969
01:26:17,576 --> 01:26:18,511
YOU SEE LISTED HERE.

1970
01:26:18,511 --> 01:26:20,646
WHETHER WE'RE THINKING ABOUT 

1971
01:26:20,646 --> 01:26:23,816
THAT ENTIRE SPECTRUM OF 

1972
01:26:23,816 --> 01:26:25,951
IMPLEMENTATION AND DISSEMINATION

1973
01:26:25,951 --> 01:26:28,454
RESEARCH ON EVIDENCE-BASED 

1974
01:26:28,454 --> 01:26:29,789
INTERVENTIONS TO DETECT AND 

1975
01:26:29,789 --> 01:26:31,791
DIAGNOSIS COGNITIVE IMPAIRMENT 

1976
01:26:31,791 --> 01:26:33,559
AND THINKING ABOUT EVALUATION 

1977
01:26:33,559 --> 01:26:35,561
STRATEGIES TO IMPROVE ACCESS TO 

1978
01:26:35,561 --> 01:26:37,763
CARE PATIENTS AND PARTNERS TO 

1979
01:26:37,763 --> 01:26:38,731
QUALITY CARE.

1980
01:26:38,731 --> 01:26:41,333
THINKING OF CONDUCTING RESEARCH 

1981
01:26:41,333 --> 01:26:43,436
FOR THE ADVOCACY AND 

1982
01:26:43,436 --> 01:26:44,103
EFFECTIVENESS OF EVIDENCE-BASED 

1983
01:26:44,103 --> 01:26:45,071
RESEARCH AND THINKING ABOUT THE 

1984
01:26:45,071 --> 01:26:46,472
OPPORTUNITY FOR PRIMARY AND 

1985
01:26:46,472 --> 01:26:47,773
SECONDARY PREVENTION AS WE GO 

1986
01:26:47,773 --> 01:26:48,641
FORWARD.

1987
01:26:48,641 --> 01:26:50,009
SO THANK YOU VERY MUCH AND I'LL 

1988
01:26:50,009 --> 01:26:52,645
TURN IT BACK TO THE SESSION 

1989
01:26:52,645 --> 01:26:53,579
CHAIR.

1990
01:26:53,579 --> 01:26:54,113
>> THANK YOU.

1991
01:26:54,113 --> 01:26:56,082
I WANT TO THANK THE PRESENTERS.

1992
01:26:56,082 --> 01:26:59,418
I ALSO WANT TO THANK ALL OF THE 

1993
01:26:59,418 --> 01:27:02,922
COMMITTEE MEMBERS THAT WORKED 

1994
01:27:02,922 --> 01:27:04,356
TOGETHER FOR THE RECOMMENDATIONS

1995
01:27:04,356 --> 01:27:05,558
AND INVITE THEM ALL TO TURN ON 

1996
01:27:05,558 --> 01:27:06,992
THEIR CAMERAS THEY'RE ABLE TO 

1997
01:27:06,992 --> 01:27:08,661
JOIN US TODAY.

1998
01:27:08,661 --> 01:27:13,165
WE ARE VERY EAGER TO HEAR 

1999
01:27:13,165 --> 01:27:14,867
COMMENT.

2000
01:27:14,867 --> 01:27:17,069
SO, I THINK YOU CAN USE THE 

2001
01:27:17,069 --> 01:27:19,171
RAISE HAND FEATURE IF YOU'D LIKE

2002
01:27:19,171 --> 01:27:22,308
TO SHARE A COMMENT OR QUESTION 

2003
01:27:22,308 --> 01:27:22,808
FOR THE PANELISTS.

2004
01:27:22,808 --> 01:27:26,979
I SEE THE FIRST HAND IS RAISED.

2005
01:27:26,979 --> 01:27:29,081
PLEASE TURN ON YOUR CAMERA IF 

2006
01:27:29,081 --> 01:27:29,882
YOU'RE COMFORTABLE AND TELL US 

2007
01:27:29,882 --> 01:27:40,259
WHAT YOU HAVE TO SAY.

2008
01:28:03,716 --> 01:28:07,620
>> ANYONE WHO WANTS TO ASK
A 

2009
01:28:07,620 --> 01:28:08,187
QUESTION USE THE RAISE HAND 

2010
01:28:08,187 --> 01:28:18,097
FEATURE.

2011
01:28:18,097 --> 01:28:19,798
SO ENABLE YOUR CAMERA AND 

2012
01:28:19,798 --> 01:28:23,135
MICROPHONE AND THEN YOU CAN TURN

2013
01:28:23,135 --> 01:28:33,279
IT OFF.

2014
01:28:40,486 --> 01:28:42,955
WE DON'T HAVE ALL THE NAMES.

2015
01:28:42,955 --> 01:28:52,631
I'M GOING TO TRY TO COME BACK TO

2016
01:28:52,631 --> 01:28:56,402
THIS.

2017
01:28:56,402 --> 01:28:57,670
>> CAN YOU HEAR ME?

2018
01:28:57,670 --> 01:28:57,903
>> YES.

2019
01:28:57,903 --> 01:29:03,275
THANK YOU.

2020
01:29:03,275 --> 01:29:04,243
>> YEAH, HI.

2021
01:29:04,243 --> 01:29:08,714
THANKS FOR THE VERY INTERESTING 

2022
01:29:08,714 --> 01:29:12,418
PRESENTATIONS IT MAY BE NAIVE TO

2023
01:29:12,418 --> 01:29:15,487
THINK WE CAN DISCUSS POLITICIANS

2024
01:29:15,487 --> 01:29:18,791
AND DO YOU THINK IT WILL AFFECT 

2025
01:29:18,791 --> 01:29:22,661
AND SEEMS LIKE IT COULD BE SEEN 

2026
01:29:22,661 --> 01:29:25,297
AS A DEI EFFORT SO CAN YOU 

2027
01:29:25,297 --> 01:29:26,599
COMMENT ON HOW POLITICS CAN 

2028
01:29:26,599 --> 01:29:27,833
AFFECT SOME MUCH THESE?

2029
01:29:27,833 --> 01:29:30,302
>> THANK YOU FOR THAT VERY

2030
01:29:30,302 --> 01:29:31,704
IMPORTANT QUESTION.

2031
01:29:31,704 --> 01:29:34,506
I THINK DR. KOROSHETZ MAY BE 

2032
01:29:34,506 --> 01:29:36,642
ABLE TO SPEAK THAT.

2033
01:29:36,642 --> 01:29:39,645
>> DR. KOROSHETZ: DEMENTIA
IS A 

2034
01:29:39,645 --> 01:29:40,312
POLITICAL PROBLEM.

2035
01:29:40,312 --> 01:29:40,879
LET'S GET THAT ON THE TABLE 

2036
01:29:40,879 --> 01:29:46,318
FIRST.

2037
01:29:46,318 --> 01:29:52,791
HEALTH DISPARITIES ARE PROGRAMS 

2038
01:29:52,791 --> 01:29:58,264
THAT EVERYONE, HEALTH CARE AND 

2039
01:29:58,264 --> 01:30:00,633
EVERYONE HAS TO WRESTLE WITH.

2040
01:30:00,633 --> 01:30:05,704
HEALTH DISPARITIES ARE NOT 

2041
01:30:05,704 --> 01:30:08,907
INCLUDED IN THE GOVERNMENT'S DEI

2042
01:30:08,907 --> 01:30:12,645
ADMINISTRATIONS AT THE CURRENT 

2043
01:30:12,645 --> 01:30:17,683
TIME.

2044
01:30:17,683 --> 01:30:19,752
ALL INDICATIONS TALKING TO THE 

2045
01:30:19,752 --> 01:30:21,553
NIH DIRECTOR WHO HAS MADE IT 

2046
01:30:21,553 --> 01:30:23,222
VERY CLEAR, HEALTH DISPARITIES 

2047
01:30:23,222 --> 01:30:26,625
AND DEI ARE COMPLETELY DIFFERENT

2048
01:30:26,625 --> 01:30:28,661
ISSUES ACCORDING TO THE 

2049
01:30:28,661 --> 01:30:29,895
ADMINISTRATION'S DEFINITION.

2050
01:30:29,895 --> 01:30:35,567
WE REALLY DO NEED TO RECOGNIZE 

2051
01:30:35,567 --> 01:30:39,104
AND MORE THAN RECOGNIZE, DEVELOP

2052
01:30:39,104 --> 01:30:40,339
INTERVENTIONS THAT WILL REDUCE 

2053
01:30:40,339 --> 01:30:41,707
HEALTH DISPARITIES WITH REGARD 

2054
01:30:41,707 --> 01:30:44,643
TO DEMENTIA AND DEMENTIA CARE IN

2055
01:30:44,643 --> 01:30:47,880
THE U.S. AND THAT'S REALLY 

2056
01:30:47,880 --> 01:30:51,850
IMPORTANT FOR THE SUMMIT.

2057
01:30:51,850 --> 01:30:55,654
WE'RE GOING TO HEAR ON JUNE 2 

2058
01:30:55,654 --> 01:30:58,157
PARTICULARLY ON THE ISSUE.

2059
01:30:58,157 --> 01:30:58,791
VERY IMPORTANT.

2060
01:30:58,791 --> 01:31:04,129
I'M GLAD TO GET THAT CLEARED UP.

2061
01:31:04,129 --> 01:31:06,265
>> SORRY TO PUSH FOR THE 

2062
01:31:06,265 --> 01:31:11,236
FOLLOW-UP CAN I ASKED ABOUT THE 

2063
01:31:11,236 --> 01:31:13,739
PROPOSED 44% DECREASE IN NIH 

2064
01:31:13,739 --> 01:31:14,807
BUDGET FOR NEXT YEAR.

2065
01:31:14,807 --> 01:31:16,775
DO YOU THINK IT'S LIKELY TO 

2066
01:31:16,775 --> 01:31:21,513
AFFECT NIA AND NINDS?

2067
01:31:21,513 --> 01:31:24,650
>> DR. KOROSHETZ: THE
BUDGETS 

2068
01:31:24,650 --> 01:31:26,185
COME OUT IN DIFFERENT STAGES AND

2069
01:31:26,185 --> 01:31:28,320
GET WORKED ON BY THE SENATE AND 

2070
01:31:28,320 --> 01:31:28,654
HOUSE.

2071
01:31:28,654 --> 01:31:31,857
WE HAVE NO IDEA WHAT THE 

2072
01:31:31,857 --> 01:31:33,225
BUDGET'S GOING TO BE.

2073
01:31:33,225 --> 01:31:34,126
SO, WE CAN'T REALLY COMMENT 

2074
01:31:34,126 --> 01:31:34,793
BECAUSE WE DON'T KNOW WHAT THE 

2075
01:31:34,793 --> 01:31:43,702
BUDGET IS.

2076
01:31:43,702 --> 01:31:47,873
>> SHOULD WE TRY AGAIN?

2077
01:31:47,873 --> 01:31:49,641
AFTER THAT WE'LL SEE DALE 

2078
01:31:49,641 --> 01:31:58,717
LESINA.

2079
01:31:58,717 --> 01:32:00,652
IT LOOKS LIKE THERE'S A BLOCK 

2080
01:32:00,652 --> 01:32:01,687
SIGN.

2081
01:32:01,687 --> 01:32:04,890
LET'S GO FORWARD WITH DALE FOR 

2082
01:32:04,890 --> 01:32:05,858
NOW.

2083
01:32:05,858 --> 01:32:06,392
DALE, PLEASE, SHARE YOUR 

2084
01:32:06,392 --> 01:32:12,564
COMMENTS.

2085
01:32:12,564 --> 01:32:16,001
WE CAN'T QUITE HEAR YOU YET.

2086
01:32:16,001 --> 01:32:20,639
ARE YOU ABLE STO  -- TO UNMUTE?

2087
01:32:20,639 --> 01:32:22,741
WE CAN SEE YOU.

2088
01:32:22,741 --> 01:32:24,543
WE CAN'T HEAR YOU YET.

2089
01:32:24,543 --> 01:32:28,647
ARE YOU ABLE TO UNMUTE?

2090
01:32:28,647 --> 01:32:37,923
NO, CAN'T UNMUTE.

2091
01:32:37,923 --> 01:32:39,324
I WISH WE COULD HEAR YOUR 

2092
01:32:39,324 --> 01:32:40,659
COMMENT.

2093
01:32:40,659 --> 01:32:41,860
HMM.

2094
01:32:41,860 --> 01:32:46,298
WHILE THE TEAM IS TROUBLE 

2095
01:32:46,298 --> 01:32:47,866
SHOOTING LET'S SEE IF ANOTHER 

2096
01:32:47,866 --> 01:32:51,804
PERSON CAN UNMUTE.

2097
01:32:51,804 --> 01:32:53,872
WE'LL COME BACK TO YOU DALE.

2098
01:32:53,872 --> 01:32:57,543
HOPEFULLY WE CAN FIX THIS.

2099
01:32:57,543 --> 01:32:59,812
ERIC, I THINK ALSO NOT ABLE TO.

2100
01:32:59,812 --> 01:33:01,346
WE'LL TRY ONE MORE PERSON 

2101
01:33:01,346 --> 01:33:04,550
OTHERWISE THIS SEEMS TO BE A 

2102
01:33:04,550 --> 01:33:08,454
PROBLEM ON OUR END.

2103
01:33:08,454 --> 01:33:09,755
>> I THINK SO.

2104
01:33:09,755 --> 01:33:11,089
CAN YOU HEAR ME?

2105
01:33:11,089 --> 01:33:11,857
>> YES.

2106
01:33:11,857 --> 01:33:17,863
>> ALL RIGHT.

2107
01:33:17,863 --> 01:33:22,968
>> DR. KOROSHETZ:  PENNY,
HOW 

2108
01:33:22,968 --> 01:33:23,869
DID YOU DO THAT?

2109
01:33:23,869 --> 01:33:26,305
>> MAGIC.

2110
01:33:26,305 --> 01:33:29,508
I THINK SOMEONE ENABLED IT 

2111
01:33:29,508 --> 01:33:32,244
BECAUSE IT WASN'T POSSIBLE FOR 

2112
01:33:32,244 --> 01:33:35,881
ME AND SEEMS TO BE FINE SOMEONE 

2113
01:33:35,881 --> 01:33:38,484
ON YOUR I.T. SIDE ENABLED IT BUT

2114
01:33:38,484 --> 01:33:39,618
I THINK THE PEOPLE HERE HAVE 

2115
01:33:39,618 --> 01:33:40,919
BEEN TRYING SO I CAN'T ANSWER 

2116
01:33:40,919 --> 01:33:44,122
THAT FOR YOU, WALTER.

2117
01:33:44,122 --> 01:33:46,091
I WILL COMMENT ON A QUESTION.

2118
01:33:46,091 --> 01:33:47,860
NUMBER ONE, THANK YOU TO ALL OF 

2119
01:33:47,860 --> 01:33:49,194
YOU FOR YOUR EXCEPTIONAL WORK 

2120
01:33:49,194 --> 01:33:50,796
AND I WANT TO THANK THE NIH AND 

2121
01:33:50,796 --> 01:33:52,231
ALL THE ACADEMIC RESEARCH 

2122
01:33:52,231 --> 01:33:55,534
LEADERS WHO ARE BEHIND THE 

2123
01:33:55,534 --> 01:34:05,777
BREAKTHRO

2124
01:34:07,312 --> 01:34:10,249
BREAKTHROUGHS THAT BROUGHT OUT 

2125
01:34:10,249 --> 01:34:13,719
TO THE CONVERSATION TO HOW TO 

2126
01:34:13,719 --> 01:34:22,361
ACCESS AND YOU HAVE PEOPLE WITH 

2127
01:34:22,361 --> 01:34:24,630
PARKINSON'S DISEASE THAT DEVELOP

2128
01:34:24,630 --> 01:34:28,300
LEWY BODY DISEASE AND DISORDERS 

2129
01:34:28,300 --> 01:34:32,404
ACTUALLY FTD INITIALLY DIAGNOSED

2130
01:34:32,404 --> 01:34:35,140
WITHIN THE PARKINSON CLINICS.

2131
01:34:35,140 --> 01:34:38,677
WE HAVE THE VARIANT FORMS THAT 

2132
01:34:38,677 --> 01:34:39,278
MAY NOT MANIFEST IN THE SAME 

2133
01:34:39,278 --> 01:34:41,146
WAY.

2134
01:34:41,146 --> 01:34:42,047
IN THE WORK YOUR RECOMMENDING 

2135
01:34:42,047 --> 01:34:44,182
AND HOW TO IMPROVE ACCESS TO 

2136
01:34:44,182 --> 01:34:45,784
DIAGNOSIS, CAN YOU TALK ABOUT 

2137
01:34:45,784 --> 01:34:48,420
HOW TO INCORPORATE THAT 

2138
01:34:48,420 --> 01:34:50,656
COMPLEXITY PEOPLE CAN BE SHOWING

2139
01:34:50,656 --> 01:34:52,624
UP WITH DIFFERENT TYPES OF 

2140
01:34:52,624 --> 01:34:54,860
SYMPTOMS, IT'S NOT ALWAYS 

2141
01:34:54,860 --> 01:34:57,362
MODERATE COGNITIVE IMPAIRMENT.

2142
01:34:57,362 --> 01:35:01,733
HOW DO WE GET BETTER ACCESS TO 

2143
01:35:01,733 --> 01:35:02,334
EVERYBODY FACING ONE OF THE 

2144
01:35:02,334 --> 01:35:04,069
ALZHEIMER'S DISEASE OR 

2145
01:35:04,069 --> 01:35:04,670
ALZHEIMER'S DISEASE RELATED 

2146
01:35:04,670 --> 01:35:08,640
DEMENTIAS?

2147
01:35:08,640 --> 01:35:11,076
>> THANK YOU, PENNY, FOR
THAT.

2148
01:35:11,076 --> 01:35:12,110
I'LL GIVE A BRIEF ANSWER AND IF 

2149
01:35:12,110 --> 01:35:14,279
ANYBODY ELSE WANTS TO SPEAK, I 

2150
01:35:14,279 --> 01:35:15,314
WANT TO SAY WE'RE NOTING THIS 

2151
01:35:15,314 --> 01:35:20,652
DOWN AND CAN MAKE SURE OUR 

2152
01:35:20,652 --> 01:35:21,219
RECOMMENDATION INCLUDES 

2153
01:35:21,219 --> 01:35:22,721
EVALUATION FOR NOT ONLY THE 

2154
01:35:22,721 --> 01:35:25,624
TYPICAL SIGNS OF EARLY DISEASE 

2155
01:35:25,624 --> 01:35:27,492
BUT THE LESS TYPICAL SIGNS SUCH 

2156
01:35:27,492 --> 01:35:28,660
AS BEHAVIORAL SYMPTOMS.

2157
01:35:28,660 --> 01:35:31,530
I'M NOTING THIS AS A COMMENT FOR

2158
01:35:31,530 --> 01:35:32,631
US TO INCORPORATE.

2159
01:35:32,631 --> 01:35:39,171
THANK YOU.

2160
01:35:39,171 --> 01:35:49,514
SHOULD WE TRY AGAIN?

2161
01:35:50,449 --> 01:35:53,385
>> IN THE TEAMS PLATFORM
AT THE 

2162
01:35:53,385 --> 01:35:56,655
TOP THERE'S A CAMERA ICON.

2163
01:35:56,655 --> 01:35:59,257
WE ENABLED TO USE THE BUTTONS.

2164
01:35:59,257 --> 01:36:00,392
SO YOU CLICK ON IT AND IT SHOULD

2165
01:36:00,392 --> 01:36:03,662
UNMUTE YOU.

2166
01:36:03,662 --> 01:36:06,898
I CAN SEE DALE YOU STILL 

2167
01:36:06,898 --> 01:36:08,600
[INDISCERNIBLE] 

2168
01:36:16,708 --> 01:36:17,209
>> IT LOOKS LIKE ERIC IS 

2169
01:36:17,209 --> 01:36:21,179
UNMUTED.

2170
01:36:21,179 --> 01:36:23,949
>> THANK YOU.

2171
01:36:23,949 --> 01:36:34,459
YES AND THANK YOU DR. KONKWLO.

2172
01:36:40,699 --> 01:36:50,976
LET'S HEAR FROM YOU.

2173
01:37:17,069 --> 01:37:18,837
>> IT KIND OF GOES BACK
AND 

2174
01:37:18,837 --> 01:37:21,039
FORTH BETWEEN A MUTE AND BLOCKED

2175
01:37:21,039 --> 01:37:24,009
SIGN WHICH MAKES ME THINK IT'S 

2176
01:37:24,009 --> 01:37:27,679
NOT JUST -- 

2177
01:37:27,679 --> 01:37:31,950
>> I'M TRYING TO MUTE AND
UNMUTE

2178
01:37:31,950 --> 01:37:32,684
BUT FOR WHATEVER REASON IT'S NOT

2179
01:37:32,684 --> 01:37:35,353
ABLE TO [INDISCERNIBLE] 

2180
01:37:35,721 --> 01:37:38,223
>> HI, DR. MCCARTNEY.

2181
01:37:38,223 --> 01:37:41,960
MAYBE IT'S THAT WHEN LLOYD IS 

2182
01:37:41,960 --> 01:37:43,695
DOING IT I THINK THE USER IS 

2183
01:37:43,695 --> 01:37:44,362
SIMULTANEOUSLY TRYING TO UNMUTE 

2184
01:37:44,362 --> 01:37:47,866
THEMSELVES.

2185
01:37:47,866 --> 01:37:49,901
IT MAY CAUSE A PROBLEM.

2186
01:37:49,901 --> 01:37:53,705
WE ALSO HAVE A LINK ON VIDEOCAST

2187
01:37:53,705 --> 01:37:56,641
WHERE YOU CAN SUBMIT WRITTEN 

2188
01:37:56,641 --> 01:37:59,978
COMMENTS.

2189
01:37:59,978 --> 01:38:01,079
WE'LL BUT THAT INFORMATION ON 

2190
01:38:01,079 --> 01:38:04,649
THE SLIDE SO EVERYONE CAN SEE 

2191
01:38:04,649 --> 01:38:14,726
IT.

2192
01:38:16,194 --> 01:38:17,262
THIS IS REALLY THE IMPORTANT 

2193
01:38:17,262 --> 01:38:18,730
PART OF THE MEETING AND WHAT I 

2194
01:38:18,730 --> 01:38:20,632
CARE ABOUT MOST IS GETTING INPUT

2195
01:38:20,632 --> 01:38:22,701
FROM ALL OF YOU.

2196
01:38:22,701 --> 01:38:24,035
SORRY FOR THE TECHNICAL 

2197
01:38:24,035 --> 01:38:24,503
PROBLEMS.

2198
01:38:24,503 --> 01:38:28,640
>> IS IT POSSIBLE TO
UNLOCK THE 

2199
01:38:28,640 --> 01:38:38,750
CHAT?

2200
01:38:43,722 --> 01:38:45,957
>> RAUL, DO YOU WANT TO
ASK A 

2201
01:38:45,957 --> 01:38:46,558
QUESTION?

2202
01:38:46,558 --> 01:38:48,627
>> THANK YOU FOR THE
WONDERFUL 

2203
01:38:48,627 --> 01:38:52,631
QUESTIONS COMMENT ON THE 

2204
01:38:52,631 --> 01:38:56,201
NEUROPSYCHIATRIC SYMPTOMS IN 

2205
01:38:56,201 --> 01:38:56,802
THIS POPULATIONS AND CURRENT 

2206
01:38:56,802 --> 01:39:03,408
MEDICATIONS.

2207
01:39:03,408 --> 01:39:06,545
>> I THINK THE QUESTION IS
CAN 

2208
01:39:06,545 --> 01:39:08,446
WE COMMENT ON THE 

2209
01:39:08,446 --> 01:39:09,014
NEUROPSYCHIATRIC SYMPTOMS.

2210
01:39:09,014 --> 01:39:12,651
I THINK IT'S A NICE POINT THAT 

2211
01:39:12,651 --> 01:39:15,120
WE NEED TO MAKE SURE THAT WHEN 

2212
01:39:15,120 --> 01:39:20,659
WE'RE EVALUATING PATIENTS IN 

2213
01:39:20,659 --> 01:39:21,993
PRIMARY SETTING WE'RE LOOKING 

2214
01:39:21,993 --> 01:39:23,295
FOR THOSE SYMPTOMS.

2215
01:39:23,295 --> 01:39:23,995
ANYONE ELSE IN THE SESSION WANT 

2216
01:39:23,995 --> 01:39:30,702
TO COMMENT?

2217
01:39:30,702 --> 01:39:32,871
>> I WOULD JUST OFFER IT'S
ALSO 

2218
01:39:32,871 --> 01:39:35,974
IMPORTANT IN TERMS OF 

2219
01:39:35,974 --> 01:39:38,043
COORDINATED CARE TO IDENTIFY THE

2220
01:39:38,043 --> 01:39:39,511
SYMPTOMS AND HAVE A COORDINATED 

2221
01:39:39,511 --> 01:39:41,780
APPROACH TO CLINICAL AND 

2222
01:39:41,780 --> 01:39:43,481
NON-CLINICAL INTERVENTIONS FOR 

2223
01:39:43,481 --> 01:39:44,649
THE SYMPTOMS.

2224
01:39:44,649 --> 01:39:47,052
SO THE DRUG THERAPIES AS PERHAPS

2225
01:39:47,052 --> 01:39:49,554
LAST RESORT BUT KNOWING THERE'S 

2226
01:39:49,554 --> 01:39:54,960
A LOT OF NON-DRUG INTERVENTIONS 

2227
01:39:54,960 --> 01:39:55,660
NON-EMERGENCY SITUATIONS ARE 

2228
01:39:55,660 --> 01:39:58,096
TRIED INITIALLY AND IN MANY 

2229
01:39:58,096 --> 01:39:59,631
CASES ARE ENTIRELY SUCCESSFUL 

2230
01:39:59,631 --> 01:40:01,099
BUT JUST KNOWING WE NEED TO 

2231
01:40:01,099 --> 01:40:02,500
CONTINUE ADVANCING THE RESEARCH 

2232
01:40:02,500 --> 01:40:07,239
ABOUT THE NON-PHARMACOLOGIC AND 

2233
01:40:07,239 --> 01:40:08,540
PHARMACOLOGIC INTERVENTIONS AND 

2234
01:40:08,540 --> 01:40:11,810
THE CLINICIANS AND INDIVIDUALS 

2235
01:40:11,810 --> 01:40:17,048
WITH COGNITIVE EXPERIENCES HAVE 

2236
01:40:17,048 --> 01:40:21,419
A FULL COMPLEMENT TO ADDRESS THE

2237
01:40:21,419 --> 01:40:23,588
INCREDIBLY SERIOUS AND COMPLEX 

2238
01:40:23,588 --> 01:40:24,289
MANIFESTATIONS OF COGNITIVE 

2239
01:40:24,289 --> 01:40:24,856
IMPAIRMENT FROM INDIVIDUALS.

2240
01:40:24,856 --> 01:40:24,923
 

2241
01:40:29,594 --> 01:40:32,631
>> THAT DOVETAILS NICELY
WITH 

2242
01:40:32,631 --> 01:40:39,771
DR. SNYDER'S PRESENTATION FOR 

2243
01:40:39,771 --> 01:40:45,744
TREATING AND DIAGNOSING AND 

2244
01:40:45,744 --> 01:40:47,012
PROVIDING CURES TO THESE 

2245
01:40:47,012 --> 01:40:47,279
DISORDERS.

2246
01:40:47,279 --> 01:40:48,046
IT'S A NICE WAY TO TIE THEM 

2247
01:40:48,046 --> 01:40:51,583
TOGETHER.

2248
01:40:51,583 --> 01:40:53,752
>> MAYBE JUST TO ADD --
SORRY, I

2249
01:40:53,752 --> 01:40:55,086
CAN'T TURN ON MY CAMERA.

2250
01:40:55,086 --> 01:40:57,722
MAYBE JUST TO ADD THE ONE PIECE 

2251
01:40:57,722 --> 01:40:59,090
AS WE THINK ABOUT THE SPECTRUM 

2252
01:40:59,090 --> 01:41:01,359
OF SYMPTOMS THAT AN INDIVIDUAL 

2253
01:41:01,359 --> 01:41:03,795
MY EXPERIENCE.

2254
01:41:03,795 --> 01:41:04,663
WE WERE INTENTIONAL IN TALKING 

2255
01:41:04,663 --> 01:41:09,467
AROUND PRIMARY AND SECONDARY 

2256
01:41:09,467 --> 01:41:11,236
PREVENTION AND DISEASES IS 

2257
01:41:11,236 --> 01:41:12,270
POTENTIALLY SOMETHING VERY 

2258
01:41:12,270 --> 01:41:13,838
DIFFERENT AND WE MADE THAT 

2259
01:41:13,838 --> 01:41:14,572
DISTINCTION WITHIN OUR 

2260
01:41:14,572 --> 01:41:17,943
DISCUSSIONS AND THINKING ABOUT 

2261
01:41:17,943 --> 01:41:18,543
BEHAVIORAL CONSIDERATIONS A 

2262
01:41:18,543 --> 01:41:19,778
PERSON MADE PART OF THAT AS WE 

2263
01:41:19,778 --> 01:41:22,714
THINK ABOUT THE PRIMARY AND 

2264
01:41:22,714 --> 01:41:24,649
SECONDARY PREVENTION.

2265
01:41:24,649 --> 01:41:26,451
OF COURSE THE FULL SPECTRUM OF 

2266
01:41:26,451 --> 01:41:29,154
THE RECOMMENDATION.

2267
01:41:29,154 --> 01:41:30,055
>> WONDERFUL.

2268
01:41:30,055 --> 01:41:38,330
AND I'D JUST ENCOURAGE DALE AND 

2269
01:41:38,330 --> 01:41:39,698
AN I'LL TURN NOW TO SARA 

2270
01:41:39,698 --> 01:41:49,841
DELANEY.

2271
01:42:14,265 --> 01:42:16,468
>> AND IN TREATING
DEMENTIA FOR 

2272
01:42:16,468 --> 01:42:18,103
PEOPLE WHO DON'T HAVE A 

2273
01:42:18,103 --> 01:42:19,804
CAREGIVER OR SOCIALLY ISOLATED.

2274
01:42:19,804 --> 01:42:30,348
I WONDERED IF THAT WAS PART OF 

2275
01:42:31,916 --> 01:42:32,117
THAT.

2276
01:42:32,117 --> 01:42:34,119
>> THIS IS EXPLICITLY PART
OF 

2277
01:42:34,119 --> 01:42:37,222
OUR RECOMMENDATIONS FOR 

2278
01:42:37,222 --> 01:42:39,591
IMPROVING COLLABORATIVE DEMENTIA

2279
01:42:39,591 --> 01:42:42,360
CARE TO MEET THE NEEDS OF PEOPLE

2280
01:42:42,360 --> 01:42:43,828
WITHOUT AN INVOLVED CAREGIVER 

2281
01:42:43,828 --> 01:42:47,032
THAT LIVE ALONE.

2282
01:42:47,032 --> 01:42:48,466
SOMETHING WE SHOULD THINK ABOUT 

2283
01:42:48,466 --> 01:42:50,268
ACROSS ALL FOUR OF OUR 

2284
01:42:50,268 --> 01:42:50,869
RECOMMENDATIONS SO I'M NOTING 

2285
01:42:50,869 --> 01:42:52,637
THIS.

2286
01:42:52,637 --> 01:42:57,509
>> THANK YOU.

2287
01:42:57,509 --> 01:42:59,377
>> LET'S TRY MIA.

2288
01:42:59,377 --> 01:43:01,146
>> HI, THANK YOU ALL.

2289
01:43:01,146 --> 01:43:03,481
I'M ONE OF THE PARTICIPATING 

2290
01:43:03,481 --> 01:43:04,349
GUIDE SITES.

2291
01:43:04,349 --> 01:43:07,919
ONE THING I WANTED TO BRING UP 

2292
01:43:07,919 --> 01:43:11,823
IS THAT THE NUMBER OF FOLKS WHO 

2293
01:43:11,823 --> 01:43:13,558
ARE ELIGIBLE FOR GUIDE IS 

2294
01:43:13,558 --> 01:43:18,463
SMALLER THAN POTENTIALLY 

2295
01:43:18,463 --> 01:43:19,864
ELIGIBLE BECAUSE IT'S ONLY FOLKS

2296
01:43:19,864 --> 01:43:21,633
WITH TRADITIONAL MEDICARE.

2297
01:43:21,633 --> 01:43:23,101
I'M WONDERING IF THE PRESENTERS 

2298
01:43:23,101 --> 01:43:26,404
HAVE ANY SUGGESTIONS OR ADVOCACY

2299
01:43:26,404 --> 01:43:30,075
ON THE PART OF ASKING MEDICARE 

2300
01:43:30,075 --> 01:43:32,744
ADVANTAGE PROGRAMS TO ALSO 

2301
01:43:32,744 --> 01:43:35,380
CONSIDER A COLLABORATIVE 

2302
01:43:35,380 --> 01:43:38,149
DEMENTIA CARE MODEL BECAUSE THAT

2303
01:43:38,149 --> 01:43:40,652
IS THE MAJORITY OF THE MARKET IN

2304
01:43:40,652 --> 01:43:44,422
MANY PARTS OF THE COUNTRY.

2305
01:43:44,422 --> 01:43:46,024
>> DO YOU WANT TO TAKE
THIS OR 

2306
01:43:46,024 --> 01:43:47,392
SHOULD I?

2307
01:43:47,392 --> 01:43:48,059
>> I'LL GIVE IT A TRY.

2308
01:43:48,059 --> 01:43:52,097
THANKS FOR YOUR QUESTION.

2309
01:43:52,097 --> 01:43:56,568
SO, TWO POINTS, IS ONE, YES, THE

2310
01:43:56,568 --> 01:43:58,503
ADVOCACY COMMUNITY AND OTHERS 

2311
01:43:58,503 --> 01:44:01,806
ARE WORKING HARD TO EXPAND 

2312
01:44:01,806 --> 01:44:04,676
ACCESS BEYOND PARTICIPANT SITES 

2313
01:44:04,676 --> 01:44:15,153
FOR THE OTHER 7 MILLION NOT 

2314
01:44:16,488 --> 01:44:19,824
ELIGIBLE TO ENSURE SHAY HAVE 

2315
01:44:19,824 --> 01:44:29,100
ACCESS AND THERE ARE MANY OTHER 

2316
01:44:29,100 --> 01:44:34,205
AVENUES TO IMPROVE DEMENTIA CARE

2317
01:44:34,205 --> 01:44:36,074
OUTSIDE OF THIS MODEL FROM CMS.

2318
01:44:36,074 --> 01:44:39,344
ON A RECOMMENDATION SITE YOU SAW

2319
01:44:39,344 --> 01:44:45,683
REFERENCE TO HCVS.

2320
01:44:45,683 --> 01:44:47,352
AND IT'S COMMUNITY-BASED 

2321
01:44:47,352 --> 01:44:48,353
SERVICES.

2322
01:44:48,353 --> 01:44:52,323
MANY ARE UNCOORDINATED THROUGH 

2323
01:44:52,323 --> 01:44:56,494
VARIOUS SERVICE PROVIDERS AND WE

2324
01:44:56,494 --> 01:44:58,029
WANT TO SEE GREATER COORDINATION

2325
01:44:58,029 --> 01:44:59,297
BETWEEN NOT ONLY CLINICAL 

2326
01:44:59,297 --> 01:45:00,632
PROVIDERS BUT NON-CLINICAL 

2327
01:45:00,632 --> 01:45:03,034
SUPPORT PROVIDERS.

2328
01:45:03,034 --> 01:45:05,003
THAT CAN HAPPEN THROUGH THE 

2329
01:45:05,003 --> 01:45:06,204
GUIDE MODEL AND THROUGH 

2330
01:45:06,204 --> 01:45:06,471
MEDICARE.

2331
01:45:06,471 --> 01:45:11,242
WE WANT TO MAKE SURE THAT'S 

2332
01:45:11,242 --> 01:45:12,043
ACCESSIBLE TO PEOPLE NOT PART OF

2333
01:45:12,043 --> 01:45:14,779
THE MODEL AND WANT TO TRY TO 

2334
01:45:14,779 --> 01:45:16,514
PUSH MEDICARE TO DEVELOP THE 

2335
01:45:16,514 --> 01:45:18,183
EVIDENCE THROUGH THE GUIDE MODEL

2336
01:45:18,183 --> 01:45:21,719
AS QUICKLY AS POSSIBLE HOPEFULLY

2337
01:45:21,719 --> 01:45:24,255
FASTER THAN THE MODEL AND GET 

2338
01:45:24,255 --> 01:45:27,292
THIS TO A FULL MEDICARE BENEFIT 

2339
01:45:27,292 --> 01:45:30,128
BOTH FOR TRADITIONAL MEDICARE 

2340
01:45:30,128 --> 01:45:31,663
AND MEDICARE ADVANTAGE 

2341
01:45:31,663 --> 01:45:32,263
PARTICIPANTS HOPEFULLY SOONER 

2342
01:45:32,263 --> 01:45:34,999
THAN EIGHT YEARS.

2343
01:45:34,999 --> 01:45:39,404
>> WE HAVE TIME FOR ONE
MORE 

2344
01:45:39,404 --> 01:45:41,172
QUESTION AND THEN AFTER THAT 

2345
01:45:41,172 --> 01:45:44,576
PLEASE STAY ON AND AMBER 

2346
01:45:44,576 --> 01:45:48,646
MCCARTNEY WILL GIVE GUIDANCE ON 

2347
01:45:48,646 --> 01:45:51,316
PROVIDING WRITTEN COMMENTS AND 

2348
01:45:51,316 --> 01:45:56,187
SUPPORT ON THE MICROPHONE 

2349
01:45:56,187 --> 01:45:56,654
ISSUES.

2350
01:45:56,654 --> 01:45:58,256
WE HAVE A COMMENT OR QUESTION.

2351
01:45:58,256 --> 01:45:59,224
>> AS THE BEEN WONDERFUL
TO 

2352
01:45:59,224 --> 01:46:01,059
LISTEN TO ALL THE PRIORITIES.

2353
01:46:01,059 --> 01:46:02,694
I'M JUST FOLLOWING UP ON AN 

2354
01:46:02,694 --> 01:46:06,531
EARLIER QUESTION IN TERMS OF 

2355
01:46:06,531 --> 01:46:06,798
DIAGNOSES.

2356
01:46:06,798 --> 01:46:08,533
I WORK WITH CARE PARTNERS OF 

2357
01:46:08,533 --> 01:46:13,638
PEOPLE WITH LEWY BODY DEMENTIA.

2358
01:46:13,638 --> 01:46:15,006
ONE COMMENT THAT COMES UP FROM 

2359
01:46:15,006 --> 01:46:16,674
SPOUSES AND SINCE MANY ARE WOMEN

2360
01:46:16,674 --> 01:46:19,978
AND OLDER ADULTS, BECAUSE OF THE

2361
01:46:19,978 --> 01:46:22,013
FLUCTUATIONS IN COGNITION IN 

2362
01:46:22,013 --> 01:46:24,649
LEWY BODY DEMENTIA IS SOMETHING 

2363
01:46:24,649 --> 01:46:28,419
THAT SOMETIMES BECOMES TRICKY.

2364
01:46:28,419 --> 01:46:29,520
PRIMARY CARE PHYSICIANS MAY NOT 

2365
01:46:29,520 --> 01:46:31,189
NOTICE IT WHEN THEY SEE THE 

2366
01:46:31,189 --> 01:46:33,658
PATIENT, THEY THINK THE PATIENT 

2367
01:46:33,658 --> 01:46:34,759
IS FUNCTIONING PERFECTLY FINE 

2368
01:46:34,759 --> 01:46:37,161
AND RESPONDING TO QUESTIONS 

2369
01:46:37,161 --> 01:46:38,796
PERFECTLY FINE WHILE THE SPOUSE 

2370
01:46:38,796 --> 01:46:44,636
AT HOME IS SEEING THE 

2371
01:46:44,636 --> 01:46:44,936
FLUCTUATION.

2372
01:46:44,936 --> 01:46:47,739
NOTING THE FLUCTUATIONS IS ONE 

2373
01:46:47,739 --> 01:46:48,640
THING TO COMMENT ON AS THE 

2374
01:46:48,640 --> 01:46:52,644
DIAGNOSTIC IMPORTANCE.

2375
01:46:52,644 --> 01:46:54,212
>> YES, OF COURSE.

2376
01:46:54,212 --> 01:47:04,756
I WANTED TO INVITE JULIE OR I'LL

2377
01:47:05,123 --> 01:47:05,890
NOTE THE IMPORTANT COMMENT THAT 

2378
01:47:05,890 --> 01:47:08,393
WE NEED TO MAKE SURE TO INCLUDE 

2379
01:47:08,393 --> 01:47:09,227
DETECTION AND DIAGNOSIS IN 

2380
01:47:09,227 --> 01:47:10,261
PRIMARY CARE AND THIS IS 

2381
01:47:10,261 --> 01:47:12,997
SOMETHING THEY KNOW ABOUT AND 

2382
01:47:12,997 --> 01:47:20,004
THEY'RE LOOKING FOR.

2383
01:47:20,004 --> 01:47:21,272
WITH THAT WE'LL LEAVE COMMENTS 

2384
01:47:21,272 --> 01:47:22,707
AND I WANT TO ENCOURAGE THOSE 

2385
01:47:22,707 --> 01:47:25,443
WHO HAD A COMMENT AND WEREN'T 

2386
01:47:25,443 --> 01:47:26,477
ABLE TO SHARE IT, PLEASE PROVIDE

2387
01:47:26,477 --> 01:47:27,478
IT IN WRITING.

2388
01:47:27,478 --> 01:47:28,313
WE'RE GOING TO GO THROUGH EVERY 

2389
01:47:28,313 --> 01:47:29,914
ONE OF THE COMMENTS AND THINK 

2390
01:47:29,914 --> 01:47:31,582
HOW TO INTEGRATE THEM IN THE 

2391
01:47:31,582 --> 01:47:31,949
RECOMMENDATIONS.

2392
01:47:31,949 --> 01:47:33,184
THIS IS WHY WE'RE HERE TODAY.

2393
01:47:33,184 --> 01:47:35,887
I'M GOING TO TURN IT OVER -- 

2394
01:47:35,887 --> 01:47:37,255
ACTUALLY, YOU HAVE A BREAK FOR 

2395
01:47:37,255 --> 01:47:38,122
ONLY 11 MINUTES.

2396
01:47:38,122 --> 01:47:40,658
WE'RE GOING TO COME BACK AT THE 

2397
01:47:40,658 --> 01:47:44,662
HOUR FOR OUR NEXT SESSION ON
FRONTAL TEMPORAL DEMENTIA AND 

2398
01:47:44,662 --> 01:47:51,110
COME BACK ON FOR GUIDANCE ON
COMMENTS OR USING YOUR
MICROPHONE.

2399
01:47:51,110 --> 01:47:54,413
>> WE'RE GOING TO GET
STARTED 

2400
01:47:54,413 --> 01:47:59,451
AND LINDE JACOBS WILL BE ON I 

2401
01:47:59,451 --> 01:48:00,285
INTRODUCE YOU.

2402
01:48:00,285 --> 01:48:00,853
THANK YOU TO EVERYBODY WHO 

2403
01:48:00,853 --> 01:48:02,421
WORKED ON THE SETTINGS.

2404
01:48:02,421 --> 01:48:02,955
I HOPE IT'S GOING TO WORK 

2405
01:48:02,955 --> 01:48:13,098
BETTER.

2406
01:48:17,536 --> 01:48:18,303
FRANK, ARE YOU READY?

2407
01:48:18,303 --> 01:48:21,240
>> IT'S MY PLEASURE TO
INTRODUCE

2408
01:48:21,240 --> 01:48:23,542
LINDE JACOBS WHO SERVED ON OUR 

2409
01:48:23,542 --> 01:48:28,047
SUBCOMMITTEE AND HAS BEEN A 

2410
01:48:28,047 --> 01:48:35,287
WONDERFUL ADVOCATE FOR FTD AND 

2411
01:48:35,287 --> 01:48:37,589
SOMEONE WHO I LEARNED A LOT 

2412
01:48:37,589 --> 01:48:38,123
FROM.

2413
01:48:38,123 --> 01:48:40,759
>> THANK YOU FOR THE 

2414
01:48:40,759 --> 01:48:41,093
INTRODUCTION.

2415
01:48:41,093 --> 01:48:41,493
GOOD MORNING.

2416
01:48:41,493 --> 01:48:47,299
MY NAME IS LINDE JAKESCOBS IT'S 

2417
01:48:47,299 --> 01:48:49,902
PRIVILEGE AND HONOR TO SPEAK TO 

2418
01:48:49,902 --> 01:48:51,637
YOU AT THE 2025 ALZHEIMER'S 

2419
01:48:51,637 --> 01:48:52,471
DISEASE-RELATED DIMENTIAS 

2420
01:48:52,471 --> 01:48:52,704
SUMMIT.

2421
01:48:52,704 --> 01:48:55,040
I COME TO THIS MEETING NOT ONLY 

2422
01:48:55,040 --> 01:48:59,178
AS A PARTICIPANT SERVING ON THE 

2423
01:48:59,178 --> 01:49:03,782
FTD SUBCOMMITTEE BUT I'VE BEEN 

2424
01:49:03,782 --> 01:49:07,886
AFFECTED BY FAMILY DESTROYED BY 

2425
01:49:07,886 --> 01:49:10,055
FRONTAL TEMPORAL DEMENTIA AND 

2426
01:49:10,055 --> 01:49:11,590
THESE GUIDELINE CURATED TO 

2427
01:49:11,590 --> 01:49:14,159
DETERMINE WHO, WHAT AND WEAR 

2428
01:49:14,159 --> 01:49:16,495
APPRECIATION FUNDING ALLOCATIONS

2429
01:49:16,495 --> 01:49:18,297
WILL BE SLOTTED AND IF CHOSEN 

2430
01:49:18,297 --> 01:49:20,399
INCORRECTLY WILL WILL DICTATE 

2431
01:49:20,399 --> 01:49:21,967
WHETHER THERE'S SOMETHING FOR ME

2432
01:49:21,967 --> 01:49:26,438
IN THE NEXT YEAR AND IF I TOO 

2433
01:49:26,438 --> 01:49:29,274
WILL SUCCUMB TO THE MISCODING IN

2434
01:49:29,274 --> 01:49:29,875
MY GENOME.

2435
01:49:29,875 --> 01:49:33,779
I WAS ASKED TO SHARE MY STORY 

2436
01:49:33,779 --> 01:49:36,748
WITH FTD AND HOW TO IT'S CREATED

2437
01:49:36,748 --> 01:49:38,117
AN OPPORTUNITY TO SERVE AS A 

2438
01:49:38,117 --> 01:49:39,885
PERSON WITH LIVED EXPERIENCE ON 

2439
01:49:39,885 --> 01:49:40,452
A SCIENTIFIC SUBCOMMITTEE.

2440
01:49:40,452 --> 01:49:44,623
BEING THE VOICE FOR MY COMMUNITY

2441
01:49:44,623 --> 01:49:45,524
AND ADVOCATING FOR THOSE WHO 

2442
01:49:45,524 --> 01:49:51,463
WORK THIS PATH ALONG SIDE.

2443
01:49:51,463 --> 01:49:53,866
YOU'LL NOTICE I LACK 

2444
01:49:53,866 --> 01:49:54,166
CREDENTIALS.

2445
01:49:54,166 --> 01:49:55,901
THERE'S NO Ph.D. OR EVEN A 

2446
01:49:55,901 --> 01:49:57,136
MASTER'S DEGREE.

2447
01:49:57,136 --> 01:49:59,705
I DON'T HOLD HIGHLY REGARDED 

2448
01:49:59,705 --> 01:50:02,474
ACRONYMS THAT FALL ON MY NAME.

2449
01:50:02,474 --> 01:50:04,610
IT'S STRANGE I FIND MYSELF 

2450
01:50:04,610 --> 01:50:07,379
SPEAKING TO INDIVIDUALS WITH THE

2451
01:50:07,379 --> 01:50:11,183
HIGHEST OF I.Q.s AND CREDENTIALS

2452
01:50:11,183 --> 01:50:12,718
AND RESUMES.

2453
01:50:12,718 --> 01:50:20,893
IT'S NOT THE CROWD I ENVISIONED 

2454
01:50:20,893 --> 01:50:22,361
I'D BE IN.

2455
01:50:22,361 --> 01:50:24,129
I WANT TO SEE CHANGES IN THE 

2456
01:50:24,129 --> 01:50:27,633
FIELD TO GET FTD FROM A PLACE OF

2457
01:50:27,633 --> 01:50:28,767
TERMINAL DISEASE TO DIAGNOSIS 

2458
01:50:28,767 --> 01:50:31,837
WITH OPTION TO TREAT OR CURE 

2459
01:50:31,837 --> 01:50:40,245
BEFORE MY BRAIN SUCCUMBS IT'S 

2460
01:50:40,245 --> 01:50:43,115
IMPERATIVE I TALK ABOUT MY 

2461
01:50:43,115 --> 01:50:45,584
FAMILY BECAUSE IT'S MY FUTURE.

2462
01:50:45,584 --> 01:50:46,985
I'M THE FUTURE FACE OF FTD AND 

2463
01:50:46,985 --> 01:50:48,086
THE SUBJECTS IN THE GRANTS AND 

2464
01:50:48,086 --> 01:50:51,523
THE PATIENTS IN THE PRIORITIES.

2465
01:50:51,523 --> 01:50:54,493
WHAT WE DECIDE HERE BECOMES MY 

2466
01:50:54,493 --> 01:51:00,699
LIFE LINE.

2467
01:51:00,699 --> 01:51:10,342
I HAVE NO DISCLOSURES TO REPORT.

2468
01:51:10,342 --> 01:51:14,446
I'M A WIFE AND MOTHER TO YOUNG 

2469
01:51:14,446 --> 01:51:16,448
YOUNG DAUGHTERS AND HAVE BEEN A 

2470
01:51:16,448 --> 01:51:17,449
REGISTERED NURSE WORKING IN A 

2471
01:51:17,449 --> 01:51:20,052
VARIETY OF SETTINGS AND WORK IN 

2472
01:51:20,052 --> 01:51:21,453
AMBULATORY SURGERY.

2473
01:51:21,453 --> 01:51:23,722
BEING IN THE COMPANY OF THOSE IN

2474
01:51:23,722 --> 01:51:24,356
HEALTH CARE IS SOMETHING I'M 

2475
01:51:24,356 --> 01:51:28,827
WELL ACCUSTOMED TO BUT I 

2476
01:51:28,827 --> 01:51:31,897
INTENTIONALLY CHOSE NOT TO 

2477
01:51:31,897 --> 01:51:34,433
OBTAIN AN ADVANCED NURSING 

2478
01:51:34,433 --> 01:51:34,666
DEGREE.

2479
01:51:34,666 --> 01:51:36,668
I WAS A CAREGIVER FOR MY MOTHER 

2480
01:51:36,668 --> 01:51:39,304
STARTING AT THE AGE OF 22 AFTER 

2481
01:51:39,304 --> 01:51:40,505
I GRADUATED COLLEGE UNTIL SHE 

2482
01:51:40,505 --> 01:51:43,675
PASSED IN AUGUST OF 2021.

2483
01:51:43,675 --> 01:51:45,110
I WILL BE THE THIRD KNOWN 

2484
01:51:45,110 --> 01:51:48,947
GENERATION IN MY FAMILY AFFECTED

2485
01:51:48,947 --> 01:51:51,183
BY BEHAVIORAL VARIANT FTD AS A 

2486
01:51:51,183 --> 01:51:52,818
KNOWN MAP 2 MUTATION CARRIER.

2487
01:51:52,818 --> 01:51:54,953
FOLLOWING MY GENERATION, THERE 

2488
01:51:54,953 --> 01:51:57,222
ARE SIX CHILDREN IN THE NEXT WHO

2489
01:51:57,222 --> 01:52:02,427
ARE NOW ALL FACING 50/50 ODDS OF

2490
01:52:02,427 --> 01:52:06,465
BEING FLAGGED, IN OTHER WORDS, 

2491
01:52:06,465 --> 01:52:10,168
GENETIC FTD WILL CONTINUE TO 

2492
01:52:10,168 --> 01:52:13,238
DESTROY GENERATIONS OF FTD UNTIL

2493
01:52:13,238 --> 01:52:15,374
THERE'S SOMETHING DONE TO STOP 

2494
01:52:15,374 --> 01:52:15,774
IT.

2495
01:52:15,774 --> 01:52:16,742
FTD HAS BEEN A CURSE ON MY 

2496
01:52:16,742 --> 01:52:20,512
FAMILY SINCE THE TIME I WAS 

2497
01:52:20,512 --> 01:52:20,712
BORN.

2498
01:52:20,712 --> 01:52:23,215
MY GRANDMOTHER STARTED 

2499
01:52:23,215 --> 01:52:24,583
EXHIBITING SYMPTOMS OF FTD AND 

2500
01:52:24,583 --> 01:52:26,518
LANGUISHED FOR THE DISEASE WITH 

2501
01:52:26,518 --> 01:52:27,953
15 YEARS UNTIL 2006.

2502
01:52:27,953 --> 01:52:30,055
JUST THREE YEARS AFTER MY 

2503
01:52:30,055 --> 01:52:32,090
GRANDMOTHER PASSED, MY MOTHER, 

2504
01:52:32,090 --> 01:52:33,025
ALLISON'S BRAIN STARTED TO 

2505
01:52:33,025 --> 01:52:36,161
CHANGE AT THE AGE OF 50.

2506
01:52:36,161 --> 01:52:38,096
DESPITE A FAMILY HISTORY AND 

2507
01:52:38,096 --> 01:52:40,632
DAUGHTER WORKING IN THE MEDICAL 

2508
01:52:40,632 --> 01:52:44,136
FIELD, IT TOOK US EIGHT YEARS TO

2509
01:52:44,136 --> 01:52:51,176
GAIN A DIAGNOSIS OF FTD IN 2018.

2510
01:52:51,176 --> 01:52:53,178
MY MOTHER PASSED IN 2022 AFTER 

2511
01:52:53,178 --> 01:52:57,382
12 YEARS OF THIS DISEASE.

2512
01:52:57,382 --> 01:52:58,550
TO DATE MY GRANDMOTHER BEVERLY 

2513
01:52:58,550 --> 01:53:01,320
AND ALL FOUR OF HER CHILDREN 

2514
01:53:01,320 --> 01:53:04,623
RECEIVED DIAGNOSIS OF BEHAVIORAL

2515
01:53:04,623 --> 01:53:08,193
VARIANT FTD WITH CONFIRMED 

2516
01:53:08,193 --> 01:53:10,262
GENETIC PINNINGS.

2517
01:53:10,262 --> 01:53:12,931
ONCE MY MOTHER AS A FIGHT ENDED,

2518
01:53:12,931 --> 01:53:19,338
I RECEIVE D MY RESULTS AND GOT 

2519
01:53:19,338 --> 01:53:21,440
CONFIRMATION THE FAMILIAL CURSE 

2520
01:53:21,440 --> 01:53:23,475
LIVES IN ME AND NOW POSSIBLY 

2521
01:53:23,475 --> 01:53:25,043
BOTH OF MY DAUGHTERS.

2522
01:53:25,043 --> 01:53:28,246
I WAS TOO LATE TO SPARE THEM.

2523
01:53:28,246 --> 01:53:29,848
MY SISTERS THEN PROCEED WITH 

2524
01:53:29,848 --> 01:53:31,283
THEIR OWN GENETIC TESTING 

2525
01:53:31,283 --> 01:53:32,250
THEREAFTER AND THEIR RESULTS 

2526
01:53:32,250 --> 01:53:34,319
MATCHED MINE.

2527
01:53:34,319 --> 01:53:34,586
POSITIVE.

2528
01:53:34,586 --> 01:53:36,254
WHICH MEANS ALL SIX OF THOSE 

2529
01:53:36,254 --> 01:53:38,290
CHILDREN IN THE PICTURES ON THE 

2530
01:53:38,290 --> 01:53:40,625
LEFT ARE ALL FACING THE GENETIC 

2531
01:53:40,625 --> 01:53:42,561
COIN TOSS THAT COMES WITH 

2532
01:53:42,561 --> 01:53:44,463
AUTOSOMAL DOMINANT DISEASES.

2533
01:53:44,463 --> 01:53:45,897
THE CHILDREN ARE ABOUT WHAT 

2534
01:53:45,897 --> 01:53:48,033
GIVES ME THE TIRELESS ENERGY TO 

2535
01:53:48,033 --> 01:53:51,303
CONTINUE TO FIGHT.

2536
01:53:51,303 --> 01:53:53,305
SOMETIMES I WONDER IF IT WOULD 

2537
01:53:53,305 --> 01:53:56,908
BE EASIER TO PRETEND I DON'T 

2538
01:53:56,908 --> 01:53:58,143
KNOW WHAT THE FUTURE LOOKS LIKE 

2539
01:53:58,143 --> 01:53:59,845
AND IT'S THE DECISIONS WE MAKE 

2540
01:53:59,845 --> 01:54:01,380
TODAY TO FUND TOMORROW TO 

2541
01:54:01,380 --> 01:54:11,790
DETERMINE THEIR FUTURE.

2542
01:54:12,758 --> 01:54:15,293
THERE'S MORE TO DO SO IT'S 

2543
01:54:15,293 --> 01:54:16,161
EASILY RECOGNIZED AND DIAGNOSED 

2544
01:54:16,161 --> 01:54:19,231
WITH THOSE FIRST COMING INTO 

2545
01:54:19,231 --> 01:54:21,099
CONTACT WITH PATIENTS.

2546
01:54:21,099 --> 01:54:22,801
HETEROGENEITY MAKES IT 

2547
01:54:22,801 --> 01:54:27,439
DIAGNOSTICALLY CHALLENGING IT 

2548
01:54:27,439 --> 01:54:28,273
TAKES OVER THREE YEARS AFTER 

2549
01:54:28,273 --> 01:54:29,841
SYMPTOMS START TO GAIN A CORRECT

2550
01:54:29,841 --> 01:54:30,375
DIAGNOSIS.

2551
01:54:30,375 --> 01:54:32,811
WHICH MEANS THE ATROPHY HAD 

2552
01:54:32,811 --> 01:54:34,413
ALREADY BEEN OCCURRING THREE 

2553
01:54:34,413 --> 01:54:38,250
YEARS PRIOR TOE THAT FOR FIRST 

2554
01:54:38,250 --> 01:54:38,483
SYSTEM.

2555
01:54:38,483 --> 01:54:40,051
WITH FTD BEING A YOUNGER ONSET 

2556
01:54:40,051 --> 01:54:41,286
DISEASE AFFECTING A PERSON IN 

2557
01:54:41,286 --> 01:54:43,789
THE PRIME OF THEIR ADULT LIFE, 

2558
01:54:43,789 --> 01:54:44,656
THERE'S SIGNIFICANT CHALLENGES 

2559
01:54:44,656 --> 01:54:48,260
THE PERSON AND FAMILY FACES.

2560
01:54:48,260 --> 01:54:49,761
LEGAL ISSUES WITH GAINING PROPER

2561
01:54:49,761 --> 01:54:50,495
CONTROL OVER THE INDIVIDUAL 

2562
01:54:50,495 --> 01:54:53,565
WHILE STILL MAINTAINING THEIR 

2563
01:54:53,565 --> 01:54:54,399
AUTONOMY, ECONOMIC ISSUES WITH 

2564
01:54:54,399 --> 01:54:57,702
ASSETS, THE IMPACT ON THE ENTIRE

2565
01:54:57,702 --> 01:54:59,471
FAMILY AS SOMEONE TYPICALLY 

2566
01:54:59,471 --> 01:55:00,505
RAISING DEPENDENT CHILDREN AND 

2567
01:55:00,505 --> 01:55:01,773
PROVIDING INCOME FOR THEIR 

2568
01:55:01,773 --> 01:55:02,007
FAMILY.

2569
01:55:02,007 --> 01:55:04,009
THERE'S A VERY APPARENT LACK OF 

2570
01:55:04,009 --> 01:55:06,011
AWARENESS IN THE PUBLIC EYE AND 

2571
01:55:06,011 --> 01:55:08,480
EVEN WITH MANY HEALTH 

2572
01:55:08,480 --> 01:55:09,147
PRACTITIONERS, STATING SYMPTOMS 

2573
01:55:09,147 --> 01:55:12,384
LIKE EXECUTIVE REASONING 

2574
01:55:12,384 --> 01:55:19,324
IMPAIRMENT, DISINHIBITION AND 

2575
01:55:19,324 --> 01:55:20,859
OTHER SYMPTOMS NO ONE KNOWS AND 

2576
01:55:20,859 --> 01:55:24,196
HARD TO DESCRIBE WITHOUT SHOWING

2577
01:55:24,196 --> 01:55:26,431
AN EXAMPLE AS EACH SPECIFIC 

2578
01:55:26,431 --> 01:55:28,567
PERSON OWN DISINHIBITION MAY NOT

2579
01:55:28,567 --> 01:55:31,203
LOOK THE SAME AS SOMEONE ELSE'S.

2580
01:55:31,203 --> 01:55:33,038
SO WE ON THE FTD SUBCOMMITTEE 

2581
01:55:33,038 --> 01:55:34,473
FOR THE NEXT SET OF MILESTONES 

2582
01:55:34,473 --> 01:55:38,443
HAVE A HUGE UNDERTAKING FOR 

2583
01:55:38,443 --> 01:55:39,578
CONSIDERATIONS.

2584
01:55:39,578 --> 01:55:41,480
IT'S NOT JUST NEEDING DIAGNOSTIC

2585
01:55:41,480 --> 01:55:42,781
MEASURES AND TREATMENTS, WE ALSO

2586
01:55:42,781 --> 01:55:43,982
HAVE TO FIGURE OUT WHAT'S 

2587
01:55:43,982 --> 01:55:45,250
CAUSING THE DISEASE.

2588
01:55:45,250 --> 01:55:46,785
WHERE'S IT HAPPENING AND WHAT 

2589
01:55:46,785 --> 01:55:49,187
TYPES OF THERAPIES A PERSON CAN 

2590
01:55:49,187 --> 01:55:50,422
BE A PART OF.

2591
01:55:50,422 --> 01:55:51,857
ARE THEY SEEING THE CORRECT 

2592
01:55:51,857 --> 01:55:53,058
PRACTITIONER AS WELL AS FINDING 

2593
01:55:53,058 --> 01:55:54,693
WAYS TO UNDERSTAND THE DISEASE 

2594
01:55:54,693 --> 01:55:56,461
TO THEN IMPLEMENT THE MILESTONES

2595
01:55:56,461 --> 01:56:03,502
TO BE SUCCESSFUL.

2596
01:56:03,502 --> 01:56:05,270
AT THIS TIME I WANTED TO GIVE A 

2597
01:56:05,270 --> 01:56:05,904
SPECIFIC MENTION OF GRATITUDE 

2598
01:56:05,904 --> 01:56:08,373
AND THANKS FOR ALL THE THINGS 

2599
01:56:08,373 --> 01:56:11,743
THE NIA, NIH AND NINDS HAS 

2600
01:56:11,743 --> 01:56:12,277
FUNDED.

2601
01:56:12,277 --> 01:56:13,845
I'VE BEEN GIVEN THE GIFT OF 

2602
01:56:13,845 --> 01:56:17,549
BEING ABLE TO PARTICIPATE IN 

2603
01:56:17,549 --> 01:56:19,217
RESEARCH THE LAST FOUR YEARS.

2604
01:56:19,217 --> 01:56:21,720
THAT'S FOUR YEARS OF IMAGING 

2605
01:56:21,720 --> 01:56:23,288
I'VE BEEN ABLE TO OBTAIN WITHOUT

2606
01:56:23,288 --> 01:56:23,688
COST.

2607
01:56:23,688 --> 01:56:26,424
THESE STUDIES HAVE PROVIDED ME 

2608
01:56:26,424 --> 01:56:28,860
THE OPTION TO GET A BASELINE MRI

2609
01:56:28,860 --> 01:56:30,262
STARTING AT THE AGE OF 32.

2610
01:56:30,262 --> 01:56:32,230
THE ONE PIECE THAT COULD HAVE 

2611
01:56:32,230 --> 01:56:35,467
DRASTICALLY ALTERED GETTING MY 

2612
01:56:35,467 --> 01:56:37,402
MOM DIAGNOSED SOONER AND TESTING

2613
01:56:37,402 --> 01:56:38,436
AND COGNITIVE TESTING AND 

2614
01:56:38,436 --> 01:56:40,038
FURTHER IMAGING.

2615
01:56:40,038 --> 01:56:41,006
EVERY TIME GIVING ME THE 

2616
01:56:41,006 --> 01:56:42,374
VALIDATION THINGS ARE STABLE 

2617
01:56:42,374 --> 01:56:51,950
RIGHT NOW.

2618
01:56:51,950 --> 01:56:57,188
IT'S TERRIFYING THE STUDIES ARE 

2619
01:56:57,188 --> 01:56:59,491
IN JEOPARDY.

2620
01:56:59,491 --> 01:57:01,793
THERE WAS LACK OF SCIENTIFIC 

2621
01:57:01,793 --> 01:57:03,228
DISCOVERY HOWEVER, AFTER THE 

2622
01:57:03,228 --> 01:57:06,398
LAST THREE YEARS OF TRYING TO 

2623
01:57:06,398 --> 01:57:09,334
UNDERSTAND EVERYTHING DISCOVERY 

2624
01:57:09,334 --> 01:57:10,435
ENTAIL I'VE CHANGED FROM 

2625
01:57:10,435 --> 01:57:14,205
FRUSTRATION TO AWE.

2626
01:57:14,205 --> 01:57:15,774
LEARNING HOW EACH RESEARCHER'S 

2627
01:57:15,774 --> 01:57:19,578
WORK PROVIDES A PIECE TO THE 

2628
01:57:19,578 --> 01:57:21,913
PUZZLE TO DISCOVERY CREATED 

2629
01:57:21,913 --> 01:57:22,581
PROFOUND GRATITUDE FOR THE WORK 

2630
01:57:22,581 --> 01:57:23,682
EVERYONE ON THE CALL IS DOING.

2631
01:57:23,682 --> 01:57:25,917
THIS IS A COMMUNITY FIGHT.

2632
01:57:25,917 --> 01:57:36,461
NOT A SINGLE INDIVIDUAL'S QUEST.

2633
01:57:36,962 --> 01:57:38,330
I REALIZE HOW MANY ALLIES ARE 

2634
01:57:38,330 --> 01:57:42,434
FIGHTING FOR WHAT I'M FIGHTING, 

2635
01:57:42,434 --> 01:57:43,702
AN END TO THESE DISEASE.

2636
01:57:43,702 --> 01:57:45,837
THANK YOU FOR YOUR TENACITY AND 

2637
01:57:45,837 --> 01:57:46,171
DETERMINATION.

2638
01:57:46,171 --> 01:57:47,372
I FEEL HONORED TO BE A MEMBER OF

2639
01:57:47,372 --> 01:57:48,340
THIS GROUP.

2640
01:57:48,340 --> 01:57:50,909
WHEN I WAS FIRST ASKED TO SERVE 

2641
01:57:50,909 --> 01:57:53,211
AS THE PWLE ON THE COMMITTEE I 

2642
01:57:53,211 --> 01:57:55,447
WAS QUITE TERRIFIED TO BE THE 

2643
01:57:55,447 --> 01:57:56,948
SOLE VOICE OF MY COMMUNITY.

2644
01:57:56,948 --> 01:57:58,984
I HAD SEVERE IMPOSTER SYNDROME 

2645
01:57:58,984 --> 01:58:01,653
AND QUESTIONED IF I WAS THE 

2646
01:58:01,653 --> 01:58:02,320
RIGHT CHOICE.

2647
01:58:02,320 --> 01:58:05,290
I KNEW IF I HAD TO ENSURE THAT 

2648
01:58:05,290 --> 01:58:09,127
MY VOICE SERVED AS THE VOICE AND

2649
01:58:09,127 --> 01:58:11,229
REPRESENTATIVE OF THE WHOLE FTD 

2650
01:58:11,229 --> 01:58:11,496
COMMUNITY.

2651
01:58:11,496 --> 01:58:12,964
WITHIN MY ADVOCACY WORK, I 

2652
01:58:12,964 --> 01:58:18,403
TYPICALLY HAVE A TARGETED FOCUS 

2653
01:58:18,403 --> 01:58:19,971
ON GENETIC FTD BUT THIS REQUIRED

2654
01:58:19,971 --> 01:58:26,444
ME TO HAVE A UNIFIED VOICE, 

2655
01:58:26,444 --> 01:58:27,712
FAMILIAL, SPORADIC AND GENETIC 

2656
01:58:27,712 --> 01:58:32,617
AND I SENT MULTIPLE E-MAILS IN 

2657
01:58:32,617 --> 01:58:35,954
THE FTD COMMUNITY TO MAKE SURE I

2658
01:58:35,954 --> 01:58:37,255
UNDERSTOOD MY ROLE AND GET 

2659
01:58:37,255 --> 01:58:40,692
FEEDBACK FOR TOP PRIORITIES AND 

2660
01:58:40,692 --> 01:58:40,992
MILESTONES.

2661
01:58:40,992 --> 01:58:41,893
THOUGH MY VOICE WAS THE ONE 

2662
01:58:41,893 --> 01:58:42,827
HEARD IN THE DISCUSSIONS IN THE 

2663
01:58:42,827 --> 01:58:45,096
LAST MONTHS, I WAS THE MEGA 

2664
01:58:45,096 --> 01:58:50,135
PHONE FOR OUR COMMUNITY MEMBERS.

2665
01:58:50,135 --> 01:58:52,737
ONE OF THE BLARING SHARED 

2666
01:58:52,737 --> 01:58:54,439
MESSAGE IS WE NEED DIAGNOSTIC 

2667
01:58:54,439 --> 01:58:55,473
TOOLS AND BIOMARKERS AND 

2668
01:58:55,473 --> 01:58:59,878
TREATMENTS AND THERAPIES AS THE 

2669
01:58:59,878 --> 01:59:01,813
FIRST, HIGHEST, TOP PRIORITY.

2670
01:59:01,813 --> 01:59:04,215
AS SOMEONE WHO WATCHED THE 

2671
01:59:04,215 --> 01:59:05,884
DEBILITATING DISEASE DESTROY A 

2672
01:59:05,884 --> 01:59:07,452
PERSON'S LIFE I WAS IN ABSOLUTE 

2673
01:59:07,452 --> 01:59:07,719
AGREEMENT.

2674
01:59:07,719 --> 01:59:08,853
AS A COMMUNITY, WE NEED TO 

2675
01:59:08,853 --> 01:59:13,258
DEVELOP WAYS TO MORE EASILY 

2676
01:59:13,258 --> 01:59:14,759
DIAGNOSIS FTD AND THE SUB TYPES 

2677
01:59:14,759 --> 01:59:17,095
AND WAYS TO DETERMINE WHICH 

2678
01:59:17,095 --> 01:59:18,129
UNDERLYING PATHOLOGY WE'RE 

2679
01:59:18,129 --> 01:59:21,366
WORKING WITH AND THEN WE NEED TO

2680
01:59:21,366 --> 01:59:24,502
FIND A WAY TO TREAT THIS DISEASE

2681
01:59:24,502 --> 01:59:26,237
WHETHER IT'S CURATE OR SYMPTOM 

2682
01:59:26,237 --> 01:59:27,806
MANAGEMENT BUT TRYING TO SOLVE 

2683
01:59:27,806 --> 01:59:30,675
THE PROBLEM IS OF THE HIGHEST 

2684
01:59:30,675 --> 01:59:31,009
PRIORITY.

2685
01:59:31,009 --> 01:59:32,243
BECAUSE ISN'T THAT TRULY WHAT 

2686
01:59:32,243 --> 01:59:40,185
WE'RE ALL TRYING TO ACCOMPLISH?

2687
01:59:40,185 --> 01:59:43,521
AREN'T WE HERE TO FORMULATE WAYS

2688
01:59:43,521 --> 01:59:45,824
TO CURE THESE DISEASES?

2689
01:59:45,824 --> 01:59:49,427
I REORGANIZED THE MILESTONES OF 

2690
01:59:49,427 --> 01:59:50,628
RENOWN CLINICIANS TO VOICE AN 

2691
01:59:50,628 --> 01:59:53,098
OPINION I DIDN'T FEEL I HAD 

2692
01:59:53,098 --> 01:59:53,431
EARNED.

2693
01:59:53,431 --> 01:59:55,400
AFTER SUGGESTING A REORDERING TO

2694
01:59:55,400 --> 01:59:57,068
SET A PRECEDENT OF DIAGNOSTICS 

2695
01:59:57,068 --> 01:59:59,471
AND TREATMENTS AS THE HIGHEST 

2696
01:59:59,471 --> 02:00:01,372
PRIORITY, DO WANT TO KNOW WHAT 

2697
02:00:01,372 --> 02:00:02,440
HAPPENED?

2698
02:00:02,440 --> 02:00:04,142
THEY LISTENED.

2699
02:00:04,142 --> 02:00:06,745
NOT ONLY DID THEY LISTEN, THEY 

2700
02:00:06,745 --> 02:00:09,414
AGREED AND THEY TOOK ACTION.

2701
02:00:09,414 --> 02:00:10,682
NOW, THE MILESTONES FOR FTD FOR 

2702
02:00:10,682 --> 02:00:13,685
THE NEXT THREE YEARS REFLECT 

2703
02:00:13,685 --> 02:00:16,721
THIS, NUMBER ONE, ACCELERATE THE

2704
02:00:16,721 --> 02:00:18,223
EVALUATION OF NOVEL FTD 

2705
02:00:18,223 --> 02:00:19,157
TREATMENTS AND NUMBER TWO, 

2706
02:00:19,157 --> 02:00:22,093
ADVANCE DEVELOPMENT OF AN ARRAY 

2707
02:00:22,093 --> 02:00:24,529
OF STANDARDIZED BIOMARKERS IN 

2708
02:00:24,529 --> 02:00:25,730
DIGITAL HEALTH TECHNOLOGY FOR 

2709
02:00:25,730 --> 02:00:25,997
SCREENING.

2710
02:00:25,997 --> 02:00:27,365
THAT MOMENT WAS SOMETHING I WILL

2711
02:00:27,365 --> 02:00:28,032
NEVER FORGET.

2712
02:00:28,032 --> 02:00:30,435
TO BE VALIDATED IN A WAY THAT 

2713
02:00:30,435 --> 02:00:32,937
BOLDLY DEMONSTRATED MY VOICE, MY

2714
02:00:32,937 --> 02:00:35,373
OPINION AND MY POSITION WITHIN 

2715
02:00:35,373 --> 02:00:38,176
THIS SUBCOMMITTEE WAS JUST AS 

2716
02:00:38,176 --> 02:00:39,911
VALUED AS EVERYONE ELSE'S.

2717
02:00:39,911 --> 02:00:42,514
FOR THAT I REALLY WANT TO THANK 

2718
02:00:42,514 --> 02:00:44,048
THOSE WHO SERVE ON THE FTD 

2719
02:00:44,048 --> 02:00:44,783
SUBCOMMITTEE FOR GIVING ME THE 

2720
02:00:44,783 --> 02:00:46,651
OPPORTUNITY AND FOR YOUR 

2721
02:00:46,651 --> 02:00:56,795
SUPPORT.

2722
02:00:58,429 --> 02:01:00,532
IT'S STILL MISUNDERSTOOD AND 

2723
02:01:00,532 --> 02:01:02,934
UNDER DIAGNOSED AND UNDER FUNDED

2724
02:01:02,934 --> 02:01:05,937
AND FOR MANY STILL A MYSTERY.

2725
02:01:05,937 --> 02:01:07,438
WE NEED MOMENTUM IN SCIENCE, 

2726
02:01:07,438 --> 02:01:08,473
CARE AND COMMUNITY AND EARLIER 

2727
02:01:08,473 --> 02:01:09,808
DETECTION AND MORE TRIALS AND 

2728
02:01:09,808 --> 02:01:11,309
SUPPORT FOR THE CAREGIVERS AND 

2729
02:01:11,309 --> 02:01:13,011
ACCESS TO SPECIALISTS AND 

2730
02:01:13,011 --> 02:01:14,445
THERAPIES THAT REFLECT THE 

2731
02:01:14,445 --> 02:01:16,815
COMPLEXITY OF THIS DISEASE.

2732
02:01:16,815 --> 02:01:18,449
THIS HOPE IS WHAT DRIVES ME TO 

2733
02:01:18,449 --> 02:01:21,052
PUSH BOUNDARIES AND SEEK ANSWERS

2734
02:01:21,052 --> 02:01:22,720
AND SUPPORT OTHERS ON THE 

2735
02:01:22,720 --> 02:01:22,954
JOURNEY.

2736
02:01:22,954 --> 02:01:25,790
IT IS A HOPE ROOTED IN SCIENCE, 

2737
02:01:25,790 --> 02:01:27,725
NURTURED BY COMMUNITY AND 

2738
02:01:27,725 --> 02:01:30,895
PROPELLED BY UNWAVERING 

2739
02:01:30,895 --> 02:01:31,229
DETERMINATION.

2740
02:01:31,229 --> 02:01:32,964
HOPE IS THE FIGHT.

2741
02:01:32,964 --> 02:01:37,302
THE RELENTLESS PUSH FORWARD 

2742
02:01:37,302 --> 02:01:38,336
UNTIL THERE'S NOTHING LEFT TO 

2743
02:01:38,336 --> 02:01:39,137
PUSH.

2744
02:01:39,137 --> 02:01:40,138
I'M AWARE OF THE REALITY THERE'S

2745
02:01:40,138 --> 02:01:41,773
NO GUARANTEE THERE WILL BE A 

2746
02:01:41,773 --> 02:01:44,309
TREATMENT IN TIME TO SAVE ME BUT

2747
02:01:44,309 --> 02:01:45,410
WITH THE INTELLIGENCE AND 

2748
02:01:45,410 --> 02:01:47,078
DETERMINATION I SAW IN THIS 

2749
02:01:47,078 --> 02:01:51,082
COMMITTEE, I KNOW THAT MY 

2750
02:01:51,082 --> 02:01:51,816
DAUGHTERS WILL BE GIVEN OPTION 

2751
02:01:51,816 --> 02:01:53,151
AND AN OPPORTUNITY FOR A 

2752
02:01:53,151 --> 02:01:53,818
DIFFERENT FUTURE.

2753
02:01:53,818 --> 02:01:54,586
ONE THEY WON'T HAVE TO FIGHT SO 

2754
02:01:54,586 --> 02:01:58,356
HARD FOR.

2755
02:01:58,356 --> 02:01:59,691
MAY WE ALL CONTINUE TO KEEP 

2756
02:01:59,691 --> 02:02:00,725
FILING FOR THE NEXT GENERATION.

2757
02:02:00,725 --> 02:02:02,227
THANK YOU.

2758
02:02:02,227 --> 02:02:02,961
-- FIGHTING FOR THE NEXT 

2759
02:02:02,961 --> 02:02:03,261
GENERATION.

2760
02:02:03,261 --> 02:02:06,431
THANK YOU.

2761
02:02:06,431 --> 02:02:06,497
 

2762
02:02:40,865 --> 02:02:44,535
>> DO YOU WARRANT TO  --
WANT TO

2763
02:02:44,535 --> 02:02:55,013
TAKE US IN THE NEXT SESSION?

2764
02:02:56,247 --> 02:02:58,750
>> I'D LIKE TO WELCOME YOU
ALL 

2765
02:02:58,750 --> 02:03:03,454
ON BEHALF OF MY CO-CHAIR, I'M 

2766
02:03:03,454 --> 02:03:04,522
CELESTE KARCH.

2767
02:03:04,522 --> 02:03:09,694
WE JUST HEARD BEAUTIFULLY FROM 

2768
02:03:09,694 --> 02:03:20,238
LINDY ABOUT THE REAL JOURNEY AND

2769
02:03:20,738 --> 02:03:22,440
COMPLEX DIAGNOSIS.

2770
02:03:22,440 --> 02:03:24,676
WHEN WE THINK OF FRONTAL 

2771
02:03:24,676 --> 02:03:28,813
TEMPORAL DEMENTIA WE'RE THINKING

2772
02:03:28,813 --> 02:03:30,615
ABOUT THE COMPLEX SET OF 

2773
02:03:30,615 --> 02:03:33,384
SYMPTOMS THAT CAN PRESENT IN 

2774
02:03:33,384 --> 02:03:43,895
THREE MAJOR WAYS AND THEY'RE 

2775
02:03:56,808 --> 02:04:00,645
MEDICAL TERMS AND WHAT WE SEE IS

2776
02:04:00,645 --> 02:04:05,116
THAT THE REAL WAY IN WHICH 

2777
02:04:05,116 --> 02:04:07,218
PATIENTS ARE COMING INTO THE 

2778
02:04:07,218 --> 02:04:09,020
CLINICS IS WITH CLINICAL 

2779
02:04:09,020 --> 02:04:10,455
PRESENTATIONS MORE COMPLEX THAN 

2780
02:04:10,455 --> 02:04:12,790
THESE THREE VERY BROAD 

2781
02:04:12,790 --> 02:04:15,026
CATEGORIES OF CLINICAL 

2782
02:04:15,026 --> 02:04:16,627
PRESENTATIONS THAT BOTH 

2783
02:04:16,627 --> 02:04:19,497
INCORPORATE THE KEY FEATURES AS 

2784
02:04:19,497 --> 02:04:22,834
WELL AS CAPTURE ASPECTS OF 

2785
02:04:22,834 --> 02:04:23,401
PARKINSON'S OR ALZHEIMER'S 

2786
02:04:23,401 --> 02:04:28,139
DISEASE OR EVEN ALS.

2787
02:04:28,139 --> 02:04:31,609
AND SO THIS COMPLEX CLINICAL 

2788
02:04:31,609 --> 02:04:33,344
PRESENTATION OF FTD REALLY 

2789
02:04:33,344 --> 02:04:37,882
REQUIRES WE PUT FORTH INNOVATIVE

2790
02:04:37,882 --> 02:04:39,550
APPROACHES TO DIAGNOSE AND 

2791
02:04:39,550 --> 02:04:40,885
MONITOR THE PROGRESSION OF 

2792
02:04:40,885 --> 02:04:43,755
DISEASE AND FIGURE OUT WHICH 

2793
02:04:43,755 --> 02:04:46,424
TREATMENT BEST FOR WHICH FORMS 

2794
02:04:46,424 --> 02:04:50,428
OF DISEASE.

2795
02:04:50,428 --> 02:04:53,998
NOT JUST IN THE CLINIC BUT IF WE

2796
02:04:53,998 --> 02:04:56,367
GO BACK TO THE MOLECULAR CAUSES 

2797
02:04:56,367 --> 02:04:59,771
OF DISEASE WE'RE REMINDED FTD IS

2798
02:04:59,771 --> 02:05:02,373
AN UMBRELLA TERM THAT REPRESENTS

2799
02:05:02,373 --> 02:05:04,275
SEVERAL DIFFERENT SUB TYPES.

2800
02:05:04,275 --> 02:05:07,645
THEY'RE INITIATED BY A NUMBER OF

2801
02:05:07,645 --> 02:05:11,015
DIFFERENT GENES IN FAMILIAL 

2802
02:05:11,015 --> 02:05:16,487
FORMS LIKE T THESE AND ULTIMATEY

2803
02:05:16,487 --> 02:05:19,957
WHETHER SPORADIC OR FAMILIAL IT 

2804
02:05:19,957 --> 02:05:21,225
CAN LEAD TO DIFFERENT TYPES OF 

2805
02:05:21,225 --> 02:05:23,194
PATHOLOGY THAT ACCUMULATES IN 

2806
02:05:23,194 --> 02:05:26,297
DISEASE AND IN THE BRAIN.

2807
02:05:26,297 --> 02:05:30,301
SO WE MUST CONSIDER THESE AS 

2808
02:05:30,301 --> 02:05:32,503
WE'RE DEVELOPING THE TREATMENTS 

2809
02:05:32,503 --> 02:05:34,972
AND EVEN THE DIAGNOSES TO DEFINE

2810
02:05:34,972 --> 02:05:37,308
IN THE CLINIC WHICH SUB TYPE AN 

2811
02:05:37,308 --> 02:05:47,819
INDIVIDUAL PRESENTS ITSELF AS.

2812
02:05:47,819 --> 02:05:49,687
ULTIMATELY THE RECOMMENDATIONS 

2813
02:05:49,687 --> 02:05:51,923
YOU'LL HEAR ABOUT IN THE SESSION

2814
02:05:51,923 --> 02:05:56,894
ARE REALLY BUILDING OFF THE 

2815
02:05:56,894 --> 02:06:00,631
URGENT NEEDS TO BE ABLE TO 

2816
02:06:00,631 --> 02:06:02,166
DIAGNOSIS FTD AND TO UNDERSTAND 

2817
02:06:02,166 --> 02:06:05,136
OF THE SUB TYPES AND EFFECTIVELY

2818
02:06:05,136 --> 02:06:06,437
MANAGE AND ASSIGN THE BEST 

2819
02:06:06,437 --> 02:06:10,441
TREATMENT FOR THE SUB TYPES.

2820
02:06:10,441 --> 02:06:13,444
AND IN ORDER TO DO THIS WE STILL

2821
02:06:13,444 --> 02:06:14,479
NEED TO UNDERSTAND THE 

2822
02:06:14,479 --> 02:06:15,713
FUNDAMENTAL MECHANISMS THAT 

2823
02:06:15,713 --> 02:06:16,614
DRIVE DISEASE AND WORK ACROSS 

2824
02:06:16,614 --> 02:06:18,950
THE MODALITIES FROM THE PATIENT 

2825
02:06:18,950 --> 02:06:22,453
POPULATIONS ALL THE WAY INTO OUR

2826
02:06:22,453 --> 02:06:23,287
MODEL SYSTEMS AND BACK AGAIN.

2827
02:06:23,287 --> 02:06:25,723
AND THESE MILESTONES AND 

2828
02:06:25,723 --> 02:06:27,859
RECOMMENDATIONS ARE REALLY BUILT

2829
02:06:27,859 --> 02:06:30,495
OFF WHAT IS AN EXCEEDINGLY 

2830
02:06:30,495 --> 02:06:33,531
EXCITING TIME IN THE FTD FIELD 

2831
02:06:33,531 --> 02:06:35,199
WHERE WE'RE GETTING AT NEW 

2832
02:06:35,199 --> 02:06:36,968
BIOMARKERS, NEW MECHANISMS, NEW 

2833
02:06:36,968 --> 02:06:40,571
MODELS AND THOSE I THINK ARE ALL

2834
02:06:40,571 --> 02:06:42,874
A REFLECTION OF THE SUPPORT THAT

2835
02:06:42,874 --> 02:06:46,477
CAME FROM THE LAST SUMMIT'S 

2836
02:06:46,477 --> 02:06:48,646
RECOMMENDATIONS AND THESE NEW 

2837
02:06:48,646 --> 02:06:50,414
RECOMMENDATIONS YOU'LL HEAR ARE 

2838
02:06:50,414 --> 02:06:52,750
REALLY A REFLECTION OF WHERE 

2839
02:06:52,750 --> 02:06:57,455
WE'RE AT AND WHERE WE CAN GO TO 

2840
02:06:57,455 --> 02:06:57,955
MEANINGFULLY TREAT THIS 

2841
02:06:57,955 --> 02:07:00,625
DEVASTATING DISEASE.

2842
02:07:00,625 --> 02:07:10,902
I'LL STOP THERE.

2843
02:07:14,572 --> 02:07:18,109
WE CAN GO ON TO DR. BOXER.

2844
02:07:18,109 --> 02:07:20,244
>> DR. BOXER: THANK YOU
FOR 

2845
02:07:20,244 --> 02:07:21,879
INVITING ME TO SPEAK TODAY.

2846
02:07:21,879 --> 02:07:24,615
I'M GOING TO TALK TO YOU ABOUT 

2847
02:07:24,615 --> 02:07:25,049
THE FIRST AND FIFTH 

2848
02:07:25,049 --> 02:07:34,425
RECOMMENDATIONS.

2849
02:07:34,425 --> 02:07:37,395
HERE'S MY DISCLOSURES.

2850
02:07:37,395 --> 02:07:38,429
SO THE FIRST RECOMMENDATION THAT

2851
02:07:38,429 --> 02:07:42,133
OUR COMMITTEE CAME UP WITH IS TO

2852
02:07:42,133 --> 02:07:43,000
ACCELERATE THE EVALUATION OF 

2853
02:07:43,000 --> 02:07:45,937
NOVEL FTD TREATMENTS BY BOTH 

2854
02:07:45,937 --> 02:07:47,338
CAPITALIZING ON EXISTING 

2855
02:07:47,338 --> 02:07:48,005
EVIDENCE, INFRASTRUCTURE AND 

2856
02:07:48,005 --> 02:07:54,412
RESOURCES AND ON THE DEVELOPMENT

2857
02:07:54,412 --> 02:07:57,515
OF FTD SPECIFIC DESIGNS AND NEW 

2858
02:07:57,515 --> 02:07:59,517
PREVENTION AND TREATMENT TRIALS 

2859
02:07:59,517 --> 02:08:00,885
REPRESENTATIVE OF THE 

2860
02:08:00,885 --> 02:08:02,753
U.S. POPULATION AND IT'S TOP 

2861
02:08:02,753 --> 02:08:04,755
PRIORITY AND YOU HEARD FROM 

2862
02:08:04,755 --> 02:08:05,690
LINDE JACOBS JUST NOW HOW 

2863
02:08:05,690 --> 02:08:06,557
IMPORTANT IT IS TO OUR 

2864
02:08:06,557 --> 02:08:13,831
COMMUNITIES.

2865
02:08:13,831 --> 02:08:14,599
SO IMPORTANT TO MENTION THERE 

2866
02:08:14,599 --> 02:08:18,436
ARE NO APPROVED TREATMENTS FOR 

2867
02:08:18,436 --> 02:08:26,010
FTD IN ANY FORM.

2868
02:08:26,010 --> 02:08:29,213
AND RIGHT NOW WE'RE LIMITED AS 

2869
02:08:29,213 --> 02:08:31,482
PHYSICIAN TO USE 

2870
02:08:31,482 --> 02:08:34,418
NON-PHARMACOLOGIC APPROACHES AND

2871
02:08:34,418 --> 02:08:35,386
SYMPTOMATIC TREATMENTS WITH 

2872
02:08:35,386 --> 02:08:36,787
PSYCHIATRIC MEDICATIONS BUT 

2873
02:08:36,787 --> 02:08:40,124
DON'T HAVE ANYTHING TO SLOW THE 

2874
02:08:40,124 --> 02:08:40,825
INEXTRICABLE COURSE OF THIS 

2875
02:08:40,825 --> 02:08:41,492
DISEASE TOWARDS SEVERE 

2876
02:08:41,492 --> 02:08:42,426
DISABILITY AND DEATH IN MANY 

2877
02:08:42,426 --> 02:08:50,167
PEOPLE.

2878
02:08:50,167 --> 02:08:52,169
DESPITE THIS AN EXCITING TIME 

2879
02:08:52,169 --> 02:08:56,607
FOR THE DEVELOPMENT OF TREATMENT

2880
02:08:56,607 --> 02:09:00,645
FOR NEURAL DEGENERATIVE DISEASES

2881
02:09:00,645 --> 02:09:04,448
AND SEEN IN SOD 1 ALS IT'S 

2882
02:09:04,448 --> 02:09:06,417
POSSIBLE TO DEVELOP DISEASE 

2883
02:09:06,417 --> 02:09:08,486
MODIFYING DRUGS TO SLOW 

2884
02:09:08,486 --> 02:09:09,387
PROGRESSION OF DISEASE AND HAVE 

2885
02:09:09,387 --> 02:09:10,955
AN IMPORTANT IMPACT OF SURVIVAL.

2886
02:09:10,955 --> 02:09:14,425
WE CAN LEARN FROM THE EXPERIENCE

2887
02:09:14,425 --> 02:09:20,231
AND BRING THIS TO FTD.

2888
02:09:20,231 --> 02:09:23,200
WE'RE ALSO SEEING IN OTHER 

2889
02:09:23,200 --> 02:09:26,604
DISEASES TAU AND TDP43 

2890
02:09:26,604 --> 02:09:27,238
TREATMENTS ARE BEING DEVELOPED 

2891
02:09:27,238 --> 02:09:29,573
TO INTO AND THE CLINIC AND MAY 

2892
02:09:29,573 --> 02:09:33,611
BE WE CAN ALSO TEST THEM FOR 

2893
02:09:33,611 --> 02:09:34,211
OVED.

2894
02:09:34,211 --> 02:09:37,248
THEY MAY ALSO WORK BETTER THAN 

2895
02:09:37,248 --> 02:09:40,384
FOR OTHER NEUROGENE RATIVE 

2896
02:09:40,384 --> 02:09:40,685
DISEASES.

2897
02:09:40,685 --> 02:09:41,919
I WANT TO ACKNOWLEDGE THE 

2898
02:09:41,919 --> 02:09:43,554
SUPPORT FROM THE NATIONAL 

2899
02:09:43,554 --> 02:09:44,722
INSTITUTE ON AGING AND 

2900
02:09:44,722 --> 02:09:46,557
NEUROLOGICAL DISORDERS AND 

2901
02:09:46,557 --> 02:09:50,027
STROKE FOR THE ALL FTD RESEARCH 

2902
02:09:50,027 --> 02:09:53,597
NETWORK AND THE FTD DISORDERS 

2903
02:09:53,597 --> 02:09:57,268
REGISTRY WHICH HAS BUILT THE 

2904
02:09:57,268 --> 02:09:58,803
INFRASTRUCTURE THROUGHOUT NORTH 

2905
02:09:58,803 --> 02:09:59,904
AMERICA TO SUPPORT THE NEXT 

2906
02:09:59,904 --> 02:10:04,241
GENERATION OF FTD TRIALS.

2907
02:10:04,241 --> 02:10:06,410
THIS IS A BIT OF A BUSY CHART 

2908
02:10:06,410 --> 02:10:12,783
AND WANT TO ILLUSTRATE TO YOU 

2909
02:10:12,783 --> 02:10:14,418
USING ALZHEIMER'S DISEASE AND 

2910
02:10:14,418 --> 02:10:16,620
SOD-1 RELATED ALS AS DISEM 

2911
02:10:16,620 --> 02:10:27,365
PARTICULARS -- EXEMPLARS AND 

2912
02:10:28,766 --> 02:10:31,769
IT'S PROVEN VIABLE FOR THE 

2913
02:10:31,769 --> 02:10:32,169
INDICATIONS.

2914
02:10:32,169 --> 02:10:32,970
IN FRONTOTEMPORAL DEMENTIA WHAT 

2915
02:10:32,970 --> 02:10:35,239
YOU CAN SEE IS THERE ARE REALLY 

2916
02:10:35,239 --> 02:10:35,906
TWO FORMS.

2917
02:10:35,906 --> 02:10:39,543
THOSE LINKED TO GOOD MORNINGS OR

2918
02:10:39,543 --> 02:10:42,813
FAMILIAL FTD AND SPORADIC FORMS 

2919
02:10:42,813 --> 02:10:45,916
OF FRONTOTEMPORAL DEMENTIA 

2920
02:10:45,916 --> 02:10:46,250
DEGENERATION.

2921
02:10:46,250 --> 02:10:48,519
YOU CAN SEE IN THE RIGHT IN BLUE

2922
02:10:48,519 --> 02:10:49,820
ARE HOW FAR DRUG DEVELOPMENT HAS

2923
02:10:49,820 --> 02:10:53,157
MADE IT IN CLINICAL TRIALS FOR 

2924
02:10:53,157 --> 02:10:54,492
THESE VARIOUS DIFFERENT FORMS OF

2925
02:10:54,492 --> 02:10:54,725
FTD.

2926
02:10:54,725 --> 02:10:56,394
AND HOPEFULLY WHAT YOU CAN 

2927
02:10:56,394 --> 02:10:58,529
NOTICE IT'S THE AVAILABILITY OF 

2928
02:10:58,529 --> 02:11:01,665
BIOMARKERS AND YOU'LL HEAR ABOUT

2929
02:11:01,665 --> 02:11:02,867
THIS IN IN THE NEXT 

2930
02:11:02,867 --> 02:11:04,935
RECOMMENDATION THAT'S REALLY 

2931
02:11:04,935 --> 02:11:06,437
ALLOWED THE DEVELOPMENT OF THESE

2932
02:11:06,437 --> 02:11:11,709
CLINICAL TRIALS.

2933
02:11:11,709 --> 02:11:13,844
AS WE THINK OF THE NEXT FIVE 

2934
02:11:13,844 --> 02:11:17,281
YEARS OF THE FTD NETWORK WE'RE 

2935
02:11:17,281 --> 02:11:18,783
FOCUSSING ON PREPARING FOR 

2936
02:11:18,783 --> 02:11:19,550
CLINICAL TRIALS AND DEVELOPING 

2937
02:11:19,550 --> 02:11:21,619
MORE BIOMARKERS AND MORE TOOLS 

2938
02:11:21,619 --> 02:11:23,254
TO DO CLINICAL TRIALS THROUGHOUT

2939
02:11:23,254 --> 02:11:29,960
THE FIRST SPECTRUM OF FTD.

2940
02:11:29,960 --> 02:11:31,328
SO WHAT OTHER ADVANCES HAVE 

2941
02:11:31,328 --> 02:11:41,272
HAPPENED SINCE THE LAST SUMMIT?

2942
02:11:41,272 --> 02:11:43,007
IMPORTANTLY WE'RE EXCITED THE 

2943
02:11:43,007 --> 02:11:45,075
FIRST TRIAL RESULTS WERE 

2944
02:11:45,075 --> 02:11:47,011
REPORTED EARLIER THIS YEAR AND 

2945
02:11:47,011 --> 02:11:49,547
THIS WAS WITH A SYMPTOMATIC 

2946
02:11:49,547 --> 02:11:51,048
AGENT THAT REALLY SEEMS TO HAVE 

2947
02:11:51,048 --> 02:11:54,418
AN IMPORTANT IMPACT ON THE 

2948
02:11:54,418 --> 02:11:56,687
SYMPTOMS OF BEHAVIORAL VARIANT 

2949
02:11:56,687 --> 02:11:56,854
FTD.

2950
02:11:56,854 --> 02:12:00,758
THIS IS INTRANASAL OXYTOCIN FOR 

2951
02:12:00,758 --> 02:12:00,925
FTD.

2952
02:12:00,925 --> 02:12:04,161
WE'VE ALSO SEEN IN PROGRANULIN 

2953
02:12:04,161 --> 02:12:07,198
RELATED FTD THAT GENE THERAPY 

2954
02:12:07,198 --> 02:12:12,069
WITH INTRAFECALLY ADMINISTERED 

2955
02:12:12,069 --> 02:12:15,739
VIRAL VECTOR PROGRANULIN CAN 

2956
02:12:15,739 --> 02:12:18,876
CORRECT THE CHEMICAL ASSOCIATED 

2957
02:12:18,876 --> 02:12:24,482
WITH A PROGRANULIN MUTATION AND 

2958
02:12:24,482 --> 02:12:26,417
AWAITING THE RESULTS OF THE 

2959
02:12:26,417 --> 02:12:26,884
TRIALS.

2960
02:12:26,884 --> 02:12:29,286
THERE'S OTHER THERAPIES OTHER 

2961
02:12:29,286 --> 02:12:29,487
WAY.

2962
02:12:29,487 --> 02:12:31,956
OUR CLINICAL TRIAL PROGRAMS 

2963
02:12:31,956 --> 02:12:32,223
UNDERWAY.

2964
02:12:32,223 --> 02:12:34,425
AND AGAIN I JUST WANT TO REMIND 

2965
02:12:34,425 --> 02:12:35,993
YOU THAT WE ARE BUILDING UPON 

2966
02:12:35,993 --> 02:12:39,830
AND STARTING TO BRING SOME DRUGS

2967
02:12:39,830 --> 02:12:41,966
FROM OTHER INDICATIONS INTO FTD 

2968
02:12:41,966 --> 02:12:42,633
AND I'LL TELL YOU ABOUT THIS IN 

2969
02:12:42,633 --> 02:12:52,810
A MINUTE.

2970
02:12:53,477 --> 02:12:55,646
ONE IDEA AND THIS IS NOW 

2971
02:12:55,646 --> 02:12:58,415
HAPPENING IN ALS BECAUSE WE KNOW

2972
02:12:58,415 --> 02:13:02,419
CERTAIN FORMS OF FTD INDIVIDUALS

2973
02:13:02,419 --> 02:13:04,121
HAVE MUTATIONS THAT PUT THEM AT 

2974
02:13:04,121 --> 02:13:07,591
RISK FOR DISEASE, WE MAY BE ABLE

2975
02:13:07,591 --> 02:13:09,827
TO DESIGN PREVENTION TRIALS 

2976
02:13:09,827 --> 02:13:10,861
WHERE WE INITIATE TREATMENT 

2977
02:13:10,861 --> 02:13:13,430
PRIOR TO THE ONSET OF SYMPTOMS.

2978
02:13:13,430 --> 02:13:17,001
OVER THE PAST YEAR, RESEARCHERS 

2979
02:13:17,001 --> 02:13:19,036
FROM THE ALS AND FTD COMMUNITIES

2980
02:13:19,036 --> 02:13:22,406
HAVE MET TO BEGIN PLANNING THE 

2981
02:13:22,406 --> 02:13:24,675
FIRST PREVENTION TRIALS OF FTD.

2982
02:13:24,675 --> 02:13:26,176
>> TWO-MINUTE WARNING.

2983
02:13:26,176 --> 02:13:30,915
>> WE ALSO ARE TAKING THE
IDEA 

2984
02:13:30,915 --> 02:13:34,084
OF PLASTER PROTOCOLS NEW TRIAL 

2985
02:13:34,084 --> 02:13:36,887
DESIGN AND FUNDED BY THE 

2986
02:13:36,887 --> 02:13:38,422
NATIONAL INSTITUTES OF HEALTH.

2987
02:13:38,422 --> 02:13:40,491
WE'RE BEGINNING LATER THIS YEAR 

2988
02:13:40,491 --> 02:13:41,926
A NEW PLATFORM TRIAL FOR 

2989
02:13:41,926 --> 02:13:42,459
PROGRESSIVE SUPER NUCLEAR 

2990
02:13:42,459 --> 02:13:50,434
POLICY.

2991
02:13:50,434 --> 02:13:52,870
THE IDEA OF A PERFORM TRIAL IS A

2992
02:13:52,870 --> 02:13:56,140
COST AND RAPID WAY TO TEST NEW 

2993
02:13:56,140 --> 02:13:59,343
TREATMENT OR TO DEVELOP NEW 

2994
02:13:59,343 --> 02:14:00,911
TREATMENTS FOR A DISEASE.

2995
02:14:00,911 --> 02:14:02,813
WHAT YOU SEE IS THE DESIGN OF 

2996
02:14:02,813 --> 02:14:07,284
THE NEW PSP TRIAL PLATFORM.

2997
02:14:07,284 --> 02:14:09,787
IN THIS TRIAL WE WILL BE TESTING

2998
02:14:09,787 --> 02:14:14,425
THREE DIFFERENT DRUGS FOR PSP 

2999
02:14:14,425 --> 02:14:15,025
SIMULTANEOUSLY.

3000
02:14:15,025 --> 02:14:16,393
INDIVIDUALS WILL BE RANDOMIZED 

3001
02:14:16,393 --> 02:14:18,128
TO ONE OF THE THREE DRUG 

3002
02:14:18,128 --> 02:14:19,930
REGIMENTS AND WITHIN EACH 

3003
02:14:19,930 --> 02:14:22,733
REGIMENT, THEY ARE HAVE A 3-1 

3004
02:14:22,733 --> 02:14:23,500
CHANCE OF RECEIVING THE DRUG.

3005
02:14:23,500 --> 02:14:25,936
ONE OF THE EFFICIENCIES IS WE 

3006
02:14:25,936 --> 02:14:29,673
CAN PULL THE PLACEBO SO WE CAN 

3007
02:14:29,673 --> 02:14:33,544
TEST DRUGS MORE QUICKLY WITH 

3008
02:14:33,544 --> 02:14:38,148
FEWER PATIENTS HAVING TO BE 

3009
02:14:38,148 --> 02:14:43,621
EXPOSED TO PLACEBO AND THIS WILL

3010
02:14:43,621 --> 02:14:44,622
CREATE A NEW RESOURCE FOR OTHER 

3011
02:14:44,622 --> 02:14:46,991
INVESTIGATORS AROUND THE COUNTRY

3012
02:14:46,991 --> 02:14:48,726
TO DEVELOP NEW TREATMENTS AND 

3013
02:14:48,726 --> 02:14:54,765
NEW BIOMARKERS FOR PSP.

3014
02:14:54,765 --> 02:14:58,402
NOW I'M GOING TO END WITH THE 

3015
02:14:58,402 --> 02:14:59,837
FIFTH RECOMMENDATION, 

3016
02:14:59,837 --> 02:15:04,174
RECOMMENDATION NUMBER 5, WHICH 

3017
02:15:04,174 --> 02:15:09,213
IS TO UNDERSTAND FTD 

3018
02:15:09,213 --> 02:15:12,816
MANIFESTATIONS AND HOW DISEASE 

3019
02:15:12,816 --> 02:15:15,819
FACTORS LIKE HETEROGENEITY AND 

3020
02:15:15,819 --> 02:15:17,054
SEX AND EXPOSOME AFFECT DISEASE 

3021
02:15:17,054 --> 02:15:21,558
RISK AND CLINICAL MANIFESTATIONS

3022
02:15:21,558 --> 02:15:23,794
AND THE LIVED EXPERIENCE OF FTD.

3023
02:15:23,794 --> 02:15:26,563
IT'S IMPORTANT TO MENTION THE 

3024
02:15:26,563 --> 02:15:27,831
CLINICAL DIAGNOSTIC CRITERIA WE 

3025
02:15:27,831 --> 02:15:29,199
USED ARE BASED ON STUDIES OF 

3026
02:15:29,199 --> 02:15:31,702
INDIVIDUALS WITH ACCESS TO 

3027
02:15:31,702 --> 02:15:34,271
SPECIALIZED CARE MOSTLY IN NORTH

3028
02:15:34,271 --> 02:15:36,874
AMERICA AND IN EUROPE.

3029
02:15:36,874 --> 02:15:41,145
BUT WHAT WE'RE LEARNING IS THAT 

3030
02:15:41,145 --> 02:15:42,112
THERE ARE SPECIFIC GENETIC 

3031
02:15:42,112 --> 02:15:43,747
AFFECTS THAT MAY BE IMPORTANT 

3032
02:15:43,747 --> 02:15:46,550
FOR CAUSING FTD.

3033
02:15:46,550 --> 02:15:54,158
SO FOR THE MAJOR AUTOSOMAL 

3034
02:15:54,158 --> 02:15:56,894
DOMINANT FOR FAMILIAL GENE WE 

3035
02:15:56,894 --> 02:16:00,564
THINK THIS AROSE IN SCANDINAVIA 

3036
02:16:00,564 --> 02:16:09,873
AND PROGRANULIN IN MEDITERRANEAN

3037
02:16:09,873 --> 02:16:12,176
FAMILIES AND OTHER CAUSES FOR 

3038
02:16:12,176 --> 02:16:15,679
EXAMPLE IN EAST ASIA ANXA11 

3039
02:16:15,679 --> 02:16:18,415
MUTATION A MORE IMPORTANT CAUSE 

3040
02:16:18,415 --> 02:16:21,118
OF FTD.

3041
02:16:21,118 --> 02:16:22,419
THEY'RE ALL IMPORTANT AND 

3042
02:16:22,419 --> 02:16:23,087
POTENTIALLY IMPORTANT BIOMARKER 

3043
02:16:23,087 --> 02:16:27,991
TO DEVELOP NEW TLAPIES.

3044
02:16:27,991 --> 02:16:30,561
WE ALSO KNOW FOR TAUOPATHIES 

3045
02:16:30,561 --> 02:16:33,197
THERE'S A GENETIC FACTOR RELATED

3046
02:16:33,197 --> 02:16:36,533
TO TAU CALLED THE H2 ALLELE 

3047
02:16:36,533 --> 02:16:38,602
WHICH PROTECTS BUT IS A RISK 

3048
02:16:38,602 --> 02:16:40,637
FACTOR FOR ANOTHER DISEASE.

3049
02:16:40,637 --> 02:16:42,873
IT'S NOT PRESENT IN ASIAN 

3050
02:16:42,873 --> 02:16:44,875
ANCESTRIES.

3051
02:16:44,875 --> 02:16:46,410
AGAIN, IT'S SOMETHING THAT 

3052
02:16:46,410 --> 02:16:48,879
SUGGESTS WE SHOULD BE 

3053
02:16:48,879 --> 02:16:49,546
UNDERSTANDING THE EPIDEMIOLOGY 

3054
02:16:49,546 --> 02:16:51,348
AND GENETICS OF FTD THROUGHOUT 

3055
02:16:51,348 --> 02:16:53,884
THE WORLD BECAUSE IT MAY HELP 

3056
02:16:53,884 --> 02:16:58,822
DEVELOP NEW TREATMENTS.

3057
02:16:58,822 --> 02:17:02,426
FINALLY AGAIN, WE ARE 

3058
02:17:02,426 --> 02:17:03,293
INCREASINGLY COLLABORATING WITH 

3059
02:17:03,293 --> 02:17:05,362
OUR ALS COLLEAGUES IN THE ALL 

3060
02:17:05,362 --> 02:17:06,430
ALS RESEARCH NETWORK.

3061
02:17:06,430 --> 02:17:10,434
ONE THING WE LEARNED FROM ALS IS

3062
02:17:10,434 --> 02:17:11,702
THE EXPOSOME SO THE 

3063
02:17:11,702 --> 02:17:14,438
ENVIRONMENTAL RISK FACTORS AND 

3064
02:17:14,438 --> 02:17:15,072
POTENTIALLY TOXIN IN THE 

3065
02:17:15,072 --> 02:17:17,941
ENVIRONMENT ARE LIKELY TO BE 

3066
02:17:17,941 --> 02:17:20,110
IMPORTANT FOR ALS AND 

3067
02:17:20,110 --> 02:17:22,279
INCREASINGLY WE'RE LEARNING IT'S

3068
02:17:22,279 --> 02:17:24,615
IMPORTANT FOR FTD SO WE NEED TO 

3069
02:17:24,615 --> 02:17:27,484
FOCUS ON THIS IN COLLABORATION 

3070
02:17:27,484 --> 02:17:28,385
WITH OUR ALS COLLEAGUES IN THE 

3071
02:17:28,385 --> 02:17:30,420
FUTURE.

3072
02:17:30,420 --> 02:17:37,928
THANK YOU.

3073
02:17:37,928 --> 02:17:40,297
>> THANK YOU.

3074
02:17:40,297 --> 02:17:42,432
GOOD AFTERNOON, EVERYONE.

3075
02:17:42,432 --> 02:17:47,237
DAVID IRWIN FROM THE UNIVERSITY 

3076
02:17:47,237 --> 02:17:48,138
OF PENNSYLVANIA.

3077
02:17:48,138 --> 02:17:53,777
I'LL BE PRESENTING ON BEHALF OF 

3078
02:17:53,777 --> 02:17:55,846
THE SUBCOMMITTEE ON THE 

3079
02:17:55,846 --> 02:17:58,715
ADVANCING FTD BIOMARKERS TO 

3080
02:17:58,715 --> 02:18:02,119
DISENTANGLE THE FTD CLINICO 

3081
02:18:02,119 --> 02:18:05,556
PATHOLOGICAL HETEROGENEITY.

3082
02:18:05,556 --> 02:18:07,291
TO START, THE VAST HETEROGENEITY

3083
02:18:07,291 --> 02:18:09,726
OF FTD FROM A CLINICAL AND 

3084
02:18:09,726 --> 02:18:11,929
PATHOLOGICAL PERSPECTIVE POSES A

3085
02:18:11,929 --> 02:18:14,198
SIGNIFICANT OBSTACLE IN TERMS OF

3086
02:18:14,198 --> 02:18:16,533
NOMENCLATURE AND BIOLOGICAL 

3087
02:18:16,533 --> 02:18:19,303
CLASSIFICATION OF FTD AND THE 

3088
02:18:19,303 --> 02:18:22,206
DESIGN AND IMPLEMENTATION OF THE

3089
02:18:22,206 --> 02:18:22,973
MECHANISTIC AND TREATMENT 

3090
02:18:22,973 --> 02:18:24,408
STRATEGIES WHICH IS THE FOCUS OF

3091
02:18:24,408 --> 02:18:27,277
OUR SUBCOMMITTEE AS WE HEARD 

3092
02:18:27,277 --> 02:18:33,383
FROM THE POWERFUL TALK BY LINDE.

3093
02:18:33,383 --> 02:18:36,286
WHAT THERE'S PHOTO MICROGRAPHS 

3094
02:18:36,286 --> 02:18:40,858
OF THE ASSOCIATED PATHOLOGIES 

3095
02:18:40,858 --> 02:18:46,396
CAN BE FOUND MICROSCOPICALLY 

3096
02:18:46,396 --> 02:18:50,701
POSTMORTEM BY THE PROTEINS THAT 

3097
02:18:50,701 --> 02:18:54,438
AGGREGATE IN THE BRAIN CELLS AND

3098
02:18:54,438 --> 02:19:01,011
THERE'S TAU PROTEINS AND FTLD 

3099
02:19:01,011 --> 02:19:06,416
AND OTHER PROTEINOPATHIES AND 

3100
02:19:06,416 --> 02:19:08,886
PRIMARY ALZHEIMER'S DISEASE 

3101
02:19:08,886 --> 02:19:10,654
CHANGE CAN PRESENT WITH FOCAL 

3102
02:19:10,654 --> 02:19:12,956
CLINICAL SYNDROME WITHIN THE FTD

3103
02:19:12,956 --> 02:19:18,996
SYNDROME.

3104
02:19:18,996 --> 02:19:24,835
SO SUPER IMPOSING THE 

3105
02:19:24,835 --> 02:19:28,672
PATHOLOGIES WE CAN SEE THE MAIN 

3106
02:19:28,672 --> 02:19:32,943
FTD SYNDROMES COLOR CODED BY THE

3107
02:19:32,943 --> 02:19:34,444
FREQUENCY OF THE VARIOUS 

3108
02:19:34,444 --> 02:19:35,879
PATHOLOGIES BELOW AND WHAT WE 

3109
02:19:35,879 --> 02:19:37,814
SAW IN A PRIOR SLIDE.

3110
02:19:37,814 --> 02:19:41,785
YOU CAN SEE SOME SYNDROME SUCH 

3111
02:19:41,785 --> 02:19:46,690
AS SUPRAPROGRESSIVE PALSY IS 

3112
02:19:46,690 --> 02:19:49,760
PREDICTIVE AND THE VARIANT OF 

3113
02:19:49,760 --> 02:19:53,263
FTD HAS VARIOUS TAU AND 

3114
02:19:53,263 --> 02:19:54,932
PATHOLOGY COULD BE THE 

3115
02:19:54,932 --> 02:19:56,266
UNDERLYING CAUSE.

3116
02:19:56,266 --> 02:19:58,435
AND WHAT WE SAW FROM DR. KARCH 

3117
02:19:58,435 --> 02:20:00,837
EARLIER IS THESE SYNDROMES CAN 

3118
02:20:00,837 --> 02:20:10,080
OVERLAP WITH EACH OTHER.

3119
02:20:10,080 --> 02:20:14,451
IT SETS THE RECOMMENDATION TO 

3120
02:20:14,451 --> 02:20:18,255
ADVANCE THE DEVELOPMENT OF AN 

3121
02:20:18,255 --> 02:20:19,990
ARRAY OF BIOMARKERS AND DIGITAL 

3122
02:20:19,990 --> 02:20:23,527
HEALTH TECHNOLOGIES FOR MULTIPLE

3123
02:20:23,527 --> 02:20:26,363
USES TO AFFECT THE MAIN GOAL AND

3124
02:20:26,363 --> 02:20:28,398
PROBLEM OF THE CRITICAL 

3125
02:20:28,398 --> 02:20:31,001
IMPORTANCE OF AN EARLY AND 

3126
02:20:31,001 --> 02:20:32,436
ACCURATE DIAGNOSIS OF FTD.

3127
02:20:32,436 --> 02:20:35,505
THIS IS IMPORTANT FOR SCREENING 

3128
02:20:35,505 --> 02:20:46,016
INDIVIDUALS AT RISK TO OBTAIN 

3129
02:20:50,787 --> 02:20:53,724
RISKS AND IDENTIFYING BIOLOGICAL

3130
02:20:53,724 --> 02:20:55,759
CHANGES TO PREDICT 

3131
02:20:55,759 --> 02:20:57,828
PHENOCONVERSION TO MANIFEST FTD 

3132
02:20:57,828 --> 02:20:59,196
AND IN THE CONTEXT OF CLINICAL 

3133
02:20:59,196 --> 02:21:01,565
TRIALS AND THE IMPORTANCE OF 

3134
02:21:01,565 --> 02:21:03,367
DISEASE MONITORING, PATIENT 

3135
02:21:03,367 --> 02:21:06,636
STRATIFICATION TO BIOLOGICAL SUB

3136
02:21:06,636 --> 02:21:09,306
GROUPS WITH HOMOGENEOUS BIOLOGY 

3137
02:21:09,306 --> 02:21:12,075
AND ENHANCE POWER AND TOOLS TO 

3138
02:21:12,075 --> 02:21:14,311
DETECT TARGET ENGAGEMENT FOR 

3139
02:21:14,311 --> 02:21:14,911
ASSOCIATED PATHOLOGIES AS THE 

3140
02:21:14,911 --> 02:21:17,714
OVER ALL RECOMMENDATION.

3141
02:21:17,714 --> 02:21:19,416
WE PRIORITIZE LOW COST AND 

3142
02:21:19,416 --> 02:21:21,118
NON-INVASIVE MODALITIES.

3143
02:21:21,118 --> 02:21:22,953
THEY HELP FACILITATE SCREENING 

3144
02:21:22,953 --> 02:21:24,388
AND DIAGNOSIS, PARTICULARLY IN 

3145
02:21:24,388 --> 02:21:27,224
REMOTE AREAS THAT MAY NOT HAVE 

3146
02:21:27,224 --> 02:21:30,060
ACCESS TO TERTIARY CARE TO HELP 

3147
02:21:30,060 --> 02:21:34,765
EXPAND OUR ABILITY TO DIAGNOSE 

3148
02:21:34,765 --> 02:21:39,302
EARLY AND REDUCE THE DELAY.

3149
02:21:39,302 --> 02:21:40,937
EMPHASIZE NATURAL HISTORY 

3150
02:21:40,937 --> 02:21:42,439
STUDIES TO UNDERSTAND THE 

3151
02:21:42,439 --> 02:21:44,141
BIOLOGY OF FTD AND THE 

3152
02:21:44,141 --> 02:21:46,476
IMPORTANCE OF BRAIN DONATION TO 

3153
02:21:46,476 --> 02:21:48,211
VALIDATE MARKERS TESTED AND 

3154
02:21:48,211 --> 02:21:50,380
DEVELOPMENT AND PET IMAGING 

3155
02:21:50,380 --> 02:21:52,682
MODALITIES TO HELP ACCELERATE 

3156
02:21:52,682 --> 02:21:56,553
OUR ABILITY TO CROSS VALIDATE.

3157
02:21:56,553 --> 02:21:58,188
WE OBSERVED IN ALZHEIMER'S 

3158
02:21:58,188 --> 02:21:59,556
DISEASE WHERE AUTOPSIES ARE THEN

3159
02:21:59,556 --> 02:22:03,827
TO ABLE CROSS-VALIDATE EMERGING 

3160
02:22:03,827 --> 02:22:06,463
BIO FLUID BIOMARKERS RATHER THAN

3161
02:22:06,463 --> 02:22:11,835
TO RELY ON AUTOPSY ALONE.

3162
02:22:11,835 --> 02:22:13,904
AS WE MAKE GAINS IN THE AREAS 

3163
02:22:13,904 --> 02:22:15,138
ACCORDING TO THE RECOMMENDATION 

3164
02:22:15,138 --> 02:22:18,141
WE CAN PREPARE FOR BIOLOGICAL 

3165
02:22:18,141 --> 02:22:18,942
FRAMEWORK AND CONSIDER HOW 

3166
02:22:18,942 --> 02:22:20,010
BIOMARKER CLASSIFICATION EXISTS 

3167
02:22:20,010 --> 02:22:24,481
WITH EXISTING AND EMERGING 

3168
02:22:24,481 --> 02:22:26,183
STRATEGIES FOR ALZHEIMER'S 

3169
02:22:26,183 --> 02:22:30,454
DISEASE AND SYNUCLEIN MYOPATHIES

3170
02:22:30,454 --> 02:22:34,324
AND THE INITIATIVE.

3171
02:22:34,324 --> 02:22:37,727
TO BRIEFLY HIGHLIGHT SOME OF THE

3172
02:22:37,727 --> 02:22:40,464
ADVANCES SINCE THE LAST SUMMIT.

3173
02:22:40,464 --> 02:22:42,466
SOME HAVE BEEN IN BLOOD BRAIN 

3174
02:22:42,466 --> 02:22:45,102
BARRIER BIOMARKERS AND 

3175
02:22:45,102 --> 02:22:48,305
NEUROFILAMENT LIGHT CHAIN TO 

3176
02:22:48,305 --> 02:22:50,407
DETERMINE EARLY BIOLOGICAL 

3177
02:22:50,407 --> 02:22:52,609
CHANGES FOR INDIVIDUALS AT RISK 

3178
02:22:52,609 --> 02:22:57,681
OF DEVELOPING CLINICALLY 

3179
02:22:57,681 --> 02:22:59,783
MANIFESTING FTD AND UNDER GO 

3180
02:22:59,783 --> 02:23:00,717
QUALIFICATIONS FOR THE USE IN 

3181
02:23:00,717 --> 02:23:05,422
THE CONTEXT OF FAMILIAL FTD.

3182
02:23:05,422 --> 02:23:08,425
IN TERMS OF DIAGNOSING BIOLOGY 

3183
02:23:08,425 --> 02:23:10,694
AND IDENTIFYING THOSE LIKELY TO 

3184
02:23:10,694 --> 02:23:15,232
HAVE TAU OR TPD43 AND COMBINING 

3185
02:23:15,232 --> 02:23:18,902
FILAMENT LIGHT WITH OTHER 

3186
02:23:18,902 --> 02:23:19,536
BIOMARKERS SHOW PROMISING EARLY 

3187
02:23:19,536 --> 02:23:25,542
RESULTS.

3188
02:23:25,542 --> 02:23:30,280
PHOSPHORYLATED TAU EPITOPES TO 

3189
02:23:30,280 --> 02:23:31,047
DETECT PATHOLOGY IN THE CONTEXT 

3190
02:23:31,047 --> 02:23:32,916
OF FTD WHICH IS IMPORTANT AND 

3191
02:23:32,916 --> 02:23:34,918
ALSO IMPORTANT TO NOTE THE NEED 

3192
02:23:34,918 --> 02:23:36,586
FOR FTD SPECIFIC BIOMARKERS TO 

3193
02:23:36,586 --> 02:23:39,322
COMPLEMENT THESE IN THE ERA OF 

3194
02:23:39,322 --> 02:23:41,291
AMYLOID THERAPIES.

3195
02:23:41,291 --> 02:23:44,227
NEWER TECHNIQUES SUCH AS MASS 

3196
02:23:44,227 --> 02:23:47,497
SPEC TROSSCOPY TO LOOK AT 

3197
02:23:47,497 --> 02:23:50,834
PRAGMENTS OF TAU AND PROTEOMIC 

3198
02:23:50,834 --> 02:23:54,471
TECHNIQUES AND DERIVED EXTRA 

3199
02:23:54,471 --> 02:23:57,807
CELLULAR VESICLES AND PET 

3200
02:23:57,807 --> 02:24:00,911
TRACERS FOR FTLD FORMS OF TAI 

3201
02:24:00,911 --> 02:24:03,947
AND TDP43 ARE UNDERWAY.

3202
02:24:03,947 --> 02:24:05,549
AND THE WAY TO INTEGRATE 

3203
02:24:05,549 --> 02:24:07,884
BIOLOGICAL INDEXES AND 

3204
02:24:07,884 --> 02:24:09,419
BIOMARKERS AND BUILD STATISTICAL

3205
02:24:09,419 --> 02:24:12,155
MODELS OF PROGRESSION ARE AN 

3206
02:24:12,155 --> 02:24:18,461
IMPORTANT ADVANCE AND HELP GUIDE

3207
02:24:18,461 --> 02:24:19,062
CLINICAL TRIAL END POINTS AS 

3208
02:24:19,062 --> 02:24:22,299
WELL.

3209
02:24:22,299 --> 02:24:24,868
A COMPLEMENTARY RECOMMENDATION 

3210
02:24:24,868 --> 02:24:26,636
IS RECOMMENDATION 7 SO IDENTIFY 

3211
02:24:26,636 --> 02:24:28,138
THE SHARED AND DISPARATE 

3212
02:24:28,138 --> 02:24:30,740
MECHANISMS UNDERLYING THE 

3213
02:24:30,740 --> 02:24:32,576
CLINICAL AND MOLECULAR SUB TYPES

3214
02:24:32,576 --> 02:24:35,512
INCLUSION OF CO-PATHOLOGIES AT 

3215
02:24:35,512 --> 02:24:38,481
THE MOLECULAR, CELLULAR, CIRCUIT

3216
02:24:38,481 --> 02:24:40,984
AND TISSUE LEVELS.

3217
02:24:40,984 --> 02:24:42,052
THIS RECOMMENDATION IS FOCUSSED 

3218
02:24:42,052 --> 02:24:47,624
ON COMPARATIVE STUDIES USING 

3219
02:24:47,624 --> 02:24:48,692
HUMAN TISSUE AND DATA AND 

3220
02:24:48,692 --> 02:24:50,827
TRANSLATE THE MECCISTIC STUDIES 

3221
02:24:50,827 --> 02:24:53,296
WE'LL HEAR ABOUT IN CLINICAL 

3222
02:24:53,296 --> 02:24:57,234
APPLICATION WITH AN EMPHASIS ON 

3223
02:24:57,234 --> 02:24:58,301
IMPROVING AND INFORMING 

3224
02:24:58,301 --> 02:25:01,071
RECRUITMENT STRATEGIES TARGETING

3225
02:25:01,071 --> 02:25:11,481
MOLECULAR MECHANISMS OF FTD.

3226
02:25:11,481 --> 02:25:12,449
FOR EXAMPLE COMPARING FEATURES 

3227
02:25:12,449 --> 02:25:17,721
WITH FTD SUB TYPES WITH THE 

3228
02:25:17,721 --> 02:25:18,455
COMMUNITY TO UNDERSTAND THE 

3229
02:25:18,455 --> 02:25:21,358
BASIS FOR THE VARIOUS CLINICAL 

3230
02:25:21,358 --> 02:25:26,796
EXPRESSION OF TDP43 

3231
02:25:26,796 --> 02:25:29,633
PROTEINOPATHIES.

3232
02:25:29,633 --> 02:25:32,869
AND MORE CLEAR MECHANISMS AND 

3233
02:25:32,869 --> 02:25:35,805
HOW THEY MAY RELATE TO THE 

3234
02:25:35,805 --> 02:25:40,210
BIOLOGY OF SPORADIC OVEDs IS 

3235
02:25:40,210 --> 02:25:46,449
ANOTHER HIGH PRIORITY.

3236
02:25:46,449 --> 02:25:47,817
AND PARTS OF THE BRAIN THAT 

3237
02:25:47,817 --> 02:25:48,485
CONTRIBUTE TO LANGUAGE AND 

3238
02:25:48,485 --> 02:25:50,353
SOCIAL BEHAVIOR AND STUDY THIS 

3239
02:25:50,353 --> 02:25:54,291
IN THE CONTEXT OF HUMAN DISEASE 

3240
02:25:54,291 --> 02:25:56,960
WE PRIORITIZE STANDARDIZING NEW 

3241
02:25:56,960 --> 02:25:59,996
APPROACHES OF PATHOLOGY AND 

3242
02:25:59,996 --> 02:26:01,831
INTERROGATE HUMAN BRAIN TISSUE 

3243
02:26:01,831 --> 02:26:05,935
AND HOW TO INTEGRATE THESE TO 

3244
02:26:05,935 --> 02:26:07,070
STUDY THE BIOLOGY IN THE CONTEXT

3245
02:26:07,070 --> 02:26:09,406
OF THE HUMAN BRAIN CONNECTOME 

3246
02:26:09,406 --> 02:26:10,974
AND INTEGRATE OTHER MODEL 

3247
02:26:10,974 --> 02:26:12,475
SYSTEMS FROM HUMAN DERIVED DATA 

3248
02:26:12,475 --> 02:26:13,643
AND TISSUES.

3249
02:26:13,643 --> 02:26:17,113
THE OVER ALL ARCHING GOAL OF THE

3250
02:26:17,113 --> 02:26:18,448
PRIORITY WHICH IS A LONGER TERM 

3251
02:26:18,448 --> 02:26:20,350
GOAL IS TO IDENTIFY THE NEURAL 

3252
02:26:20,350 --> 02:26:22,719
SUBSTRATES AND MODULATING FACTOR

3253
02:26:22,719 --> 02:26:25,755
FOR DIFFERENT FTD SUB TYPES TO 

3254
02:26:25,755 --> 02:26:28,158
IDENTIFY THERAPEUTIC TARGETS AND

3255
02:26:28,158 --> 02:26:28,792
OPTIMIZE THERAPEUTIC CLINICAL 

3256
02:26:28,792 --> 02:26:34,964
TRIAL RECRUITMENT STRATEGIES.

3257
02:26:34,964 --> 02:26:37,067
I'LL BRIEFLY SUMMARIZE EXAMPLES 

3258
02:26:37,067 --> 02:26:40,203
OF RECENT BIOLOGICAL SUB TYPES 

3259
02:26:40,203 --> 02:26:46,443
DEPICTED ARE FINDING OF TDP43 

3260
02:26:46,443 --> 02:26:54,451
TYPE C HAVING CONSISTENT ANXA11 

3261
02:26:54,451 --> 02:27:01,925
PROTEINOPATHY AND A UNIQUE 

3262
02:27:01,925 --> 02:27:05,595
FEATURE IS FILAMENT STRUCTURE.

3263
02:27:05,595 --> 02:27:08,264
AND EXCITING WORK LOOKING AT 

3264
02:27:08,264 --> 02:27:18,475
CRYPTICEX  -- CRYPTIC AM  AXON 

3265
02:27:18,475 --> 02:27:22,479
AND FLUIDS IN THE VARIOUS FORMS 

3266
02:27:22,479 --> 02:27:24,681
OF PROTEINOPATHIES SHOW 

3267
02:27:24,681 --> 02:27:26,449
POTENTIAL MECHANISMS AND FURTHER

3268
02:27:26,449 --> 02:27:28,585
UNDERSTANDING OF THE CELLULAR 

3269
02:27:28,585 --> 02:27:29,753
AND TRANSCRIPTIONAL SUB TYPES 

3270
02:27:29,753 --> 02:27:31,721
AND HOW THEY RELATE ARE 

3271
02:27:31,721 --> 02:27:32,389
IMPORTANT.

3272
02:27:32,389 --> 02:27:34,691
USING DIGITAL PATHOLOGY TO 

3273
02:27:34,691 --> 02:27:36,760
INTERROGATE BRAIN TISSUE AND 

3274
02:27:36,760 --> 02:27:38,628
LOOKING AT CLINICALLY DEFINED 

3275
02:27:38,628 --> 02:27:41,431
GROUP AND BEHAVIORAL VARIANT OF 

3276
02:27:41,431 --> 02:27:47,070
FTD WE CAN STUD 

3277
02:27:47,070 --> 02:27:48,605
NEURODEGENERATION IN BRAIN 

3278
02:27:48,605 --> 02:27:52,108
PATTERNS AND CONNECTIVITY AND 

3279
02:27:52,108 --> 02:27:58,448
FINALLY FINDINGS OF PROGRANULIN 

3280
02:27:58,448 --> 02:28:06,322
AND HAPLO INSUFFICIENCY SUGGEST 

3281
02:28:06,322 --> 02:28:07,190
AD/ADRD AND I'D LIKE TO THANK 

3282
02:28:07,190 --> 02:28:08,358
OUR PATIENTS AND FAMILIES WHO 

3283
02:28:08,358 --> 02:28:18,468
PARTICIPATE IN RESEARCH.

3284
02:28:18,468 --> 02:28:19,769
>> I'M BACK.

3285
02:28:19,769 --> 02:28:21,538
THIS IS CELESTE KARCH IN 

3286
02:28:21,538 --> 02:28:24,274
ST. LOUIS AND I'LL BE SHARING 

3287
02:28:24,274 --> 02:28:28,411
OUR RECOMMENDATIONS AND MODELS 

3288
02:28:28,411 --> 02:28:31,581
AND MY DISCLOSURES ARE HERE.

3289
02:28:31,581 --> 02:28:38,455
I BRING YOU BACK TO THIS IDEA OF

3290
02:28:38,455 --> 02:28:40,557
THE WRESTLING WITH THE UMBRELLA 

3291
02:28:40,557 --> 02:28:42,192
TERM WHILE KNOWING THERE'S BIG 

3292
02:28:42,192 --> 02:28:45,328
CLEAR GENETIC CAUSE DIFFER 

3293
02:28:45,328 --> 02:28:47,464
ACROSS THE DIFFERENT FTD SUB 

3294
02:28:47,464 --> 02:28:48,998
TYPES AND AMONG THE NON-GENETIC 

3295
02:28:48,998 --> 02:28:52,902
FORMS THE SPORADIC FORMS THERE'S

3296
02:28:52,902 --> 02:28:55,438
DIFFERENT AS RESPECTS OF 

3297
02:28:55,438 --> 02:29:00,844
MOLECULAR PATHOLOGY THAT AFFECTS

3298
02:29:00,844 --> 02:29:04,247
THE PHENOTYPE WE SEE WHEN 

3299
02:29:04,247 --> 02:29:13,156
PATIENTS COME REPORT IING ISSUE.

3300
02:29:13,156 --> 02:29:17,293
AS WE THINK OF MODELLING 

3301
02:29:17,293 --> 02:29:18,161
DISEASE, PERHAPS THE TRADITIONAL

3302
02:29:18,161 --> 02:29:23,533
THOUGHT IS SORT OF TO MODEL THE 

3303
02:29:23,533 --> 02:29:25,201
CELL BASIS OF DISEASE AND WHILE 

3304
02:29:25,201 --> 02:29:28,137
THAT'S IMPORTANT THE COMMITTEE 

3305
02:29:28,137 --> 02:29:30,540
WANTED TO EMPHASIZE THAT MODELS 

3306
02:29:30,540 --> 02:29:32,141
REALLY WILL BE VALUABLE TO 

3307
02:29:32,141 --> 02:29:35,411
CAPTURE EVERY LEVEL OF THE 

3308
02:29:35,411 --> 02:29:38,448
ASPECTS OF FTD FROM THE GENETIC 

3309
02:29:38,448 --> 02:29:40,984
AND PATH LOGIC FEATURES AND ALSO

3310
02:29:40,984 --> 02:29:42,418
THINKING ABOUT WAYS TO 

3311
02:29:42,418 --> 02:29:43,319
EFFECTIVELY MODEL THE CLINICAL 

3312
02:29:43,319 --> 02:29:53,563
PRESENTATIONS.

3313
02:30:01,471 --> 02:30:03,640
 I WANT TO SHOW THE RECENT WORK 

3314
02:30:03,640 --> 02:30:04,674
IN THE LITERATURE THAT SHOW THE 

3315
02:30:04,674 --> 02:30:06,643
VALUE OF MODELS AND THE VALUE OF

3316
02:30:06,643 --> 02:30:08,444
INTEGRATIVE MODELS AND I 

3317
02:30:08,444 --> 02:30:14,217
APOLOGIZE FOR THE BLURRINESS OF 

3318
02:30:14,217 --> 02:30:17,854
THIS PICTURE AND WHAT'S EMERGED 

3319
02:30:17,854 --> 02:30:19,289
FROM STUDIES FROM TWO 

3320
02:30:19,289 --> 02:30:21,257
INDEPENDENT ROLES IS THERE'S A 

3321
02:30:21,257 --> 02:30:26,462
ROLE FOR TDP43 IN ALTERING 

3322
02:30:26,462 --> 02:30:31,134
SPECIFIC TRANSCRIPTS THAT 

3323
02:30:31,134 --> 02:30:33,536
PRODUCE WHAT IS TERMED CRYPTIC 

3324
02:30:33,536 --> 02:30:35,805
AXON WE HEARD FROM DR. IRWIN 

3325
02:30:35,805 --> 02:30:39,208
THAT CAN TELL US ABOUT THE 

3326
02:30:39,208 --> 02:30:43,146
BIOLOGY OF DISEASE AND 

3327
02:30:43,146 --> 02:30:45,582
POTENTIALLY SERVE AS BIOMARKERS.

3328
02:30:45,582 --> 02:30:46,516
WHAT THE COMPANION PAPERS SHOWED

3329
02:30:46,516 --> 02:30:50,553
US IS WE CAN GET AT THE IDEAS 

3330
02:30:50,553 --> 02:30:55,024
THROUGH VERY DIFFERENT 

3331
02:30:55,024 --> 02:30:56,593
APPROACHES TO MODELS.

3332
02:30:56,593 --> 02:30:57,827
IN THE FIRST STUDY STEM CELL 

3333
02:30:57,827 --> 02:31:02,832
MODELS WERE USED WHERE A WELL 

3334
02:31:02,832 --> 02:31:03,733
CHARACTERIZED POTENT STEM CELL 

3335
02:31:03,733 --> 02:31:09,205
LINE WAS MANIPULATED TO REMOVE 

3336
02:31:09,205 --> 02:31:10,807
TDP43 AND SUBSEQUENT ANALYSIS OF

3337
02:31:10,807 --> 02:31:17,747
THE NEURONS REVEALED THIS CHANGE

3338
02:31:17,747 --> 02:31:22,251
IN IN A PARTICULAR GENE IN 13A 

3339
02:31:22,251 --> 02:31:24,187
WHICH HAD ALTERED CRYPTIC AXONS.

3340
02:31:24,187 --> 02:31:26,623
IN A PARALLEL APPROACH 

3341
02:31:26,623 --> 02:31:29,859
INVESTIGATORS WERE ABLE TO TAKE 

3342
02:31:29,859 --> 02:31:31,928
HUMAN BRAIN TISSUE FROM PEOPLE 

3343
02:31:31,928 --> 02:31:34,464
WHO HAVE FTD AND WERE ABLE TO 

3344
02:31:34,464 --> 02:31:37,166
ISOLATE NEURONS FROM THE BRAINS 

3345
02:31:37,166 --> 02:31:38,434
AND ASK WHAT'S THERE, WHAT'S 

3346
02:31:38,434 --> 02:31:40,069
DIFFERENT AND HOW DOES THAT 

3347
02:31:40,069 --> 02:31:41,571
COMPARE TO NORMAL CONTROL BRAINS

3348
02:31:41,571 --> 02:31:44,440
AND AGAIN THEY WERE ABLE TO SEE 

3349
02:31:44,440 --> 02:31:48,378
THIS CHANGE IN A GENE ONC 13A IN

3350
02:31:48,378 --> 02:31:49,145
GENERATIONS IN THE SPLICING.

3351
02:31:49,145 --> 02:31:54,450
SO THIS REALLY HIGHLIGHTED THE 

3352
02:31:54,450 --> 02:31:57,220
ADDED VALUE OF MOILING FROM 

3353
02:31:57,220 --> 02:31:57,787
DIFFERENT PERSPECTIVES AND 

3354
02:31:57,787 --> 02:32:03,693
DIFFERENT LEVELS.

3355
02:32:03,693 --> 02:32:05,662
IN DISCOVERY OF FUNDAMENTAL 

3356
02:32:05,662 --> 02:32:07,964
MECHANISMS AND TO REVEAL NEW 

3357
02:32:07,964 --> 02:32:10,700
BIOMARKERS AND THERAPEUTIC 

3358
02:32:10,700 --> 02:32:20,443
TARGETS.

3359
02:32:20,443 --> 02:32:24,814
ANOTHER AREA OF  MASSIVE GROWTH 

3360
02:32:24,814 --> 02:32:27,450
HAS BEEN ABLE TO LEVERAGE CELLS 

3361
02:32:27,450 --> 02:32:30,353
IN WAYS AND WHILE THE PRIOR 

3362
02:32:30,353 --> 02:32:31,621
STUDY USED SYSTEM MODELS TO 

3363
02:32:31,621 --> 02:32:33,623
REMOVE A GENE, THERE ARE EFFORTS

3364
02:32:33,623 --> 02:32:35,558
FOCUSSED ON TAKING CELLS FROM 

3365
02:32:35,558 --> 02:32:41,130
PEOPLE WHO CARRY MUTATIONS THAT 

3366
02:32:41,130 --> 02:32:42,231
CAUSE DISEASE LIKE THOSE LINDE 

3367
02:32:42,231 --> 02:32:43,666
DESCRIBED AND TO MAKE THEM INTO 

3368
02:32:43,666 --> 02:32:46,069
CELL TYPES IN THE BRAIN SUCH AS 

3369
02:32:46,069 --> 02:32:47,336
BRAIN ORGANOIDS THAT DEVELOP IN 

3370
02:32:47,336 --> 02:32:50,540
A MANNER THAT LOOKS LIKE THE 

3371
02:32:50,540 --> 02:32:51,908
DEVELOPING BRAIN.

3372
02:32:51,908 --> 02:32:55,445
AND THEN TO TRACK HOW THESE 

3373
02:32:55,445 --> 02:32:59,348
CHANGES OCCUR ORE HOW SPECIFIC 

3374
02:32:59,348 --> 02:33:02,452
CHANGES OCCUR OVER TIME AND HOW 

3375
02:33:02,452 --> 02:33:04,320
THEY COMPARE TO CELLS WHERE THE 

3376
02:33:04,320 --> 02:33:06,189
GENETIC MUTATION HAS BEEN 

3377
02:33:06,189 --> 02:33:06,456
CORRECTED.

3378
02:33:06,456 --> 02:33:07,824
ULTIMATELY THE EFFORTS HAVE LED 

3379
02:33:07,824 --> 02:33:10,526
TO A REALLY BEAUTIFUL SET OF 

3380
02:33:10,526 --> 02:33:13,663
PHENOTYPES THAT ARE CHANGING 

3381
02:33:13,663 --> 02:33:17,667
OVER TIME AND CAN BE TARGETED.

3382
02:33:17,667 --> 02:33:19,469
IN ADDITION TO THAT THERE'S A 

3383
02:33:19,469 --> 02:33:23,039
LOT OF GROUPS THAT HAVE MADE 

3384
02:33:23,039 --> 02:33:25,208
HUGE HEADWINDS IN MAKING 

3385
02:33:25,208 --> 02:33:26,442
FIBROBLASTS FROM PEOPLE WHO 

3386
02:33:26,442 --> 02:33:30,446
CARRY DIFFERENT MUTATIONS OR ARE

3387
02:33:30,446 --> 02:33:32,148
CLINICALLY DIAGNOSED WITH FTDs 

3388
02:33:32,148 --> 02:33:34,383
AND CONVERT THOSE FROM A SKIN 

3389
02:33:34,383 --> 02:33:36,219
CELL INTO A NEURON AND THOSE ARE

3390
02:33:36,219 --> 02:33:39,655
ENABLED US TO BE ABLE TO BEGIN 

3391
02:33:39,655 --> 02:33:43,226
TO VISUALIZE PROTEIN AGGREGATS 

3392
02:33:43,226 --> 02:33:45,595
IN A WAY WE HAVEN'T BEFORE.

3393
02:33:45,595 --> 02:33:49,232
THIS ALLOWS US TO UNDERSTAND THE

3394
02:33:49,232 --> 02:33:51,200
BIOLOGY AND AGGREGATES IN WHICH 

3395
02:33:51,200 --> 02:33:52,668
THEY ARE FORM AND HAVE TOOLS 

3396
02:33:52,668 --> 02:33:56,139
NOW, CELL LINES WE CAN SCREEN 

3397
02:33:56,139 --> 02:34:00,376
FOR COMPOUNDS THAT BLOCK OR 

3398
02:34:00,376 --> 02:34:03,780
REDUCE THE FORMATION OF THE 

3399
02:34:03,780 --> 02:34:06,616
AGGREGATES THAT CAN BE MOVED 

3400
02:34:06,616 --> 02:34:07,583
INTO TRIALS.

3401
02:34:07,583 --> 02:34:11,154
WITH OF THE MANY EXAMPLES I'VE 

3402
02:34:11,154 --> 02:34:21,631
SHOWN ARE REALLY ON EFFECTS 

3403
02:34:22,231 --> 02:34:23,232
WITHIN NEURONS AND THE FTD FIELD

3404
02:34:23,232 --> 02:34:25,802
IS SEEING A LEVEL OF COMPLEXITY 

3405
02:34:25,802 --> 02:34:28,304
ACROSS THE CELL TYPES THAT ARE 

3406
02:34:28,304 --> 02:34:30,439
FOUND IN THE BRAIN THAT ARE 

3407
02:34:30,439 --> 02:34:32,809
LIKELY CONTRIBUTING TO FTD AND 

3408
02:34:32,809 --> 02:34:34,744
MODELS ARE BEGINNING TO POINT US

3409
02:34:34,744 --> 02:34:37,213
IN THIS DIRECTION BUT REMAINS AN

3410
02:34:37,213 --> 02:34:39,549
IMPORTANT AREA OF GROWTH AND 

3411
02:34:39,549 --> 02:34:50,059
EMPHASIS IN THE COMING YEARS.

3412
02:34:52,195 --> 02:34:53,896
RECOMMENDATION 3 IS FOCUSSED ON 

3413
02:34:53,896 --> 02:34:56,265
A NEED TO ESTABLISH AND VALIDATE

3414
02:34:56,265 --> 02:34:58,067
PRECLINICAL AND TRANSLATIONAL 

3415
02:34:58,067 --> 02:35:01,204
MODELS BECAUSE WE THINK THESE 

3416
02:35:01,204 --> 02:35:03,606
ARE ESSENTIAL TO UNDERSTAND 

3417
02:35:03,606 --> 02:35:04,941
BASIC CELLULAR MECHANISM AND TO 

3418
02:35:04,941 --> 02:35:07,543
GET TO THERAPEUTICS.

3419
02:35:07,543 --> 02:35:10,246
AND WHEN WE TALK ABOUT MODELS I 

3420
02:35:10,246 --> 02:35:13,082
WANT TO EMPHASIZE THAT WE'RE 

3421
02:35:13,082 --> 02:35:14,951
DEFINING MODELS QUITE BROADLY.

3422
02:35:14,951 --> 02:35:18,254
IN FACT BECAUSE OUR MODELS ARE 

3423
02:35:18,254 --> 02:35:22,458
ONLY AS GOOD AS THE DISEASE THAT

3424
02:35:22,458 --> 02:35:27,496
WE'RE ABLE TO UNDERSTAND.

3425
02:35:27,496 --> 02:35:29,198
WE NEED TO UNDERSTAND WHAT THE 

3426
02:35:29,198 --> 02:35:30,466
PATIENT POPULATION LOOKS LIKE 

3427
02:35:30,466 --> 02:35:34,437
AND HOW THE DIFFERENT SUB TYPE 

3428
02:35:34,437 --> 02:35:36,272
MANIFESTING IN THE BRAIN AND IN 

3429
02:35:36,272 --> 02:35:46,816
OTHER FEATURES LIKE IN IMAGING 

3430
02:35:48,484 --> 02:35:50,353
AND FLUID BIOMARKERS AND TAKING 

3431
02:35:50,353 --> 02:35:54,457
AN UNBIASSED APPROACH 

3432
02:35:54,457 --> 02:35:56,092
INTEGRATING A.I. TO DEFINE THE 

3433
02:35:56,092 --> 02:35:58,995
WAYS IN WHICH THE GROUPS ARE 

3434
02:35:58,995 --> 02:36:00,997
SIMILAR AND DISCREPANT SO OUR 

3435
02:36:00,997 --> 02:36:03,799
MODELS IN CELLS AND IN MICE CAN 

3436
02:36:03,799 --> 02:36:06,469
ULTIMATELY REFLECT THOSE 

3437
02:36:06,469 --> 02:36:08,304
INDIVIDUALS.

3438
02:36:08,304 --> 02:36:11,774
IN ORDER TO DO THIS WE REALLY 

3439
02:36:11,774 --> 02:36:19,248
SEE A NEED TO WORK IN 

3440
02:36:19,248 --> 02:36:21,817
PUBLIC-PRIVATE PARTNERSHIPS TO 

3441
02:36:21,817 --> 02:36:23,386
AGGREGATE THE DATA AND HARMONIZE

3442
02:36:23,386 --> 02:36:28,991
THE RESOURCES AND REALLY ENABLE 

3443
02:36:28,991 --> 02:36:31,494
OUR UNDERSTANDING OF DISEASE AND

3444
02:36:31,494 --> 02:36:35,464
IN DOING THIS, WE THINK THAT 

3445
02:36:35,464 --> 02:36:37,833
THERE'S A SPECIAL NEED TO ALSO 

3446
02:36:37,833 --> 02:36:39,502
FOCUS ON MODELLING THE SPORADIC 

3447
02:36:39,502 --> 02:36:41,704
FORMS OF DISEASE, WHICH IS 

3448
02:36:41,704 --> 02:36:42,338
PRESENTED AS A MAJOR CHALLENGE 

3449
02:36:42,338 --> 02:36:47,476
IN THE PAST.

3450
02:36:47,476 --> 02:36:49,211
SO I'LL STOP THERE AND THANK 

3451
02:36:49,211 --> 02:36:52,548
EVERYONE FOR THEIR ASSISTANCE IN

3452
02:36:52,548 --> 02:36:54,450
DEVELOPING THESE 

3453
02:36:54,450 --> 02:36:56,218
RECOMMENDATIONS.

3454
02:36:56,218 --> 02:36:57,153
>> THANK YOU.

3455
02:36:57,153 --> 02:37:01,223
I APPRECIATE THE OPPORTUNITY TO 

3456
02:37:01,223 --> 02:37:09,131
PRESENT HERE AT THIS ADRD 

3457
02:37:09,131 --> 02:37:09,799
SUMMIT.

3458
02:37:09,799 --> 02:37:11,701
I'LL TALK ABOUT RECOMMENDATION 

3459
02:37:11,701 --> 02:37:13,769
NUMBER SIX WHICH IS PRIORITY 

3460
02:37:13,769 --> 02:37:15,871
THREE AND THERE'S A LOT OF 

3461
02:37:15,871 --> 02:37:16,405
WORDS.

3462
02:37:16,405 --> 02:37:18,841
RECOMMENDATION SIX IS TO 

3463
02:37:18,841 --> 02:37:24,447
ELUCIDATE THE CELL AUTONOMOUS 

3464
02:37:24,447 --> 02:37:28,451
AND UNDERSTANDING SELECTIVELY 

3465
02:37:28,451 --> 02:37:30,453
VULNERABILITIES AND THERE BE 

3466
02:37:30,453 --> 02:37:31,988
IDENTIFYING NEW TARGETS FOR 

3467
02:37:31,988 --> 02:37:33,155
THERAPEUTIC DEVELOPMENT.

3468
02:37:33,155 --> 02:37:34,991
THE BULLETS ARE BASICALLY AN 

3469
02:37:34,991 --> 02:37:37,326
OUTLINE OF HOW I'M GOING TO GO 

3470
02:37:37,326 --> 02:37:38,294
THROUGH THIS BUT IT'S IMPORTANT 

3471
02:37:38,294 --> 02:37:43,566
FOR FOLKS TO KNOW AS DR. KARCH 

3472
02:37:43,566 --> 02:37:45,267
PRESENTED THE BRAIN REGIONS 

3473
02:37:45,267 --> 02:37:48,337
VULNERABLE AND FTD ARE 

3474
02:37:48,337 --> 02:37:50,639
DISTINCTIVE FROM ALZHEIMER'S 

3475
02:37:50,639 --> 02:37:58,447
DISEASE AND OTHER ALZHEIMER'S 

3476
02:37:58,447 --> 02:37:59,081
DISEASE-RELATED DIMENTIAS AND 

3477
02:37:59,081 --> 02:38:02,418
THEY COME IN GLIA AND IMMUNE 

3478
02:38:02,418 --> 02:38:04,020
CELLS AND ENDOTHELIAL CELLS I'LL

3479
02:38:04,020 --> 02:38:05,321
UNPACK IN A MOMENT.

3480
02:38:05,321 --> 02:38:09,258
IF WE CAN GAIN DEEPER 

3481
02:38:09,258 --> 02:38:11,060
MECHANISTIC INSIGHT WHETHER 

3482
02:38:11,060 --> 02:38:12,628
THEY'RE STARTING OR PROGRESSING 

3483
02:38:12,628 --> 02:38:20,736
IN NEURON OR NON AUTONOMOUS OR 

3484
02:38:20,736 --> 02:38:21,470
NON-NEURONAL CONTRIBUTIONS WILL 

3485
02:38:21,470 --> 02:38:23,472
HELP DEVELOP BETTER THERAPIES.

3486
02:38:23,472 --> 02:38:26,442
THE PROCESSES THAT INVOLVE 

3487
02:38:26,442 --> 02:38:27,943
NEURONS AND OTHER CELLS 

3488
02:38:27,943 --> 02:38:31,447
INCLUDING NEURAL INFLAMMATION 

3489
02:38:31,447 --> 02:38:38,854
AND SENESCENCE AND VASCULAR 

3490
02:38:38,854 --> 02:38:40,156
DYSFUNCTION, ETCETERA.

3491
02:38:40,156 --> 02:38:43,859
THE HEADLINE HIERE IS WE KNOW 

3492
02:38:43,859 --> 02:38:45,161
THROUGH THE COURSE OF SCIENTIFIC

3493
02:38:45,161 --> 02:38:46,996
RESEARCH AND EFFECTIVE THERAPIES

3494
02:38:46,996 --> 02:38:48,364
DEVELOPED TO DATE IF WE BETTER 

3495
02:38:48,364 --> 02:38:50,032
UNDERSTAND DISEASE MECHANISMS 

3496
02:38:50,032 --> 02:38:52,234
WE'RE GOING TO GET BETTER 

3497
02:38:52,234 --> 02:38:54,270
THERAPIES AND TO THIS I'LL ADD 

3498
02:38:54,270 --> 02:38:57,673
WHAT DR. IRWIN TALKED ABOUT IS 

3499
02:38:57,673 --> 02:39:01,343
BETTER BIOMARKERS AND DR. BOXER 

3500
02:39:01,343 --> 02:39:03,779
SAID WE NEED THEM TO DO BETTER 

3501
02:39:03,779 --> 02:39:04,046
THERAPIES.

3502
02:39:04,046 --> 02:39:08,551
THE BRAIN REGIONS AFFECTED ARE 

3503
02:39:08,551 --> 02:39:15,891
THE FRONTO TEMPORAL LOBES AND 

3504
02:39:15,891 --> 02:39:17,326
EACH BRAIN REGIONS HAVE 

3505
02:39:17,326 --> 02:39:19,328
DIFFERENT CELLS.

3506
02:39:19,328 --> 02:39:22,631
NEURON THERE AND THERE'S ASTRO 

3507
02:39:22,631 --> 02:39:24,867
GLIA WHICH ARE THE PARENTS OF 

3508
02:39:24,867 --> 02:39:27,703
NEURONS, THE COUSINS OF NEURONS 

3509
02:39:27,703 --> 02:39:29,438
OR SIBLINGS RATHER THAN JUST A 

3510
02:39:29,438 --> 02:39:31,774
GLUE CELL.

3511
02:39:31,774 --> 02:39:34,443
MICROGLIA WHICH ARE IMPORTANT TO

3512
02:39:34,443 --> 02:39:39,882
THE IMMUNE SYSTEM AND APPENDMEL 

3513
02:39:39,882 --> 02:39:42,451
CELLS AND ADREN DROE SITES AND 

3514
02:39:42,451 --> 02:39:49,258
MAY CONTRIBUTE TO THE DISEASES 

3515
02:39:49,258 --> 02:39:52,261
AND NEED TO BE STUDIED AND 

3516
02:39:52,261 --> 02:39:53,095
UNDERSTOOD.

3517
02:39:53,095 --> 02:39:55,264
ALSO THE GENETICS OF THE GENES 

3518
02:39:55,264 --> 02:39:56,899
FOUND TO BE ASSOCIATED WITH FTD 

3519
02:39:56,899 --> 02:40:01,337
ARE NOT ALWAYS EXPRESSED IN THE 

3520
02:40:01,337 --> 02:40:02,438
NEURONS.

3521
02:40:02,438 --> 02:40:04,740
THE VAST MAJORITY ARE EXPRESSED 

3522
02:40:04,740 --> 02:40:06,275
IN MOST CELLS.

3523
02:40:06,275 --> 02:40:08,711
SOMETIMES FOR PROGRANULIN IT'S 

3524
02:40:08,711 --> 02:40:11,213
EXPRESSED MORE IN MICROGLIA THAN

3525
02:40:11,213 --> 02:40:13,149
IN NEURONS AND TO TAKE AN 

3526
02:40:13,149 --> 02:40:14,416
EXAMPLE FROM ALZHEIMER'S DISEASE

3527
02:40:14,416 --> 02:40:16,685
THERE'S GENES SUCH THAT ARE OATH

3528
02:40:16,685 --> 02:40:18,120
EXPRESSED IN MICROGLIA AND NOT 

3529
02:40:18,120 --> 02:40:19,321
IN NEURONS AT ALL.

3530
02:40:19,321 --> 02:40:20,456
IT'S IMPORTANT AS WE THINK ABOUT

3531
02:40:20,456 --> 02:40:24,193
THE GENETICS WE THINK ABOUT 

3532
02:40:24,193 --> 02:40:26,128
WHERE THE GENE MUTATION IS 

3533
02:40:26,128 --> 02:40:26,362
ACTING.

3534
02:40:26,362 --> 02:40:30,065
IN ADDITION, I THINK FOR A LONG 

3535
02:40:30,065 --> 02:40:34,737
TIME I THOUGHT THE AGGREGATES 

3536
02:40:34,737 --> 02:40:37,239
IMPLICATIONS THE TDP43 AND TAU 

3537
02:40:37,239 --> 02:40:41,143
AGGREGATE ONLY FOUND IN NEURONS 

3538
02:40:41,143 --> 02:40:43,312
WE KNOW NOW IN SUPRANUCLEAR 

3539
02:40:43,312 --> 02:40:51,921
PALSY YOU CAN SEE THEM IN ASTRO 

3540
02:40:51,921 --> 02:40:56,058
GLIA AND ADRENDOCYTES AND WE AS 

3541
02:40:56,058 --> 02:40:58,460
WE UNDERSTAND DISEASE MECHANISMS

3542
02:40:58,460 --> 02:41:00,963
IT WILL LEAD TO APPROPRIATE 

3543
02:41:00,963 --> 02:41:02,998
THERAPIES THAT PERHAPS TARGET 

3544
02:41:02,998 --> 02:41:03,966
MORE THAN NEURONS.

3545
02:41:03,966 --> 02:41:05,234
AS A CORRELATE WHAT I SHOULD 

3546
02:41:05,234 --> 02:41:09,438
HAVE ADDED IS AS WE UNDERSTAND 

3547
02:41:09,438 --> 02:41:10,372
MECHANISM, WE CAN BETTER 

3548
02:41:10,372 --> 02:41:11,807
UNDERSTAND WHAT WE NEED TO 

3549
02:41:11,807 --> 02:41:13,976
DEVELOP AS BIOMARKERS.

3550
02:41:13,976 --> 02:41:16,145
SO TOGETHER THESE MAKE UP THE 

3551
02:41:16,145 --> 02:41:19,782
CELL AUTONOMOUS VERSUS 

3552
02:41:19,782 --> 02:41:25,321
NON-AUTONOMOUS MECHANISMS.

3553
02:41:25,321 --> 02:41:27,056
SO SELECTIVE VULNERABILITY IS 

3554
02:41:27,056 --> 02:41:29,592
THE CONCEPT CERTAIN NEURONS OR 

3555
02:41:29,592 --> 02:41:33,128
CERTAIN CELLS IN DIFFERENT BRAIN

3556
02:41:33,128 --> 02:41:34,430
AFFECTED IN DIFFERENT DISEASES.

3557
02:41:34,430 --> 02:41:35,664
THIS TERM HAS BEEN AROUND FOR 

3558
02:41:35,664 --> 02:41:38,334
OVER 20 YEARS.

3559
02:41:38,334 --> 02:41:40,536
I REMEMBER READING REVIEWS ABOUT

3560
02:41:40,536 --> 02:41:42,371
THIS IN THE EARLY 2000s BUT THE 

3561
02:41:42,371 --> 02:41:44,440
ADVANCES WE HAVE MADE HAVE COME 

3562
02:41:44,440 --> 02:41:45,474
FROM UNDERSTANDING THERE'S A LOT

3563
02:41:45,474 --> 02:41:47,743
OF GENETIC MUTATIONS ASSOCIATED 

3564
02:41:47,743 --> 02:41:49,311
WITH THE DIFFERENT DISEASES.

3565
02:41:49,311 --> 02:41:51,013
SOMETIMES THEY'RE OVERLAPPING, 

3566
02:41:51,013 --> 02:41:52,448
SOMETIMES THEY'RE NOT AND 

3567
02:41:52,448 --> 02:41:53,249
THEY'RE HIGHLIGHTED IN THE 

3568
02:41:53,249 --> 02:41:54,116
PURPLE BOX.

3569
02:41:54,116 --> 02:41:56,785
IN ADDITION, WE NOW KNOW THAT 

3570
02:41:56,785 --> 02:41:58,621
THERE ARE DIFFERENT CELL TYPES 

3571
02:41:58,621 --> 02:42:01,924
THAT MAY BE AFFECTED, FOR 

3572
02:42:01,924 --> 02:42:05,261
EXAMPLE, LAYER TWO VERSUS LAYER 

3573
02:42:05,261 --> 02:42:06,929
SIX IN BRAIN STEM VERSUS 

3574
02:42:06,929 --> 02:42:09,265
CORTICAL AND THEY'VE BEEN VERY 

3575
02:42:09,265 --> 02:42:10,432
IMPORTANT IN UNDERSTANDING 

3576
02:42:10,432 --> 02:42:12,368
SELECTIVE VULNERABILITY.

3577
02:42:12,368 --> 02:42:14,670
THE BOTTOM LINE IS WE DON'T 

3578
02:42:14,670 --> 02:42:16,372
UNDERSTAND WHAT MAKES CERTAIN 

3579
02:42:16,372 --> 02:42:17,640
BRAIN REGIONS AND CELL TYPES 

3580
02:42:17,640 --> 02:42:17,940
VULNERABLE.

3581
02:42:17,940 --> 02:42:21,477
SO THIS IS A KEY AREA WE NEED TO

3582
02:42:21,477 --> 02:42:22,011
PUSH FORWARD IN TERMS OF 

3583
02:42:22,011 --> 02:42:30,452
DEVELOPING INSIGHT.

3584
02:42:30,452 --> 02:42:32,488
AMONG THE REASONS FOR MOVING 

3585
02:42:32,488 --> 02:42:34,456
BEYOND THE NEURON CENTRIC VIEW 

3586
02:42:34,456 --> 02:42:36,492
ARE THE DISTRIBUTION OF 

3587
02:42:36,492 --> 02:42:38,360
AGGREGATES, THE RELATIVE GENE 

3588
02:42:38,360 --> 02:42:41,397
EXPRESSION AND CELL 

3589
02:42:41,397 --> 02:42:42,798
NON-AUTONOMOUS MECHANISMS I'VE 

3590
02:42:42,798 --> 02:42:43,232
MENTIONED.

3591
02:42:43,232 --> 02:42:45,200
THESE THREE THINGS ALSO LEAD US 

3592
02:42:45,200 --> 02:42:49,138
TO FOCUS ON DIFFERENT PROCESSES 

3593
02:42:49,138 --> 02:42:49,538
FOR INVESTIGATION.

3594
02:42:49,538 --> 02:42:52,841
SO NEURAL INFLAMMATION WE KNOW 

3595
02:42:52,841 --> 02:42:55,444
IS A BIG CONTRIBUTOR IN FTD 

3596
02:42:55,444 --> 02:42:59,315
BECAUSE WE SEE EXPANSION OF 

3597
02:42:59,315 --> 02:43:01,383
GLIAL CELLS AND THERE'S THE 

3598
02:43:01,383 --> 02:43:05,487
INABILITY TO CLEAR PROTEINS AND 

3599
02:43:05,487 --> 02:43:06,422
LIPID METABOLISM IS IMPORTANT 

3600
02:43:06,422 --> 02:43:08,390
AND METABOLISM AND SENESCENCE 

3601
02:43:08,390 --> 02:43:10,459
AND THE SPREADING OF TOXIC 

3602
02:43:10,459 --> 02:43:12,628
PROTEINS AND VASCULAR 

3603
02:43:12,628 --> 02:43:15,064
DYSFUNCTION AND APOE 

3604
02:43:15,064 --> 02:43:18,434
MUTATIONS -- VARIANTS LEADING TO

3605
02:43:18,434 --> 02:43:21,737
INCREASED RISK FOR FTD ALONG 

3606
02:43:21,737 --> 02:43:22,971
WITH ALZHEIMER'S DISEASE AND 

3607
02:43:22,971 --> 02:43:24,406
SLEEP DYSFUNCTION, STRESS AND 

3608
02:43:24,406 --> 02:43:26,008
AGING WHICH IS THE SINGLE MOST 

3609
02:43:26,008 --> 02:43:27,710
IMPORTANT RISK FACTOR FOR ALL 

3610
02:43:27,710 --> 02:43:30,679
THE NEURAL DEGENERATIVE 

3611
02:43:30,679 --> 02:43:34,116
DISORDERS.

3612
02:43:34,116 --> 02:43:36,452
SO, THE NEXT QUESTION IS WHAT IS

3613
02:43:36,452 --> 02:43:37,453
NEEDED TO ADVANCE THE 

3614
02:43:37,453 --> 02:43:37,820
RECOMMENDATION?

3615
02:43:37,820 --> 02:43:40,389
YOU CAN GO AHEAD AND PRESS 

3616
02:43:40,389 --> 02:43:40,723
THROUGH THESE.

3617
02:43:40,723 --> 02:43:42,291
FIRST IS CELL BIOLOGICAL TOOLS 

3618
02:43:42,291 --> 02:43:44,860
AND APPROACHES.

3619
02:43:44,860 --> 02:43:52,601
BY CELL BIOLOGICAL I MEAN THESE 

3620
02:43:52,601 --> 02:43:54,436
APPROACHES THAT WE DON'T YET 

3621
02:43:54,436 --> 02:44:04,780
KNOW AND MOST OF US DOESN'T KNOW

3622
02:44:04,780 --> 02:44:06,915
WE NEEDED SMARTPHONES AND CELL 

3623
02:44:06,915 --> 02:44:07,816
PHONES AND NOW WE CAN'T LIVE 

3624
02:44:07,816 --> 02:44:09,485
WITHOUT THEM AND IN TERMS OF 

3625
02:44:09,485 --> 02:44:14,456
SCIENTIFIC TOOLS ARE THE CRISPR 

3626
02:44:14,456 --> 02:44:17,559
EDITING AS WELL AS CRISPR 

3627
02:44:17,559 --> 02:44:19,328
INHIBITION AND ACTIVATION THAT 

3628
02:44:19,328 --> 02:44:20,863
HAVE NOT JUST BEEN THOUGHT OF IN

3629
02:44:20,863 --> 02:44:22,564
TERMS OF THERAPEUTIC APPROACHES 

3630
02:44:22,564 --> 02:44:23,665
BUT TRANSFORMED OUR ABILITY TO 

3631
02:44:23,665 --> 02:44:25,467
DO SCIENCE IN THE LAB.

3632
02:44:25,467 --> 02:44:27,536
AS DR. KARCH TALKED ABOUT THE 

3633
02:44:27,536 --> 02:44:29,405
STEM CELL AND ORGANOID MODELS 

3634
02:44:29,405 --> 02:44:34,443
ARE INCREDIBLY IMPORTANT AND 

3635
02:44:34,443 --> 02:44:36,478
AS

3636
02:44:36,478 --> 02:44:36,812
AS

3637
02:44:36,812 --> 02:44:37,446
ASEMBLOIDS ARE BEING DEVELOPED.

3638
02:44:37,446 --> 02:44:43,452
THE ANIMAL MODELS WE HAVE IN C. 

3639
02:44:43,452 --> 02:44:45,587
ELEGANS AND MICE ARE IMPORTANT 

3640
02:44:45,587 --> 02:44:48,791
AND BECAUSE FTD AFFECTS HIGHER 

3641
02:44:48,791 --> 02:44:50,459
BRAIN FUNCTIONS SUCH AS SOCIAL 

3642
02:44:50,459 --> 02:44:51,493
COGNITION, ETCETERA, IT'S 

3643
02:44:51,493 --> 02:44:53,529
IMPORTANT TO HAVE MODELS WHERE 

3644
02:44:53,529 --> 02:44:57,099
WE CAN STUDY BEHAVIORS AND ONE 

3645
02:44:57,099 --> 02:45:01,470
EXAMPLE I LOVE TO SITE IS THE 

3646
02:45:01,470 --> 02:45:05,274
PRAIRIE FOLDS WHICH FALL IN LOVE

3647
02:45:05,274 --> 02:45:07,476
AND EXHIBIT PAIR BONDING FOR A 

3648
02:45:07,476 --> 02:45:09,111
LIFE TIME IS IMPORTANT FOR 

3649
02:45:09,111 --> 02:45:09,678
UNDERSTANDING DISEASES AND 

3650
02:45:09,678 --> 02:45:14,183
MODELS TO STUDY AGING IN.

3651
02:45:14,183 --> 02:45:16,752
CELL TYPE SPECIFIC OMICS ARE 

3652
02:45:16,752 --> 02:45:17,019
IMPORTANT.

3653
02:45:17,019 --> 02:45:18,754
I THINK RNA SEQ HAS BEEN AT THE 

3654
02:45:18,754 --> 02:45:20,956
FOREFRONT AT FIGURING OUT WHAT 

3655
02:45:20,956 --> 02:45:23,058
CELLS ARE EXPRESSING WHAT BUT 

3656
02:45:23,058 --> 02:45:25,227
PROTEOMICS ARE ALSO GOING TO BE 

3657
02:45:25,227 --> 02:45:25,494
IMPORTANT.

3658
02:45:25,494 --> 02:45:27,529
CELL TYPE SPECIFIC PROTEOMICS.

3659
02:45:27,529 --> 02:45:30,098
LIPID OMICS, METABOLOMICS ARE 

3660
02:45:30,098 --> 02:45:31,467
ALL REALLY IMPORTANT.

3661
02:45:31,467 --> 02:45:32,801
IF WE HAVE THE DATA WE NEED DATA

3662
02:45:32,801 --> 02:45:35,504
ANALYSIS AND SHARING PIPELINES 

3663
02:45:35,504 --> 02:45:37,372
TO DECONVOLUTE THE DATA TO FIND 

3664
02:45:37,372 --> 02:45:38,006
THE SECRETS THE DATA IS TRYING 

3665
02:45:38,006 --> 02:45:41,710
TO TELL US.

3666
02:45:41,710 --> 02:45:42,845
REALLY IMPORTANTLY IT IS 

3667
02:45:42,845 --> 02:45:45,547
IMPORTANT TO KEEP BRINGING A 

3668
02:45:45,547 --> 02:45:48,016
PIPELINE OF SCIENTISTS IN 

3669
02:45:48,016 --> 02:45:51,787
TRAINING... THE NIH HAS BEEN A 

3670
02:45:51,787 --> 02:45:53,322
HUGE PROPONENT AND PUBLIC 

3671
02:45:53,322 --> 02:45:55,557
PRIVATE PARTNERSHIP WHICH 

3672
02:45:55,557 --> 02:45:57,125
SUPPORT THIS AND ADVOCATES SUCH 

3673
02:45:57,125 --> 02:45:59,528
AS JACOBS. TOGETHER, ALL THESE 

3674
02:45:59,528 --> 02:46:01,463
THINGS CAN LEAD US TO 

3675
02:46:01,463 --> 02:46:04,066
MECHANISTIC INSIGHTS, NEW 

3676
02:46:04,066 --> 02:46:06,301
TARGETS, NEW BIO MARKER, 

3677
02:46:06,301 --> 02:46:08,971
THERAPIES IN PRECISION MEDICINE.

3678
02:46:08,971 --> 02:46:10,339
WITH THAT, I'LL FINISH. 

3679
02:46:10,339 --> 02:46:12,307
   >> ALL RIGHT. HI,
EVERYONE. 

3680
02:46:12,307 --> 02:46:17,646
I'M BETH FROST, DIRECTOR OF 

3681
02:46:17,646 --> 02:46:19,882
SENSORS FOR ALZHEIMER'S BROWN. I

3682
02:46:19,882 --> 02:46:23,285
WILL COVER TWO ISSUES INCLUDING 

3683
02:46:23,285 --> 02:46:26,188
MODIFIERS OF FRONTAL TEMPORAL 

3684
02:46:26,188 --> 02:46:32,127
DEMENTIA RISK AND ACCELERATING 

3685
02:46:32,127 --> 02:46:33,729
THERAPEUTIC DISCOVERY. WE 

3686
02:46:33,729 --> 02:46:36,765
RECOMMEND TO DEFINE GENETIC AND 

3687
02:46:36,765 --> 02:46:38,534
MOLECULAR MODIFIER OF GENETIC 

3688
02:46:38,534 --> 02:46:41,036
AND SPORADIC FTD INCLUDING 

3689
02:46:41,036 --> 02:46:42,871
COHORTS OF THE U.S.  POPULATION 

3690
02:46:42,871 --> 02:46:44,673
ALONG WITH MOLECULAR AND 

3691
02:46:44,673 --> 02:46:49,444
CELLULAR MECHANISMS OF ACTION. 

3692
02:46:49,444 --> 02:46:52,814
NEXT SLIDE. SO OVER HALF OF 

3693
02:46:52,814 --> 02:46:55,450
FRONTAL TEMPORAL DEMENTIAS ARE 

3694
02:46:55,450 --> 02:46:57,586
SPORADIC, MEANING THEY DON'T 

3695
02:46:57,586 --> 02:46:59,421
FALL WITHIN A FAMILY THAT IS 

3696
02:46:59,421 --> 02:47:03,325
AFFECTED. THERE ARE ABOUT 15% OF

3697
02:47:03,325 --> 02:47:08,397
FAMILIAL CASE WHERES WE KNOW S 

3698
02:47:08,397 --> 02:47:09,631
/* -- CASES WHERE WE KNOW WHAT 

3699
02:47:09,631 --> 02:47:13,602
IS CAUSING THE FTD. THESE ARE 

3700
02:47:13,602 --> 02:47:17,573
CAUSED BY THREE MUTATIONS. THIS 

3701
02:47:17,573 --> 02:47:24,746
EXPANSION AND C972 MUTATION AND 

3702
02:47:24,746 --> 02:47:26,782
PROGRANULIN AND GENE THAT EN 

3703
02:47:26,782 --> 02:47:31,186
COALS TA, MAP T, WHICH AFFECTS 

3704
02:47:31,186 --> 02:47:34,790
WENDY AND HER GROUP. THEIR GENES

3705
02:47:34,790 --> 02:47:36,658
HAVE BEEN IDENTIFIED THAT CAUSE 

3706
02:47:36,658 --> 02:47:39,361
ABOUT -- CONTRIBUTE TO THAT 15% 

3707
02:47:39,361 --> 02:47:43,065
OF FTD CAUSED BY A KNOWN 

3708
02:47:43,065 --> 02:47:45,300
MUTATION. HOWEVER A BIG CHUNK OF

3709
02:47:45,300 --> 02:47:47,369
FAMILIAL CASES ARE DUE TO 

3710
02:47:47,369 --> 02:47:49,271
VARIANTS AND MUTATIONS WE DON'T 

3711
02:47:49,271 --> 02:47:50,939
KNOW WHAT THEY ARE OR 

3712
02:47:50,939 --> 02:47:52,908
POTENTIALLY OTHER FACTORS THAT 

3713
02:47:52,908 --> 02:47:55,677
MAY UNDERLIE DEVELOPMENT OF FTD 

3714
02:47:55,677 --> 02:47:57,946
WITHIN A CERTAIN FAMILY. SO WE 

3715
02:47:57,946 --> 02:48:00,215
NEED TO UNDERSTAND HOW THESE 

3716
02:48:00,215 --> 02:48:01,617
MUTATIONS ACTUALLY DRIVE DISEASE

3717
02:48:01,617 --> 02:48:04,186
AT A MOLECULAR AND CELLULAR 

3718
02:48:04,186 --> 02:48:05,020
LEVEL AND UNDERSTAND WHAT CELL 

3719
02:48:05,020 --> 02:48:08,657
TYPES ARE AFFECTED BY THESE 

3720
02:48:08,657 --> 02:48:11,393
MUTATIONS. DR. GA NICELY COVERED

3721
02:48:11,393 --> 02:48:13,261
THE IMPORTANCE OF UNDERSTANDING 

3722
02:48:13,261 --> 02:48:15,364
WHENEVER THESE DEPOSIT WHAT CELL

3723
02:48:15,364 --> 02:48:17,532
TYPES THEY ARE DEPOSITING IN AND

3724
02:48:17,532 --> 02:48:20,168
HOW THAT MIGHT AFFECT 

3725
02:48:20,168 --> 02:48:22,137
NEIGHBORING CELLS. SO 

3726
02:48:22,137 --> 02:48:24,106
UNDERSTANDING WE ARE EACH A 

3727
02:48:24,106 --> 02:48:25,941
CONSTELLATION OF GENES, SOME OF 

3728
02:48:25,941 --> 02:48:28,877
WHICH MAY EXACERBATE OR PROTECT 

3729
02:48:28,877 --> 02:48:30,479
AGAINST DISEASE-CAUSING 

3730
02:48:30,479 --> 02:48:32,280
MUTATIONS WE NEED TO UNDERSTAND 

3731
02:48:32,280 --> 02:48:33,749
HOW DIFFERENT THE BACKGROUNDS 

3732
02:48:33,749 --> 02:48:36,785
AFFECT THE RISK AND RESILIENCE 

3733
02:48:36,785 --> 02:48:39,988
FOR INDIVIDUALS CARRYING THESE 

3734
02:48:39,988 --> 02:48:40,889
MUTATIONS. GOING THROUGH THE 

3735
02:48:40,889 --> 02:48:43,458
SLIDES, AHEAD OF ME THERE, BUT 

3736
02:48:43,458 --> 02:48:45,661
FOR -- IN UNDERSTANDING HOW 

3737
02:48:45,661 --> 02:48:46,795
GENETIC BACKGROUND AFFECTS RISK 

3738
02:48:46,795 --> 02:48:48,730
WE NEED TO KNOW HOW THESE 

3739
02:48:48,730 --> 02:48:53,602
MUTATIONS IN DIFFERENT POP LAYS 

3740
02:48:53,602 --> 02:48:57,039
AFFECT RISK, AGE OF ONSET AND 

3741
02:48:57,039 --> 02:48:59,408
HOW QUICKLY THESE PROGRESS. WE 

3742
02:48:59,408 --> 02:49:01,610
NEED TO SUPPORT AND DEVELOP CORE

3743
02:49:01,610 --> 02:49:04,680
SERVICES INCLUDING GENE KNOW 

3744
02:49:04,680 --> 02:49:07,115
TYPING AND CELLULAR MODELS AND 

3745
02:49:07,115 --> 02:49:09,084
BUILD AND SUPPORT COHORTS FOR 

3746
02:49:09,084 --> 02:49:10,652
INDIVIDUAL WHO'S CARRY THESE. AN

3747
02:49:10,652 --> 02:49:12,454
EXAMPLE HOW THIS WORKS WELCOMES 

3748
02:49:12,454 --> 02:49:13,622
FROM THE ALZHEIMER'S DISEASE 

3749
02:49:13,622 --> 02:49:18,193
FIELD, MENTIONED IN THE INTRO. 

3750
02:49:18,193 --> 02:49:22,030
WHILE MUTATIONS INCREASE 1, 

3751
02:49:22,030 --> 02:49:23,231
NORMALLY SUFFICIENT TO CAUSE 

3752
02:49:23,231 --> 02:49:26,334
ALZHEIMER'S, A STUDY OF COHORT 

3753
02:49:26,334 --> 02:49:29,404
IN COLUMBIA WHO CARRY A MUTATION

3754
02:49:29,404 --> 02:49:31,840
THAT WOULD NORMALLY CAUSE 

3755
02:49:31,840 --> 02:49:34,242
ALZHEIMER'S FOUND A SUBSET WERE 

3756
02:49:34,242 --> 02:49:36,378
RESISTANT TO DEVELOPING 

3757
02:49:36,378 --> 02:49:38,447
ALZHEIMER'S, DESPITE CARRY ING 

3758
02:49:38,447 --> 02:49:42,451
THAT MUTATION. SO IT WAS 

3759
02:49:42,451 --> 02:49:46,888
DISCOVERED THESE PEOPLE CARRY 

3760
02:49:46,888 --> 02:49:48,990
THE CHRIST CHURCH MUTATION THAT 

3761
02:49:48,990 --> 02:49:51,226
PROTECTS THEM. THIS TYPE -- WE 

3762
02:49:51,226 --> 02:49:57,999
NEED MORE THOF WORK IN FRON-- M 

3763
02:49:57,999 --> 02:49:59,901
WORK IN FRONTAL TEMPORAL WORK AS

3764
02:49:59,901 --> 02:50:01,737
WELL. UNDERSTANDING WHY THERE IS

3765
02:50:01,737 --> 02:50:03,271
THIS HUGE FRACTION WHERE THEY 

3766
02:50:03,271 --> 02:50:06,942
DON'T RUN IN FAMILIES, OCCUR 

3767
02:50:06,942 --> 02:50:08,310
SPORADICALLY, WE NEED TO FOCUS 

3768
02:50:08,310 --> 02:50:08,844
ON UNDERSTAND ING WHAT 

3769
02:50:08,844 --> 02:50:12,748
ENVIRONMENTAL FACTORS MIGHT BE 

3770
02:50:12,748 --> 02:50:20,489
CONTRIBUTING THERE. NEXT SLIDE 

3771
02:50:20,489 --> 02:50:22,591
SO RECOMMENDATION 8 IS PRIORITY 

3772
02:50:22,591 --> 02:50:25,627
4 FOCUSING ON PRE-CLINICAL 

3773
02:50:25,627 --> 02:50:27,796
DISEASE MODIFYING -- BACK ONE 

3774
02:50:27,796 --> 02:50:29,664
SLIDE, I DON'T HAVE IT 

3775
02:50:29,664 --> 02:50:33,168
MEMORIZED. IN FRONTAL TEMPORAL 

3776
02:50:33,168 --> 02:50:34,836
DEMENTIA BUT DEF RAJING KNOWN 

3777
02:50:34,836 --> 02:50:37,305
PATHWAYS OR MECHANISM-AGNOSTIC 

3778
02:50:37,305 --> 02:50:39,708
APPROACHES SUCH AS HIGH 

3779
02:50:39,708 --> 02:50:41,643
THROUGHPUT SCREENING. WE KNOW 

3780
02:50:41,643 --> 02:50:44,646
THE PROTEINS THAT DEPOSIT IN 

3781
02:50:44,646 --> 02:50:49,618
FRONTAL TEMPORAL DEMENTIA. THESE

3782
02:50:49,618 --> 02:50:57,826
ARE TA, TDP43 AND FUS. THESE ARE

3783
02:50:57,826 --> 02:51:05,433
TARGETS WHETHER TAN BO IT /* AN 

3784
02:51:05,433 --> 02:51:06,935
UNDERSTANDING OF FACTORS THAT 

3785
02:51:06,935 --> 02:51:08,737
MAY CONTRIBUTE TO DEPOSITION OF 

3786
02:51:08,737 --> 02:51:14,009
SOME OF THESE PATHOGENIC PREE 

3787
02:51:14,009 --> 02:51:16,278
PROTEINS FOR DEVELOPMENT. WE ARE

3788
02:51:16,278 --> 02:51:17,412
BEGINNING TO UNDERSTAND HOW 

3789
02:51:17,412 --> 02:51:21,950
THESE ARE CAUSING NEURAL 

3790
02:51:21,950 --> 02:51:22,951
DENEUDENEWURO

3791
02:51:22,951 --> 02:51:25,520
DENEURODEGENERATION AND NEEDS TO

3792
02:51:25,520 --> 02:51:27,289
UNDERSTAND ACROSS THE SPECTRUM, 

3793
02:51:27,289 --> 02:51:28,723
WE NEED TO RECOGNIZE THAT 

3794
02:51:28,723 --> 02:51:31,726
INDIVIDUALS ARE MAYBE NOT GOING 

3795
02:51:31,726 --> 02:51:33,895
TO BE -- THEY GOING TO NEED 

3796
02:51:33,895 --> 02:51:35,230
DIFFERENT DRUGS DEPENDING WHICH 

3797
02:51:35,230 --> 02:51:38,967
STAGE THEY ARE IN. WE NEED TO BE

3798
02:51:38,967 --> 02:51:40,569
ABLE TO DIAGNOSE PEOPLE AND KNOW

3799
02:51:40,569 --> 02:51:42,437
WHERE THEY ARE IN THE SPECTRUM 

3800
02:51:42,437 --> 02:51:49,444
SO WE CAN DEVELOP -- GIVE THEM 

3801
02:51:49,444 --> 02:51:50,779
THANK YOU, MR. PR

3802
02:51:50,779 --> 02:51:51,446
THERAPEUTICS FOR THE STAGE THEY 

3803
02:51:51,446 --> 02:51:52,480
ARE IN AND UNDERSTAND HOW THEY 

3804
02:51:52,480 --> 02:51:56,251
AFFECT DIFFERENT CELL TYPES, AS 

3805
02:51:56,251 --> 02:52:02,090
DR. GAL MENTIONED, NEXT SLIDE. A

3806
02:52:02,090 --> 02:52:03,592
EXAMPLE HOW THIS HAS WORKED 

3807
02:52:03,592 --> 02:52:05,827
WELL. SO WE AND OTHERS HAVE 

3808
02:52:05,827 --> 02:52:08,463
FOUND THAT PATHOGENIC FORMS OF 

3809
02:52:08,463 --> 02:52:16,738
TA AND TDP43 DRIVE 

3810
02:52:16,738 --> 02:52:18,974
NEURODEGENERATIVE THROUGH 

3811
02:52:18,974 --> 02:52:22,744
ACTIVATION OF RETRO TRANSPOSONS,

3812
02:52:22,744 --> 02:52:25,547
MAKE UP ABOUT 45% OF THE HUMAN 

3813
02:52:25,547 --> 02:52:28,817
GENOME. WHEN THESE ELEMENTS GET 

3814
02:52:28,817 --> 02:52:32,854
ACTIVATED THROUGH TA OR TDP43 

3815
02:52:32,854 --> 02:52:35,824
THEY ARE TRANSCRIBED INTO RNA, 

3816
02:52:35,824 --> 02:52:38,426
SOMETIMES PROTEIN-CODING. THOSE 

3817
02:52:38,426 --> 02:52:40,195
PROTEINS CAN ACT TO MAKE A NEW 

3818
02:52:40,195 --> 02:52:41,529
COPY OF D.N.A. AND THAT CAN 

3819
02:52:41,529 --> 02:52:44,332
INSERT SOMEWHERE ELSE IN THE 

3820
02:52:44,332 --> 02:52:50,438
GENOME. OVER THE COURSE OF RETRO

3821
02:52:50,438 --> 02:52:51,640
TRANSPOSON ACTIVATION THEY CAN 

3822
02:52:51,640 --> 02:52:53,942
JUMP, REFERRED TO AS JUMPING 

3823
02:52:53,942 --> 02:52:55,610
GENES. THE PRODUCTS MADE OVER 

3824
02:52:55,610 --> 02:52:57,913
THE COURSE OF THE ACTIVATION CAN

3825
02:52:57,913 --> 02:53:01,750
LOOK LIKE A VIRUS TO THE CELL. 

3826
02:53:01,750 --> 02:53:07,656
WE FOUND THAT AN ANTI VIRAL 

3827
02:53:07,656 --> 02:53:10,458
NORMALLY PRESCRIBED FOR HIV CAN 

3828
02:53:10,458 --> 02:53:12,260
BLOCK THE TRANSCRIPTION OF 

3829
02:53:12,260 --> 02:53:13,595
R.N.A. INTO D.N.A. WE FOUND THIS

3830
02:53:13,595 --> 02:53:18,433
WAS EFFECTIVE IN TA MODELS, FLY 

3831
02:53:18,433 --> 02:53:26,374
MODELS, TEL O 

3832
02:53:26,374 --> 02:53:26,775
   

3833
02:53:26,775 --> 02:53:29,277
DIFFERENT MOUSE WORKS. WE 

3834
02:53:29,277 --> 02:53:31,212
FINISH ED A PHASE 2 TRIAL AT UT 

3835
02:53:31,212 --> 02:53:34,049
HEALTH BEFORE I MOVED TO BROWN 

3836
02:53:34,049 --> 02:53:36,985
FOR ALZHEIMER'S DISEASE USE ING 

3837
02:53:36,985 --> 02:53:38,887
THIS HIV DRUG. A DIFFERENT HIV 

3838
02:53:38,887 --> 02:53:42,691
DRUG IS TESTED AT BROWN IN 

3839
02:53:42,691 --> 02:53:46,728
ALZHEIMER'S. BECAUSE THIS IS A 

3840
02:53:46,728 --> 02:53:50,465
TA-BASED IT CAN BE EXPANDED TO 

3841
02:53:50,465 --> 02:53:53,401
NON-ALZHEIMER'S TELOPATHY. A 

3842
02:53:53,401 --> 02:53:57,072
RECENT PHASE 2A WAS FINISHED FOR

3843
02:53:57,072 --> 02:54:00,842
HIV AND PARTICIPANTS WITH SUPER 

3844
02:54:00,842 --> 02:54:02,444
NUCLEAR PAL SI WITH GOOD 

3845
02:54:02,444 --> 02:54:04,813
RESULTS. SIMILARLY FINISHED A 

3846
02:54:04,813 --> 02:54:09,384
TRIAL IN ALSFTD AND PLANNING FOR

3847
02:54:09,384 --> 02:54:13,588
PHASE 3. THOR LIGHTHOUSE TRIAL 

3848
02:54:13,588 --> 02:54:15,857
IN ALS HAD NICE RESULTS FROM 

3849
02:54:15,857 --> 02:54:18,793
PHASE 2, IN A PHASE 3 OPEN 

3850
02:54:18,793 --> 02:54:20,028
ROLLOVER BASED ON RESULTS FROM 

3851
02:54:20,028 --> 02:54:24,099
THAT TRIAL. THIS IS ONE EXAMPLE 

3852
02:54:24,099 --> 02:54:31,940
OF THERAPEUTICS THAT TARGET 

3853
02:54:31,940 --> 02:54:33,708
INFLAMMATION ASSOCIATED WITH 

3854
02:54:33,708 --> 02:54:34,943
DEMENTIA AND RECOMMEND OTHER 

3855
02:54:34,943 --> 02:54:37,445
POTENTIAL KNOWN TARGETS BE 

3856
02:54:37,445 --> 02:54:38,446
PURSUED IN PRE-CLINICAL AND 

3857
02:54:38,446 --> 02:54:43,785
CLINICAL STUDIES AS WELL AS 

3858
02:54:43,785 --> 02:54:46,421
APPROACHES AGNOSTIC AS HI 

3859
02:54:46,421 --> 02:54:47,322
THROUGHPUT COMPOUND SCREENING. 

3860
02:54:47,322 --> 02:54:53,294
BACK TO THE ORGANIZERS. 

3861
02:54:53,294 --> 02:54:56,297
   >> I JUST WANT TO THAN
TK FTD

3862
02:54:56,297 --> 02:54:58,433
COMMITTEE MEMBERS WHO WERE 

3863
02:54:58,433 --> 02:55:01,770
REALLY ESSENTIAL IN DEVELOPING 

3864
02:55:01,770 --> 02:55:04,439
THESE RECOMMENDATIONS AND WHO 

3865
02:55:04,439 --> 02:55:07,909
SOUGHT ADVICE OF PATIENT 

3866
02:55:07,909 --> 02:55:09,411
POPULATIONS, OF ADVOCATES, OF 

3867
02:55:09,411 --> 02:55:11,346
THEIR COLLEAGUES AND THANK YOU 

3868
02:55:11,346 --> 02:55:20,155
ALL. LOOKING FORWARD TO THE 

3869
02:55:20,155 --> 02:55:21,556
QUESTIONS. 

3870
02:55:21,556 --> 02:55:22,891
   >> RAISE YOU HAND IF
YOU'D 

3871
02:55:22,891 --> 02:55:25,093
LIKE TO ASK A QUESTION. WE ARE 

3872
02:55:25,093 --> 02:55:27,328
MONITORING QUESTIONS COMING IN 

3873
02:55:27,328 --> 02:55:32,567
LIVE FROM VIDEO CASTS. OUR FIRST

3874
02:55:32,567 --> 02:55:34,936
QUESTION HAS A HAND RAISED, 

3875
02:55:34,936 --> 02:55:35,170
GENE. 

3876
02:55:35,170 --> 02:55:37,238
   >> YES, THANK YOU SO
MUCH. 

3877
02:55:37,238 --> 02:55:39,841
THANK YOU, EVERYONE, FOR 

3878
02:55:39,841 --> 02:55:41,776
SPEAKING. I WANT TO ZERO IN ON 

3879
02:55:41,776 --> 02:55:46,481
DRUG DISCOVERY AND USE 

3880
02:55:46,481 --> 02:55:51,219
THERAPEUTICS TO PREVENT OR TREAT

3881
02:55:51,219 --> 02:56:01,763
FTD. THE DOCTOR HAD A NICE CHART

3882
02:56:08,403 --> 02:56:11,239
TO CONSIDER THIS. IF WE CONSIDER

3883
02:56:11,239 --> 02:56:14,075
THIS, WE SHOULD ALSO REALLY 

3884
02:56:14,075 --> 02:56:16,878
CONSIDER THE NOT DRAMATIC AFFECT

3885
02:56:16,878 --> 02:56:20,682
OF RELASAL IN ALS. THOSE NOT 

3886
02:56:20,682 --> 02:56:22,917
AWARE, 72, MY FAMILY SIMILAR 

3887
02:56:22,917 --> 02:56:25,787
PACTED BY, THE MOST COMMON CAUSE

3888
02:56:25,787 --> 02:56:30,024
OF GENETIC FTD AND GENETIC ALS. 

3889
02:56:30,024 --> 02:56:32,794
IF SOMEBODY HAS BFCT AND GET 

3890
02:56:32,794 --> 02:56:36,064
DIAGNOSED ALS THEY WILL BE 

3891
02:56:36,064 --> 02:56:37,765
PRESCRIBED (?) AS 

3892
02:56:37,765 --> 02:56:39,267
DISEASE-MODIFYING THERAPY. YET 

3893
02:56:39,267 --> 02:56:42,137
IF THE CAUSE OF THE DISEASE IS 

3894
02:56:42,137 --> 02:56:45,140
CNR72 AND WORKS FOR ALS, WHY 

3895
02:56:45,140 --> 02:56:47,475
WOULDN'T IT WORK FOR FTD. IF WE 

3896
02:56:47,475 --> 02:56:48,409
ARE CONSIDERING 

3897
02:56:48,409 --> 02:56:49,410
DISEASE-MODIFYING THERAPIES WE 

3898
02:56:49,410 --> 02:56:51,479
SHOULD -- WHY ARE WE NOT 

3899
02:56:51,479 --> 02:56:57,418
CONSIDERING RENASAL. ALSO I SO 

3900
02:56:57,418 --> 02:56:58,353
APPRECIATE EVERYONE'S ATTENTION 

3901
02:56:58,353 --> 02:57:01,789
THAT THERE'S DRUGS IN TRIAL FOR 

3902
02:57:01,789 --> 02:57:06,427
ALS THAT MIGHT BE USEFUL IN FTD.

3903
02:57:06,427 --> 02:57:08,830
JUST TO BRING IT BACK, HOW ARE 

3904
02:57:08,830 --> 02:57:13,101
WE GOING TO ENSURE THE CRYPTIC 

3905
02:57:13,101 --> 02:57:17,372
AXON ANTI OLIOGO NUCLEOTIDE 

3906
02:57:17,372 --> 02:57:21,309
THERAPIES IN TRIALS FOR ALS OR 

3907
02:57:21,309 --> 02:57:26,181
SOON TO BE IN TRIAL, SHOW AFFECT

3908
02:57:26,181 --> 02:57:29,417
IN ADVANCED ALS, HOW WILL WE BE 

3909
02:57:29,417 --> 02:57:31,886
SURE THOSE DRUGS MIGHT ONLY WORK

3910
02:57:31,886 --> 02:57:33,254
EARLIER IN THE DISEASE AND 

3911
02:57:33,254 --> 02:57:35,190
PEOPLE WHO ARE PREDISPOSED TO 

3912
02:57:35,190 --> 02:57:38,426
DEVELOPING ALS AND FTD. SO IT IS

3913
02:57:38,426 --> 02:57:39,661
NOT JUST THAT WE ARE WILLING TO 

3914
02:57:39,661 --> 02:57:43,831
SEE A HOME RUN BUT HOW DO WE 

3915
02:57:43,831 --> 02:57:45,533
GUARD AGAINST THESE DRUGS 

3916
02:57:45,533 --> 02:57:46,901
WORKING EARLIER IN THE DISEASE 

3917
02:57:46,901 --> 02:57:49,103
AND WITH URGENCY BECAUSE IF WE 

3918
02:57:49,103 --> 02:57:51,339
DISCARD THOSE THERAPIES WITHOUT 

3919
02:57:51,339 --> 02:57:53,708
AFFIRMING THEY MIGHT ONLY WORK 

3920
02:57:53,708 --> 02:57:55,276
EARLIER, THEN HOW WILL WE EVER 

3921
02:57:55,276 --> 02:58:03,785
KNOW? SO THANK YOU SO MUCH. 

3922
02:58:03,785 --> 02:58:06,087
   >> ADAM, WOULD YOU LIKE
TO 

3923
02:58:06,087 --> 02:58:06,854
RESPOND? 

3924
02:58:06,854 --> 02:58:11,626
   >> YEAH, WELL THANK
YOU, 

3925
02:58:11,626 --> 02:58:13,561
JEAN. THANK YOU FOR YOUR MANY 

3926
02:58:13,561 --> 02:58:14,729
CONTRIBUTIONS TO EVERYTHING I 

3927
02:58:14,729 --> 02:58:19,901
TALKED ABOUT FOR THOSE WHO DON'T

3928
02:58:19,901 --> 02:58:23,171
KNOW, THIS HAS BEEN PART OF 

3929
02:58:23,171 --> 02:58:24,706
THESE DISCUSSIONS AND COME UP 

3930
02:58:24,706 --> 02:58:26,474
WITH MANY FANTASTIC IDEAS WE ARE

3931
02:58:26,474 --> 02:58:29,410
TRYING TO INCORPORATE INTO OUR 

3932
02:58:29,410 --> 02:58:31,846
FUTURE WORK. I COMPLETELY AGREE 

3933
02:58:31,846 --> 02:58:34,749
WITH PRETTY MUCH EVERYTHING YOU 

3934
02:58:34,749 --> 02:58:38,386
SAID. I WANTED TO HIGHLIGHT THE 

3935
02:58:38,386 --> 02:58:41,222
STRENGTH OF THE PUBLIC-PRIVATE 

3936
02:58:41,222 --> 02:58:42,357
PARTNERSHIP THAT IS FUNDED 

3937
02:58:42,357 --> 02:58:43,891
THROUGH THE NATIONAL INSTITUTES 

3938
02:58:43,891 --> 02:58:45,727
OF HEALTH THROUGH ALL FTD, 

3939
02:58:45,727 --> 02:58:47,729
THROUGH THE NEW PSP PLATFORM 

3940
02:58:47,729 --> 02:58:51,132
TRIAL AND WHAT WE HOPE TO DO 

3941
02:58:51,132 --> 02:58:54,135
MORE IN FUTURE BECAUSE TO ANSWER

3942
02:58:54,135 --> 02:58:55,436
MANY OF THE THERAPEUTICS 

3943
02:58:55,436 --> 02:58:57,839
QUESTIONS THAT YOU BRING UP, WE 

3944
02:58:57,839 --> 02:58:59,274
REALLY NEED NOT JUST INDUSTRY 

3945
02:58:59,274 --> 02:59:03,144
SUPPORT BUT WE NEED THE NIH TO 

3946
02:59:03,144 --> 02:59:06,447
HELP US TO REALLY BRING THESE 

3947
02:59:06,447 --> 02:59:08,316
TREATMENTS INTO SCENARIOS THAT 

3948
02:59:08,316 --> 02:59:10,451
MAY NOT BE AS ATTRACTIVE TO 

3949
02:59:10,451 --> 02:59:11,719
INDUSTRY TO DO ON THEIR OWN. 

3950
02:59:11,719 --> 02:59:14,088
THIS IS WHERE THIS PARTNERSHIP 

3951
02:59:14,088 --> 02:59:18,426
IS SO IMPORTANT BETWEEN YOU AND 

3952
02:59:18,426 --> 02:59:22,463
US AT THE NIH ACADEMIC 

3953
02:59:22,463 --> 02:59:29,270
INVESTIGATORS, THE COMMUNITY AND

3954
02:59:29,270 --> 02:59:35,810
INDUSTRY SO THANK YOU SO MUCH. 

3955
02:59:35,810 --> 02:59:37,045
   >> I DON'T KNOW IF
THERE IS 

3956
02:59:37,045 --> 02:59:42,016
ANY -- SORRY, OKAY. SINCE THE 

3957
02:59:42,016 --> 02:59:44,585
QUESTION FROM VIDEO CAST IS 

3958
02:59:44,585 --> 02:59:47,822
SINCE AM LLOYD PLAQUE AND TA 

3959
02:59:47,822 --> 02:59:49,257
NERVE TREATMENTS ONLY PROVIDE 

3960
02:59:49,257 --> 02:59:51,826
MODEST SYMPTOM REDUCTIONS WITH 

3961
02:59:51,826 --> 02:59:54,262
SEVERE SIDE EFFECTS WHAT GOOD 

3962
02:59:54,262 --> 02:59:56,197
COULD THEY DO FOR FTD. 

3963
02:59:56,197 --> 02:59:58,599
   >> MAYBELY TAKE THAT
ONE TOO.

3964
02:59:58,599 --> 03:00:01,903
I DIDN'T MEAN TO SUGGEST AM 

3965
03:00:01,903 --> 03:00:06,441
LLOYD TREATMENTS BE USED FOR FTD

3966
03:00:06,441 --> 03:00:09,811
BECAUSE THERE IS NO AM LLOYD IN 

3967
03:00:09,811 --> 03:00:11,779
FTD. I DON'T AGREE THEY PROVIDE 

3968
03:00:11,779 --> 03:00:13,014
MODEST BENEFITS. I THINK FOR THE

3969
03:00:13,014 --> 03:00:15,149
RIGHT PEOPLE THEY CAN BE QUITE 

3970
03:00:15,149 --> 03:00:16,217
IMPACTFUL. BUT WHAT I WAS TRYING

3971
03:00:16,217 --> 03:00:20,521
TO ALLUDE TO IS THE IDEA THAT IN

3972
03:00:20,521 --> 03:00:23,224
ALZHEIMER'S DISEASE THE NIH 

3973
03:00:23,224 --> 03:00:24,792
SUPPORTED THE DEVELOPMENT OF 

3974
03:00:24,792 --> 03:00:27,261
MANY BIO MARKERS SUCH AS BRAIN 

3975
03:00:27,261 --> 03:00:29,330
SCANS AND BLOOD TESTS WE CAN 

3976
03:00:29,330 --> 03:00:30,765
USE. THESE ARE VERY INSTRUCTIVE 

3977
03:00:30,765 --> 03:00:33,101
FOR US. WE ARE BRINGING THESE 

3978
03:00:33,101 --> 03:00:35,737
TECHNOLOGIES INTO FTD. WE THINK 

3979
03:00:35,737 --> 03:00:37,271
THAT REGARDLESS ABOUT HOW YOU 

3980
03:00:37,271 --> 03:00:39,507
FEEL ABOUT THE ALZHEIMER'S 

3981
03:00:39,507 --> 03:00:42,877
THERAPIES, THEY DO PAVE THE WAY 

3982
03:00:42,877 --> 03:00:47,014
AND PROVIDE REALLY A ROAD MAP 

3983
03:00:47,014 --> 03:00:57,492
THAT WE WILL ACCELERATE THE 

3984
03:01:00,528 --> 03:01:01,696
DEVELOPMENTS. 

3985
03:01:01,696 --> 03:01:03,164
   >> YOU CAN GO AHEAD
WITH THE 

3986
03:01:03,164 --> 03:01:05,400
NEXT QUESTION. I WILL JUST -- 

3987
03:01:05,400 --> 03:01:06,200
ONLINE ALREADY -- 

3988
03:01:06,200 --> 03:01:09,103
   >> OKAY, GREAT. I THINK
THE 

3989
03:01:09,103 --> 03:01:13,107
NEXT QUESTION IS STEVEN HAD HIS 

3990
03:01:13,107 --> 03:01:13,474
HAND OUT. 

3991
03:01:13,474 --> 03:01:15,410
   >> YEAH, THANKS FOR
ALLOWING 

3992
03:01:15,410 --> 03:01:16,978
ME TO ASK ANOTHER ONE. SORT OF 

3993
03:01:16,978 --> 03:01:23,785
ON THE TOPIC OF THE LAST FEW 

3994
03:01:23,785 --> 03:01:30,591
QUESTIONS. A WAY TO IMPROVE BOTH

3995
03:01:30,591 --> 03:01:34,228
IS BRAIN PENETRATION OF DRUG AND

3996
03:01:34,228 --> 03:01:37,465
DIFFUSE TO OTHER ORGANS. IS IT 

3997
03:01:37,465 --> 03:01:39,100
OF INTEREST TO THIS GROUP TO 

3998
03:01:39,100 --> 03:01:41,369
FORMALLY SUPPORT STUDY OF THE 

3999
03:01:41,369 --> 03:01:45,306
BLOOD BRAIN BARRIER INCLUDING 

4000
03:01:45,306 --> 03:01:48,910
APPLIED IN BASIC RESEARCH SO WE 

4001
03:01:48,910 --> 03:01:50,278
CAN WORK ON THAT? 

4002
03:01:50,278 --> 03:01:51,712
   >> I DON'T MIND JUMPING
IN 

4003
03:01:51,712 --> 03:01:54,449
AND ADDRESSING THAT. SO GLAD YOU

4004
03:01:54,449 --> 03:02:00,655
BROUGHT THAT UP. I DID MENTION 

4005
03:02:00,655 --> 03:02:01,923
END THEEL YELL CELLS WHICH MAKE 

4006
03:02:01,923 --> 03:02:04,592
UP THE BLOOD BRAIN BARRIER. I 

4007
03:02:04,592 --> 03:02:06,427
ALMOST ED THAT IDEA LIKE A 

4008
03:02:06,427 --> 03:02:07,528
HELMET SURROUNDING THE BRAIN 

4009
03:02:07,528 --> 03:02:09,964
THAT PREVENTED CELLS AND 

4010
03:02:09,964 --> 03:02:11,632
BIOLOGICS AND DRUGS FROM GETTING

4011
03:02:11,632 --> 03:02:15,436
IN. IN FACT, , THE BARRIER IS 

4012
03:02:15,436 --> 03:02:17,538
THE END THEEL YELL CELLS THAT 

4013
03:02:17,538 --> 03:02:22,443
HELP. WE KNOW THE BLOOD BRAIN 

4014
03:02:22,443 --> 03:02:23,878
BARRIER BECOMES LEAKY AND IS A 

4015
03:02:23,878 --> 03:02:25,079
BIG PART OF THIS DISEASE SO IT 

4016
03:02:25,079 --> 03:02:28,015
IS CRITICAL TO STUDY BLOOD BRAIN

4017
03:02:28,015 --> 03:02:30,151
BARRIER. THERE IS A GREAT LAB AT

4018
03:02:30,151 --> 03:02:32,019
STANFORD THAT'S STUDIED THIS IN 

4019
03:02:32,019 --> 03:02:35,089
CONTEXT OF BRAIN MUTATIONS. I'M 

4020
03:02:35,089 --> 03:02:36,023
ORGANIZING A RESEARCH CONFERENCE

4021
03:02:36,023 --> 03:02:40,094
FOR NEXT YEAR ON FRONTAL 

4022
03:02:40,094 --> 03:02:41,395
TEMPORAL DEMENTIA. WE ARE 

4023
03:02:41,395 --> 03:02:42,997
PUTTING TOGETHER THE PROGRAM 

4024
03:02:42,997 --> 03:02:44,899
NOW. ONE OF THE SESSIONS IS 

4025
03:02:44,899 --> 03:02:53,241
GOING TO BE DEVOTED TO VASCULAR 

4026
03:02:53,241 --> 03:02:53,975
BLOOD BRAIN BARRIER WORK TO LOOK

4027
03:02:53,975 --> 03:02:57,545
FORWARD TO ADVANCE ING THAT 

4028
03:02:57,545 --> 03:02:57,778
AREA. 

4029
03:02:57,778 --> 03:03:03,885
   >> THANK YOU. 

4030
03:03:03,885 --> 03:03:05,486
   >> CONGRATULATIONS TO
THE 

4031
03:03:05,486 --> 03:03:07,154
NDINS AND ALL YOU. I THINK THE 

4032
03:03:07,154 --> 03:03:09,457
RECOMMENDATIONS YOU HAVE COME UP

4033
03:03:09,457 --> 03:03:11,192
WITH, I THINK ARE IMPORTANT 

4034
03:03:11,192 --> 03:03:13,628
TOUCHSTONES FOR THE FIELD TO BE 

4035
03:03:13,628 --> 03:03:15,062
PAYING ATTENTION. THEY ARE JUST 

4036
03:03:15,062 --> 03:03:16,697
WELL PUT TOGETHER AND ALSO 

4037
03:03:16,697 --> 03:03:17,832
REFLECT THE HOPE THAT COMES FROM

4038
03:03:17,832 --> 03:03:19,634
THE INCREDIBLE PROGRESS THAT HAS

4039
03:03:19,634 --> 03:03:22,837
BEEN ENABLED LARGELY FROM 

4040
03:03:22,837 --> 03:03:24,138
NIH-FUNDED TO ACADEMIC RESEARCH 

4041
03:03:24,138 --> 03:03:25,506
CENTERS IN THE UNITED STATES. I 

4042
03:03:25,506 --> 03:03:29,644
THINK IT BRINGS SO MUCH HOPE TO 

4043
03:03:29,644 --> 03:03:30,678
FAMILIES AND COMMUNITIES THEY 

4044
03:03:30,678 --> 03:03:32,580
SUPPORT. I NEED TO ASK ONE 

4045
03:03:32,580 --> 03:03:35,116
QUESTION WHICH IS FAMILIES WE 

4046
03:03:35,116 --> 03:03:36,918
SUPPORT DON'T JUST COME FROM 

4047
03:03:36,918 --> 03:03:39,387
COGNITIVE BEHAVE YOUR OR 

4048
03:03:39,387 --> 03:03:40,521
NEUROLOGY CLINICS. THE FIELD HAS

4049
03:03:40,521 --> 03:03:42,256
DONE SO MUCH WHERE THE NETWORK 

4050
03:03:42,256 --> 03:03:44,892
IS TAPPING INTO THE ALZHEIMER'S 

4051
03:03:44,892 --> 03:03:45,593
INFRASTRUCTURE, LIKE NICK READ 

4052
03:03:45,593 --> 03:03:49,063
FOR EXAMPLE, FOR BIOSAMPLE 

4053
03:03:49,063 --> 03:03:52,066
REPOSITORIES AND THE NAC CENTERS

4054
03:03:52,066 --> 03:03:55,803
AND ADRCs. OUR PATIENTS AND 

4055
03:03:55,803 --> 03:03:58,105
FAMILIES ARE SEEN IN PARKINSON'S

4056
03:03:58,105 --> 03:04:01,142
CLINICS AND ALS AND ALZHEIMER'S 

4057
03:04:01,142 --> 03:04:03,444
CLINICS, NOT TO MENTION IF THEY 

4058
03:04:03,444 --> 03:04:04,946
HAVE BEEN MISDIAGNOSE ED IN 

4059
03:04:04,946 --> 03:04:07,048
PSYCHIATRIC CLINICS. A LOT OF 

4060
03:04:07,048 --> 03:04:07,848
THE RESEARCH INVOLVES BRINGING 

4061
03:04:07,848 --> 03:04:10,451
IN BIOSAMPLES AND UNDERSTANDING 

4062
03:04:10,451 --> 03:04:12,219
THE EPIDEMIOLOGY AND ALL OF 

4063
03:04:12,219 --> 03:04:13,988
THESE DIFFERENT RESEARCH 

4064
03:04:13,988 --> 03:04:15,356
NETWORKS TENDS TO HAVE LARGE 

4065
03:04:15,356 --> 03:04:17,091
INFRASTRUCTURE THAT IS 

4066
03:04:17,091 --> 03:04:18,292
INDEPENDENT OF ONE ANOTHER AND 

4067
03:04:18,292 --> 03:04:20,428
THE FTD FIELD TENDS TO TRY TO 

4068
03:04:20,428 --> 03:04:22,229
BRIDGE ACROSS THEM. CAN YOU 

4069
03:04:22,229 --> 03:04:23,764
COMMENT ON HOW WE CAN DO BETTER 

4070
03:04:23,764 --> 03:04:26,601
AT THAT? IS THIS RELYING ON DATA

4071
03:04:26,601 --> 03:04:29,003
SCIENCE AND AI TO FIND WHAT DATA

4072
03:04:29,003 --> 03:04:30,938
IS WHERE? IS IT ON THE 

4073
03:04:30,938 --> 03:04:32,607
DIAGNOSTIC TOOLS, MINIMAL DATA 

4074
03:04:32,607 --> 03:04:34,742
SET S SO WE CAN HAVE SOME 

4075
03:04:34,742 --> 03:04:36,210
ABILITY COMBINE OR BETTER 

4076
03:04:36,210 --> 03:04:39,714
ABILITY TO COMBINE DATA ACROSS 

4077
03:04:39,714 --> 03:04:41,182
DISPARATE PLACES? IT IS A HARD 

4078
03:04:41,182 --> 03:04:43,150
PROBLEM TO SOLVE BUT FOR FTD 

4079
03:04:43,150 --> 03:04:45,419
FAMILIES IT IS WHAT WE ARE GOING

4080
03:04:45,419 --> 03:04:46,120
TO NEED. 

4081
03:04:46,120 --> 03:04:49,857
   >> THANK YOU, RESA. A
REALLY 

4082
03:04:49,857 --> 03:04:50,925
CRITICAL POINT THAT WAS 

4083
03:04:50,925 --> 03:04:53,260
SOMETHING THAT CAME UP OVER AND 

4084
03:04:53,260 --> 03:04:56,097
OVER IN OUR DISCUSSIONS AROUND 

4085
03:04:56,097 --> 03:04:59,100
SORT OF HOW -- TO BREAK DOWN 

4086
03:04:59,100 --> 03:05:00,368
BARRIERS, HOW TO INTEGRATE AND I

4087
03:05:00,368 --> 03:05:01,969
THINK THE GROUP TRIED TO THINK 

4088
03:05:01,969 --> 03:05:06,073
ABOUT THIS IN A FEW WAYS THAT I 

4089
03:05:06,073 --> 03:05:08,709
CAN MENTION. ONE IS TO ENCOURAGE

4090
03:05:08,709 --> 03:05:11,012
THE USE OF ENGAGEMENT WITH 

4091
03:05:11,012 --> 03:05:13,080
PUBLIC PRIVATE PARTNERSHIPS THAT

4092
03:05:13,080 --> 03:05:18,052
HAVE BEEN SO SUCCESSFUL FOR DATA

4093
03:05:18,052 --> 03:05:23,624
REPOSITORIES AND INTEGRATED 

4094
03:05:23,624 --> 03:05:28,362
STUDIES. YOU KNOW, TARGET ALS. 

4095
03:05:28,362 --> 03:05:30,097
SO BRIDGING THOSE UNDER SIMILAR 

4096
03:05:30,097 --> 03:05:32,266
-- POTENTIALS TO BRING THOSE 

4097
03:05:32,266 --> 03:05:36,404
UNDER A SIMILAR PLATFORM HAS THE

4098
03:05:36,404 --> 03:05:38,005
POTENTIAL TO CONNECT INDIVIDUALS

4099
03:05:38,005 --> 03:05:40,474
AND SAMPLES AND GET AT SOME OF 

4100
03:05:40,474 --> 03:05:42,176
THESE QUESTIONS BUT I THINK THIS

4101
03:05:42,176 --> 03:05:45,579
IS ALSO WHERE DR. IRWIN TALKED 

4102
03:05:45,579 --> 03:05:48,549
ABOUT SORT OF INEXPENSIVE, YOU 

4103
03:05:48,549 --> 03:05:51,485
KNOW, BIO MARKERS, TESTS THAT 

4104
03:05:51,485 --> 03:05:55,056
CAN BE DONE, ENABLED ACROSS 

4105
03:05:55,056 --> 03:05:56,357
DIFFERENT CENTER TYPES. I THINK 

4106
03:05:56,357 --> 03:05:59,527
THIS IS AN AREA OF GREAT 

4107
03:05:59,527 --> 03:06:01,262
IMPORTANCE. IF ANYONE ELSE WANTS

4108
03:06:01,262 --> 03:06:05,700
TO COMMENT, PLEASE DO. 

4109
03:06:05,700 --> 03:06:07,401
   >> MAYBE I'LL BRIEFLY
ECHO 

4110
03:06:07,401 --> 03:06:10,905
THAT AND SAY THE BIOLOGICAL 

4111
03:06:10,905 --> 03:06:12,973
CHARACTERIZATION NOMENCLATURE 

4112
03:06:12,973 --> 03:06:14,108
CLASSIFICATION, THOSE EFFORTS I 

4113
03:06:14,108 --> 03:06:16,877
THINK WILL HELP ACCELERATE AS 

4114
03:06:16,877 --> 03:06:18,345
THE DEMENTIA NOMENCLATURE 

4115
03:06:18,345 --> 03:06:19,947
INITIATIVE. ONE OF THE FEEDBACK 

4116
03:06:19,947 --> 03:06:22,416
FROM THAT GROUP WAS THAT IN THE 

4117
03:06:22,416 --> 03:06:24,285
RESEARCH REALM, REQUESTING 

4118
03:06:24,285 --> 03:06:25,986
SAMPLES AND WHAT TERMS WE USE 

4119
03:06:25,986 --> 03:06:31,759
CAN SOMETIME BES S BE A BARRIER.

4120
03:06:31,759 --> 03:06:35,596
THE MORE WE DEVELOP BIOLOGICAL 

4121
03:06:35,596 --> 03:06:36,130
CAN HARMONIZE AND BETTER 

4122
03:06:36,130 --> 03:06:38,532
COMMUNICATE ACROSS DISCIPLINES 

4123
03:06:38,532 --> 03:06:41,802
OF NEUROLOGY AND OTHER FORMS OF 

4124
03:06:41,802 --> 03:06:52,213
MEDICINE AND RESEARCH. 

4125
03:07:05,993 --> 03:07:06,260
 

4126
03:07:06,260 --> 03:07:07,027
    

4127
03:07:07,027 --> 03:07:07,495
   >> SUSAN. 

4128
03:07:07,495 --> 03:07:09,964
   >> I WANTED TO FOLLOW
UP. ON 

4129
03:07:09,964 --> 03:07:11,165
ALL THE DIFFERENT FORMS OF 

4130
03:07:11,165 --> 03:07:12,366
DEMENTIA WE WILL BE DISCUSSING 

4131
03:07:12,366 --> 03:07:14,568
OVER THE COURSE OF THIS SUMMIT, 

4132
03:07:14,568 --> 03:07:15,903
ALTHOUGH WE DON'T KNOW THE 

4133
03:07:15,903 --> 03:07:18,572
PREVALENCE OF FTD, AS YOU 

4134
03:07:18,572 --> 03:07:19,774
APPROPRIATELY ADDRESS IN 

4135
03:07:19,774 --> 03:07:20,641
RECOMMENDATION, WE CAN BE SURE 

4136
03:07:20,641 --> 03:07:23,677
THIS IS PROBABLY, BY FAR, THE 

4137
03:07:23,677 --> 03:07:30,417
LEAST PREVIOUS LE PREF /* -- 

4138
03:07:30,417 --> 03:07:32,186
PREVALENT. I WANTED TO CALL OUT 

4139
03:07:32,186 --> 03:07:33,254
HOW MUCH THE COMMUNITY 

4140
03:07:33,254 --> 03:07:35,322
APPRECIATES THE NIH'S INVESTMENT

4141
03:07:35,322 --> 03:07:37,925
IN FTD AND HOW WE RECOGNIZE THAT

4142
03:07:37,925 --> 03:07:41,295
IT IS STUDIES THAT NIH HAS 

4143
03:07:41,295 --> 03:07:44,031
BACKED, ALONG WITH THE PASSION 

4144
03:07:44,031 --> 03:07:47,001
OF THIS COMMUNITY. IT HAS LED TO

4145
03:07:47,001 --> 03:07:50,805
ADVANCES AND SPECIFICALLY TO 

4146
03:07:50,805 --> 03:07:52,807
BIOPHARMA'S ADVANCEMENT IN FTD. 

4147
03:07:52,807 --> 03:07:55,576
IT IS GOING TO TAKE, AS YOU HAVE

4148
03:07:55,576 --> 03:07:59,079
ALLUDED TO, THE PUBLIC PRIVATE 

4149
03:07:59,079 --> 03:08:00,614
PARTNERSHIPS TO GET US THROUGH 

4150
03:08:00,614 --> 03:08:02,883
THE FIRST THERAPEUTICSES. A NOTE

4151
03:08:02,883 --> 03:08:04,285
OF APPRECIATION FOR ALL-TIME YOU

4152
03:08:04,285 --> 03:08:07,788
HAVE PUT IN, AS WELL AS REALLY 

4153
03:08:07,788 --> 03:08:09,423
THE DECADES BASIC AND 

4154
03:08:09,423 --> 03:08:10,424
TRANSLATIONAL RESEARCH THAT HAS 

4155
03:08:10,424 --> 03:08:13,127
GOTTEN US AS FAR AS WE ARE. AND 

4156
03:08:13,127 --> 03:08:20,868
WILL GET US TO THOSE APPROVED 

4157
03:08:20,868 --> 03:08:24,071
THERAPEUTICSES. 

4158
03:08:24,071 --> 03:08:34,515
   >> THANK YOU. COMMENTS
OR 

4159
03:08:34,515 --> 03:08:34,849
QUESTIONS? 

4160
03:08:34,849 --> 03:08:36,317
   >> I HAVE ONE COMMENT
THAT 

4161
03:08:36,317 --> 03:08:38,052
CAME IN ONLINE I CAN READ AND 

4162
03:08:38,052 --> 03:08:39,720
MAYBE TAKE -- END AND MAYBE TAKE

4163
03:08:39,720 --> 03:08:41,522
A TWO-MINUTE BREAK AND TRY TO 

4164
03:08:41,522 --> 03:08:44,058
START BACK UP AS QUICK AS WE 

4165
03:08:44,058 --> 03:08:45,626
CAN. THERE'S ONE -- I WILL READ 

4166
03:08:45,626 --> 03:08:47,995
THIS QUICK. NOT A QUESTION, JUST

4167
03:08:47,995 --> 03:08:49,763
COMMENT. FTD IS UNIQUELY CRUEL 

4168
03:08:49,763 --> 03:08:50,798
BECAUSE IT OFTEN AFFECTS PERSON 

4169
03:08:50,798 --> 03:08:52,733
IN PRIME OF THEIR CAREER AND 

4170
03:08:52,733 --> 03:08:54,869
COST OF LOST PRODUCTIVITY, 

4171
03:08:54,869 --> 03:08:57,438
INCOME IS HUGELY IMPACTFUL FOR 

4172
03:08:57,438 --> 03:09:00,074
FAMILIES, OFTEN BOTH PATIENT AND

4173
03:09:00,074 --> 03:09:02,509
CAREGIVER ARE FORCED TO LEAVE 

4174
03:09:02,509 --> 03:09:07,014
CAREERS AND STUCK FOR MANY TOR 

4175
03:09:07,014 --> 03:09:11,919
YEARS. NIH, HELP US END FTD. 

4176
03:09:11,919 --> 03:09:22,463
   >> THANK YOU. BRANDON.
UNMUTE

4177
03:09:27,468 --> 03:09:37,878
YOUR CAMERA AND MICROPHONE. 

4178
03:09:43,417 --> 03:09:46,453
   >> HE'S OPEN. 

4179
03:09:46,453 --> 03:09:46,654
    

4180
03:09:46,654 --> 03:09:50,090
   >> MAYBE WHILE BRANDON
IS 

4181
03:09:50,090 --> 03:09:52,459
TRYING TO UNMUTE, I JUST WANT TO

4182
03:09:52,459 --> 03:09:53,727
TAKE THIS OPPORTUNITY AGAIN TO 

4183
03:09:53,727 --> 03:09:57,498
THANK THE COMMITTEE AND ALSO 

4184
03:09:57,498 --> 03:10:01,568
THE, YOU KNOW, THAT OUR WORK 

4185
03:10:01,568 --> 03:10:05,406
COULDN'T BE DONE WITHOUT THE 

4186
03:10:05,406 --> 03:10:09,476
PATIENT ADVOCACY GROUPS, PEOPLE 

4187
03:10:09,476 --> 03:10:11,578
WITH LIVED EXPERIENCES. 

4188
03:10:11,578 --> 03:10:13,347
INCREDIBLE AND POWERFUL AND 

4189
03:10:13,347 --> 03:10:16,717
REALLY REVEALING HOW, YOU KNOW, 

4190
03:10:16,717 --> 03:10:18,819
HOW REAL THESE -- THIS DISEASE 

4191
03:10:18,819 --> 03:10:21,588
IS AND HOW BROAD THE IMPACT IS 

4192
03:10:21,588 --> 03:10:26,360
AND HOW URGENT IT IS TO TREAT 

4193
03:10:26,360 --> 03:10:31,865
THESE DISEASES. 

4194
03:10:31,865 --> 03:10:34,201
   >> I THINK WE WILL TAKE
A 

4195
03:10:34,201 --> 03:10:36,270
TWO-MINUTE BREAK AND COME BACK 

4196
03:10:36,270 --> 03:10:38,806
WITH THE NEXT SESSION. SORRY, 

4197
03:10:38,806 --> 03:10:41,909
BRANDON, FOR TECHNOLOGY NOT 

4198
03:10:41,909 --> 03:10:46,769
WORKING FOR YOU. 

4199
03:10:48,756 --> 03:10:50,257
   >> WELCOME BACK, A
SHORT 

4200
03:10:50,257 --> 03:10:51,458
BREAK. WE ARE ABOUT EIGHT 

4201
03:10:51,458 --> 03:11:03,206
MINUTES BEHIND AND TRY TO MAKE 

4202
03:11:03,206 --> 03:11:04,908
THAT UP IN THE BREAK. APOLOGIES 

4203
03:11:04,908 --> 03:11:10,814
FOR NOT HAVING A LONGER BREAK. 

4204
03:11:10,814 --> 03:11:12,115
KRISTIN, ARE YOU ABLE TO TURN ON

4205
03:11:12,115 --> 03:11:12,715
YOUR CAMERA? 

4206
03:11:12,715 --> 03:11:15,351
   >> I JUST HAD IT ON. DO
YOU 

4207
03:11:15,351 --> 03:11:16,386
NOT SEE ME? 

4208
03:11:16,386 --> 03:11:19,556
   >> IT MAY BE ON ME
THAT.  IS 

4209
03:11:19,556 --> 03:11:23,126
GREAT. I HEAR YOU, THANK YOU. 

4210
03:11:23,126 --> 03:11:28,665
   >> GREAT. CAN I GET
STARTED? 

4211
03:11:28,665 --> 03:11:30,200
   >> YEP, DEFINITELY. 

4212
03:11:30,200 --> 03:11:31,267
   >> GREAT, THANK YOU.
THANK 

4213
03:11:31,267 --> 03:11:32,569
YOU EVERYONE FOR STICKING WITH 

4214
03:11:32,569 --> 03:11:34,404
US. I KNOW THESE DAYIES CAN FEEL

4215
03:11:34,404 --> 03:11:37,907
LONG. I'M SO HONORED TO BE ABLE 

4216
03:11:37,907 --> 03:11:40,977
TO HAVE THIS OPPORTUNITY TO 

4217
03:11:40,977 --> 03:11:42,812
SHARE OUR SUBCOMMITTEE'S 

4218
03:11:42,812 --> 03:11:47,116
RECOMMENDATION ON POST-TRAUMATIC

4219
03:11:47,116 --> 03:11:49,219
BRAIN INJURY NEURODEGENERATION 

4220
03:11:49,219 --> 03:11:50,720
AND ALZHEIMER'S AND RELATED 

4221
03:11:50,720 --> 03:11:52,489
DISORDERS. I HAVE NO 

4222
03:11:52,489 --> 03:11:55,859
DISCLOSURES. WE JUST WANTED TO 

4223
03:11:55,859 --> 03:11:56,659
ACKNOWLEDGE THAT WE USED 

4224
03:11:56,659 --> 03:11:58,161
SPECIFIC PROGRAM TO GENERATE 

4225
03:11:58,161 --> 03:12:01,931
OTHER FIGURES IN THIS 

4226
03:12:01,931 --> 03:12:04,667
PRESENTATION. THIS SLIDE SHOWS A

4227
03:12:04,667 --> 03:12:07,036
CONDENSED OVERVIEW OF OUR FOUR 

4228
03:12:07,036 --> 03:12:08,004
RECOMMENDATIONS WHICH REALLY 

4229
03:12:08,004 --> 03:12:09,672
EMPHASIZED THE NEED TO INVEST IN

4230
03:12:09,672 --> 03:12:10,707
INFRASTRUCTURE AND WHAT IS STILL

4231
03:12:10,707 --> 03:12:13,076
A RELATIVELY NEW AREA OF 

4232
03:12:13,076 --> 03:12:16,145
RESEARCH. WE HAVE MADE SOME 

4233
03:12:16,145 --> 03:12:17,146
RAPID ADVANCEMENTS AND TO 

4234
03:12:17,146 --> 03:12:20,049
CONTINUE ON THIS TRAJECTORY WILL

4235
03:12:20,049 --> 03:12:21,885
REQUIRE INTER DISCIPLINARY 

4236
03:12:21,885 --> 03:12:24,821
COLLABORATION ACROSS TBI AND 

4237
03:12:24,821 --> 03:12:27,423
DEMENTIA COMMUNITIES, 

4238
03:12:27,423 --> 03:12:30,260
MULTI MODAL AND TRANSLATION OF 

4239
03:12:30,260 --> 03:12:37,834
KNOWLEDGE INTO CLINICAL SETTINGS

4240
03:12:37,834 --> 03:12:40,003
AS WELL AS SHARING KNOWLEDGE. 

4241
03:12:40,003 --> 03:12:43,473
TBI IS A MAJOR HEALTH PRIORITY. 

4242
03:12:43,473 --> 03:12:47,443
NOTE THAT ALSO TBI IN OLDER 

4243
03:12:47,443 --> 03:12:49,779
ADULTS IS EXCEEDING POPULATION 

4244
03:12:49,779 --> 03:12:52,649
GROWTH AND MILLIONS OF TRAUMATIC

4245
03:12:52,649 --> 03:12:53,816
BRAIN INJURIES ARE NOT COUNTED 

4246
03:12:53,816 --> 03:12:55,451
IN THESE ESTIMATES INCLUDING 

4247
03:12:55,451 --> 03:12:57,487
INJURIES SUSTAINED IN MILITARY 

4248
03:12:57,487 --> 03:13:00,089
COMBAT, THOSE FOR WHICH CARE IS 

4249
03:13:00,089 --> 03:13:02,992
NOT SOUGHT OR RECEIVED AND 

4250
03:13:02,992 --> 03:13:05,061
INJURIES THAT ARE INTENTIONALLY 

4251
03:13:05,061 --> 03:13:06,696
CONCEALED, SUCH AS INJURIES 

4252
03:13:06,696 --> 03:13:10,900
SUSTAINED IN CONTEXT OF INTIMATE

4253
03:13:10,900 --> 03:13:17,140
PARTNER VIOLENCE. WE WANT TO 

4254
03:13:17,140 --> 03:13:22,011
CLARIFY TERMS RELEVANT, SO 

4255
03:13:22,011 --> 03:13:25,048
REPETITIVE HEAD IMPACT, RHI 

4256
03:13:25,048 --> 03:13:26,950
REFERS TO REPEATED IMPACTS TO 

4257
03:13:26,950 --> 03:13:29,319
THE HEAD INCLUDING CONTACT 

4258
03:13:29,319 --> 03:13:30,320
SPORTS, PERHAPS SIMILAR TO 

4259
03:13:30,320 --> 03:13:34,691
EXPERIENCE ED IN MILITARY BLAST 

4260
03:13:34,691 --> 03:13:38,428
EXPOSURE OR IN CONTEXT INVOLVING

4261
03:13:38,428 --> 03:13:39,996
PARTNER VIOLENCE. THESE HITS TO 

4262
03:13:39,996 --> 03:13:41,364
THE HEAD DO NOT RESULT IN 

4263
03:13:41,364 --> 03:13:44,968
SYMPTOMS OF A TRAUMATIC BRAIN 

4264
03:13:44,968 --> 03:13:46,803
INJURY. ON THE OTHER HAND 

4265
03:13:46,803 --> 03:13:48,071
TRAUMATIC BRAIN INJURY IS AN 

4266
03:13:48,071 --> 03:13:50,006
ISOLATED BLOW OR INJURY TO THE 

4267
03:13:50,006 --> 03:13:52,642
HEAD OR NECK THAT RESULTS IN 

4268
03:13:52,642 --> 03:13:56,546
LOSS OR ALTERATION OF 

4269
03:13:56,546 --> 03:13:59,048
CONSCIOUSNESS. NEXT SLIDE. THE 

4270
03:13:59,048 --> 03:14:01,951
ACUTE AND CHRONIC SYMPTOMS OF 

4271
03:14:01,951 --> 03:14:04,153
TBI CAN RANGE CONSIDERABLY SO 

4272
03:14:04,153 --> 03:14:07,991
MOST PEOPLE WITH A MILD TBI 

4273
03:14:07,991 --> 03:14:08,958
RECOVER COMPLETELY AND I WILL 

4274
03:14:08,958 --> 03:14:12,662
NOTE THAT ONGOING NIH AND NINDS 

4275
03:14:12,662 --> 03:14:19,636
EFFORTS TO IMPROVE TDI SEVERITY 

4276
03:14:19,636 --> 03:14:21,037
CLASSIFICATION INDICATES IT 

4277
03:14:21,037 --> 03:14:23,172
DOESN'T ALWAYS ALIGN WITH TBI 

4278
03:14:23,172 --> 03:14:25,008
SEVERITY. MILD TBI HAS BEEN 

4279
03:14:25,008 --> 03:14:28,645
ASSOCIATED WITH DEMENTIA RISK IN

4280
03:14:28,645 --> 03:14:32,548
SOME STUDIES. NEXT, RHI, WHICH I

4281
03:14:32,548 --> 03:14:34,017
SHOULD NOTE IS ALSO PRESENT AND 

4282
03:14:34,017 --> 03:14:36,853
-- ADVANCE, THERE WE GO. IS ALSO

4283
03:14:36,853 --> 03:14:38,755
PRESENT IN SUBSTANTIAL 

4284
03:14:38,755 --> 03:14:39,856
PROPORTION OF PEOPLE WHO 

4285
03:14:39,856 --> 03:14:42,425
SUSTAINED A SINGLE TBI, ABOUT 

4286
03:14:42,425 --> 03:14:44,694
HALF AND SOME OF OUR STUDIES 

4287
03:14:44,694 --> 03:14:47,063
HAVE SUSTAINED EXTENSIVE 

4288
03:14:47,063 --> 03:14:49,365
EXPOSURE TO RHI, WHICH DOES NOT 

4289
03:14:49,365 --> 03:14:51,067
ITSELF RESULT IN IMMEDIATE 

4290
03:14:51,067 --> 03:14:53,836
SYMPTOMS IN MOST CASES BUT 

4291
03:14:53,836 --> 03:14:55,138
COMPELLING EVIDENCE DOES SUGGEST

4292
03:14:55,138 --> 03:15:01,310
A SUBSET OF THOSE WITH RF RHI 

4293
03:15:01,310 --> 03:15:02,912
EXPOSURE DEVELOP DECLINE LATER 

4294
03:15:02,912 --> 03:15:06,315
IN LIFE. THIS IS JUST A SNAPSHOT

4295
03:15:06,315 --> 03:15:09,285
OF FIVE-YEAR OUTCOMES FROM THE 

4296
03:15:09,285 --> 03:15:10,820
NIDLER-FUNDED TBI SYSTEMS WHERE 

4297
03:15:10,820 --> 03:15:12,722
YOU CAN SEE AMONG SURVIVORS OF 

4298
03:15:12,722 --> 03:15:16,659
MODERATE TO SEVERE TBI, NEARLY A

4299
03:15:16,659 --> 03:15:19,629
THIRD DECLINE WITHIN FIVE YEARS,

4300
03:15:19,629 --> 03:15:22,165
BUT OVER A QUARTER CONTINUE TO 

4301
03:15:22,165 --> 03:15:26,335
IMPROVE. WE NEED TO KNOW WHAT IS

4302
03:15:26,335 --> 03:15:28,638
DRIVING THESE HETEROGENOUS 

4303
03:15:28,638 --> 03:15:32,208
CHRONIC TRAJECTORIES. NEXT. 

4304
03:15:32,208 --> 03:15:36,879
ANOTHER QUICK NOTE ON KN

4305
03:15:36,879 --> 03:15:38,381
NOMENCLATURE AND WORDS WE ARE 

4306
03:15:38,381 --> 03:15:39,382
USING IN OUR PRESENTATION TODAY,

4307
03:15:39,382 --> 03:15:42,051
WHEN WE ARE TALKING ABOUT 

4308
03:15:42,051 --> 03:15:45,555
POST-TBI, ADRD, ALSO REFERRED TO

4309
03:15:45,555 --> 03:15:48,024
AS POST-TRAUMATIC 

4310
03:15:48,024 --> 03:15:49,192
NEURODEGENERATION OR PTRD, WE 

4311
03:15:49,192 --> 03:15:51,828
ARE NOT TALKING ABOUT ACUTE 

4312
03:15:51,828 --> 03:15:53,396
SYMPTOMS THAT HAPPEN AFTER TBI; 

4313
03:15:53,396 --> 03:15:55,565
WE ARE REFERRING TO A SUBSEQUENT

4314
03:15:55,565 --> 03:15:57,333
PATTERN OF DECLINE THAT IS 

4315
03:15:57,333 --> 03:15:59,669
EXPERIENCED FOLLOWING RECOVERY 

4316
03:15:59,669 --> 03:16:06,375
IN A SUBSET OF CHRONIC TBI 

4317
03:16:06,375 --> 03:16:07,777
SURVIVORS. NEXT SLIDE. THIS 

4318
03:16:07,777 --> 03:16:10,346
IMAGE IS FROM A PAPER WE WROTE 

4319
03:16:10,346 --> 03:16:12,348
AFTER THE 2019ADRD SUMMIT. I 

4320
03:16:12,348 --> 03:16:14,016
HAVE INCLUDED IT BECAUSE IT 

4321
03:16:14,016 --> 03:16:18,955
REALLY EMPHASIZES THAT PTND IS 

4322
03:16:18,955 --> 03:16:20,523
INDISPUTEDLY A MULTIPLE ETIOLOGY

4323
03:16:20,523 --> 03:16:23,793
DEMENTIA. TBI IS ONE OF MANY 

4324
03:16:23,793 --> 03:16:25,194
THINGS IN A LIFETIME THAT CAN 

4325
03:16:25,194 --> 03:16:28,865
INFLUENCE DEMENTIA RISK. TBI HAS

4326
03:16:28,865 --> 03:16:30,466
UNIQUE PATHOLOGICAL FOOT PRINTS 

4327
03:16:30,466 --> 03:16:37,874
WE ARE JUST NOW BEGINNING TO 

4328
03:16:37,874 --> 03:16:40,610
EXPLORE. JUST BRIEFLY GROWING 

4329
03:16:40,610 --> 03:16:44,447
EVIDENCE SUGGESTS HEAD TRAUMA OF

4330
03:16:44,447 --> 03:16:47,316
DISTINCT ETIOLOGIES MAY HAVE 

4331
03:16:47,316 --> 03:16:48,718
DISTINCT FOOTPRINT S SO CTE HAS 

4332
03:16:48,718 --> 03:16:52,588
A WELL-DEFINED LESION THAT 

4333
03:16:52,588 --> 03:16:55,158
APPEARS TO BE UNIQUE TO RHI. 

4334
03:16:55,158 --> 03:16:56,893
THEN WE HAVE EVIDENCE THAT 

4335
03:16:56,893 --> 03:16:58,294
SUGGESTS THAT BLAST EXPOSURE MAY

4336
03:16:58,294 --> 03:17:01,964
HAVE A UNIQUE PATTERN OF -- WE 

4337
03:17:01,964 --> 03:17:05,768
CALL IT INTER FACE ASTRO GLIAL 

4338
03:17:05,768 --> 03:17:07,870
SCARRING. NEXT INTIMATE PARTNER 

4339
03:17:07,870 --> 03:17:10,439
VIOLENCE, WHICH IS A PATTERN 

4340
03:17:10,439 --> 03:17:12,575
OFTENTIMES OF BRAIN INJURY THAT 

4341
03:17:12,575 --> 03:17:15,578
CAN INVOLVE REPETITIVE HEAD 

4342
03:17:15,578 --> 03:17:24,120
IMPACTS, AGNOSTIC OR HIGH POHIC 

4343
03:17:24,120 --> 03:17:25,488
INJURY IN AN INDIVIDUAL. BASED 

4344
03:17:25,488 --> 03:17:27,924
ON VERY FEW CASES STUDIED TO 

4345
03:17:27,924 --> 03:17:31,427
DATE. BUT WE HAVE NOT FOUND MUCH

4346
03:17:31,427 --> 03:17:33,963
CTE IN IPV, SUGGESTING THIS IS 

4347
03:17:33,963 --> 03:17:38,901
NOT A PRIMARY PATHOLOGY OF IPV. 

4348
03:17:38,901 --> 03:17:41,437
FINALLY ISOLATED TRAUMATIC BRAIN

4349
03:17:41,437 --> 03:17:43,439
INJURY SEEMS TO RESULT IN WIDE 

4350
03:17:43,439 --> 03:17:44,941
RANGE OF DISTINCT AND 

4351
03:17:44,941 --> 03:17:48,477
OVERLAPPING PATHOLOGIES 

4352
03:17:48,477 --> 03:17:51,981
INCLUDING TISSUE TEARS AND NEW 

4353
03:17:51,981 --> 03:17:53,649
EVIDENT EVIDENCE IS SUGGESTING 

4354
03:17:53,649 --> 03:17:57,920
IT MAY BE AMPLIFIED BY OR 

4355
03:17:57,920 --> 03:18:02,925
PROXIMAL TO TRAUMATIC LESIONS. 

4356
03:18:02,925 --> 03:18:07,230
NEXT. WE WANT TO ALSO 

4357
03:18:07,230 --> 03:18:09,298
ACKNOWLEDGE THAT WE HAVE HAD 

4358
03:18:09,298 --> 03:18:10,233
TREMENDOUS PROGRESS SINCE EVEN 

4359
03:18:10,233 --> 03:18:13,569
JUST THE LAST SUMMIT IN 2022. 

4360
03:18:13,569 --> 03:18:15,538
THE NIH HAS FUNDED SEVERAL 

4361
03:18:15,538 --> 03:18:16,505
AWARDS TO ADVANCE 

4362
03:18:16,505 --> 03:18:17,473
RECOMMENDATIONS WITH A 

4363
03:18:17,473 --> 03:18:18,941
PARTICULAR EMPHASIS ON 

4364
03:18:18,941 --> 03:18:21,811
MULTI MODAL INVESTIGATIONS INTO 

4365
03:18:21,811 --> 03:18:23,646
TBI AS A MULTIPLE ETIOLOGY 

4366
03:18:23,646 --> 03:18:26,515
DEMENTIA EMPHASIZING 

4367
03:18:26,515 --> 03:18:27,250
MULTI DISCIPLINARY COLLABORATION

4368
03:18:27,250 --> 03:18:29,719
AND FACILITATING DATA SHARING. 

4369
03:18:29,719 --> 03:18:30,119
NEXT. 

4370
03:18:30,119 --> 03:18:31,153
   >> TWO MINUTES. 

4371
03:18:31,153 --> 03:18:33,789
   >> WE HAVE CHANGED OUR
TIME 

4372
03:18:33,789 --> 03:18:39,195
ALLOCATION, JUST SO YOU KNOW. 

4373
03:18:39,195 --> 03:18:41,130
NEXT. PRIORITY ONE IS -- I'M 

4374
03:18:41,130 --> 03:18:42,832
GOING TO GO THROUGH EACH OF OUR 

4375
03:18:42,832 --> 03:18:44,333
PRIORITIES. I'M GOING TO START 

4376
03:18:44,333 --> 03:18:46,335
WITH PRIORITY ONE THEN HAVE SOME

4377
03:18:46,335 --> 03:18:47,570
SLIDES THAT JUST ILLUSTRATE SOME

4378
03:18:47,570 --> 03:18:49,705
OF THE SUB COMPONENTS OF 

4379
03:18:49,705 --> 03:18:53,643
PRIORITY ONE. LET'S GO TO THE 

4380
03:18:53,643 --> 03:18:57,580
NEXT SLIDE. SO PRIORITY ONE IS 

4381
03:18:57,580 --> 03:18:58,948
REALLY ABOUT LONGITUDINAL 

4382
03:18:58,948 --> 03:19:01,150
MULTI MODAL STUDIES, THE NEED TO

4383
03:19:01,150 --> 03:19:02,952
DEVELOP THIS INFRASTRUCTURE TO 

4384
03:19:02,952 --> 03:19:06,489
STUDY THE LONG-TERM IMPLICATIONS

4385
03:19:06,489 --> 03:19:08,925
OF TBI AND INTERSECTIONS WITH 

4386
03:19:08,925 --> 03:19:12,428
ADRDs SO FOUNDATIONAL TO THIS 

4387
03:19:12,428 --> 03:19:15,131
EFFORT IS FURTHER VALIDATION AND

4388
03:19:15,131 --> 03:19:17,466
STANDARDIZATION OF METHODS TO 

4389
03:19:17,466 --> 03:19:20,636
QUANTIFY TBI AND RHI. 

4390
03:19:20,636 --> 03:19:21,938
SELF-REPORT IS OFTEN BEST OPTION

4391
03:19:21,938 --> 03:19:24,173
FOR LIFETIME EXPOSURE 

4392
03:19:24,173 --> 03:19:26,208
CHARACTERIZATION. IDEALLY IT IS 

4393
03:19:26,208 --> 03:19:28,077
SUPPLEMENTED BY MEDICAL RECORDS 

4394
03:19:28,077 --> 03:19:32,281
WHICH CAN GIVE SNAPSHOTS OF 

4395
03:19:32,281 --> 03:19:34,116
INJURIES THAT HAVE RECEIVED CARE

4396
03:19:34,116 --> 03:19:35,451
AND EACH HAS STRENGTHS AND 

4397
03:19:35,451 --> 03:19:38,187
WEAKNESSES THERE ARE ONGOING 

4398
03:19:38,187 --> 03:19:41,724
EFFORTS TO QUANTIFY RHI IN 

4399
03:19:41,724 --> 03:19:43,693
CONTACT SPORTS AND MILITARY 

4400
03:19:43,693 --> 03:19:47,063
SETTINGS. NEXT. IMPORTANTLY, 

4401
03:19:47,063 --> 03:19:48,064
GROWING EVIDENCE SUGGESTS 

4402
03:19:48,064 --> 03:19:49,932
READILY REPORTABLE INDICES SUCH 

4403
03:19:49,932 --> 03:19:52,635
AS DURATION OF EXPOSURE TO 

4404
03:19:52,635 --> 03:19:54,804
CONTACT SPORT S HAVE A DOSE 

4405
03:19:54,804 --> 03:19:58,341
RELATIONSHIP WITH FOR EXAMPLE 

4406
03:19:58,341 --> 03:20:03,346
CTU NEURAL PATHOLOGY, NEXT. 

4407
03:20:03,346 --> 03:20:10,486
OKAY. NEXT. THERE GO. NEXT. SO A

4408
03:20:10,486 --> 03:20:14,056
DIAGNOSIS OF POST-TRAUMATIC 

4409
03:20:14,056 --> 03:20:15,191
NEURO DEGENERATION DURING LIFE, 

4410
03:20:15,191 --> 03:20:17,626
WHEN WE CAN STILL INTERVENE, IS 

4411
03:20:17,626 --> 03:20:19,829
OF HIGH PRIORITY. THIS REQUIRES 

4412
03:20:19,829 --> 03:20:21,864
LONGITUDINAL STUDY IN COHORTS 

4413
03:20:21,864 --> 03:20:24,200
WILLING TO UNDERGO MULTI MODAL, 

4414
03:20:24,200 --> 03:20:27,069
CLINICAL AND BIO MARKER 

4415
03:20:27,069 --> 03:20:28,104
EVALUATIONS TO DISTINGUISH THE 

4416
03:20:28,104 --> 03:20:38,748
STABLE POST TBI SYMPTOMS AND 

4417
03:20:38,748 --> 03:20:41,984
CRITERIA UNDERLYING DISEASE 

4418
03:20:41,984 --> 03:20:43,919
PROCESSES. NEXT AGAIN TRAUMATIC 

4419
03:20:43,919 --> 03:20:47,957
BRAIN INJURY IS AN ADRD RISK 

4420
03:20:47,957 --> 03:20:50,226
FACTOR WITH A TIME ZERO WHICH 

4421
03:20:50,226 --> 03:20:52,695
MEANS TBI SURVIVORS ARE A RISK 

4422
03:20:52,695 --> 03:20:53,929
POPULATION THAT MAY SUPPORT 

4423
03:20:53,929 --> 03:20:55,498
IDENTIFICATION OF THE EARLIEST 

4424
03:20:55,498 --> 03:20:57,533
BIOLOGICAL SIGNS OF DEMENTIA 

4425
03:20:57,533 --> 03:21:00,603
RISK. IT IS ESSENTIAL TO 

4426
03:21:00,603 --> 03:21:02,171
RECOGNIZE THAT MOST INDIVIDUALS 

4427
03:21:02,171 --> 03:21:05,841
WITH RHI EXPOSURE AND WITH TBI 

4428
03:21:05,841 --> 03:21:10,279
WILL NOT DEVELOP ADRDs. WE NEED 

4429
03:21:10,279 --> 03:21:12,214
ASYSTEMATIC INDIVIDUALS WITH 

4430
03:21:12,214 --> 03:21:13,716
THESE EXPOSURES WITH RHI AND T 

4431
03:21:13,716 --> 03:21:16,519
BIV TO BE INCLUDED IN OUR 

4432
03:21:16,519 --> 03:21:17,887
LONGITUDINAL STUDIES SO WE CAN 

4433
03:21:17,887 --> 03:21:22,525
ALSO IDENTIFY PROTECTIVE 

4434
03:21:22,525 --> 03:21:25,361
FACTORS. NEXT. WE NEED 

4435
03:21:25,361 --> 03:21:32,635
BIO MARKERS OF PTMD. TPI 

4436
03:21:32,635 --> 03:21:33,636
BIOMARKER DISCOVERIES HAVE 

4437
03:21:33,636 --> 03:21:35,704
FOCUSED ALMOST EXCLUSIVELY ON 

4438
03:21:35,704 --> 03:21:38,107
ACUTE CARE TRIAGING. OUR 

4439
03:21:38,107 --> 03:21:39,341
COLLEAGUES MEANWHILE WHO ARE 

4440
03:21:39,341 --> 03:21:43,045
STUDYING AD AND ADRDs HAVE MADE 

4441
03:21:43,045 --> 03:21:45,347
REALLY IMPORTANT DISCOVERIES IN 

4442
03:21:45,347 --> 03:21:48,017
IMAGING AND FLUID BIOMARKERS OF 

4443
03:21:48,017 --> 03:21:49,752
DEMENTIA SO IN SEARCHING FOR 

4444
03:21:49,752 --> 03:21:54,290
BIO MARKERS OF POST TBI ADRD WE 

4445
03:21:54,290 --> 03:21:56,659
HAVE FOCUSED SO FAR ON THOSE WE 

4446
03:21:56,659 --> 03:22:00,596
KNOW TO BE PERTURBED BY ACUTE 

4447
03:22:00,596 --> 03:22:02,798
TBI AND KNOWN RELEVANT TO ADRDs.

4448
03:22:02,798 --> 03:22:05,734
WE MAY BE MISSING IMPORTANT PTND

4449
03:22:05,734 --> 03:22:08,003
SPECIFIC BIOMARKERS AND NEED TO 

4450
03:22:08,003 --> 03:22:10,506
BROAD INTO IDENTIFY OTHER 

4451
03:22:10,506 --> 03:22:12,842
NON-INVASIVE BIOMARKERS THAT CAN

4452
03:22:12,842 --> 03:22:15,177
PREDICT AND MONITOR DISSEEDS 

4453
03:22:15,177 --> 03:22:16,679
PROGRESSION OVER TIME AND 

4454
03:22:16,679 --> 03:22:20,649
IDENTIFY THE PATHOLOGIES THAT 

4455
03:22:20,649 --> 03:22:25,187
UNDERLIE CLINICAL DECLINE. NEXT.

4456
03:22:25,187 --> 03:22:29,058
A GROWING UNDERSTANDING OF 

4457
03:22:29,058 --> 03:22:30,860
INJURY BIOMECHANIC NICK S IS 

4458
03:22:30,860 --> 03:22:32,027
HELPING US UNDERSTAND HOW 

4459
03:22:32,027 --> 03:22:34,263
DIFFERENT TYPES IN HEAD TRAUMA 

4460
03:22:34,263 --> 03:22:36,132
CAN RESULT IN PATHOLOGICAL 

4461
03:22:36,132 --> 03:22:37,666
PROCESSES. WHAT WE DON'T KNOW IS

4462
03:22:37,666 --> 03:22:40,870
HOW TBI SPECIFIC PATHOLOGIES CAN

4463
03:22:40,870 --> 03:22:44,240
INTER ACT WITH AD AND OTHER ADRD

4464
03:22:44,240 --> 03:22:47,176
PATHOLOGIES OR WITH CLINICAL 

4465
03:22:47,176 --> 03:22:49,311
SYMPTOMS, OR SPECIFICALLY HOW 

4466
03:22:49,311 --> 03:22:51,747
ESTABLISHED AD BIO MARKERS ARE 

4467
03:22:51,747 --> 03:22:54,250
INFLUENCED BY A TBI. WE NEED TO 

4468
03:22:54,250 --> 03:22:55,484
BETTER UNDERSTAND WHETHER HEAD 

4469
03:22:55,484 --> 03:22:57,753
TRAUMA INFLUENCES THE RESPONSE 

4470
03:22:57,753 --> 03:23:00,189
TO DISEASE MODIFYING TREATMENTS 

4471
03:23:00,189 --> 03:23:03,993
WITH EXISTING APPROVED 

4472
03:23:03,993 --> 03:23:05,361
THERAPIES. NEXT. FINALLY OUR 

4473
03:23:05,361 --> 03:23:08,464
SUBCOMMITTEE HAS EMPHASIZED THE 

4474
03:23:08,464 --> 03:23:10,399
IMPORTANCE OF COLLECTING COMMON 

4475
03:23:10,399 --> 03:23:14,003
DATA ELEMENTS. CAN WE GO TO THE 

4476
03:23:14,003 --> 03:23:16,872
NEXT SLIDE. THERE WE GO. COMMON 

4477
03:23:16,872 --> 03:23:20,109
DATA ELEMENTS, SO THIS IS A 

4478
03:23:20,109 --> 03:23:21,410
RECOMMENDATION TO INCLUDE 

4479
03:23:21,410 --> 03:23:23,779
SIMILAR MEASURES IN STUDIES EVEN

4480
03:23:23,779 --> 03:23:26,782
ONGOING STUDIES OF TRAUMATIC 

4481
03:23:26,782 --> 03:23:28,717
BRAIN INJURY, WHICH MAY IN SOME 

4482
03:23:28,717 --> 03:23:31,086
CASES MEAN COLLECTING ADDITIONAL

4483
03:23:31,086 --> 03:23:33,756
DATA TO OPTIMIZE OVERLAP BETWEEN

4484
03:23:33,756 --> 03:23:38,394
TBI STUDIES AND DEMENTIA STUDIES

4485
03:23:38,394 --> 03:23:41,730
SPECIFICALLY, NEXT, PROVIDE THE 

4486
03:23:41,730 --> 03:23:43,732
FOUNDATIONS THAT WE NEED FOR 

4487
03:23:43,732 --> 03:23:46,235
CROSS-STUDY COMPARISONS AND DATA

4488
03:23:46,235 --> 03:23:48,337
SHARING IN PUBLIC REPOSITORIES. 

4489
03:23:48,337 --> 03:23:50,573
I'M GOING TO TURN IT OVER NOW TO

4490
03:23:50,573 --> 03:23:53,275
MY COLLEAGUE, WHO IS GOING TO 

4491
03:23:53,275 --> 03:23:56,645
PRESENT RECOMMENDATION TWO, 

4492
03:23:56,645 --> 03:24:06,855
THANK YOU. 

4493
03:24:19,268 --> 03:24:24,540
    CAN WE UNMUTE, DR. GRAHAM? 

4494
03:24:24,540 --> 03:24:27,743
   >> WONDERFUL, THAT
COMING 

4495
03:24:27,743 --> 03:24:30,613
THROUGH? THANKS, I WANT TO THANK

4496
03:24:30,613 --> 03:24:36,085
THE ORGANIZERS AT NIH FOR 

4497
03:24:36,085 --> 03:24:38,220
PUTTING TOGETHER THIS AND 

4498
03:24:38,220 --> 03:24:39,488
BRINGING TOGETHER THESE 

4499
03:24:39,488 --> 03:24:40,990
RECOMMENDATIONS, I THINK ARE 

4500
03:24:40,990 --> 03:24:42,825
REALLY IMPORTANT. AND, YOU KNOW,

4501
03:24:42,825 --> 03:24:45,494
ARE GOING TO BE VERY IMPACTFUL A

4502
03:24:45,494 --> 03:24:46,929
MOMENT OF OPPORTUNITY FOR OUR 

4503
03:24:46,929 --> 03:24:50,266
FIELD. SO, YOU KNOW, AS WE SET 

4504
03:24:50,266 --> 03:24:53,836
OUT WE HAVE MADE A GREAT DEAL OF

4505
03:24:53,836 --> 03:24:55,871
PROGRESS SO FAR IN TERMS FROM MY

4506
03:24:55,871 --> 03:24:58,040
PERSPECTIVE, BIOMARKERS OF 

4507
03:24:58,040 --> 03:25:00,075
INJURY, GAVE ME A MECHANISTIC 

4508
03:25:00,075 --> 03:25:01,343
UNDERSTANDING BUT LOTS FOR US TO

4509
03:25:01,343 --> 03:25:03,078
DO. IF WE COULD ADVANCE TO THE 

4510
03:25:03,078 --> 03:25:04,580
NEXT SLIDE, PLEASE .

4511
03:25:04,580 --> 03:25:05,347
THE RECOMMENDATION I WANTED TO 

4512
03:25:05,347 --> 03:25:08,183
SHARE WITH YOU, WHICH WE HAVE 

4513
03:25:08,183 --> 03:25:11,787
PUT TOGETHER, IS ABOUT LINKING 

4514
03:25:11,787 --> 03:25:16,058
UP THE ALZHEIMER'S AND TBI 

4515
03:25:16,058 --> 03:25:17,526
FIELDS TO GAIN SOME KIND OF 

4516
03:25:17,526 --> 03:25:19,395
SCALE AND LEVERAGE EXISTING 

4517
03:25:19,395 --> 03:25:21,630
INVESTMENT IN SKILLS, EXPERIENCE

4518
03:25:21,630 --> 03:25:22,464
PRESENT IN EACH OF THOSE IN 

4519
03:25:22,464 --> 03:25:26,068
ORDER TO HAVE THE SCALE TO KIND 

4520
03:25:26,068 --> 03:25:27,670
OF MAKE THE BREAKTHROUGHS 

4521
03:25:27,670 --> 03:25:31,173
NECESSARY IF WE ARE GOING TO 

4522
03:25:31,173 --> 03:25:36,211
TRANSLATE INTO PATIENT CARE. FOR

4523
03:25:36,211 --> 03:25:40,649
EXAMPLE IT IS CLEAR TBI IS A 

4524
03:25:40,649 --> 03:25:43,986
VERY HETEROGENOUS DISEASE AND 

4525
03:25:43,986 --> 03:25:45,954
UNDERLYING BASIS, FOR INSTANCE, 

4526
03:25:45,954 --> 03:25:49,491
NEED LARGE SAMPLE SIZES. THIS IS

4527
03:25:49,491 --> 03:25:51,960
WHAT OUR RECOMMENDATION TWO 

4528
03:25:51,960 --> 03:25:53,796
FOCUSES ON. I CAN GIVE YOU SOME 

4529
03:25:53,796 --> 03:25:55,664
KIND OF DETAIL OF WHAT WE ARE 

4530
03:25:55,664 --> 03:25:57,866
GOING TO DO. THE FIRST CHUNK, IF

4531
03:25:57,866 --> 03:26:02,971
WE CAN ADVANCE TO THE NEXT 

4532
03:26:02,971 --> 03:26:03,672
SLIDE, PLEASE, IS ABOUT 

4533
03:26:03,672 --> 03:26:05,274
CONVENING A WORKING GROUP OF 

4534
03:26:05,274 --> 03:26:07,509
STAKEHOLDERS FROM TBI AND ADRD 

4535
03:26:07,509 --> 03:26:11,547
COMMUNITIES TO EVALUATE EXTENT 

4536
03:26:11,547 --> 03:26:14,850
WHAT WE KNOW CAN MR. APPLIED TO 

4537
03:26:14,850 --> 03:26:19,688
STUDY OF TBI AND VICE VERSA AND 

4538
03:26:19,688 --> 03:26:21,056
DEVELOP A FORUM KNOWLEDGE 

4539
03:26:21,056 --> 03:26:22,424
EXCHANGE WHICH WOULD INCLUDE 

4540
03:26:22,424 --> 03:26:24,093
BASIC SCIENCE, TRANSLATIONAL AND

4541
03:26:24,093 --> 03:26:26,528
CLINICAL RESEARCH, WHICH WOULD 

4542
03:26:26,528 --> 03:26:28,430
HOPEFULLY GIVE BIDIRECTIONAL 

4543
03:26:28,430 --> 03:26:29,331
COMMUNICATION. I THINK THIS 

4544
03:26:29,331 --> 03:26:30,733
WOULD HELP US TO HIGHLIGHT 

4545
03:26:30,733 --> 03:26:34,436
CLINICAL DISCOVERIES THAT REVEAL

4546
03:26:34,436 --> 03:26:36,505
GAPS WHERE GAINIES CAN BE MADE 

4547
03:26:36,505 --> 03:26:38,841
AND HIGHLIGHT BASIC SIZE 

4548
03:26:38,841 --> 03:26:39,641
DISCOVERIES THAT MIGHT INFORM 

4549
03:26:39,641 --> 03:26:41,877
DEVELOPMENT OF CLINICALLY 

4550
03:26:41,877 --> 03:26:44,680
ACCESSIBLE BIOMARKERS AND 

4551
03:26:44,680 --> 03:26:49,051
INTERPRETATION OF FACTORS 

4552
03:26:49,051 --> 03:26:52,821
RELEVANT TO PATHOLOGY. THIS IS 

4553
03:26:52,821 --> 03:26:56,759
DONE YET WE DON'T HAVE SOMETHING

4554
03:26:56,759 --> 03:26:58,494
THAT BRINGS TOGETHER THESE 

4555
03:26:58,494 --> 03:27:02,664
FIELDS. CERTAINLY WITHIN TBI WE 

4556
03:27:02,664 --> 03:27:03,932
HAVE A STRONG INTERNATIONAL 

4557
03:27:03,932 --> 03:27:05,467
RESEARCH COMMUNITY THROUGH INBIR

4558
03:27:05,467 --> 03:27:07,803
BUT I THINK THERE IS POTENTIALLY

4559
03:27:07,803 --> 03:27:09,972
MORE THAT CAN BE DONEN. SOME 

4560
03:27:09,972 --> 03:27:12,641
WAYS THIS IS LOW HANGING FRUIT 

4561
03:27:12,641 --> 03:27:13,976
ABOUT WORKING TOGETHER. IF WE 

4562
03:27:13,976 --> 03:27:15,411
COULD HAVE THE NEXT SLIDE, THE 

4563
03:27:15,411 --> 03:27:17,012
SECOND SUBPART OF THIS 

4564
03:27:17,012 --> 03:27:19,448
RECOMMENDATION IS AROUND, YOU 

4565
03:27:19,448 --> 03:27:21,417
KNOW, HARMIZATION. WHAT WOULD WE

4566
03:27:21,417 --> 03:27:23,786
NEED TO DO TO ACHIEVE THESE KIND

4567
03:27:23,786 --> 03:27:27,723
OF GAINS. YOU KNOW, WE STRONGLY 

4568
03:27:27,723 --> 03:27:30,159
PROMOTE HARMONIZATION OF 

4569
03:27:30,159 --> 03:27:31,627
EXISTING DATA THAT'S ALREADY 

4570
03:27:31,627 --> 03:27:33,529
BEEN DONE INCLUDING DATA IN 

4571
03:27:33,529 --> 03:27:36,665
FEDERAL REPOSITORIES FOR 

4572
03:27:36,665 --> 03:27:38,767
RIGOROUS AND REPRODUCIBLE 

4573
03:27:38,767 --> 03:27:40,936
RESEARCH. THAT MAY MEAN DATA 

4574
03:27:40,936 --> 03:27:42,037
STRUCTURE TO SUPPORT HARMIZATION

4575
03:27:42,037 --> 03:27:44,440
AND ESTABLISHING SPECIFIC CODE 

4576
03:27:44,440 --> 03:27:46,208
BOOKS, FUNDING USABILITY STUDIES

4577
03:27:46,208 --> 03:27:48,811
TO SIMPLIFY AND SHARING 

4578
03:27:48,811 --> 03:27:51,680
REQUIRING PROSPECTIVE DATA 

4579
03:27:51,680 --> 03:27:52,881
COLLECTION USING STANDARDIZED 

4580
03:27:52,881 --> 03:27:55,083
ELEMENTS AND MINIMUM DATA 

4581
03:27:55,083 --> 03:27:59,254
ELEMENTS, IMPORTANT FROM OUR 

4582
03:27:59,254 --> 03:28:02,024
PERSPECTIVE. LAST IS ABOUT 

4583
03:28:02,024 --> 03:28:02,791
FOSTERING COLLABORATION. 

4584
03:28:02,791 --> 03:28:03,759
SPECIFICALLY TO BUILD TOWARDS 

4585
03:28:03,759 --> 03:28:05,561
THE GOAL OF GAINING REGULATORY 

4586
03:28:05,561 --> 03:28:09,064
SUPPORT FOR DIAGNOSTICS AND 

4587
03:28:09,064 --> 03:28:11,900
ASSESSMENT METHODS, LOOKING AT 

4588
03:28:11,900 --> 03:28:14,903
SAFETY AND EFFICACY IN CLINICAL 

4589
03:28:14,903 --> 03:28:17,372
TRIALS. FROM OUR PERSPECTIVE WE 

4590
03:28:17,372 --> 03:28:18,507
WANT BETTER COLLABORATION BUT WE

4591
03:28:18,507 --> 03:28:21,143
WANT TO DO SO WITH A VERY CLEAR 

4592
03:28:21,143 --> 03:28:24,646
PURPOSE THAT WE ARE AIMING 

4593
03:28:24,646 --> 03:28:26,281
ULTIMATELY TO OVER COME BARRIERS

4594
03:28:26,281 --> 03:28:28,884
THE FIELD HAS HAD TOWARD 

4595
03:28:28,884 --> 03:28:30,085
DEVELOPING NEW THERAPEUTICSES. 

4596
03:28:30,085 --> 03:28:38,961
WE ARE HOPING THAT, YOU KNOW, 

4597
03:28:38,961 --> 03:28:40,896
KIND OF PRECISION DIAGNOSTIC 

4598
03:28:40,896 --> 03:28:42,231
APPROACH TO PATIENTS THAT IS 

4599
03:28:42,231 --> 03:28:44,633
GOING TO YIELD SUCCESS IN 

4600
03:28:44,633 --> 03:28:48,203
TRIALS. SO THAT WRAPS UP 

4601
03:28:48,203 --> 03:28:51,206
RECOMMENDATION NUMBER TWO TO OUR

4602
03:28:51,206 --> 03:28:57,713
NEXT PRESENTER, THANK YOU. 

4603
03:28:57,713 --> 03:28:59,081
   >> YES, GOOD MORNING. I
TOO 

4604
03:28:59,081 --> 03:29:02,551
WOULD LIKE TO ECHO MY THANKS TO 

4605
03:29:02,551 --> 03:29:03,619
NINDS AND NIH IN GENERAL, 

4606
03:29:03,619 --> 03:29:04,920
CERTAINLY ALL THE SUBCOMMITTEE 

4607
03:29:04,920 --> 03:29:06,054
MEMBERS I HAVE HAD THE PRIVILEGE

4608
03:29:06,054 --> 03:29:09,091
OF WORKING WITH. I HAVE THE 

4609
03:29:09,091 --> 03:29:11,326
PRIVILEGE OF INTRODUCING 

4610
03:29:11,326 --> 03:29:12,961
RECOMMENDATION 3. IF I COULD 

4611
03:29:12,961 --> 03:29:14,830
HAVE THE NEXT SLIDE. I HAVE 

4612
03:29:14,830 --> 03:29:20,202
NOTHING TO DISCLOSE. NEXT SLIDE.

4613
03:29:20,202 --> 03:29:23,705
NEXT SLIDE, THANK YOU. SO 

4614
03:29:23,705 --> 03:29:28,911
RECOMMENDATION 3 REALLY IS TO 

4615
03:29:28,911 --> 03:29:31,346
CROSS-LINK MODELS AND CONDUCT 

4616
03:29:31,346 --> 03:29:34,616
BASIC AND TRANSLATIONAL RESEARCH

4617
03:29:34,616 --> 03:29:37,553
WITH HUMAN SPECIMENS AND 

4618
03:29:37,553 --> 03:29:40,088
EXPERIMENTAL MODELS FOR THE POST

4619
03:29:40,088 --> 03:29:42,558
TISSUE RESPONSE, IE IDENTIFY 

4620
03:29:42,558 --> 03:29:46,228
MECHANISTIC PATHWAYS AND 

4621
03:29:46,228 --> 03:29:48,664
ELUCIDATE PATHWAYS AGAINST 

4622
03:29:48,664 --> 03:29:54,169
PROGRESSION OF POST TBI, ADRDs. 

4623
03:29:54,169 --> 03:29:55,537
UNDERNEATH THIS RECOMMENDATION 

4624
03:29:55,537 --> 03:29:57,439
WERE SORT OF THE FIVE SUB 

4625
03:29:57,439 --> 03:29:59,241
RECOMMENDATIONS, IF YOU WILL. I 

4626
03:29:59,241 --> 03:30:02,411
WILL TOUCH ON THAT BRIEFLY AS WE

4627
03:30:02,411 --> 03:30:04,646
GO THROUGH THIS TALK. NEXT 

4628
03:30:04,646 --> 03:30:07,282
SLIDE, PLEASE. I JUST WANTED TO 

4629
03:30:07,282 --> 03:30:09,451
REMIND EVERYONE THAT POST TBI 

4630
03:30:09,451 --> 03:30:14,122
AND ITS PROGRESSION TO ADRD IS A

4631
03:30:14,122 --> 03:30:16,425
CONTINUUM. THE LEFT PANEL IS 

4632
03:30:16,425 --> 03:30:17,993
SUMMARY, ALBEIT A LITTLE 

4633
03:30:17,993 --> 03:30:22,030
SIMPLIFIED, OF HOW A TBI MIGHT 

4634
03:30:22,030 --> 03:30:26,001
THEN SLOWLY SPIRAL DOWN TO 

4635
03:30:26,001 --> 03:30:27,603
COGNITIVE IMPAIRMENT TYPE 

4636
03:30:27,603 --> 03:30:29,771
PATHOLOGY AND KEY WORDS ARE 

4637
03:30:29,771 --> 03:30:30,772
AD-LIKE PATHOLOGY BUT IT IS 

4638
03:30:30,772 --> 03:30:33,275
IMPORTANT TO NOTE THIS LITTLE 

4639
03:30:33,275 --> 03:30:37,679
SCHEMATIC INCLUDES FEATURES 

4640
03:30:37,679 --> 03:30:41,984
PREVALENT IN AD, INCLUDING BETA 

4641
03:30:41,984 --> 03:30:44,853
AM LLOYD, VASCULAR DIGITAL ET 

4642
03:30:44,853 --> 03:30:48,357
CETERA. EMERGING EVIDENCE IN THE

4643
03:30:48,357 --> 03:30:50,292
FIELD INCLUDING THIS MANUSCRIPT 

4644
03:30:50,292 --> 03:30:52,628
FROM GRAHAM AND COLLEAGUES IN 

4645
03:30:52,628 --> 03:30:54,363
2023, WHERE IN THE TOP PANEL YOU

4646
03:30:54,363 --> 03:30:57,232
CAN SEE BRAIN REGIONS THAT ARE 

4647
03:30:57,232 --> 03:30:59,468
IMPACTED, BOTH GRAY MATTER, 

4648
03:30:59,468 --> 03:31:02,337
WHITE MATTER, CSF, IMPACTS A 

4649
03:31:02,337 --> 03:31:04,706
LARGE SWATH OF VARIOUS BRAIN 

4650
03:31:04,706 --> 03:31:06,508
REGIONS. IN THE MIDDLE PANEL YOU

4651
03:31:06,508 --> 03:31:10,145
CAN SEE TBI SIMILARLY HAS OTHER 

4652
03:31:10,145 --> 03:31:13,715
REGIONS ALSO CO -EMERGED AS WITH

4653
03:31:13,715 --> 03:31:17,185
THE ADRD PATIENT SUGGESTING 

4654
03:31:17,185 --> 03:31:19,354
THERE ARE POTENTIAL COMMON 

4655
03:31:19,354 --> 03:31:21,123
MECHANISMS. HOWEVER AS THESE 

4656
03:31:21,123 --> 03:31:22,090
PROCESSES ARE DIFFERENT BETWEEN 

4657
03:31:22,090 --> 03:31:25,827
THE TBI AND ADRD AND THEY ARE 

4658
03:31:25,827 --> 03:31:26,928
DISTINCT BUT IT IS ALSO 

4659
03:31:26,928 --> 03:31:28,397
IMPORTANT TECHNOLOGY THAT 

4660
03:31:28,397 --> 03:31:33,669
CONSIDERABLE OVERLAP EXISTS. 

4661
03:31:33,669 --> 03:31:38,774
NEXT SLIDE, PLEASE. AS NOTED 

4662
03:31:38,774 --> 03:31:41,410
EARLIER, AS NOTED EARLIER BY DR.

4663
03:31:41,410 --> 03:31:46,948
OH C OH CONNOR, SOME HAVE BEEN 

4664
03:31:46,948 --> 03:31:49,184
FUNDED. THIS IS A NEW HOPE TBI 

4665
03:31:49,184 --> 03:31:50,419
STUDY, WHERE THEY ARE EXPANDING 

4666
03:31:50,419 --> 03:31:53,622
A LARGE NETWORK OF WELL 

4667
03:31:53,622 --> 03:31:55,090
CHARACTERIZED BRAIN DONORS 

4668
03:31:55,090 --> 03:31:57,292
LOOKING AT NEURAL IMAGING, 

4669
03:31:57,292 --> 03:32:00,662
BEHAVIORAL MEASURES AND 

4670
03:32:00,662 --> 03:32:01,563
IDENTIFYING SIGNATURES FROM 

4671
03:32:01,563 --> 03:32:05,867
THESE DATA TYPES, INCLUDING 

4672
03:32:05,867 --> 03:32:09,037
QUANTITATIVE NEURO PATHOLOGY TO 

4673
03:32:09,037 --> 03:32:10,272
BETTER INFORM FUTURE RESEARCH 

4674
03:32:10,272 --> 03:32:11,473
AND ONGOING TREATMENTS FOR 

4675
03:32:11,473 --> 03:32:13,175
PATIENTS INCLUDING VASCULAR 

4676
03:32:13,175 --> 03:32:15,877
PATHOLOGY. THE END GOAL, OF 

4677
03:32:15,877 --> 03:32:18,246
COURSE, IS TO PROVIDE A 

4678
03:32:18,246 --> 03:32:19,114
LONG-TERM REPOSITORY THAT 

4679
03:32:19,114 --> 03:32:22,184
RESEARCHERS AND CLINICIANS CAN 

4680
03:32:22,184 --> 03:32:23,819
NOW START TO VACCINATE FUTURE 

4681
03:32:23,819 --> 03:32:25,353
RESEARCH DIRECTIONS. IF I CAN 

4682
03:32:25,353 --> 03:32:31,993
HAVE THE NEXT SLIDE, PLEASE. SO 

4683
03:32:31,993 --> 03:32:33,829
THE NEXT RECOMMENDATION, ONE OF 

4684
03:32:33,829 --> 03:32:35,897
THE SUB RECOMMENDATIONS WAS 

4685
03:32:35,897 --> 03:32:39,534
REALLY TO START TO STRENGTHEN 

4686
03:32:39,534 --> 03:32:42,237
THIS LINKAGE OF HUMAN SPECIMENS 

4687
03:32:42,237 --> 03:32:46,174
TO CHARACTERIZE POST TBIADRD. IN

4688
03:32:46,174 --> 03:32:48,310
THIS SUMMARY FROM SMITH AND ALL,

4689
03:32:48,310 --> 03:32:49,711
THIS REVIEW PAPER, WHERE YOU 

4690
03:32:49,711 --> 03:32:52,547
HAVE SINGLE TO MODERATE SEVERE 

4691
03:32:52,547 --> 03:33:02,924
TBI OR REPETITIVE T BIV,TBI, WH 

4692
03:33:02,924 --> 03:33:07,229
STRENGTHENED INCLUDING TA, 

4693
03:33:07,229 --> 03:33:09,531
INFLAMMATION, A BETA, LONG-TERM 

4694
03:33:09,531 --> 03:33:13,201
DEVELOPMENT OF ATROPHY. IN LATE 

4695
03:33:13,201 --> 03:33:15,270
EFFECTS OF TBI STUDIES, WHERE 

4696
03:33:15,270 --> 03:33:19,875
THEY ARE DOING HIGH RESOLUTION 7

4697
03:33:19,875 --> 03:33:22,344
TESLA ANATOMICAL IMAGING, 

4698
03:33:22,344 --> 03:33:24,146
COMBINING THAT WITH VARIOUS 

4699
03:33:24,146 --> 03:33:26,615
NEURO PA LOGICAL STAINS AND 

4700
03:33:26,615 --> 03:33:30,452
SHOWN HERE IN C, YOU CAN SEE A 

4701
03:33:30,452 --> 03:33:31,620
VASCULAR STRUCTURE SURROUNDED BY

4702
03:33:31,620 --> 03:33:34,089
A BETA STAINING, SUGGESTING A 

4703
03:33:34,089 --> 03:33:35,557
VASCULAR ETIOLOGY, SO 

4704
03:33:35,557 --> 03:33:37,092
CHARACTERIZING THESE IN MORE 

4705
03:33:37,092 --> 03:33:38,827
DETAIL IS CERTAINLY A HIGH 

4706
03:33:38,827 --> 03:33:41,863
RECOMMENDATION OF THIS 

4707
03:33:41,863 --> 03:33:42,430
SUBCOMMITTEE. NEXT SLIDE, 

4708
03:33:42,430 --> 03:33:46,268
PLEASE. OF COURSE THE EVALUATION

4709
03:33:46,268 --> 03:33:48,970
OF -- NEXT SLIDE. THE EVALUATION

4710
03:33:48,970 --> 03:33:52,174
OF CLINICALLY RELEVANT ANIMAL 

4711
03:33:52,174 --> 03:33:54,876
MODELS THAT MAY ACCELERATE ADRD 

4712
03:33:54,876 --> 03:33:57,078
IS VERY IMPORTANT. IN THE LEFT 

4713
03:33:57,078 --> 03:33:59,548
PANEL HERE YOU CAN SEE SORT OF 

4714
03:33:59,548 --> 03:34:03,051
CLASSICAL INDUCTION MODELS OF 

4715
03:34:03,051 --> 03:34:04,786
TRAUMATIC BRAIN INJURY AND 

4716
03:34:04,786 --> 03:34:07,122
INCLUDING HERE IN THE MIDDLE 

4717
03:34:07,122 --> 03:34:08,256
REPEATED HEAD INJURY OR CLOSE 

4718
03:34:08,256 --> 03:34:11,026
HEAD INJURY. MANY OF THESE ARE 

4719
03:34:11,026 --> 03:34:13,428
USED TO STUDY THE ACUTE TYPE OF 

4720
03:34:13,428 --> 03:34:15,096
TBI BUT NOW WE ARE STARTING TO 

4721
03:34:15,096 --> 03:34:19,668
BE USED TO STUDY LONG-TERM 

4722
03:34:19,668 --> 03:34:27,375
EVENTS IN TBI. THE USE OF 

4723
03:34:27,375 --> 03:34:30,545
ENCEPHALOPHIC MODELS, STUDIES 

4724
03:34:30,545 --> 03:34:32,581
OVER 16 WEEKS IN A FERRET MODEL,

4725
03:34:32,581 --> 03:34:35,016
ONE CAN SEE INCREASING 

4726
03:34:35,016 --> 03:34:36,184
FRACTIONAL SIGNATURES STARTING 

4727
03:34:36,184 --> 03:34:39,287
TO EMERGE, PARTICULARLY AT THE 

4728
03:34:39,287 --> 03:34:41,489
GRAY MATTER WHITE MATTER 

4729
03:34:41,489 --> 03:34:42,390
BOUNDARIES IN THESE. SO 

4730
03:34:42,390 --> 03:34:45,627
DEVELOPMENT OF THESE MODELS AND 

4731
03:34:45,627 --> 03:34:46,928
FOLLOWING THEM OVER LONG-TERM 

4732
03:34:46,928 --> 03:34:50,432
LIFE SPAN STUDIES IS VERY 

4733
03:34:50,432 --> 03:34:55,170
IMPORT

4734
03:34:55,170 --> 03:34:56,137
IMPORTANT. A FINAL 

4735
03:34:56,137 --> 03:34:57,138
RECOMMENDATION IS IDENTIFY MORE 

4736
03:34:57,138 --> 03:35:00,642
CLEARLY FACTORS THAT CAN CONFER 

4737
03:35:00,642 --> 03:35:02,377
RESILIENCE SUSCEPTIBILITY AFTER 

4738
03:35:02,377 --> 03:35:04,846
TBI. MOST IMPORTANTLY, USE THOSE

4739
03:35:04,846 --> 03:35:06,381
FACTORS TO GUIDE PATIENT CARE. 

4740
03:35:06,381 --> 03:35:08,483
SO IN THE VIN DIAGRAM ON THE 

4741
03:35:08,483 --> 03:35:11,152
LEFT YOU CAN SEE PRE-INJURY, 

4742
03:35:11,152 --> 03:35:13,421
FACTORS INCLUDING GENETIC 

4743
03:35:13,421 --> 03:35:14,923
SUSCEPTIBILITY, INJURY RELATED 

4744
03:35:14,923 --> 03:35:17,959
FACTORS SUCH AS SEVERITY AND 

4745
03:35:17,959 --> 03:35:18,894
LOCATION, POST INJURY AND MOST 

4746
03:35:18,894 --> 03:35:20,629
IMPORTANTLY POST INJURY FACTORS 

4747
03:35:20,629 --> 03:35:24,199
SUCH AS CO. MORBID DEFICITS AND 

4748
03:35:24,199 --> 03:35:26,401
REHABILITATIONS ALL CAN GUIDE 

4749
03:35:26,401 --> 03:35:28,536
OUR CARE AND IDENTIFY BETTER 

4750
03:35:28,536 --> 03:35:33,041
WAYS TO TREAT PATIENTS. IN THE 

4751
03:35:33,041 --> 03:35:35,110
SCHEMATIC FROM 2022 THEY 

4752
03:35:35,110 --> 03:35:36,077
ACKNOWLEDGE WE HAVE MADE GREAT 

4753
03:35:36,077 --> 03:35:38,713
PROGRESS IN BIOMARKERS AND MRI 

4754
03:35:38,713 --> 03:35:40,749
FOR TRIAGING AND UNDERSTANDING 

4755
03:35:40,749 --> 03:35:42,951
PROGRESSION AND MANAGEMENT OF 

4756
03:35:42,951 --> 03:35:45,287
TBI. AS THEY ALSO POINT OUT 

4757
03:35:45,287 --> 03:35:47,856
THERE ARE SIGNIFICANT GAPS, 

4758
03:35:47,856 --> 03:35:49,024
PARTICULARLY IN HOW TO TREAT 

4759
03:35:49,024 --> 03:35:51,693
OLDER POPULATIONS OF WHICH FORM 

4760
03:35:51,693 --> 03:35:55,397
A CONSIDERABLE NUMBER OF TBI 

4761
03:35:55,397 --> 03:35:56,564
PATIENTS. SO THESE 

4762
03:35:56,564 --> 03:35:59,134
RECOMMENDATIONS AND SUB 

4763
03:35:59,134 --> 03:36:00,201
RECOMMENDATIONS REALLY ARE TO 

4764
03:36:00,201 --> 03:36:02,237
GUIDE ENHANCE BASIC AND 

4765
03:36:02,237 --> 03:36:03,672
TRANSLATIONAL RESEARCH TO 

4766
03:36:03,672 --> 03:36:05,941
ELUCIDATE MECHANISMS AND 

4767
03:36:05,941 --> 03:36:07,909
TREATMENT TARGETS FOR POST TBI, 

4768
03:36:07,909 --> 03:36:09,444
ADRD. WITH THAT I WILL HAND IT 

4769
03:36:09,444 --> 03:36:19,955
OVER THE MY OTHER COLLEAGUES. 

4770
03:36:44,579 --> 03:36:52,087
   >> WE CAN'T HEAR YOU. I
SEE 

4771
03:36:52,087 --> 03:36:54,489
-- MONIQUE, YOU HEAR SNUS WE 

4772
03:36:54,489 --> 03:36:57,459
CAN'T HEAR YOUF YOU ARE TRYING 

4773
03:36:57,459 --> 03:37:07,836
TO USE YOUR MICROPHONE. 

4774
03:37:07,836 --> 03:37:12,007
   >> CAN YOU HEAR ME NOW?

4775
03:37:12,007 --> 03:37:17,312
   >> IT IS VERY QUIET.
ADJUST. 

4776
03:37:17,312 --> 03:37:18,046
   >> BETTER? 

4777
03:37:18,046 --> 03:37:19,180
   >> THANK YOU. 

4778
03:37:19,180 --> 03:37:22,917
   >> GREAT. JUST WANTED
TO ECHO

4779
03:37:22,917 --> 03:37:27,355
JUST THANKING NINDS AND NIH FOR 

4780
03:37:27,355 --> 03:37:28,456
THIS OPPORTUNITY. THE NEXT 

4781
03:37:28,456 --> 03:37:34,562
SLIDE, PLEASE. NO DISCLOSURES. 

4782
03:37:34,562 --> 03:37:35,697
( POOR AUDIO) 

4783
03:37:35,697 --> 03:37:37,132
   >> FOR THIS FOURTH 

4784
03:37:37,132 --> 03:37:40,769
RECOMMENDATION THE POINT WE WANT

4785
03:37:40,769 --> 03:37:43,038
TO BEIPOINT TO ACKNOWLEDGE IT TS

4786
03:37:43,038 --> 03:37:44,939
YEARS FOR SCIENTIFIC DISCOVERIES

4787
03:37:44,939 --> 03:37:47,909
AND ADVANCES TO BE IMPLEMENTED, 

4788
03:37:47,909 --> 03:37:50,445
SO WE ACKNOWLEDGE WE NEED TO BE 

4789
03:37:50,445 --> 03:37:51,780
ABLE TO SHARE INFORMATION. 

4790
03:37:51,780 --> 03:37:55,150
THERE'S CHALLENGES WITH BEING 

4791
03:37:55,150 --> 03:37:57,852
ABLE TO SHARE KNOWLEDGE AND 

4792
03:37:57,852 --> 03:38:01,956
INFORMATION TO ALL INTER TESTED 

4793
03:38:01,956 --> 03:38:05,560
PARTIES, ESPECIALLY INDIVIDUALS 

4794
03:38:05,560 --> 03:38:06,394
WHO WOULD RECEIVE SUCH 

4795
03:38:06,394 --> 03:38:07,929
INFORMATION SUCH AS PEOPLE WITH 

4796
03:38:07,929 --> 03:38:10,231
TRAUMATIC BRAIN INJURY AS WELL 

4797
03:38:10,231 --> 03:38:11,466
AS FAMILIES AND COMMUNITY. WE 

4798
03:38:11,466 --> 03:38:13,435
HAVE FOUR SUB RECOMMENDATIONS 

4799
03:38:13,435 --> 03:38:15,603
RELATED TO THIS TOPIC. THIS IS 

4800
03:38:15,603 --> 03:38:17,005
ABOUT DIVERSIFYING -- HAVING A 

4801
03:38:17,005 --> 03:38:23,878
DIVERSE TEAM, ADVANCING 

4802
03:38:23,878 --> 03:38:30,518
FINDINGS, MAKING SURE THERE IS 

4803
03:38:30,518 --> 03:38:32,987
SHARING TO OPTIMIZE ENGAGEMENT 

4804
03:38:32,987 --> 03:38:35,523
WITH RESEARCH AND MAXIMIZE 

4805
03:38:35,523 --> 03:38:38,927
CLINICAL TRANSLATABILITY. NEXT 

4806
03:38:38,927 --> 03:38:42,397
SLIDE, PLEASE. SO FOR THIS FIRST

4807
03:38:42,397 --> 03:38:44,399
SUB RECOMMENDATION, AGAIN, TO 

4808
03:38:44,399 --> 03:38:47,469
THE LEFT IS THIS IDEA OF MAKING 

4809
03:38:47,469 --> 03:38:49,604
SURE WE HAVE ALL INTERESTED 

4810
03:38:49,604 --> 03:38:52,240
PARTIES THAT ARE INCLUDED, 

4811
03:38:52,240 --> 03:38:53,508
ESPECIALLY INDIVIDUALS WITH 

4812
03:38:53,508 --> 03:38:56,344
LIVED EXPERIENCES AND THEIR 

4813
03:38:56,344 --> 03:38:57,946
FAMILY. YOU KNOW , THE PRINCIPAL

4814
03:38:57,946 --> 03:38:59,747
OF NOTHING ABOUT US WITHOUT US, 

4815
03:38:59,747 --> 03:39:02,150
MAKING SURE THEY ARE INCLUDED IN

4816
03:39:02,150 --> 03:39:05,854
EVERY PROCESS, FROM PLANNING, 

4817
03:39:05,854 --> 03:39:07,622
IMPLEMENTATION, AS WELL AS 

4818
03:39:07,622 --> 03:39:08,289
DISSEMINATION OF SUCH RESEARCH 

4819
03:39:08,289 --> 03:39:09,557
AND INCLUDING OTHER INDIVIDUALS 

4820
03:39:09,557 --> 03:39:12,994
AT THE TABLE, RIGHT. CLINICIAN, 

4821
03:39:12,994 --> 03:39:13,895
RESEARCHERS, ADDITIONAL 

4822
03:39:13,895 --> 03:39:15,697
COMMUNITY PARTNERS. AND, OF 

4823
03:39:15,697 --> 03:39:17,966
COURSE W THE NEW FIELD OF 

4824
03:39:17,966 --> 03:39:19,033
IMPLEMENTATION SCIENCE, YOU 

4825
03:39:19,033 --> 03:39:22,103
KNOW, INCLUDING IMPLEMENTATION 

4826
03:39:22,103 --> 03:39:24,339
SCIENTISTS IN ORDER FOR US TO BE

4827
03:39:24,339 --> 03:39:26,207
ABLE TO DEVELOP AND CREATE, 

4828
03:39:26,207 --> 03:39:28,543
CO -CREATE SIGNATURE ROUSE 

4829
03:39:28,543 --> 03:39:30,245
RESEARCH, TO REDUCE THIS BURDEN 

4830
03:39:30,245 --> 03:39:34,449
OF POST-TBI, ADRD. SO NO LONGER 

4831
03:39:34,449 --> 03:39:39,587
WORKING IN SILOS. TO THE RIGHT, 

4832
03:39:39,587 --> 03:39:42,323
THE POINT TO EMPHASIZE IS AFTER 

4833
03:39:42,323 --> 03:39:44,058
HAVING A TRAUMATIC BRAIN INJURY 

4834
03:39:44,058 --> 03:39:47,695
THERE COULD BE SINGLE TRAUMATIC 

4835
03:39:47,695 --> 03:39:49,030
BRAIN INJURY THAT IS SEVERE. 

4836
03:39:49,030 --> 03:39:51,466
OBVIOUSLY THERE ARE A VARIETY OF

4837
03:39:51,466 --> 03:39:54,636
DIFFERENT PATHWAYS OR -- THAT 

4838
03:39:54,636 --> 03:39:57,939
CAN HAPPEN AFTER AN INJURY. THEN

4839
03:39:57,939 --> 03:40:01,376
FROM RESILIENCE WHERE 

4840
03:40:01,376 --> 03:40:06,281
INDIVIDUALS MAY BE -- RESUME 

4841
03:40:06,281 --> 03:40:10,285
BACK TO FULL RECOVERY, WHEREAS 

4842
03:40:10,285 --> 03:40:11,953
OTHERS MAY EXPERIENCE 

4843
03:40:11,953 --> 03:40:13,588
PROGRESSIVE NEURO DEGENERATION. 

4844
03:40:13,588 --> 03:40:15,957
AT THE LOWER END IS RELATED TO 

4845
03:40:15,957 --> 03:40:17,358
INDIVIDUALS THAT MAY HAVE 

4846
03:40:17,358 --> 03:40:19,194
REPEATED MILD TRAUMATIC BRAIN 

4847
03:40:19,194 --> 03:40:21,930
INJURIES. SO WHAT IS REALLY AS 

4848
03:40:21,930 --> 03:40:24,966
IMPORTANT IS WE HAVE TO 

4849
03:40:24,966 --> 03:40:29,504
CO -CREATE OPPORTUNITIES AND 

4850
03:40:29,504 --> 03:40:31,973
INTERVENTIONS AND PROGRAMMING TO

4851
03:40:31,973 --> 03:40:35,109
HELP HOW CAN WE PREVENT OR AT 

4852
03:40:35,109 --> 03:40:36,911
LEAST DELAY THE PROGRESSION OF 

4853
03:40:36,911 --> 03:40:40,648
POST TBIADRD. NEXT SLIDE. 

4854
03:40:40,648 --> 03:40:42,850
   >> TWO MINUTES. 

4855
03:40:42,850 --> 03:40:45,453
   >> THEN IN THE SECOND 

4856
03:40:45,453 --> 03:40:46,421
SUBCOMMITTEE SETUP 

4857
03:40:46,421 --> 03:40:47,589
RECOMMENDATION IS ABOUT 

4858
03:40:47,589 --> 03:40:49,557
INCLUDING ALL OF THE DIFFERENT 

4859
03:40:49,557 --> 03:40:51,492
TYPES OF RESEARCH, FROM 

4860
03:40:51,492 --> 03:40:53,194
PRECLINICAL TO CLINICAL, BOTH IN

4861
03:40:53,194 --> 03:40:55,997
THE ADRD AND TBI SPACES AND 

4862
03:40:55,997 --> 03:40:58,466
USING THESE -- THIS KNOWLEDGE TO

4863
03:40:58,466 --> 03:41:01,269
BE ABLE TO DEVELOP, VALIDATE, 

4864
03:41:01,269 --> 03:41:03,238
TRANSLATE AND OBVIOUSLY 

4865
03:41:03,238 --> 03:41:04,906
IMPLEMENT INTO CLINICAL 

4866
03:41:04,906 --> 03:41:05,907
PRACTICE, USING DIFFERENT TYPE 

4867
03:41:05,907 --> 03:41:08,276
OF DIAGNOSTIC APPROACHES AND 

4868
03:41:08,276 --> 03:41:10,011
HOLISTIC INTERVENTIONS SO WE 

4869
03:41:10,011 --> 03:41:11,779
CAN, AS I MENTIONED BEFORE, BE 

4870
03:41:11,779 --> 03:41:18,386
ABLE TO PREVENT OR DELAY 

4871
03:41:18,386 --> 03:41:20,655
POST-TBIADRD. NEXT SLIDE. THEN 

4872
03:41:20,655 --> 03:41:22,190
THE THIRD SUB RECOMMENDATION, 

4873
03:41:22,190 --> 03:41:25,660
RIGHT, IS, AGAIN, CREATING THIS 

4874
03:41:25,660 --> 03:41:27,462
SPACE, RIGHT, A PRECOMPETITIVE 

4875
03:41:27,462 --> 03:41:29,897
SPACE WHERE YOU HAVE A VARIETY 

4876
03:41:29,897 --> 03:41:31,466
OF DIFFERENT INDIVIDUALS THAT 

4877
03:41:31,466 --> 03:41:33,735
ARE COLLABORATING, SHARING 

4878
03:41:33,735 --> 03:41:37,238
KNOWLEDGE, TRYING TO IDENTIFY 

4879
03:41:37,238 --> 03:41:38,806
SOLUTIONS, SHARING DATA. YOU 

4880
03:41:38,806 --> 03:41:42,176
KNOW, HELPING TO GUIDE DIFFERENT

4881
03:41:42,176 --> 03:41:44,312
METHODOLOGIES OR DEVELOPMENTS 

4882
03:41:44,312 --> 03:41:46,814
AND JUST ENCOURAGING THIS SPACE 

4883
03:41:46,814 --> 03:41:49,584
WITH NUMEROUS REGULATORY 

4884
03:41:49,584 --> 03:41:52,654
PARTNERS, INDUSTRY PARTNERS, 

4885
03:41:52,654 --> 03:41:54,489
HOSPITAL CLINICIANS, PEOPLE WITH

4886
03:41:54,489 --> 03:41:55,690
LIVED EXPERIENCE, MAKING SURE 

4887
03:41:55,690 --> 03:41:58,760
EVERYONE IS AT THE TABLE TO BE 

4888
03:41:58,760 --> 03:42:01,896
ABLE TO CONTRIBUTE AND HELP US 

4889
03:42:01,896 --> 03:42:04,332
WITH PROMOTING THE INNOVATION 

4890
03:42:04,332 --> 03:42:08,636
AND FURTHER DEVELOPING NEW 

4891
03:42:08,636 --> 03:42:12,206
TECHNOLOGIES OR METHODOLOGIES 

4892
03:42:12,206 --> 03:42:15,510
AND TREATMENTS EARLY BY WORKING 

4893
03:42:15,510 --> 03:42:20,648
TOGETHER TO SOLVE SUCH PROBLEMS.

4894
03:42:20,648 --> 03:42:29,791
NEXT SLIDE. THEN I WILL ITERATE 

4895
03:42:29,791 --> 03:42:32,327
WE HAVE TO BE ABLE TO TRANSLATE 

4896
03:42:32,327 --> 03:42:33,795
OUR FINDING INTO CLINICAL 

4897
03:42:33,795 --> 03:42:35,697
PRACTICE, HOW DO WE DO THAT. HOW

4898
03:42:35,697 --> 03:42:38,032
DO WE SHARE IN THE BEST WAY TO 

4899
03:42:38,032 --> 03:42:41,269
SHARE INFORMATION. BOTH 

4900
03:42:41,269 --> 03:42:44,205
RECIPROCAL, RIGHT, INDIVIDUALS 

4901
03:42:44,205 --> 03:42:52,280
THAT INDIVIDUALS WITH LIVED 

4902
03:42:52,280 --> 03:42:52,814
XHEE 

4903
03:42:52,814 --> 03:42:54,382
EXPERIENCE MAY SUPPORT THE 

4904
03:42:54,382 --> 03:42:56,317
RESEARCH PROCESS AND PROMOTE 

4905
03:42:56,317 --> 03:42:58,052
FURTHER ENGAGEMENT. INCLUDING A 

4906
03:42:58,052 --> 03:43:00,388
VARIETY OF DIFFERENT PARTNERS, 

4907
03:43:00,388 --> 03:43:05,293
SPECIAL INSTITUTIONAL

4908
03:43:05,293 --> 03:43:06,527
THOSE WITH THE BRAIN INJURY 

4909
03:43:06,527 --> 03:43:07,395
ASSOCIATION OF AMERICA AGAIN NOT

4910
03:43:07,395 --> 03:43:10,465
WORKING IN SILOS BUT WORKING 

4911
03:43:10,465 --> 03:43:12,066
TOGETHER WITH A VARIETY OF 

4912
03:43:12,066 --> 03:43:14,936
DIFFERENT PARTNERS ENSURING THAT

4913
03:43:14,936 --> 03:43:16,671
WE HELP PROMOTE AND SHARE THE 

4914
03:43:16,671 --> 03:43:19,073
KNOWLEDGE AND ALL THE FINDINGS 

4915
03:43:19,073 --> 03:43:21,075
THAT WE HAVE BASED OFF THE 

4916
03:43:21,075 --> 03:43:22,543
RESEARCH THAT WE'RE DOING AND 

4917
03:43:22,543 --> 03:43:25,113
THAT MAKES THE RESEARCH, BETTER,

4918
03:43:25,113 --> 03:43:25,747
RIGHT.

4919
03:43:25,747 --> 03:43:28,649
HOW CAN WE ENGAGE ALL 

4920
03:43:28,649 --> 03:43:31,052
INDIVIDUALS IN THE PROCESS TO 

4921
03:43:31,052 --> 03:43:35,723
HELP IMPROVE CLINICAL PRACTICE 

4922
03:43:35,723 --> 03:43:37,458
AS WELL AS INFORM -- MAKING SURE

4923
03:43:37,458 --> 03:43:38,493
INDIVIDUALS ARE AT THE RECEIVING

4924
03:43:38,493 --> 03:43:42,296
END AND MAKING SURE THAT THERE 

4925
03:43:42,296 --> 03:43:43,498
ARE DIVERSE INDIVIDUALS.

4926
03:43:43,498 --> 03:43:48,002
SO JUST INCLUDING A VARIETY OF 

4927
03:43:48,002 --> 03:43:48,669
DIFFERENT INTERESTED PARTIES OR 

4928
03:43:48,669 --> 03:43:59,147
STAKEHOLDERS IN THE PROCESS.

4929
03:44:03,885 --> 03:44:05,086
>> THANK YOU, MONIQUE AND 

4930
03:44:05,086 --> 03:44:08,322
EVERYONE TO PARTICIPATED ON THE 

4931
03:44:08,322 --> 03:44:08,656
SUBCOMMITTEE.

4932
03:44:08,656 --> 03:44:09,524
WE HAVE A FEW MINUTES NOW FOR 

4933
03:44:09,524 --> 03:44:19,734
DISCUSSION.

4934
03:44:21,969 --> 03:44:24,605
>> WE'RE RUNNING A LITTLE
LATE 

4935
03:44:24,605 --> 03:44:25,339
SO WE'LL HAVE 15 MINUTES FOR 

4936
03:44:25,339 --> 03:44:28,643
DISCUSSION.

4937
03:44:28,643 --> 03:44:33,981
>> THANK YOU.

4938
03:44:33,981 --> 03:44:37,785
AMBER, I CAN'T SEE HANDS RAISED 

4939
03:44:37,785 --> 03:44:38,986
SO IF YOU DO -- 

4940
03:44:38,986 --> 03:44:41,823
>> RIGHT NOW I DO NOT SEE
HANDS 

4941
03:44:41,823 --> 03:44:42,290
RAISED.

4942
03:44:42,290 --> 03:44:44,025
LET ME CHECK VIDEOCAST.

4943
03:44:44,025 --> 03:44:50,064
>> I SEE PENNY.

4944
03:44:50,064 --> 03:44:55,837
PENNY ARE YOU ABLE TO UNMUTE?

4945
03:44:55,837 --> 03:44:57,038
>> WORKING ON IT.

4946
03:44:57,038 --> 03:44:59,941
TOOK A MINUTE.

4947
03:44:59,941 --> 03:45:00,141
SORRY.

4948
03:45:00,141 --> 03:45:01,676
YOU GUYS HAVE DONE A WONDERFUL 

4949
03:45:01,676 --> 03:45:01,843
JOB.

4950
03:45:01,843 --> 03:45:03,077
THANK YOU FOR PULLING THIS 

4951
03:45:03,077 --> 03:45:03,511
TOGETHER.

4952
03:45:03,511 --> 03:45:04,912
MY QUESTION IS THERE WERE A 

4953
03:45:04,912 --> 03:45:06,781
COUPLE TIMES IN THE DISCUSSION 

4954
03:45:06,781 --> 03:45:12,620
WHERE IT HEARD THE REFERENCE 

4955
03:45:12,620 --> 03:45:15,323
BETWEEN  TBI AND ALZHEIMER'S AND

4956
03:45:15,323 --> 03:45:17,992
A KNOWLEDGE SHARING BETWEEN THE 

4957
03:45:17,992 --> 03:45:18,993
TBI AND ALZHEIMER'S FIELD AND 

4958
03:45:18,993 --> 03:45:24,365
YET TBI IS NOT JUST RELATED TO 

4959
03:45:24,365 --> 03:45:27,935
ALZHEIMER'S IT'S RELATED TO THE 

4960
03:45:27,935 --> 03:45:31,172
COMPLEX IDEOLOGY AND BEHIND 

4961
03:45:31,172 --> 03:45:33,608
HAVING NOT JUST ALZHEIMER'S BUT 

4962
03:45:33,608 --> 03:45:37,144
ALSO THE PLACE WHERE FTD AND ALS

4963
03:45:37,144 --> 03:45:37,845
IS WELCOME.

4964
03:45:37,845 --> 03:45:40,448
WELCOME HOW THE TBI FIELD AND 

4965
03:45:40,448 --> 03:45:41,749
HOW YOUR RECOMMENDATIONS ARE 

4966
03:45:41,749 --> 03:45:43,384
THINKING ABOUT THE HOLISTIC 

4967
03:45:43,384 --> 03:45:46,654
CAUSES OF DEMENTIA AND HOW HEAD 

4968
03:45:46,654 --> 03:45:48,756
IMPACT AND TBI AND FORGIVE ME 

4969
03:45:48,756 --> 03:45:50,825
BECAUSE I'M PROBABLY GET YOUR 

4970
03:45:50,825 --> 03:45:53,461
TERMINOLOGY LONG, I KNOW IT'S 

4971
03:45:53,461 --> 03:45:53,761
COMPLICATED.

4972
03:45:53,761 --> 03:45:55,963
HOW DO THEY RELATE TO DIFFERENT 

4973
03:45:55,963 --> 03:45:56,831
FORMS OF DEMENTIA?

4974
03:45:56,831 --> 03:45:59,267
I'LL STOP.

4975
03:45:59,267 --> 03:46:00,668
>> THANK YOU, PENNY.

4976
03:46:00,668 --> 03:46:02,603
IT'S A GREAT QUESTION.

4977
03:46:02,603 --> 03:46:04,639
IT ACKNOWLEDGES THE EVOLUTION OF

4978
03:46:04,639 --> 03:46:06,440
SCIENCE IN THE SPACE.

4979
03:46:06,440 --> 03:46:08,409
FOR DECADES WE WERE ALL TAUGHT 

4980
03:46:08,409 --> 03:46:11,178
TRAUMATIC BRAIN INJURY WAS THE 

4981
03:46:11,178 --> 03:46:11,779
GREATEST ENVIRONMENTAL RISK 

4982
03:46:11,779 --> 03:46:13,014
FACTOR FOR ALZHEIMER'S DISEASE 

4983
03:46:13,014 --> 03:46:14,315
IN PARTICULAR.

4984
03:46:14,315 --> 03:46:16,651
IN THE ENSUING DECADES WE HAVE 

4985
03:46:16,651 --> 03:46:20,021
COME TO APPRECIATE THAT WE 

4986
03:46:20,021 --> 03:46:22,924
ACTUALLY DO NOT SEE ALZHEIMER'S 

4987
03:46:22,924 --> 03:46:24,158
DISEASE NEUROPATHOLOGY AS 

4988
03:46:24,158 --> 03:46:25,660
COMMONLY AS WE WOULD HAVE 

4989
03:46:25,660 --> 03:46:27,762
EXPECTED IF THAT WERE 

4990
03:46:27,762 --> 03:46:30,398
EXCLUSIVELY TRUE.

4991
03:46:30,398 --> 03:46:35,102
TRAUMATIC BRAIN INJURY AND 

4992
03:46:35,102 --> 03:46:36,938
POST-TRAUMATIC BRAIN IS A 

4993
03:46:36,938 --> 03:46:42,143
DEMENTIA AND INHERENT THAT A 

4994
03:46:42,143 --> 03:46:45,513
TRAUMATIC BRAIN INJURY IS ONE OF

4995
03:46:45,513 --> 03:46:49,150
LIFE EXPOSURES OVERLAID TO OTHER

4996
03:46:49,150 --> 03:46:53,087
EXPOSURES THAT MAY HAVE IMPACTED

4997
03:46:53,087 --> 03:46:54,689
DEMENTIA RISK IN A GIVEN 

4998
03:46:54,689 --> 03:46:55,156
INDIVIDUAL.

4999
03:46:55,156 --> 03:46:56,857
DR. GRANT, IT WOULD BE GREAT IF 

5000
03:46:56,857 --> 03:46:58,759
YOU'D BE WILLING TO TOUCH ON 

5001
03:46:58,759 --> 03:46:59,827
THIS TOO.

5002
03:46:59,827 --> 03:47:01,162
I KNOW WE SPENT TIME THINKING 

5003
03:47:01,162 --> 03:47:02,630
THROUGH THIS IN OUR MEETINGS ON 

5004
03:47:02,630 --> 03:47:03,764
THE IMPORTANCE OF UNDERSTANDING 

5005
03:47:03,764 --> 03:47:08,636
HOW A NEW ONSET TRAUMATIC BRAIN 

5006
03:47:08,636 --> 03:47:18,879
INJURY MY IMPACT DISEASES AND 

5007
03:47:18,879 --> 03:47:20,181
DIAGNOSES AND USE OF EXISTING 

5008
03:47:20,181 --> 03:47:20,648
TREATMENT.

5009
03:47:20,648 --> 03:47:30,257
>> THANKS FOR THE
QUESTION.

5010
03:47:30,257 --> 03:47:32,627
IT'S THE QUESTION AND I DON'T 

5011
03:47:32,627 --> 03:47:34,195
WANT TO OVEREMPHASIZE THE LINK.

5012
03:47:34,195 --> 03:47:35,963
THERE'S A VERY GOOD EXAMPLE OF A

5013
03:47:35,963 --> 03:47:38,733
COMMUNITY THAT WORKS WELL AND 

5014
03:47:38,733 --> 03:47:41,335
THEY COVER LOTS OF ETIOLOGIES.

5015
03:47:41,335 --> 03:47:45,906
WE NEED TO BE TALKING TO A VERY 

5016
03:47:45,906 --> 03:47:47,675
WIDE RANGE OF SPECIALIST GROUPS 

5017
03:47:47,675 --> 03:47:50,411
AND TRYING TO BRIDGE ACROSS 

5018
03:47:50,411 --> 03:47:52,647
THESE BECAUSE THERE ARE 

5019
03:47:52,647 --> 03:47:55,416
INTERESTING AND SCIENTIFICALLY 

5020
03:47:55,416 --> 03:47:56,584
INFORMATIVE OVERLAPS BETWEEN 

5021
03:47:56,584 --> 03:47:58,452
WHAT YOU SEE AND TBI.

5022
03:47:58,452 --> 03:48:00,454
IT TOUCHES ON OUR IGNORANCE OF 

5023
03:48:00,454 --> 03:48:01,856
THE GENERAL HIGH LEVEL THINGS 

5024
03:48:01,856 --> 03:48:02,757
LIKE AGING.

5025
03:48:02,757 --> 03:48:08,529
IT'S NOT CLEAR WHAT TBI DOES TO 

5026
03:48:08,529 --> 03:48:10,731
YOUR NEURODEGENERATIVE 

5027
03:48:10,731 --> 03:48:12,366
TRAJECTORY AND MIGHT ACCELERATE 

5028
03:48:12,366 --> 03:48:15,102
WHAT WOULD HAVE HAPPENED ANYWAY.

5029
03:48:15,102 --> 03:48:16,170
THERE'S A LOT OF WORK TO BE DONE

5030
03:48:16,170 --> 03:48:17,938
AND WE'RE THINKING INCREASINGLY 

5031
03:48:17,938 --> 03:48:20,641
OPEN MINDED AND IT'S CHALLENGING

5032
03:48:20,641 --> 03:48:23,544
AS A CONDITION TO TREAT BECAUSE 

5033
03:48:23,544 --> 03:48:27,248
CO-PATHOLOGY IS SO COMMON OR 

5034
03:48:27,248 --> 03:48:28,649
POLY PATHOLOGY AND IN THE 

5035
03:48:28,649 --> 03:48:30,518
SPORTING CONTEXT THERE'S A GREAT

5036
03:48:30,518 --> 03:48:33,421
DEAL OF TALK WITH CTE AND IT'S 

5037
03:48:33,421 --> 03:48:33,754
ALMOST A BRANDING 

5038
03:48:35,389 --> 03:48:40,628
 BUT OF COURSE WE INCREASINGLY 

5039
03:48:40,628 --> 03:48:41,629
RECOGNIZE CO-PATHOLOGIES ARE 

5040
03:48:41,629 --> 03:48:43,130
EXTREMELY COMMON AFTER HEAD 

5041
03:48:43,130 --> 03:48:44,765
IMPACTS AND EVEN IF YOU WERE TO 

5042
03:48:44,765 --> 03:48:47,368
TREAT THE CTE PATHOLOGY IN ALL 

5043
03:48:47,368 --> 03:48:49,737
THOSE GROUPS THEN YOU'D PROBABLY

5044
03:48:49,737 --> 03:48:51,839
FIND THERE'S STILL A GREAT DEAL 

5045
03:48:51,839 --> 03:48:55,876
OF DEMENTIA VARIANTS KIND OF 

5046
03:48:55,876 --> 03:48:56,143
UNTREATED.

5047
03:48:56,143 --> 03:49:03,117
IT'S A GREAT CONDITION I'D ARGUE

5048
03:49:03,117 --> 03:49:04,185
TO MEASURE INFLAMMATION AND 

5049
03:49:04,185 --> 03:49:05,853
PATHOLOGY AND TARGETING 

5050
03:49:05,853 --> 03:49:07,421
DIFFERENT THINGS BUT WORKING AT 

5051
03:49:07,421 --> 03:49:09,390
AN INDIVIDUAL LEVEL WHAT'S 

5052
03:49:09,390 --> 03:49:09,657
HAPPENING.

5053
03:49:09,657 --> 03:49:15,463
THAT'S MY TAKE ON IT BUT THERE'S

5054
03:49:15,463 --> 03:49:17,298
LOTS OF WORK THAT NEEDS TO BE 

5055
03:49:17,298 --> 03:49:17,498
DONE.

5056
03:49:17,498 --> 03:49:28,008
>> I WORK FOR THE
ASSOCIATION 

5057
03:49:28,743 --> 03:49:29,510
FRONTOTEM

5058
03:49:29,510 --> 03:49:30,878
FRONTOTEMPORAL DEGENERATION AND 

5059
03:49:30,878 --> 03:49:32,680
HEAD IMPACT WAS UP BUT LITTLE IS

5060
03:49:32,680 --> 03:49:34,849
KNOWN FROM IT BUT FROM A 

5061
03:49:34,849 --> 03:49:36,083
THEORETICAL SIDE THAT NO REASON 

5062
03:49:36,083 --> 03:49:40,654
TO THINK IT WOULDN'T HAVE A 

5063
03:49:40,654 --> 03:49:42,890
SIGNIFICANT RELATIONSHIP.

5064
03:49:42,890 --> 03:49:45,893
>> IT'S IMPORTANT TO
RECOGNIZE 

5065
03:49:45,893 --> 03:49:47,928
OUR RECOMMENDATIONS ARE STRIVING

5066
03:49:47,928 --> 03:49:51,132
TO FY WHAT ARE THE UNIQUE 

5067
03:49:51,132 --> 03:49:53,167
PATHOLOGIES OF DISTINCT IT HEAD 

5068
03:49:53,167 --> 03:49:55,136
TRAUMA EXPOSURES SUB TYPES AND 

5069
03:49:55,136 --> 03:50:00,641
HOW DO THEY INTERACT WITH THE 

5070
03:50:00,641 --> 03:50:01,642
PATHOLOGIES OF BETTER KNOWN 

5071
03:50:01,642 --> 03:50:02,443
ADRDs?

5072
03:50:02,443 --> 03:50:04,545
THIS IS THE HALLMARK OF WHAT 

5073
03:50:04,545 --> 03:50:05,546
WE'RE TRYING TO PRIORITIZE 

5074
03:50:05,546 --> 03:50:07,181
ACROSS OUR RECOMMENDATIONS.

5075
03:50:07,181 --> 03:50:10,751
AND WE ALSO TRY TO EMPHASIZE 

5076
03:50:10,751 --> 03:50:14,488
THAT RECOGNIZE THE RELATIVE 

5077
03:50:14,488 --> 03:50:18,192
INFANCY OF OUR RESEARCH AND THIS

5078
03:50:18,192 --> 03:50:19,660
HAS BEEN STUDIED FOR CENTURIES.

5079
03:50:19,660 --> 03:50:22,563
AND SO WE WANT TO LEARN FROM OUR

5080
03:50:22,563 --> 03:50:25,966
COLLEAGUES WHO HAVE BEEN AT IT 

5081
03:50:25,966 --> 03:50:28,602
LONGER AND USE THE TREMENDOUS 

5082
03:50:28,602 --> 03:50:30,371
WORK THAT'S ALREADY BEEN DONE AS

5083
03:50:30,371 --> 03:50:32,039
A STARTING POINT AND CONTINUE 

5084
03:50:32,039 --> 03:50:33,274
COLLABORATION SO WE CAN 

5085
03:50:33,274 --> 03:50:33,908
ACCELERATE KNOWLEDGE AS QUICKLY 

5086
03:50:33,908 --> 03:50:36,143
AS POSSIBLE.

5087
03:50:36,143 --> 03:50:46,687
I SEE A QUESTION FROM NICOLE 

5088
03:50:48,722 --> 03:50:58,933
BR --BJORKLUND.

5089
03:51:00,968 --> 03:51:03,470
>> WHEN WE KNOW ABOUT THE 

5090
03:51:03,470 --> 03:51:04,271
PARTNER VIOLENCE AND WE DON'T 

5091
03:51:04,271 --> 03:51:06,874
KNOW WHAT THE IMPACT OF THAT IS 

5092
03:51:06,874 --> 03:51:09,710
COMPREHENSIVELY BUT ONE QUESTION

5093
03:51:09,710 --> 03:51:10,878
I HAD WAS CONSIDERING WHAT 

5094
03:51:10,878 --> 03:51:13,247
YOU'RE STUDYING IT SEEMS LIKE 

5095
03:51:13,247 --> 03:51:16,417
THERE SHOULD BE MORE WORK WITH 

5096
03:51:16,417 --> 03:51:21,422
THE AND DOD, ARE THERE 

5097
03:51:21,422 --> 03:51:23,290
POSSIBILITIES OF INCORPORATING 

5098
03:51:23,290 --> 03:51:25,893
OR MESHING WITH THEM IN TERMS OF

5099
03:51:25,893 --> 03:51:36,303
DATA AND BIO SPECIMENS?

5100
03:51:37,404 --> 03:51:38,839
>> I THINK WE HAVE SOMEONE
TO 

5101
03:51:38,839 --> 03:51:39,173
SPEAK TO THIS.

5102
03:51:39,173 --> 03:51:39,240
 

5103
03:51:55,289 --> 03:52:01,228
>> EVERYTHING WE DO IS IN 

5104
03:52:01,228 --> 03:52:06,934
PARTNERSHIP AND WITH NINDS AND 

5105
03:52:06,934 --> 03:52:08,435
DOD AND V.A. AND DR. HOFFMAN IS 

5106
03:52:08,435 --> 03:52:10,638
A WORKING MEMBER ON THIS 

5107
03:52:10,638 --> 03:52:10,905
COMMITTEE.

5108
03:52:10,905 --> 03:52:14,008
IF YOU HAVE SOMETHING TO ADD 

5109
03:52:14,008 --> 03:52:14,174
TOO.

5110
03:52:14,174 --> 03:52:14,241
 

5111
03:52:23,651 --> 03:52:28,088
>> YOU'RE ON MUTE.

5112
03:52:28,088 --> 03:52:30,691
DOES SOMEONE NEED TO ENABLE YOUR

5113
03:52:30,691 --> 03:52:30,991
MICROPHONE.

5114
03:52:30,991 --> 03:52:31,725
>> NOW IT'S ON.

5115
03:52:31,725 --> 03:52:32,860
EVERYONE CAN HEAR ME?

5116
03:52:32,860 --> 03:52:34,395
>> YES.

5117
03:52:34,395 --> 03:52:35,396
>> YEAH.

5118
03:52:35,396 --> 03:52:37,398
THE LONG-TERM ISSUES IS A 

5119
03:52:37,398 --> 03:52:40,034
PRIORITY FOR THE V.A. BECAUSE 

5120
03:52:40,034 --> 03:52:43,237
UNLIKE DOD AROUND MANY OF THE 

5121
03:52:43,237 --> 03:52:44,939
HOSPITAL SYSTEMS OUT THERE, WE 

5122
03:52:44,939 --> 03:52:48,642
DON'T TREAT ACUTE TBI.

5123
03:52:48,642 --> 03:52:53,714
WE GET THE PERSON AFTER THEY 

5124
03:52:53,714 --> 03:52:55,215
HAVE HAD LIFE TIME BRAIN 

5125
03:52:55,215 --> 03:52:55,783
INJURIES.

5126
03:52:55,783 --> 03:53:00,321
SO WE TRY TO WORK BACK THAT.

5127
03:53:00,321 --> 03:53:02,256
WE HAVE TWO LONGITUDINAL STUDIES

5128
03:53:02,256 --> 03:53:03,524
THAT ARE ONGOING.

5129
03:53:03,524 --> 03:53:06,961
ONE IS STARTING FROM 2010 AND 

5130
03:53:06,961 --> 03:53:15,269
THE OTHER ABOUT 2013 THE V.A. IS

5131
03:53:15,269 --> 03:53:19,106
NOW GOING TO CARRY IT ON FOR THE

5132
03:53:19,106 --> 03:53:19,974
FORESEEABLE FUTURE.

5133
03:53:19,974 --> 03:53:21,608
AND WE'RE ACTUALLY HARMONIZING 

5134
03:53:21,608 --> 03:53:23,844
THE DATA BETWEEN THE TWO THAT 

5135
03:53:23,844 --> 03:53:27,748
WILL HELP US TO UNDERSTAND 

5136
03:53:27,748 --> 03:53:30,217
CRITICAL BIOMARKERS FOR 

5137
03:53:30,217 --> 03:53:31,352
DIAGNOSTIC PURPOSES AND PERHAPS 

5138
03:53:31,352 --> 03:53:35,289
ALLOW US TO EVEN APPROACH HOW TO

5139
03:53:35,289 --> 03:53:37,224
MAYBE DEVELOP TREATMENTS THAT 

5140
03:53:37,224 --> 03:53:39,960
ARE MECHANISTIC IN THE FUTURE 

5141
03:53:39,960 --> 03:53:40,761
FOR SOME OF THESE MORE 

5142
03:53:40,761 --> 03:53:47,234
PROGRESSIVE PROCESSES.

5143
03:53:47,234 --> 03:53:49,236
LIKE YOU ASKED, IT IS A MAJOR 

5144
03:53:49,236 --> 03:53:50,738
PRIORITY AND WE DO COLLABORATE 

5145
03:53:50,738 --> 03:53:53,707
ESPECIALLY AT POLY TRAUMA 

5146
03:53:53,707 --> 03:53:56,677
CENTERS COLLABORATE WITH THE TBI

5147
03:53:56,677 --> 03:54:00,280
MODEL SYSTEMS AND SO OUR MODEL 

5148
03:54:00,280 --> 03:54:04,018
SYSTEM IS CONSIDERS THE CIVILIAN

5149
03:54:04,018 --> 03:54:06,620
VERSION A CRITICAL PARTNER WE'VE

5150
03:54:06,620 --> 03:54:09,289
BEEN TEAMING UP WITH WELL OVER 

5151
03:54:09,289 --> 03:54:11,258
10 YEARS.

5152
03:54:11,258 --> 03:54:14,428
THIS IS THE IMPORTANT PART, TBI 

5153
03:54:14,428 --> 03:54:19,867
AS CMS, CENTERS FOR MEDICAID -- 

5154
03:54:19,867 --> 03:54:23,370
SORRY, I DON'T REMEMBER ALL THE 

5155
03:54:23,370 --> 03:54:27,007
CMS INITIALS.

5156
03:54:27,007 --> 03:54:28,642
I'M FORGETTING ON THE SPOT HERE,

5157
03:54:28,642 --> 03:54:30,144
BUT THEY HAVE NOW RECOGNIZED 

5158
03:54:30,144 --> 03:54:31,845
SOMETHING THAT THE V.A. HAS 

5159
03:54:31,845 --> 03:54:36,183
RECOGNIZED SINCE 2011 THAT TBI 

5160
03:54:36,183 --> 03:54:37,651
IS A CHRONIC CONDITION.

5161
03:54:37,651 --> 03:54:40,287
SO WE IN OUR FEDERAL PARTNERS 

5162
03:54:40,287 --> 03:54:44,058
AND NIH AND DOD, THIS ASPECT IS 

5163
03:54:44,058 --> 03:54:44,691
A HIGH PRIORITY SO THANK YOU FOR

5164
03:54:44,691 --> 03:54:47,027
THE QUESTION.

5165
03:54:47,027 --> 03:54:47,761
>> THANKS.

5166
03:54:47,761 --> 03:54:51,632
I ALSO WANTED TO ADD THAT WE 

5167
03:54:51,632 --> 03:54:54,935
HAVE THE BIO REPOSITORY WHERE 

5168
03:54:54,935 --> 03:54:58,138
WE'RE NOW LINKING THE TISSUE AND

5169
03:54:58,138 --> 03:55:00,340
FLUIDS BIO SAMPLES WITH THE DATA

5170
03:55:00,340 --> 03:55:03,510
FROM THE CLINICAL STUDIES AS 

5171
03:55:03,510 --> 03:55:05,746
WELL AS THE BRAIN BANKS.

5172
03:55:05,746 --> 03:55:09,883
SO THERE'S DEFINITELY A LOT OF 

5173
03:55:09,883 --> 03:55:10,918
ADDITIONAL INFORMATION THAT WE 

5174
03:55:10,918 --> 03:55:14,488
GET WHEN WE HAVE A COMPREHENSIVE

5175
03:55:14,488 --> 03:55:16,056
COALITION OF ALL THE DATA AND 

5176
03:55:16,056 --> 03:55:17,024
WE'RE EXCITED TO SEE HOW THINGS 

5177
03:55:17,024 --> 03:55:20,594
WILL MOVE FORWARD AND I ALSO 

5178
03:55:20,594 --> 03:55:27,201
WANTED TO GIVE TIME FOR SARAH 

5179
03:55:27,201 --> 03:55:28,869
FONTANE THE DOD PARTNER, IF YOU 

5180
03:55:28,869 --> 03:55:31,271
HAVE ANYTHING TO ADD.

5181
03:55:31,271 --> 03:55:36,043
>>  I WANTED TO ADD IN
THAT 

5182
03:55:36,043 --> 03:55:38,879
THERE'S OFTEN A STIGMA THE DOD 

5183
03:55:38,879 --> 03:55:40,481
WORKS WITH AND WHILE THERE CAN 

5184
03:55:40,481 --> 03:55:41,915
BE, THERE'S MANY RESEARCHERS 

5185
03:55:41,915 --> 03:55:44,184
WITHIN THE DOD WILLING TO WORK 

5186
03:55:44,184 --> 03:55:47,454
ON THIS LONG TERM EFFECT OF WHAT

5187
03:55:47,454 --> 03:55:50,657
IS HAPPENING WITH THE TISSUES, 

5188
03:55:50,657 --> 03:55:53,660
WITH THE BIO SAMPLES WE HAVE 

5189
03:55:53,660 --> 03:55:53,894
BANKED.

5190
03:55:53,894 --> 03:56:04,404
WE'VE GOT COLLABORATIVE FOLKS.

5191
03:56:08,709 --> 03:56:11,345
THE WHOLE POINT IS TO LOOK AT 

5192
03:56:11,345 --> 03:56:13,814
THE DEGENERATION AND RELATED 

5193
03:56:13,814 --> 03:56:15,549
DEMENTIAS BECAUSE WE SIMPLY 

5194
03:56:15,549 --> 03:56:16,316
DON'T HAVE ENOUGH INFORMATION IN

5195
03:56:16,316 --> 03:56:20,487
THE AREA OF THE FIELD TO BE ABLE

5196
03:56:20,487 --> 03:56:24,625
TO DISTINGUISH WHAT, IF ANY, IS 

5197
03:56:24,625 --> 03:56:27,194
THE LIKELY POST TBI PATHOLOGY 

5198
03:56:27,194 --> 03:56:29,096
WE'LL END UP WITH WE'RE 

5199
03:56:29,096 --> 03:56:30,931
INCLUSIVE THERE BUT THERE'S A 

5200
03:56:30,931 --> 03:56:31,932
WHOLE RESEARCH PROGRAM THAT I 

5201
03:56:31,932 --> 03:56:33,634
MANAGE THAT FOCUSES PRIMARILY ON

5202
03:56:33,634 --> 03:56:36,637
THAT.

5203
03:56:36,637 --> 03:56:38,605
SO, THANK YOU.

5204
03:56:38,605 --> 03:56:40,941
>> I JUST WANT TO ADD ONE
MORE 

5205
03:56:40,941 --> 03:56:41,141
THING.

5206
03:56:41,141 --> 03:56:44,244
THE V.A. ALSO THROUGH THE WORK 

5207
03:56:44,244 --> 03:56:52,519
OF DR. PUGH HAS A DATA SET FOR 

5208
03:56:52,519 --> 03:56:53,987
VETERANS GOING BACK TO THEIR 

5209
03:56:53,987 --> 03:56:57,090
MILITARY SERVICE AND THAT NUMBER

5210
03:56:57,090 --> 03:57:07,501
IS ABOUT OVER 2 MILLION.

5211
03:57:12,306 --> 03:57:15,709
AROUND AND LOOKING AT THEIR 

5212
03:57:15,709 --> 03:57:16,410
HEALTH CURRENTLY.

5213
03:57:16,410 --> 03:57:20,080
WHETHER IT'S DEMENTIA OR OTHER 

5214
03:57:20,080 --> 03:57:22,749
ASPECTS OF BRAIN HEALTH, WE HAVE

5215
03:57:22,749 --> 03:57:23,350
THAT MILITARY DATA SET THAT'S 

5216
03:57:23,350 --> 03:57:26,954
AVAILABLE.

5217
03:57:26,954 --> 03:57:28,188
>> THANK YOU ALL.

5218
03:57:28,188 --> 03:57:30,257
YOU CAN SEE OUR SUBCOMMITTEE IS 

5219
03:57:30,257 --> 03:57:31,091
LUCKY TO HAVE OUR FEDERAL 

5220
03:57:31,091 --> 03:57:32,926
COLLEAGUES WEIGH IN AND NICOLE, 

5221
03:57:32,926 --> 03:57:34,861
GREAT QUESTION, THAT ALLOWS US 

5222
03:57:34,861 --> 03:57:36,630
TO UNDER SCORE THE THEME ACROSS 

5223
03:57:36,630 --> 03:57:38,232
OUR RECOMMENDATION WE NEED TO 

5224
03:57:38,232 --> 03:57:39,266
BREAK DOWN BARRIERS AND 

5225
03:57:39,266 --> 03:57:40,467
COLLABORATE AND WORK ACROSS 

5226
03:57:40,467 --> 03:57:40,734
AGENCIES.

5227
03:57:40,734 --> 03:57:43,270
THANK YOU FOR THAT.

5228
03:57:43,270 --> 03:57:53,580
I SEE IAN KREMER.

5229
03:57:53,580 --> 03:57:56,617
>> I APOLOGIZE IF I MISSED
THIS 

5230
03:57:56,617 --> 03:57:59,186
BUT I LOST CONNECTIVITY EARLIER 

5231
03:57:59,186 --> 03:57:59,786
IN THE TALK.

5232
03:57:59,786 --> 03:58:01,388
DO THE RESEARCH RECOMMENDATIONS 

5233
03:58:01,388 --> 03:58:03,757
ADDRESS ONE OR BOTH OF THE 

5234
03:58:03,757 --> 03:58:04,391
FOLLOWING POSSIBILITIES.

5235
03:58:04,391 --> 03:58:09,396
ONE IS LOOKING AT OTHER FORMS OF

5236
03:58:09,396 --> 03:58:10,530
DEMENTIA THAT HAVE HIGH INCI

5237
03:58:10,530 --> 03:58:12,065
INCIDENTS OF FALLS AS POTENTIAL 

5238
03:58:12,065 --> 03:58:15,769
DRIVERS OF TBI AND THEREFORE AS 

5239
03:58:15,769 --> 03:58:17,671
RISK REDUCTION POSSIBILITIES AND

5240
03:58:17,671 --> 03:58:20,641
THE OTHER IS THE RESEARCH 

5241
03:58:20,641 --> 03:58:22,876
RECOMMENDATIONS ADDRESS 

5242
03:58:22,876 --> 03:58:24,344
OPPORTUNITIES TO COLLABORATE 

5243
03:58:24,344 --> 03:58:26,446
WITH THE INTERNATIONAL RESEARCH 

5244
03:58:26,446 --> 03:58:28,649
COMMUNITY PARTICULARLY COUNTRIES

5245
03:58:28,649 --> 03:58:34,821
WITH EXTENSIVE HISTORIES DURING 

5246
03:58:34,821 --> 03:58:40,627
WARTIME TO STUDY TBI IN THE 

5247
03:58:40,627 --> 03:58:44,264
NON-U.S.-BASED POPULATIONS.

5248
03:58:44,264 --> 03:58:46,066
>> THAT'S A GREAT QUESTION
AND 

5249
03:58:46,066 --> 03:58:47,434
KEEP IN MIND PART OF THE MAIN 

5250
03:58:47,434 --> 03:58:50,137
GOALS OF THE DAY TOGETHER IS TO 

5251
03:58:50,137 --> 03:58:52,372
SOLICIT INPUT ON OUR 

5252
03:58:52,372 --> 03:58:52,739
RECOMMENDATIONS.

5253
03:58:52,739 --> 03:58:54,641
AND MAKING SOME NOTES, THESE ARE

5254
03:58:54,641 --> 03:58:55,509
GREAT IDEAS.

5255
03:58:55,509 --> 03:58:57,077
HEATHER SNYDER ARE YOU STILL 

5256
03:58:57,077 --> 03:58:58,545
WITH US TO SPEAK TO THE QUESTION

5257
03:58:58,545 --> 03:58:59,846
PERTAINING TO FALLS AND 

5258
03:58:59,846 --> 03:59:05,919
RELATIONSHIPS WITH POST-TBI 

5259
03:59:05,919 --> 03:59:06,186
DEMENTIAS?

5260
03:59:06,186 --> 03:59:08,055
>> I DON'T THINK SO.

5261
03:59:08,055 --> 03:59:09,323
>> IT'S SUCH AN IMPORTANT
AREA 

5262
03:59:09,323 --> 03:59:11,358
OF RESEARCH.

5263
03:59:11,358 --> 03:59:14,861
A LOT OF STUDIES HAVE EXAMINED 

5264
03:59:14,861 --> 03:59:15,662
ASSOCIATIONS OF FALLS WITH 

5265
03:59:15,662 --> 03:59:19,666
DEMENTIA RISK AND MANY ASSUMED 

5266
03:59:19,666 --> 03:59:22,369
TRAUMATIC BRAIN INJURY IS THE 

5267
03:59:22,369 --> 03:59:25,839
CONFOUNDER AND A COUPLE STUDIES 

5268
03:59:25,839 --> 03:59:29,543
FOUND THAT AND THE NOTION THAT A

5269
03:59:29,543 --> 03:59:33,313
FALL MAY BE A HARBINGER OR AN 

5270
03:59:33,313 --> 03:59:36,383
EARLY SIGN OF A 

5271
03:59:36,383 --> 03:59:37,884
NEURODEGENERATIVE PROCESS I 

5272
03:59:37,884 --> 03:59:40,854
THINK REQUIRES INVESTIGATION AND

5273
03:59:40,854 --> 03:59:50,063
SPANS BEYOND OUR SUBCOMMITTEE.

5274
03:59:50,063 --> 03:59:52,632
THERE'S A NEED TO UNDERSTAND HOW

5275
03:59:52,632 --> 03:59:54,735
NUANCED THE TRAUMATIC BRAIN 

5276
03:59:54,735 --> 03:59:55,535
INJURY, IN LATE LIFE, FOR 

5277
03:59:55,535 --> 03:59:59,840
EXAMPLE, INTERACTS WITH OTHER 

5278
03:59:59,840 --> 04:00:00,640
NEURODEGENERATIVE PROCESSES AND 

5279
04:00:00,640 --> 04:00:01,942
MAY HAVE RESULTED FROM LATE LIFE

5280
04:00:01,942 --> 04:00:05,345
FALLS WHICH IS A CRITICAL TARGET

5281
04:00:05,345 --> 04:00:12,552
FOR PREVENTION.

5282
04:00:12,552 --> 04:00:16,623
>> FOR THE SECOND QUESTION
ABOUT

5283
04:00:16,623 --> 04:00:19,292
COUNTRIES THAT HAVE HIGHER 

5284
04:00:19,292 --> 04:00:23,597
INCIDENTS DUE TO CONFLICTS OR 

5285
04:00:23,597 --> 04:00:28,034
OTHER ENVIRONMENTAL REASONS.

5286
04:00:28,034 --> 04:00:28,702
AS PART OF THE ALZHEIMER'S 

5287
04:00:28,702 --> 04:00:30,036
RESEARCH PROGRAM WE'RE ALLOWED 

5288
04:00:30,036 --> 04:00:32,139
TO FUND INVESTIGATORS IN THOSE 

5289
04:00:32,139 --> 04:00:33,340
COUNTRIES AND COLLABORATING WITH

5290
04:00:33,340 --> 04:00:35,308
SOME OF THOSE AND WE ACTUALLY DO

5291
04:00:35,308 --> 04:00:39,413
HAVE SEVERAL STUDIES RIGHT NOW 

5292
04:00:39,413 --> 04:00:48,288
WHERE WE'RE LOOKING AT THE 

5293
04:00:48,288 --> 04:00:49,356
FOLLOW-UP FROM POPULATIONS WHO 

5294
04:00:49,356 --> 04:00:54,728
HAVE A HIGH LEVEL OF TRAUMATIC 

5295
04:00:54,728 --> 04:00:56,663
BRAIN INJURIES EVEN COMPARED TO 

5296
04:00:56,663 --> 04:01:00,667
THE UNITED STATES DUE TO 

5297
04:01:00,667 --> 04:01:09,576
MILITARY SERVICE AND G

5298
04:01:09,576 --> 04:01:10,610
GEOPOLITICAL COMPLEX AND CAN ADD

5299
04:01:10,610 --> 04:01:14,014
THAT TO THE KNOWLEDGE BASE GOING

5300
04:01:14,014 --> 04:01:14,381
FORWARD.

5301
04:01:14,381 --> 04:01:20,854
>> HOPEFULLY THE FOGARTY
CENTER 

5302
04:01:20,854 --> 04:01:22,589
WILL CONTINUE TO EXIST.

5303
04:01:22,589 --> 04:01:25,158
>> I BELIEVE THAT
CONCLUDES OUR 

5304
04:01:25,158 --> 04:01:25,358
TIME.

5305
04:01:25,358 --> 04:01:27,260
>> WE'LL SKIP THE
SCHEDULED 

5306
04:01:27,260 --> 04:01:28,628
BREAK AND KEEP GOING WITH THE 

5307
04:01:28,628 --> 04:01:32,332
LAST SESSION OF THE DAY IF THAT 

5308
04:01:32,332 --> 04:01:36,937
WORKS FOR EVERYBODY.

5309
04:01:36,937 --> 04:01:38,705
WE CAN TAKE A MINUTE WHILE OUR 

5310
04:01:38,705 --> 04:01:40,674
TEAM BRINGS UP THE SLIDES AND 

5311
04:01:40,674 --> 04:01:43,443
SESSION 4 SPEAKERS, PLEASE GET 

5312
04:01:43,443 --> 04:01:48,648
READY TO PRESENT.

5313
04:01:48,648 --> 04:01:58,825
THANK YOU.

5314
04:02:22,148 --> 04:02:23,416
>> ALL RIGHT.

5315
04:02:23,416 --> 04:02:26,653
THANK YOU FOR TUNING INTO OUR 

5316
04:02:26,653 --> 04:02:34,227
SESSION LATE AND I'M FROM 

5317
04:02:34,227 --> 04:02:37,297
BRIGHAM AND WOMEN'S HOSPITAL AND

5318
04:02:37,297 --> 04:02:41,101
LATE WAS NAMED IN 2019 DEFINED 

5319
04:02:41,101 --> 04:02:48,675
BY THE IMMIGRAAGGREGATION IN A  

5320
04:02:48,675 --> 04:02:59,219
ENTER SERVICE AND IT WAS FOUND 

5321
04:02:59,619 --> 04:03:05,158
IN THE FRONTAL GYRUS AND THE 

5322
04:03:05,158 --> 04:03:07,327
CLINICAL SYNDROME IS A COGNITIVE

5323
04:03:07,327 --> 04:03:10,063
DECLINE.

5324
04:03:10,063 --> 04:03:20,507
WHY DO WE CARE ABOUT LATE?

5325
04:03:20,907 --> 04:03:24,177
IT'S SENIOR AND PATHOLOGICAL 

5326
04:03:24,177 --> 04:03:29,616
SENSE SO IT'S AN IMPACTFUL 

5327
04:03:29,616 --> 04:03:31,518
PATHOLOGY THE THIRD TYPE OF 

5328
04:03:31,518 --> 04:03:33,753
DEMENTIA PRESENTATION AND 

5329
04:03:33,753 --> 04:03:36,523
FOLLOWS ALZHEIMER'S DISEASE AND 

5330
04:03:36,523 --> 04:03:39,426
VASCULAR IMPAIRMENT TO ATTRIBUTE

5331
04:03:39,426 --> 04:03:49,903
TO THE RISK IN OLDER ADULTS.

5332
04:04:04,217 --> 04:04:08,655
ONE IN EVERY FIVE WITH TAU 

5333
04:04:08,655 --> 04:04:10,690
PATHOLOGY HAVE A PURE FORM OF 

5334
04:04:10,690 --> 04:04:15,061
LATE NC CAN BE FOUND IN OVER AGE

5335
04:04:15,061 --> 04:04:18,365
75 WITH SOLE PROGRESSION BUT 

5336
04:04:18,365 --> 04:04:21,334
PRETTY MUCH FROM CLINICAL 

5337
04:04:21,334 --> 04:04:22,235
PRACTICE STANDPOINT IT'S 

5338
04:04:22,235 --> 04:04:26,039
DIFFICULT TO DISTINGUISH FROM 

5339
04:04:26,039 --> 04:04:26,706
ALZHEIMER'S DISEASE AND YOU HAVE

5340
04:04:26,706 --> 04:04:31,945
TO RELY ON BIOMARKERS TO 

5341
04:04:31,945 --> 04:04:33,647
DISTINGUISH AND THE BIGGER 

5342
04:04:33,647 --> 04:04:38,151
IMPLICATIONS COME FROM THE MIX 

5343
04:04:38,151 --> 04:04:38,752
PATHOLOGY AND ALZHEIMER'S 

5344
04:04:38,752 --> 04:04:41,087
DISEASE AND LATE LIKES TO 

5345
04:04:41,087 --> 04:04:41,354
COMMINGLE.

5346
04:04:41,354 --> 04:04:45,492
MORE THAN HALF CASES WITH AD 

5347
04:04:45,492 --> 04:04:50,130
PATHOLOGY HAVE LATE NC AND THEY 

5348
04:04:50,130 --> 04:04:52,098
HAPPEN IN THE BACKGROUND OF 

5349
04:04:52,098 --> 04:04:52,732
ALZHEIMER'S DISEASE AND THIS 

5350
04:04:52,732 --> 04:04:54,634
COMBINED PATHOLOGY IS NOT ONLY 

5351
04:04:54,634 --> 04:04:57,771
THE MOST COMMON BUT THE MOST 

5352
04:04:57,771 --> 04:05:03,376
PROGRESSIVE AND SHOWS RAPID V

5353
04:05:03,376 --> 04:05:04,778
VOLUME LOSS AND HAS A GREAT 

5354
04:05:04,778 --> 04:05:07,414
PUBLIC HEALTH IMPACT AND 

5355
04:05:07,414 --> 04:05:12,652
ESPECIALLY PROBATIC IN 

5356
04:05:12,652 --> 04:05:14,020
ANTI-AMYLOID ANTIBODIES BECAUSE 

5357
04:05:14,020 --> 04:05:17,190
IT CAN BE A MAJOR CONFOUNDER OF 

5358
04:05:17,190 --> 04:05:18,625
RESPONSE AND THE CLINICAL COURSE

5359
04:05:18,625 --> 04:05:19,426
IN THE SETTING OF COMBINED 

5360
04:05:19,426 --> 04:05:25,965
PATHOLOGY.

5361
04:05:25,965 --> 04:05:28,068
LAST BUT NOT LEAST, THE PUBLIC 

5362
04:05:28,068 --> 04:05:29,035
HEALTH IMPACT ASSOCIATED WITH 

5363
04:05:29,035 --> 04:05:31,404
LATE IS ONLY EXPECTED TO 

5364
04:05:31,404 --> 04:05:34,107
INCREASE OVER TIME.

5365
04:05:34,107 --> 04:05:35,809
IT'S PREDOMINANTLY FOUND IN THE 

5366
04:05:35,809 --> 04:05:38,645
OLDEST OLD POPULATION AND THE 

5367
04:05:38,645 --> 04:05:42,248
RAPIDLY EXPANDING SEGMENT AND 

5368
04:05:42,248 --> 04:05:44,484
OVER 80 AND 90 THE IMPACT IS 

5369
04:05:44,484 --> 04:05:46,553
GREATER THAN ALZHEIMER'S DISEASE

5370
04:05:46,553 --> 04:05:50,256
ITSELF AS SHOWN BY THE 90 PLUS 

5371
04:05:50,256 --> 04:05:51,624
STUDY FROM THE UNITED STATES AND

5372
04:05:51,624 --> 04:05:57,497
THE STUDY FROM FINLAND.

5373
04:05:57,497 --> 04:05:59,833
GIVEN THE SIGNIFICANCE THE 

5374
04:05:59,833 --> 04:06:01,735
SUBCOMMITTEE WAS ESTABLISHED IN 

5375
04:06:01,735 --> 04:06:05,371
2019 AND MADE RECOMMENDATIONS IN

5376
04:06:05,371 --> 04:06:08,708
2022 AND GOALS WE SET WERE 

5377
04:06:08,708 --> 04:06:09,709
SUMMARIZED HONING THE DEFINITION

5378
04:06:09,709 --> 04:06:12,612
OF LATE AND HOW TO BETTER 

5379
04:06:12,612 --> 04:06:13,513
DIAGNOSIS THIS IN VIVO AND LOU 

5380
04:06:13,513 --> 04:06:15,048
TO STUDY MECHANISMS OF LATE 

5381
04:06:15,048 --> 04:06:18,384
PATHOGENESIS.

5382
04:06:18,384 --> 04:06:20,286
I'M GLAD TO REPORT THERE'S BEEN 

5383
04:06:20,286 --> 04:06:20,920
SIGNIFICANT PROGRESS IN THE PAST

5384
04:06:20,920 --> 04:06:29,129
THREE YEARS.

5385
04:06:29,129 --> 04:06:30,163
WE NOW HAVE INITIAL CLINICAL 

5386
04:06:30,163 --> 04:06:31,564
CRITERIA TO USE IN THE CLINIC.

5387
04:06:31,564 --> 04:06:34,134
FOR EXAMPLE, THIS IS THE OUTLINE

5388
04:06:34,134 --> 04:06:38,505
OF THE CLINICAL KROO CRITERIA TO

5389
04:06:38,505 --> 04:06:41,941
DEFINE AS A PRIMARY DIAGNOSIS.

5390
04:06:41,941 --> 04:06:43,409
IF SOMEONE PRESENTS WITH 

5391
04:06:43,409 --> 04:06:45,612
COGNITIVE DECLINE WITH OTHER 

5392
04:06:45,612 --> 04:06:50,884
DOMAINS RELATIVELY PRESERVES AND

5393
04:06:50,884 --> 04:06:52,719
HIPPOCAMPAL ATROPHY AND 

5394
04:06:52,719 --> 04:06:55,488
BIOMARKERS THAT CASE IS 

5395
04:06:55,488 --> 04:06:58,992
DIAGNOSED AS PROBABLE LATE MEANS

5396
04:06:58,992 --> 04:07:00,160
LATE NEUROLOGICAL CHANGES ARE 

5397
04:07:00,160 --> 04:07:03,530
LIKELY THE PRIMARY DRIVER OF THE

5398
04:07:03,530 --> 04:07:04,664
CLASSIFICATION.

5399
04:07:04,664 --> 04:07:08,768
IF THEY HAVE A POSITIVE A BETA 

5400
04:07:08,768 --> 04:07:10,236
BIOMARKER WE CHECK TAU 

5401
04:07:10,236 --> 04:07:12,338
BIOMARKERS IN THE MEDIAL 

5402
04:07:12,338 --> 04:07:14,107
TEMPORAL LOBE AND IF IT'S 

5403
04:07:14,107 --> 04:07:16,776
NEGATIVE IT CAN BE DIAGNOSED AS 

5404
04:07:16,776 --> 04:07:19,312
POSSIBLE AND THERE'S MRI AND PET

5405
04:07:19,312 --> 04:07:22,849
PATTERNS ASSOCIATED WITH THE 

5406
04:07:22,849 --> 04:07:24,651
PATHOLOGICAL CHANGE.

5407
04:07:24,651 --> 04:07:29,556
HOWEVER, THERE'S STILL REMAINING

5408
04:07:29,556 --> 04:07:40,099
GAPS AND ONE BIG LIMITATION IS 

5409
04:07:40,733 --> 04:07:46,472
CLINICAL DATA SETS FOR OUR 

5410
04:07:46,472 --> 04:07:48,875
ABILITY TO PERFORM TARGET 

5411
04:07:48,875 --> 04:07:59,185
DISCOVERY EFFORTS.

5412
04:08:00,186 --> 04:08:02,088
WE HAVE A NEUROPATHOLOGY 

5413
04:08:02,088 --> 04:08:03,323
CRITERIA FOR LATE CHANGE AND 

5414
04:08:03,323 --> 04:08:07,160
DETAILS HOW TO DEFINE IT FOR 

5415
04:08:07,160 --> 04:08:09,562
EACH STAGE ALSO BETTER WAYS TO 

5416
04:08:09,562 --> 04:08:15,335
DISTINGUISH IT FROM OTHER TDP 

5417
04:08:15,335 --> 04:08:25,845
AGGREGATION DISORDERS AND ALS.

5418
04:08:29,215 --> 04:08:31,417
CLARIFYING THE RELATIONSHIP WITH

5419
04:08:31,417 --> 04:08:33,386
THE HIPPOCAMPUS IS CLOSELY 

5420
04:08:33,386 --> 04:08:36,656
RELATED HISTOLOGICAL FINDING 

5421
04:08:36,656 --> 04:08:43,696
NEEDS MORE WORK.

5422
04:08:43,696 --> 04:08:45,899
THERE'S BEEN PROGRESS IN 

5423
04:08:45,899 --> 04:08:46,432
MECHANISTIC STUDIES.

5424
04:08:46,432 --> 04:08:49,402
THE GENOME WIDE STUDY HAS BEEN 

5425
04:08:49,402 --> 04:08:51,104
PERFORMED AND CONFIRMED 

5426
04:08:51,104 --> 04:08:52,238
PREVIOUSLY IDENTIFIED GENETIC 

5427
04:08:52,238 --> 04:08:56,209
RISK FACTORS SUCH AS APOE 4 AND 

5428
04:08:56,209 --> 04:08:58,645
VARIANTS AS WELL AS GRANULIN 

5429
04:08:58,645 --> 04:08:59,712
VARIANT AND OTHER CANDIDATE 

5430
04:08:59,712 --> 04:09:01,014
MARKERS THAT CAN BE FOLLOWED UP 

5431
04:09:01,014 --> 04:09:11,391
IN THE FUTURE STUDIES.

5432
04:09:11,824 --> 04:09:19,365
AND SPLICING EVENTS COMPARED TO 

5433
04:09:19,365 --> 04:09:29,876
OTHER OPATHTIES AND THEY NEED 

5434
04:09:32,378 --> 04:09:32,979
MORE WORK.

5435
04:09:32,979 --> 04:09:36,816
BASED ON THE GAPS AND OTHERS, 

5436
04:09:36,816 --> 04:09:41,721
OUR SUBCOMMITTEE HAS A DRAFT FOR

5437
04:09:41,721 --> 04:09:45,024
RECOMMENDATIONS AND THESE WERE 

5438
04:09:45,024 --> 04:09:46,893
PRESENTED AND I'LL TOUCH ON 

5439
04:09:46,893 --> 04:09:48,027
RECOMMENDATION ONE BECAUSE TWO 

5440
04:09:48,027 --> 04:09:49,462
TO FOUR WILL BE COVERED BY MY 

5441
04:09:49,462 --> 04:09:50,763
COLLEAGUES FOLLOWING THIS 

5442
04:09:50,763 --> 04:09:51,264
PRESENTATION.

5443
04:09:51,264 --> 04:09:54,467
SO RECOMMENDATION ONE IS TO 

5444
04:09:54,467 --> 04:09:57,670
DEVELOP AND EXPAND THE PHENOTYPE

5445
04:09:57,670 --> 04:10:00,206
COHORTS WITH CHARACTERIZATION 

5446
04:10:00,206 --> 04:10:01,941
INCLUDING POSTMORTEM DATA WITH 

5447
04:10:01,941 --> 04:10:03,776
THE GOAL TO UNCOVER UNIQUE 

5448
04:10:03,776 --> 04:10:06,879
FEATURES OF LATE VERSUS OTHER 

5449
04:10:06,879 --> 04:10:07,513
PATHOLOGY TO INFORM DIAGNOSIS 

5450
04:10:07,513 --> 04:10:11,517
AND THERAPIES.

5451
04:10:11,517 --> 04:10:13,653
AND ALSO INFORM HOW TREATMENT 

5452
04:10:13,653 --> 04:10:16,322
AFFECTS LATE NC AND SO ON.

5453
04:10:16,322 --> 04:10:18,257
FINALLY, IT'S CRITICALLY 

5454
04:10:18,257 --> 04:10:19,058
IMPORTANT TO SUPPORT 

5455
04:10:19,058 --> 04:10:20,860
INFRASTRUCTURE FOR CROSS-TALK 

5456
04:10:20,860 --> 04:10:24,664
BETWEEN THE FIELDS WITH ALS 

5457
04:10:24,664 --> 04:10:28,334
FIELDS THAT STUDY PATHOLOGIES 

5458
04:10:28,334 --> 04:10:30,570
AND ENHANCE THE FOR ALL THE 

5459
04:10:30,570 --> 04:10:30,837
DISORDERS.

5460
04:10:30,837 --> 04:10:34,207
AND EXPANDING AWARENESS IN THE 

5461
04:10:34,207 --> 04:10:37,443
PUBLIC CLINICIANS AND OTHER 

5462
04:10:37,443 --> 04:10:39,178
STAKEHOLDERS ARE IMPORTANT FOR 

5463
04:10:39,178 --> 04:10:40,113
THE COMMON UNDER STUDIED 

5464
04:10:40,113 --> 04:10:40,513
DISORDER.

5465
04:10:40,513 --> 04:10:41,447
THIS IS ALL I HAVE.

5466
04:10:41,447 --> 04:10:43,449
THANK YOU FOR YOUR ATTENTION.

5467
04:10:43,449 --> 04:10:48,654
I'LL TURN IT OVER TO THE NEXT 

5468
04:10:48,654 --> 04:10:59,032
SPEAKER, KONSTANTINOS.

5469
04:11:08,474 --> 04:11:10,643
>> I HAVE NOTHING TO
DISCLOSE.

5470
04:11:10,643 --> 04:11:12,678
THE SECOND RECOMMENDATION IS TO 

5471
04:11:12,678 --> 04:11:18,284
AND VALIDATE IN VIVO MODIFIERS 

5472
04:11:18,284 --> 04:11:20,086
AND RISK CLASSIFIER FOR LATENCY 

5473
04:11:20,086 --> 04:11:23,956
AND THEY MUST HAVE GOOD 

5474
04:11:23,956 --> 04:11:27,293
PERFORMANCE AS WELL AS IN 

5475
04:11:27,293 --> 04:11:28,661
PERSONS WITH LATE LIFE DEMENTIA 

5476
04:11:28,661 --> 04:11:35,468
SYNDROMES.

5477
04:11:35,468 --> 04:11:38,104
DIAGNOSIS IS ONLY VIABLE IN 

5478
04:11:38,104 --> 04:11:39,639
AUTOPSY AND IT'S A MAJOR STEP 

5479
04:11:39,639 --> 04:11:42,008
FORWARD IN TERMS OF LATE 

5480
04:11:42,008 --> 04:11:42,341
DETECTION.

5481
04:11:42,341 --> 04:11:43,443
HOWEVER, WITHOUT THE MARKER 

5482
04:11:43,443 --> 04:11:44,143
WE'RE LIMITED.

5483
04:11:44,143 --> 04:11:47,580
THEREFORE THERE'S AN URGENT NEED

5484
04:11:47,580 --> 04:11:48,648
FOR MOLECULARLY SPECIFIC 

5485
04:11:48,648 --> 04:11:52,652
MARKERS, CLASSIFIERS AND RISK 

5486
04:11:52,652 --> 04:11:56,155
PROIFIER FOR LATE TO ALLOW 

5487
04:11:56,155 --> 04:11:57,523
PARTICIPANT SELECTION OF LATE 

5488
04:11:57,523 --> 04:12:00,460
AND ABRB BECAUSE LATE IS OFTEN 

5489
04:12:00,460 --> 04:12:04,097
MIXED WITH OTHER 

5490
04:12:04,097 --> 04:12:04,831
NEUROPATHOLOGIES.

5491
04:12:04,831 --> 04:12:08,668
THEREFORE SUPPORT DRUG DISCOVERY

5492
04:12:08,668 --> 04:12:11,437
AND TREATMENT AND HAVING ACCESS 

5493
04:12:11,437 --> 04:12:13,406
TO ACCURATE MARKERS WILL ENHANCE

5494
04:12:13,406 --> 04:12:23,883
ALL OTHER RESEARCH ON LATE.

5495
04:12:25,518 --> 04:12:28,654
WE KNOW LATE IS RELATED TO 

5496
04:12:28,654 --> 04:12:30,089
MEMORY LOSS AND DEFICIT AND MORE

5497
04:12:30,089 --> 04:12:31,657
COMMON IN INDIVIDUALS OLDER THAN

5498
04:12:31,657 --> 04:12:33,559
75 YEARS OF AGE.

5499
04:12:33,559 --> 04:12:35,661
WE ALSO KNOW THERE ARE A NUMBER 

5500
04:12:35,661 --> 04:12:41,534
OF GENES LINKED TO LATENCY.

5501
04:12:41,534 --> 04:12:43,503
HOWEVER WE NEED TO REFINE OUR 

5502
04:12:43,503 --> 04:12:45,204
UNDERSTANDING OF THE COGNITIVE, 

5503
04:12:45,204 --> 04:12:46,906
BEHAVIORAL AND GENETIC FEATURES 

5504
04:12:46,906 --> 04:12:48,674
ASSOCIATED WITH LATENCY.

5505
04:12:48,674 --> 04:12:51,611
BY DOING THAT WE MAY IMPROVE 

5506
04:12:51,611 --> 04:12:52,812
DETECTION OF LATE AND IF WE HAVE

5507
04:12:52,812 --> 04:12:55,982
A MARKER OF LATE, IT MAY HELP US

5508
04:12:55,982 --> 04:12:57,917
UNDERSTAND BETTER THE COGNITIVE 

5509
04:12:57,917 --> 04:12:59,919
BEHAVIOR AND GOOD MORNING 

5510
04:12:59,919 --> 04:13:01,420
FEATURES OF LATE.

5511
04:13:04,257 --> 04:13:08,327
SO, THIS IS A TWO-WAY STREET.

5512
04:13:08,327 --> 04:13:11,964
BY COMBINING IN VIVO OR EX VIVO 

5513
04:13:11,964 --> 04:13:16,202
MRI WE'VE BEEN ABLE TO SHOW 

5514
04:13:16,202 --> 04:13:19,438
LATENCY ASSOCIATED WITH THE 

5515
04:13:19,438 --> 04:13:22,975
TEMPORAL LOBES AND OTHER LOBES 

5516
04:13:22,975 --> 04:13:25,845
AND INSULA AND WE HAVE SHOWED 

5517
04:13:25,845 --> 04:13:34,987
LATENCY HAS A STRONGER IMPACT ON

5518
04:13:34,987 --> 04:13:36,656
THE HIPPOCAMPUS THAN 

5519
04:13:36,656 --> 04:13:46,866
ALZHEIMER'S.

5520
04:13:48,034 --> 04:13:50,303
WE'VE BEEN ABLE TO MAP THE 

5521
04:13:50,303 --> 04:13:52,305
PATTERN OF OUR ABNORMALITIES 

5522
04:13:52,305 --> 04:13:55,074
ASSOCIATED WITH LATENCY AND TO 

5523
04:13:55,074 --> 04:13:56,909
DEMONSTRATE THE MAIN CONNECTIONS

5524
04:13:56,909 --> 04:14:00,112
IN THE BRAIN THAT ARE IMPLICATED

5525
04:14:00,112 --> 04:14:03,950
HERE ARE TEMPORAL CONNECTIONS, 

5526
04:14:03,950 --> 04:14:05,384
TEMPORAL BASAL GANGLION 

5527
04:14:05,384 --> 04:14:06,185
CONNECTIONS.

5528
04:14:06,185 --> 04:14:07,286
IN ADDITION, WE'VE BEEN ABLE TO 

5529
04:14:07,286 --> 04:14:12,658
SHOW THE PROGRESSION OF THE 

5530
04:14:12,658 --> 04:14:15,828
ABNORMALITIES IS FOLLOWING THE 

5531
04:14:15,828 --> 04:14:24,670
PROGRESSION OF LATENCY.

5532
04:14:24,670 --> 04:14:27,707
ALSO WE HAVE PATHOLOGY MAPPED 

5533
04:14:27,707 --> 04:14:29,108
PATTERN OF ABNORMALITIES IN THE 

5534
04:14:29,108 --> 04:14:39,619
BRAIN ASSOCIATED WITH LATENCY.

5535
04:14:41,554 --> 04:14:43,789
ADDITIONALLY, BY COMBINING EX 

5536
04:14:43,789 --> 04:14:46,492
VIVO MRI PATHOLOGY WE HAVE DEM 

5537
04:14:46,492 --> 04:14:54,133
VATE D -- DEMONSTRATED LATENCY 

5538
04:14:54,133 --> 04:14:54,800
FOLLOWS THE SPREAD CONSISTENT 

5539
04:14:54,800 --> 04:14:58,070
WITH THE SPREAD OF THE PATTERN.

5540
04:14:58,070 --> 04:15:00,573
OVER THE LAST FEW SLIDES I HOPE 

5541
04:15:00,573 --> 04:15:02,508
IT BECOMES CLEAR THAT MRI IS 

5542
04:15:02,508 --> 04:15:04,343
SENSITIVE TO THE BRAIN 

5543
04:15:04,343 --> 04:15:07,513
ABNORMALITIES ASSOCIATED WITH 

5544
04:15:07,513 --> 04:15:10,383
LATE NC AND FUTURE STUDIES COULD

5545
04:15:10,383 --> 04:15:13,753
USE THESE AND OTHER FEATURES TO 

5546
04:15:13,753 --> 04:15:16,656
TRAIN MRI BASED CLASSIFIERS OF 

5547
04:15:16,656 --> 04:15:25,898
LATENCY.

5548
04:15:25,898 --> 04:15:27,733
USING PET STUDIES HAVE SHOWN 

5549
04:15:27,733 --> 04:15:31,437
LATENCY IS ASSOCIATED WITH MORE 

5550
04:15:31,437 --> 04:15:32,672
PRONOUNCED HYPERMETABOLISM IN 

5551
04:15:32,672 --> 04:15:38,077
THE MEDIAL TEMPORAL LOBE AND THE

5552
04:15:38,077 --> 04:15:41,113
PATTERN IS TRUE FOR ALZHEIMER'S.

5553
04:15:41,113 --> 04:15:44,684
THEREFORE THE STUDY HAS 

5554
04:15:44,684 --> 04:15:45,718
SUGGESTED

5555
04:15:45,718 --> 04:15:50,222
SUGGESTED IT MAY BE A MARKER FOR

5556
04:15:50,222 --> 04:15:51,157
LATENCY.

5557
04:15:51,157 --> 04:15:53,125
FURTHER WORK IS NEEDED TO TEST 

5558
04:15:53,125 --> 04:16:01,534
THE CLASSIFIERS OF LATENCY.

5559
04:16:01,534 --> 04:16:04,670
AND THERE'S FEATURES AND 

5560
04:16:04,670 --> 04:16:06,772
ADDITIONAL FEATURES AND FOR NOW 

5561
04:16:06,772 --> 04:16:10,710
WE NEED TO TEST THE CLINICAL 

5562
04:16:10,710 --> 04:16:13,546
CRITERIA USING LONGITUDINAL 

5563
04:16:13,546 --> 04:16:16,682
OBSERVATIONS AND NEUROIMAGING 

5564
04:16:16,682 --> 04:16:17,950
MARKERS AND NEUROPATHOLOGY.

5565
04:16:17,950 --> 04:16:21,053
IN THE FUTURE WE NEED TO UPDATE 

5566
04:16:21,053 --> 04:16:24,423
THE CRITERIA BASED ON 

5567
04:16:24,423 --> 04:16:34,867
DEVELOPMENTS IN THE FIELD.

5568
04:16:35,634 --> 04:16:40,673
AND HIGHER LEVELS OF TDP43 IN 

5569
04:16:40,673 --> 04:16:43,576
THE PLASMA DERIVED EXTRA 

5570
04:16:43,576 --> 04:16:45,878
CELLULAR VESICLES WITH THOSE 

5571
04:16:45,878 --> 04:16:54,987
WITH TDP AND IN ADDITION LOSS OF

5572
04:16:54,987 --> 04:16:58,791
TDP43 AND PROTEINOPATHY IS 

5573
04:16:58,791 --> 04:17:02,928
LINKED TO THE EXPRESSION OF THE 

5574
04:17:02,928 --> 04:17:04,630
AND RECENT STUDIES SUGGESTED THE

5575
04:17:04,630 --> 04:17:08,667
PLASMA OR CSF HAS POTENTIAL AS A

5576
04:17:08,667 --> 04:17:09,068
MARKER FOR LATE.

5577
04:17:09,068 --> 04:17:12,772
ADDITIONAL WORK IS NEEDED TO 

5578
04:17:12,772 --> 04:17:14,340
DEVELOP AND TEST BIOFLUID 

5579
04:17:14,340 --> 04:17:17,309
MARKERS OF LATENCY.

5580
04:17:17,309 --> 04:17:19,578
ALSO EXCITING FINDINGS COME FROM

5581
04:17:19,578 --> 04:17:24,650
THE FIELD OF PET MARKERS OF 

5582
04:17:24,650 --> 04:17:26,919
TDP43 WHERE RELATIVELY RECENTLY 

5583
04:17:26,919 --> 04:17:30,856
NEW PET LIGAND HAS SHOWN 

5584
04:17:30,856 --> 04:17:35,494
PERFORMS  PERFORMANCE IN THE 

5585
04:17:35,494 --> 04:17:38,531
SAMPLES AND IN ANIMAL TESTS.

5586
04:17:38,531 --> 04:17:41,801
AS FAR AS I KNOW THIS IS 

5587
04:17:41,801 --> 04:17:48,507
CURRENTLY BEING TESTED IN HUME 

5588
04:17:48,507 --> 04:17:49,742
CANS HAVE AND ADDITIONAL WORK IS

5589
04:17:49,742 --> 04:17:56,649
NEEDED TO TEST LATENCY.

5590
04:17:56,649 --> 04:17:58,984
IN CONCLUSION THERE'S AN URGENT 

5591
04:17:58,984 --> 04:18:00,886
NEED FOR MARKERS OR CLASSIFIERS 

5592
04:18:00,886 --> 04:18:05,624
THAT SHOW GOOD DISCRIMINATION OF

5593
04:18:05,624 --> 04:18:08,227
PATHOPHYSIOLOGY AND COULD BE 

5594
04:18:08,227 --> 04:18:12,665
NEUROIMAGING OR BIO FLUID OR IN 

5595
04:18:12,665 --> 04:18:14,600
COMBINATION.

5596
04:18:14,600 --> 04:18:18,971
IN ORDER TO ACCOMPLISH THE ABOVE

5597
04:18:18,971 --> 04:18:21,073
AWAY NEED COHORTS TO JOIN 

5598
04:18:21,073 --> 04:18:24,176
MARKERS WITH DATA AND PATHOLOGY 

5599
04:18:24,176 --> 04:18:25,211
AND EX VIVO MRI.

5600
04:18:25,211 --> 04:18:27,112
IN ADDITION WE NEED TO REFINE 

5601
04:18:27,112 --> 04:18:28,280
OUR UNDERSTANDING OF THE 

5602
04:18:28,280 --> 04:18:30,249
COGNITIVE AND GENETIC FEATURES 

5603
04:18:30,249 --> 04:18:32,852
ASSOCIATED WITH LATENCY AND WE 

5604
04:18:32,852 --> 04:18:36,021
ALSO NEED TO TEST THE CLINICAL 

5605
04:18:36,021 --> 04:18:37,957
CRITERIA AND UPDATE THIS 

5606
04:18:37,957 --> 04:18:39,291
CRITERIA IN THE FUTURE DEPENDING

5607
04:18:39,291 --> 04:18:40,459
ON NEW DEVELOPMENTS IN THE 

5608
04:18:40,459 --> 04:18:40,659
FIELD.

5609
04:18:40,659 --> 04:18:50,836
THANK YOU.

5610
04:18:56,408 --> 04:18:56,675
>> THANK YOU.

5611
04:18:56,675 --> 04:18:58,277
I'LL CONTINUE LOOKING AT THE 

5612
04:18:58,277 --> 04:18:58,777
CAUSES AND THERAPEUTIC 

5613
04:18:58,777 --> 04:19:08,654
OPPORTUNITIES.

5614
04:19:08,654 --> 04:19:10,990
AND LOOK AT CAUSES AND THROUGH 

5615
04:19:10,990 --> 04:19:12,658
HUMAN STUDIES AND ENVIRONMENTAL 

5616
04:19:12,658 --> 04:19:15,094
MODELS AND AGING AND 

5617
04:19:15,094 --> 04:19:18,697
PATHOLOGICAL AND MOLECULAR AND 

5618
04:19:18,697 --> 04:19:20,065
STRUCTURAL PATHOLOGIES WITH THE 

5619
04:19:20,065 --> 04:19:24,670
FOCUS ON DEVELOPING AND TESTING 

5620
04:19:24,670 --> 04:19:30,843
TARGETS FOR THERAPEUTICS.

5621
04:19:30,843 --> 04:19:33,045
THE FIRST ASPECT IS DESIGN AND 

5622
04:19:33,045 --> 04:19:35,481
DEVELOP MODELS OF LATE NC.

5623
04:19:35,481 --> 04:19:38,584
IN MANY SLIDES I'M USING 

5624
04:19:38,584 --> 04:19:40,386
EXAMPLES FROM OTHER ALZHEIMER'S 

5625
04:19:40,386 --> 04:19:41,787
DISEASE RELATES DEMENTIAS 

5626
04:19:41,787 --> 04:19:45,624
BECAUSE IT'S THE MODELS LACKING 

5627
04:19:45,624 --> 04:19:47,993
IN LATE NC SPECIFIC MODELS.

5628
04:19:47,993 --> 04:19:51,697
SO HUMANS SEEM TO HAVE THIS 

5629
04:19:51,697 --> 04:19:52,665
UNIQUE SUSCEPTIBILITY TO LATE NC

5630
04:19:52,665 --> 04:19:55,968
HOWEVER, WE DON'T HAVE GOOD 

5631
04:19:55,968 --> 04:19:59,238
MODELS OF LATE NC IN MISSING OR 

5632
04:19:59,238 --> 04:20:01,307
OTHER ANIMAL MODELS.

5633
04:20:01,307 --> 04:20:03,309
WHAT WE'RE LOOKING FOR IS 

5634
04:20:03,309 --> 04:20:04,677
DEVELOP MODELS OF DYSFUNCTION 

5635
04:20:04,677 --> 04:20:07,980
NOT JUST IN ALS THAT ALREADY 

5636
04:20:07,980 --> 04:20:13,419
EXIST BUT WHERE WITH HAVE 

5637
04:20:13,419 --> 04:20:16,155
PHENOTYPES IN THE MODELS.

5638
04:20:16,155 --> 04:20:17,856
ADDITIONALLY IN THE MODELS WED 

5639
04:20:17,856 --> 04:20:21,627
LIKE TO CHARACTERIZE GLIAL AND 

5640
04:20:21,627 --> 04:20:23,629
NEURAL INFLAMMATORY 

5641
04:20:23,629 --> 04:20:28,133
CONTRIBUTIONS TO TDP ADENOPATHY 

5642
04:20:28,133 --> 04:20:32,237
AND THERE'S MOLE  MODELS OF THIS

5643
04:20:32,237 --> 04:20:34,573
IN ALS AND WOULD LIKE TO 

5644
04:20:34,573 --> 04:20:43,382
TRANSLATE THE  MODELS IN LATE.

5645
04:20:43,382 --> 04:20:48,587
WE'RE ALSO TRYING TO LOOK AT 

5646
04:20:48,587 --> 04:20:50,022
DEVELOPING CELLULAR NOLDES AND 

5647
04:20:50,022 --> 04:20:55,594
HOW TO MODEL LATE NC PATHOLOGY 

5648
04:20:55,594 --> 04:21:06,005
IN INDUCED PLURIMOW  -- 

5649
04:21:12,211 --> 04:21:15,180
PLURIPOTENT MODELS AND IN THE 

5650
04:21:15,180 --> 04:21:17,249
CULTURE SYSTEM OR USED PATIENT 

5651
04:21:17,249 --> 04:21:20,352
DERIVED HAVE LATE WILL THOSE 

5652
04:21:20,352 --> 04:21:22,087
REPRESENT ANY PHENOTYPES SEEN IN

5653
04:21:22,087 --> 04:21:22,955
LATE AS SUGGESTED BY SOME FOR 

5654
04:21:22,955 --> 04:21:33,032
ALS.

5655
04:21:35,868 --> 04:21:36,769
AND OBSERVE WHAT'S BEEN IN 

5656
04:21:36,769 --> 04:21:39,505
PATIENT GLIAL CELLS AND THIS IS 

5657
04:21:39,505 --> 04:21:41,707
IMPORTANT TO DEFINE THE LOSS OF 

5658
04:21:41,707 --> 04:21:49,314
FUNCTION AND GAIN OF CYTOPLASMIC

5659
04:21:49,314 --> 04:21:51,517
CYTOPLASMIC FUNCTION AND WHAT 

5660
04:21:51,517 --> 04:21:53,752
CAN WE DO TO MODEL LATE NC IN 

5661
04:21:53,752 --> 04:21:55,821
CELLS TO STUDY THIS CONDITION IN

5662
04:21:55,821 --> 04:22:02,194
DETAIL.

5663
04:22:02,194 --> 04:22:05,264
AND TO GO FURTHER TOWARDS 

5664
04:22:05,264 --> 04:22:05,864
STRUCTURALLY SPECIFIC AND IN 

5665
04:22:05,864 --> 04:22:08,033
VITRO MODELS WHERE WE NEED TO 

5666
04:22:08,033 --> 04:22:09,835
UNDERSTAND LATE SPECIFIC ULTRA 

5667
04:22:09,835 --> 04:22:12,171
STRUCTURE OF TDP43 ITSELF WHEN 

5668
04:22:12,171 --> 04:22:16,175
IT'S DEPOSITED AND POTENTIAL 

5669
04:22:16,175 --> 04:22:17,776
CO-DEPOSITED PROTEINS IN 

5670
04:22:17,776 --> 04:22:22,081
ORGANISM MODELS AND BIO CHEMICAL

5671
04:22:22,081 --> 04:22:23,615
MODELS AND WOULD LIKE TO 

5672
04:22:23,615 --> 04:22:27,986
UNDERSTAND THE STRUCTURE OF 

5673
04:22:27,986 --> 04:22:32,357
TDP43 AND HAS BEEN DISCOVERED BY

5674
04:22:32,357 --> 04:22:34,359
WORK IN A LAB IN THE U.K. AND 

5675
04:22:34,359 --> 04:22:37,796
WHAT IS THE MOLECULAR STRUCTURE 

5676
04:22:37,796 --> 04:22:43,202
IN LATE?

5677
04:22:43,202 --> 04:22:44,670
THAT BRINGS UP AN IMPORTANT 

5678
04:22:44,670 --> 04:22:45,170
QUESTION.

5679
04:22:45,170 --> 04:22:46,572
ANOTHER ASPECT OF OUR 

5680
04:22:46,572 --> 04:22:49,108
RECOMMENDATION IS TO LOOK AT THE

5681
04:22:49,108 --> 04:22:51,443
TDP43 STRUCTURE DIRECTLY AND TRY

5682
04:22:51,443 --> 04:22:53,145
TO UNDERSTAND THE PRIMARY 

5683
04:22:53,145 --> 04:22:55,214
STRUCTURAL AND POST 

5684
04:22:55,214 --> 04:22:55,881
TRANSLATIONAL MODIFICATIONS AND 

5685
04:22:55,881 --> 04:22:57,916
THE IMPORTANCE OF COMPOSITION OF

5686
04:22:57,916 --> 04:23:00,219
CO-DEPOSITED PROTEINS.

5687
04:23:00,219 --> 04:23:04,656
FOR EXAMPLE IN FTLD IS THAT THE 

5688
04:23:04,656 --> 04:23:13,465
CASE IN THE LATE AND WE DO SEE 

5689
04:23:13,465 --> 04:23:18,604
OTHER PROTEINS CODEPOSITED IN 

5690
04:23:18,604 --> 04:23:19,605
LATE.

5691
04:23:19,605 --> 04:23:23,408
IMPORTANTLY WE'D LIKE TO 

5692
04:23:23,408 --> 04:23:25,477
UNDERSTAND HOW THE PATHOLOGICAL 

5693
04:23:25,477 --> 04:23:27,813
INCLUSION FORMED.

5694
04:23:27,813 --> 04:23:30,282
WHAT IS THE ASSEMBLIES FORMED 

5695
04:23:30,282 --> 04:23:34,186
AND CAN WE PREVENT THE FORMATION

5696
04:23:34,186 --> 04:23:40,993
OF THESE ABHORRENT STRUCTURES 

5697
04:23:40,993 --> 04:23:43,362
AND WHAT DOES IT LOOK LIKE 

5698
04:23:43,362 --> 04:23:45,063
INITIALLY BEFORE DEPOSITION AND 

5699
04:23:45,063 --> 04:23:46,665
EITHER OF THESE THINGS, THESE 

5700
04:23:46,665 --> 04:23:48,967
TOXIC OR POTENTIALLY TOXIC 

5701
04:23:48,967 --> 04:23:51,370
INCLUSIONS THAT ARE STRUCTURES 

5702
04:23:51,370 --> 04:23:54,006
ON THE LEFT OR THESE FUNCTIONAL 

5703
04:23:54,006 --> 04:23:58,844
ASSEMBLIES OF THE SAME REGION OF

5704
04:23:58,844 --> 04:24:01,647
TDP43 IN THE CENTER MAY BE 

5705
04:24:01,647 --> 04:24:02,147
TARGETS FOR THERAPEUTIC 

5706
04:24:02,147 --> 04:24:11,557
MODULATION.

5707
04:24:11,557 --> 04:24:13,625
THERE'S CO-DEPOSITED PROTEINS 

5708
04:24:13,625 --> 04:24:20,098
AND WHAT ARE THESE MOLECULAR 

5709
04:24:20,098 --> 04:24:26,371
CONSEQUENCE OF THE PATHOLOGIES?

5710
04:24:26,371 --> 04:24:28,640
WE ALSO NEED TO DESIGN MODELS 

5711
04:24:28,640 --> 04:24:32,644
THAT INCORPORATE NOT JUST TDP43 

5712
04:24:32,644 --> 04:24:36,315
PATHOLOGY BUT CO-PATHOLOGIES AND

5713
04:24:36,315 --> 04:24:40,652
IF THERE'S SYNUCLEIN PATHOLOGIES

5714
04:24:40,652 --> 04:24:43,622
AND ORGANISM MODELS AND IF IT 

5715
04:24:43,622 --> 04:24:44,890
COEXISTS WITH OTHER PATHOLOGIES 

5716
04:24:44,890 --> 04:24:48,660
WE FEED TO UNDERSTAND HOW THEY 

5717
04:24:48,660 --> 04:24:50,362
ARE INTERACT.

5718
04:24:50,362 --> 04:24:52,464
WE NEED TO STUDY THE MECHANISTIC

5719
04:24:52,464 --> 04:24:55,133
BASIS OF DISEASE INITIATION.

5720
04:24:55,133 --> 04:24:56,501
HOW DO THE DISEASE START AND HOW

5721
04:24:56,501 --> 04:24:58,937
ARE NEURONS LOST?

5722
04:24:58,937 --> 04:25:01,406
HOW ARE BRAIN REGIONS TARGETED 

5723
04:25:01,406 --> 04:25:05,544
FOR DEGENERATION SPECIFIED IN 

5724
04:25:05,544 --> 04:25:07,646
LATE AGE RELATED PROGRESSION IS 

5725
04:25:07,646 --> 04:25:08,080
PRIMARILY IMPORTANT.

5726
04:25:08,080 --> 04:25:09,615
WE NEED TO UNDERSTAND HOW THAT 

5727
04:25:09,615 --> 04:25:09,982
WORKS.

5728
04:25:09,982 --> 04:25:11,783
CAN WE DEVELOP MODELS THAT 

5729
04:25:11,783 --> 04:25:14,052
INCORPORATE AGE-RELATED 

5730
04:25:14,052 --> 04:25:17,756
PROGRESSION AND HOW IS 

5731
04:25:17,756 --> 04:25:18,624
PROGRESSION ACROSS THE BRAIN 

5732
04:25:18,624 --> 04:25:19,691
AREAS INCLUDED.

5733
04:25:19,691 --> 04:25:23,028
WE ALSO NEED TO DISCOVER GENETIC

5734
04:25:23,028 --> 04:25:23,896
CAUSATIVE FACTORS FOR LATE.

5735
04:25:23,896 --> 04:25:26,832
SO SEVERAL HAVE BEEN SHOWN AS OR

5736
04:25:26,832 --> 04:25:27,466
DISCOVERED AS SHOWN HERE.

5737
04:25:27,466 --> 04:25:29,768
WILL WE BE ABLE TO CONFIRM THESE

5738
04:25:29,768 --> 04:25:33,772
BY REPLICATION AND WILL WE FIND 

5739
04:25:33,772 --> 04:25:37,075
NEW GENES CAUSATIVE FOR LATE AND

5740
04:25:37,075 --> 04:25:40,646
OTHER TDP43 PROTEINOPATHIES BE 

5741
04:25:40,646 --> 04:25:46,285
CAUSATIVE FOR LATE.

5742
04:25:46,285 --> 04:25:52,991
WE NEED TO STUDY THE LATE 

5743
04:25:52,991 --> 04:25:53,525
PATHOPHYSIOLOGY.

5744
04:25:53,525 --> 04:25:54,893
WHAT ARE THE SPLICING CHANGES WE

5745
04:25:54,893 --> 04:25:55,327
HEARD ABOUT.

5746
04:25:55,327 --> 04:25:58,997
THERE WAS A RECENT STUDY SHOWN 

5747
04:25:58,997 --> 04:26:03,168
JUST LAST WEEK THAT THE AMYLOID 

5748
04:26:03,168 --> 04:26:05,504
PRECURSOR PROTEIN IS PROCESSED 

5749
04:26:05,504 --> 04:26:07,973
IN THE CYTOPLASMIC GAIN OF 

5750
04:26:07,973 --> 04:26:10,075
FUNCTION AND IT WOULD BE 

5751
04:26:10,075 --> 04:26:11,276
INTERESTING TO STUDY WHAT ARE 

5752
04:26:11,276 --> 04:26:12,678
THE CORRECTIBLE CHANGES THAT 

5753
04:26:12,678 --> 04:26:18,450
COULD BE TARGETED.

5754
04:26:18,450 --> 04:26:19,484
>> WE'RE AT TIME.

5755
04:26:19,484 --> 04:26:22,788
>> WE NEED TO GEAR UP TO
STUDY 

5756
04:26:22,788 --> 04:26:24,656
THESE IN MODELS.

5757
04:26:24,656 --> 04:26:28,860
WE NEED TO TAKE ACTION ON THESE 

5758
04:26:28,860 --> 04:26:30,262
POTENTIAL THERAPEUTIC 

5759
04:26:30,262 --> 04:26:36,635
TECHNOLOGIES BECAUSE WE KNOW IN'

5760
04:26:36,635 --> 04:26:42,975
SENSE ALOGOES CAN BE SUCCESSFUL 

5761
04:26:42,975 --> 04:26:45,777
TREATMENT AND WE'VE HAD 

5762
04:26:45,777 --> 04:26:48,647
THERAPEUTICS IN SPINAL ATROPHY 

5763
04:26:48,647 --> 04:26:52,284
AND WE NEED MODELS TO TEST THESE

5764
04:26:52,284 --> 04:26:57,055
THERAPIES IN TDP43.

5765
04:26:57,055 --> 04:27:00,659
I'LL LEAVE IT THERE.

5766
04:27:00,659 --> 04:27:03,829
THANK YOU VERY MUCH.

5767
04:27:03,829 --> 04:27:06,832
>> WE'LL GO STRAIGHT TO 

5768
04:27:06,832 --> 04:27:07,666
DR. NELSON'S TALK.

5769
04:27:07,666 --> 04:27:09,868
>> THANK YOU TO THE
ORGANIZERS.

5770
04:27:09,868 --> 04:27:10,669
I APPRECIATE IT.

5771
04:27:10,669 --> 04:27:12,871
IT'S WONDERFUL TO BE PART OF 

5772
04:27:12,871 --> 04:27:13,572
THIS EXCELLENT SUMMIT.

5773
04:27:13,572 --> 04:27:16,641
I HAVE NOTHING TO DISCLOSE.

5774
04:27:16,641 --> 04:27:22,280
I'M TALKING TODAY ABOUT 

5775
04:27:22,280 --> 04:27:24,649
RECOMMENDATIONS RELATED TO 

5776
04:27:24,649 --> 04:27:27,219
HIPPOCAMPAL SCLEROSIS OF AGING 

5777
04:27:27,219 --> 04:27:29,087
AND I CAN SAY BASICALLY IT 

5778
04:27:29,087 --> 04:27:30,655
BREAKS DOWN TO TWO THINGS.

5779
04:27:30,655 --> 04:27:32,657
NUMBER ONE, IMPROVING OUR 

5780
04:27:32,657 --> 04:27:34,493
CLASSIFICATION AND DIAGNOSIS AND

5781
04:27:34,493 --> 04:27:36,161
TWO, IMPROVING OUR UNDERSTANDING

5782
04:27:36,161 --> 04:27:37,929
OF THE MECHANISM TO PROVIDE 

5783
04:27:37,929 --> 04:27:45,837
TARGETS FOR FUTURE THERAPIES.

5784
04:27:45,837 --> 04:27:49,574
SO WHAT IS HIPPOCAMPUS SCLEROSIS

5785
04:27:49,574 --> 04:27:52,210
IT'S LOSS IN THE MEDIAL TEMPORAL

5786
04:27:52,210 --> 04:27:53,545
GLOBE AND THE NORMAL HIPPOCAMPUS

5787
04:27:53,545 --> 04:27:55,647
ON THE RIGHT.

5788
04:27:55,647 --> 04:27:59,551
YOU SEE THE SHRIVALLED 

5789
04:27:59,551 --> 04:28:04,423
HIPPOCAMPUS WITH CELL LOSS AND 

5790
04:28:04,423 --> 04:28:05,557
GLIOSIS.

5791
04:28:05,557 --> 04:28:07,626
THIS IS A COMMON PATHOLOGY.

5792
04:28:07,626 --> 04:28:09,394
10% LIFE TIME RISK AND AFFECTED 

5793
04:28:09,394 --> 04:28:11,596
25% OF PEOPLE WITH DEMENTIA.

5794
04:28:11,596 --> 04:28:14,066
IT DOESN'T AFFECT PEOPLE EQUALLY

5795
04:28:14,066 --> 04:28:17,836
ALONG THE HUMAN AGING SPECTRUM.

5796
04:28:17,836 --> 04:28:28,313
HERE YOU SEE THE NEXT SLIDE.

5797
04:28:36,721 --> 04:28:41,626
GO BACK TO THE LAST SLIDE.

5798
04:28:41,626 --> 04:28:43,728
THIS SHOWS YOU ON THE X AXIS IS 

5799
04:28:43,728 --> 04:28:49,134
AGE AND THE Y AXIS IS PATHOLOGY.

5800
04:28:49,134 --> 04:28:55,140
THE BLACK TRACE SMOOTHED BY 

5801
04:28:55,140 --> 04:28:58,210
MEASURES IS ALZHEIMER'S DISEASE 

5802
04:28:58,210 --> 04:28:59,444
AND HIPPOCAMPAL SCLEROSIS 

5803
04:28:59,444 --> 04:29:04,049
PATHOLOGY IS THE RED TRACE AND 

5804
04:29:04,049 --> 04:29:07,819
UNLIKE ALZHEIMER'S HIPPOCAMPAL 

5805
04:29:07,819 --> 04:29:12,657
SCLEROSIS THAT FOCUSES MOSTLY ON

5806
04:29:12,657 --> 04:29:15,861
THE OLDEST OLD.

5807
04:29:15,861 --> 04:29:19,097
HOWEVER IT'S A SOMEWHAT 

5808
04:29:19,097 --> 04:29:20,732
CONFUSING TEAM AND OFTEN LINKED 

5809
04:29:20,732 --> 04:29:21,900
TO EPILEPSY.

5810
04:29:21,900 --> 04:29:23,368
TO DESCRIBE THIS WE DID A SURVEY

5811
04:29:23,368 --> 04:29:25,303
AT THE UNIVERSITY OF KENTUCKY 

5812
04:29:25,303 --> 04:29:28,840
WHICH IS A UNIVERSITY THAT HAS A

5813
04:29:28,840 --> 04:29:33,778
VERY GOOD FAMILIARITY WITH THE 

5814
04:29:33,778 --> 04:29:34,045
CONDITION.

5815
04:29:34,045 --> 04:29:39,684
WE DID THE SURVEY TWICE.

5816
04:29:39,684 --> 04:29:43,622
IN 2018 AND 2015 TO SEE WHAT WAS

5817
04:29:43,622 --> 04:29:48,660
THE EFFECT OF THE NEW 

5818
04:29:48,660 --> 04:29:55,834
NOMENCLATURE AND THIS WAS PART 

5819
04:29:55,834 --> 04:30:03,575
OF THE PART  -- PART PASSION -- 

5820
04:30:03,575 --> 04:30:05,710
PARTICIPATION AND 80% OF THE 

5821
04:30:05,710 --> 04:30:08,813
RESPONDENTS SAID IT WAS AN 

5822
04:30:08,813 --> 04:30:09,948
EPILEPSY DISORDER TERM AND WE 

5823
04:30:09,948 --> 04:30:12,684
THOUGHT IT WOULD BE BETTER IN 

5824
04:30:12,684 --> 04:30:13,818
2025.

5825
04:30:13,818 --> 04:30:15,687
BUT REGRETTABLY IT'S NOT THE 

5826
04:30:15,687 --> 04:30:15,954
CASE.

5827
04:30:15,954 --> 04:30:18,957
IT'S STILL NOT REALLY THE TERM 

5828
04:30:18,957 --> 04:30:22,127
THAT PEOPLE THINK OF WHEN THEY 

5829
04:30:22,127 --> 04:30:24,729
THINK OF HIPPOCAMPAL SCLEROSIS 

5830
04:30:24,729 --> 04:30:29,534
THEY THINK OF A DIFFERENT 

5831
04:30:29,534 --> 04:30:32,370
PATHOMECHANISM OF HIPPOCAMPUS 

5832
04:30:32,370 --> 04:30:33,205
SCLEROSIS DIFFERENT FROM THAT 

5833
04:30:33,205 --> 04:30:36,675
WHICH AFFECTS DEMENTIA AND IT'S 

5834
04:30:36,675 --> 04:30:39,844
MORE COMMON.

5835
04:30:39,844 --> 04:30:47,852
SO WE CONCLUDE THAT WE NEED MORE

5836
04:30:47,852 --> 04:30:52,657
TERMINOLOGY FOR HIPPOCAMPAL 

5837
04:30:52,657 --> 04:30:55,794
SCLEROSIS OF AGING.

5838
04:30:55,794 --> 04:30:56,695
THE GOLD STANDARD DEFINITION 

5839
04:30:56,695 --> 04:31:01,800
WHICH IS A PATHOLOGY NEEDS TO BE

5840
04:31:01,800 --> 04:31:02,534
STANDARDIZED AND OPTIMIZED IN A 

5841
04:31:02,534 --> 04:31:07,606
DATA-DRIVEN WAY.

5842
04:31:07,606 --> 04:31:10,475
SO IT'S STRONGLY ASSOCIATED WITH

5843
04:31:10,475 --> 04:31:15,680
LATE NC BUT NOT SYNONYMOUS.

5844
04:31:15,680 --> 04:31:18,550
ON THE RIGHT YOU SEE THE VEN 

5845
04:31:18,550 --> 04:31:22,687
DIAGRAM THAT SHOWS A MEANINGFUL 

5846
04:31:22,687 --> 04:31:25,590
CONCEPTUALIZATION OF HIPPOCAMPAL

5847
04:31:25,590 --> 04:31:28,226
SCLEROSIS OF AGING IS THE MORE 

5848
04:31:28,226 --> 04:31:30,128
SEVERE SUB TYPE OF LATE NC AND 

5849
04:31:30,128 --> 04:31:33,531
THAT COULD BE CONNECTED TO THE 

5850
04:31:33,531 --> 04:31:35,000
PATHOGENIC PROGRESSION THAT'S 

5851
04:31:35,000 --> 04:31:37,869
HYPOTHESIZED FROM NO LATE TO 

5852
04:31:37,869 --> 04:31:40,639
LATE WITH NO PATHOLOGY AND THE 

5853
04:31:40,639 --> 04:31:42,741
ORANGE ARROW GOES TO LATE WITH 

5854
04:31:42,741 --> 04:31:47,312
HS MAYBE THE QUESTION IS YOU SEE

5855
04:31:47,312 --> 04:31:52,017
THE STRONG HIPPOCAMPUS AND IT'S 

5856
04:31:52,017 --> 04:31:53,218
LOGICAL YOU THINK IT WOULD BE 

5857
04:31:53,218 --> 04:31:55,353
BAD FOR YOU BUT WE AND OTHERS 

5858
04:31:55,353 --> 04:31:56,588
AROUND THE WORLD FOUND THIS 

5859
04:31:56,588 --> 04:32:04,029
PROGRESSION FROM LATE TO LATE 

5860
04:32:04,029 --> 04:32:06,398
NC-HS IS ASSOCIATED WITH WORSE 

5861
04:32:06,398 --> 04:32:11,870
PROGRESSION BUT NOT SEIZURES OR 

5862
04:32:11,870 --> 04:32:15,173
AD PATHOLOGY BUT LATE NC STAGES.

5863
04:32:15,173 --> 04:32:17,609
SO THE WAY YOU DETECT IT IN THE 

5864
04:32:17,609 --> 04:32:19,778
CLINIC IS BY MRI AT THIS POINT.

5865
04:32:19,778 --> 04:32:22,681
THIS IS MY PICTURE OF AN 

5866
04:32:22,681 --> 04:32:25,884
INDIVIDUAL WHO PASSED AT THE AGE

5867
04:32:25,884 --> 04:32:30,488
OF 93 AND HAS THESE NICE 

5868
04:32:30,488 --> 04:32:34,993
POSTMORTEM IMAGES TAKEN BUT THAT

5869
04:32:34,993 --> 04:32:37,829
IS TO UNDER SCORE SOME THINGS 

5870
04:32:37,829 --> 04:32:40,665
THAT WAS SAID THE HIPPOCAMPAL 

5871
04:32:40,665 --> 04:32:42,534
ATROPHY AND SCLEROSIS IS WORSE 

5872
04:32:42,534 --> 04:32:44,669
THAN WHAT YOU SEE WITH 

5873
04:32:44,669 --> 04:32:46,104
ALZHEIMER'S DISEASE.

5874
04:32:46,104 --> 04:32:48,573
WE NEED SPECIFIC CUT POINTS AND 

5875
04:32:48,573 --> 04:32:52,644
UNDERSTAND THE MECHANISM FOR HOW

5876
04:32:52,644 --> 04:32:55,146
THIS DEGENERATION OCCURS.

5877
04:32:55,146 --> 04:32:58,650
AND IT'S NOT JUST ABOUT LATE NC.

5878
04:32:58,650 --> 04:33:01,886
SO WHY DO SOME SUBSET OF PEOPLE 

5879
04:33:01,886 --> 04:33:04,522
WHO HAVE LATE AND NOT OTHERS 

5880
04:33:04,522 --> 04:33:06,958
DEVELOP HS AND THESE MECHANISTIC

5881
04:33:06,958 --> 04:33:12,497
INSIGHTS CAN BE TRANSLATABLE.

5882
04:33:12,497 --> 04:33:14,699
SO LABS AROUND THE WORLD THAT 

5883
04:33:14,699 --> 04:33:18,336
FOUND EVIDENCE OF POSSIBLE 

5884
04:33:18,336 --> 04:33:25,877
PATHOGENETIC MECHANISMS 

5885
04:33:25,877 --> 04:33:29,748
VASCULAROPATHY AND MORE 

5886
04:33:29,748 --> 04:33:30,749
INFLAMMATION AND WE NEED MORE 

5887
04:33:30,749 --> 04:33:33,885
SYSTEMS TO GENERATE TRANSLATABLE

5888
04:33:33,885 --> 04:33:34,819
MECHANISMS.

5889
04:33:34,819 --> 04:33:36,154
THESE MECHANISTIC INSIGHTS GIVES

5890
04:33:36,154 --> 04:33:36,688
US STRATEGIES.

5891
04:33:36,688 --> 04:33:40,325
I WANT TO GIVE AN EXAMPLE OF A 

5892
04:33:40,325 --> 04:33:41,860
SPECIFIC CLINICAL RESEARCH ARM 

5893
04:33:41,860 --> 04:33:45,764
THAT HAS LED DIRECTLY TO A 

5894
04:33:45,764 --> 04:33:48,533
CLINICAL TRIAL AIMED AT 

5895
04:33:48,533 --> 04:33:50,368
PREVENTING DEMENTIA IN OLD 

5896
04:33:50,368 --> 04:33:54,239
PEOPLE AND HAS NOTHING TO DO 

5897
04:33:54,239 --> 04:34:01,780
WITH ALZHEIMER'S AND DAVID FARDO

5898
04:34:01,780 --> 04:34:05,917
GENERATED THIS AND THERE WAS A 

5899
04:34:05,917 --> 04:34:07,685
DRUG THAT A COLLEAGUE OF MINE AT

5900
04:34:07,685 --> 04:34:09,754
THE UNIVERSITY OF KENTUCKY ARE 

5901
04:34:09,754 --> 04:34:11,122
USING IN THE FIRST CLINICAL 

5902
04:34:11,122 --> 04:34:13,625
TRIAL FOR LATE HS.

5903
04:34:13,625 --> 04:34:15,627
AND TO GIVE YOU AN IDEA OVER ALL

5904
04:34:15,627 --> 04:34:23,768
IDEA OF WHAT IS GOING ON THERE, 

5905
04:34:23,768 --> 04:34:31,075
IT'S THERE'S A NEW STANDARD OF A

5906
04:34:31,075 --> 04:34:33,578
PATIENT WHO'S COGNITION IS 

5907
04:34:33,578 --> 04:34:36,381
SLIPPING AND THERE'S A BIOMARKER

5908
04:34:36,381 --> 04:34:36,681
MANIFESTING.

5909
04:34:36,681 --> 04:34:43,988
AND IF THERE'S ABETA AMYLOIDOSIS

5910
04:34:43,988 --> 04:34:44,989
NOTICED BY BIOMARKER EVIDENCE 

5911
04:34:44,989 --> 04:34:45,790
THERE'S HOPE.

5912
04:34:45,790 --> 04:34:56,334
IT'S NOT 100% PERFECT BUT NO -- 

5913
04:34:56,868 --> 04:35:00,638
>> DR. NELSON, TIME IS UP.

5914
04:35:00,638 --> 04:35:08,079
>> I'M ALMOST DONE.

5915
04:35:08,079 --> 04:35:16,187
AND COHORTS COGNITIVE IMPAIRED 

5916
04:35:16,187 --> 04:35:22,327
AND SOME HAVE THIS TYPE OF 

5917
04:35:22,327 --> 04:35:24,496
AMYLOIDOSIS AND IF YOU HAVE THE 

5918
04:35:24,496 --> 04:35:27,031
IMPAIRMENT AND IF YOU HAVE THIS 

5919
04:35:27,031 --> 04:35:34,539
MRI PICTURE THEN HOPEFULLY WE 

5920
04:35:34,539 --> 04:35:38,877
CAN DEVELOP NEW REMEDIES AND A 

5921
04:35:38,877 --> 04:35:40,645
CLINICAL TRIAL SUBJECT TO 

5922
04:35:40,645 --> 04:35:44,682
PERHAPS PREVENT FURTHER 

5923
04:35:44,682 --> 04:35:46,251
DEGENERATION.

5924
04:35:46,251 --> 04:35:52,657
AND THANK YOU AND I'VE GOT IT.

5925
04:35:52,657 --> 04:36:03,034
>> THANK YOU SO MUCH.

5926
04:36:05,803 --> 04:36:08,072
>> SO WE'LL HAVE 15
MINUTES FOR 

5927
04:36:08,072 --> 04:36:08,473
QUESTIONS.

5928
04:36:08,473 --> 04:36:09,507
>> THANK YOU TO THE
COMMITTEE 

5929
04:36:09,507 --> 04:36:12,644
AND THE WHOLE GROUP AND 

5930
04:36:12,644 --> 04:36:14,946
OBVIOUSLY NINDS FOR SUPPORTING 

5931
04:36:14,946 --> 04:36:15,146
THIS.

5932
04:36:15,146 --> 04:36:16,648
I'M CHAIRING THE SESSION.

5933
04:36:16,648 --> 04:36:22,186
I GUESS I DID WANT TO START FROM

5934
04:36:22,186 --> 04:36:23,488
ONE COMMENT FROM WITHIN OUR 

5935
04:36:23,488 --> 04:36:34,098
PANEL AN INDIVIDUAL, DEIDRE AND 

5936
04:36:34,098 --> 04:36:35,166
HER LIVED EXPERIENCE AND GIVE 

5937
04:36:35,166 --> 04:36:36,668
HER AN OPPORTUNITY TO SAY A FEW 

5938
04:36:36,668 --> 04:36:46,778
WORDS.

5939
04:36:49,647 --> 04:36:51,749
>> YES, MY PAST YEAR MY
MOTHER 

5940
04:36:51,749 --> 04:36:52,650
WAS DIAGNOSED LATE.

5941
04:36:52,650 --> 04:36:55,520
OUR JOURNEY TO LATE BEGAN WITH 

5942
04:36:55,520 --> 04:36:59,757
THE DIAGNOSIS IN 2018 OF MILD 

5943
04:36:59,757 --> 04:37:03,127
COGNITIVE IMPAIRMENT DUE TO 

5944
04:37:03,127 --> 04:37:03,428
ALZHEIMER'S.

5945
04:37:03,428 --> 04:37:13,638
SHE WAS 81.

5946
04:37:22,914 --> 04:37:24,582
WE WERE BRACING FOR THE 

5947
04:37:24,582 --> 04:37:26,618
PROGRESSION TO DEMENTIA AND 

5948
04:37:26,618 --> 04:37:28,152
AFTER THE DIAGNOSIS OF MILD 

5949
04:37:28,152 --> 04:37:31,089
COGNITIVE IMPAIRMENT SHE 

5950
04:37:31,089 --> 04:37:32,657
REMAINED AT THAT LEVEL WITHOUT 

5951
04:37:32,657 --> 04:37:34,592
FURTHER DEFICIT WHICH WAS 

5952
04:37:34,592 --> 04:37:36,494
SURPRISING AND THEN WE WERE TOLD

5953
04:37:36,494 --> 04:37:40,164
SHE HAD LATE OR TDP43.

5954
04:37:40,164 --> 04:37:43,668
WE LEARNED IT WAS SLOWER MOVING 

5955
04:37:43,668 --> 04:37:45,370
THAN ALZHEIMER'S AND WOULD 

5956
04:37:45,370 --> 04:37:47,772
AFFECT HER ABILITY TO LEARN NEW 

5957
04:37:47,772 --> 04:37:50,108
THINGS AND HAD A PET SCAN TO 

5958
04:37:50,108 --> 04:37:52,677
CONFIRM NO AMYLOID PLAQUE AND 

5959
04:37:52,677 --> 04:37:56,080
WERE TOLD HER CEREBRAL CORTEX 

5960
04:37:56,080 --> 04:37:57,715
WAS INTACT.

5961
04:37:57,715 --> 04:38:00,284
IT'S THE FIRST TIME AS A FAMILY 

5962
04:38:00,284 --> 04:38:02,954
WE FELT HOPE BECAUSE A DIFFICULT

5963
04:38:02,954 --> 04:38:04,656
PART FOR ME WAS TALKING TO MY 

5964
04:38:04,656 --> 04:38:10,028
MOM AND EACH TIME WONDERING WILL

5965
04:38:10,028 --> 04:38:12,196
THIS BE THE LAST TIME SHE KNOWS 

5966
04:38:12,196 --> 04:38:15,400
WHO I AM AND NOW WITH THE NEW 

5967
04:38:15,400 --> 04:38:18,736
DIAGNOSIS IT'S EDUCATING ALL 

5968
04:38:18,736 --> 04:38:23,841
THOSE WHO ASSIST HER TO THIS 

5969
04:38:23,841 --> 04:38:28,546
CONDITION AND WE HAD A FAMILY 

5970
04:38:28,546 --> 04:38:30,848
WITH HER 24/7 SO SHE WOULDN'T 

5971
04:38:30,848 --> 04:38:32,116
GET LOST IN THE ENVIRONMENT AND 

5972
04:38:32,116 --> 04:38:34,886
HAD TO EDUCATE ALL THE DOCTORS 

5973
04:38:34,886 --> 04:38:35,620
AND NURSES ON THE DIAGNOSIS AND 

5974
04:38:35,620 --> 04:38:38,056
WEREN'T AWARE OF LATE AND WERE 

5975
04:38:38,056 --> 04:38:40,491
THANKFUL AND IT DOES MAKE A 

5976
04:38:40,491 --> 04:38:41,893
DIFFERENCE IN THE CARE AND I 

5977
04:38:41,893 --> 04:38:44,062
CAN'T STRESS ENOUGH TO GET THE 

5978
04:38:44,062 --> 04:38:47,799
INFORMATION OUT TO FAMILIES TO 

5979
04:38:47,799 --> 04:38:48,866
NAVIGATE LATE AND ASSIST HEALTH 

5980
04:38:48,866 --> 04:38:51,069
CARE PROVIDERS AND THEIR 

5981
04:38:51,069 --> 04:38:53,171
APPROACH TO THE PATIENTS AND I 

5982
04:38:53,171 --> 04:38:54,739
KNOW THERE'S RECENT CRITERIA 

5983
04:38:54,739 --> 04:38:56,641
ABOUT TO BE PUBLISHED WHICH IS 

5984
04:38:56,641 --> 04:38:57,742
WONDERFUL AND HOPEFULLY THERE'LL

5985
04:38:57,742 --> 04:39:00,645
BE CARE GUIDELINES TAILORED TO 

5986
04:39:00,645 --> 04:39:04,649
LATE BECAUSE RIGHT NOW AS A 

5987
04:39:04,649 --> 04:39:09,854
FAMILY WE IS HAVE TO EDUCATE 

5988
04:39:09,854 --> 04:39:11,656
THOSE AROUND US HOW BEST TO 

5989
04:39:11,656 --> 04:39:13,725
SUPPORT MY MOTHER AND AT THE END

5990
04:39:13,725 --> 04:39:16,327
IT REALLY WAS A GAME CHANGER TO 

5991
04:39:16,327 --> 04:39:18,463
FIND OUT HER ACTUAL DIAGNOSIS 

5992
04:39:18,463 --> 04:39:20,298
AND IT'S HEARTENING TO KNOW 

5993
04:39:20,298 --> 04:39:24,602
THERE'S TEAMS LIKE AT PENN 

5994
04:39:24,602 --> 04:39:27,271
MEDICINE TO CARE ENOUGH TO 

5995
04:39:27,271 --> 04:39:30,108
PROVIDE ANSWERS TO THOSE WHO 

5996
04:39:30,108 --> 04:39:32,310
DON'T EXHIBIT THE TYPICAL 

5997
04:39:32,310 --> 04:39:33,010
MANIFESTATIONS OF ALZHEIMER'S 

5998
04:39:33,010 --> 04:39:34,779
AND GIVES PEOPLE A SENSE OF 

5999
04:39:34,779 --> 04:39:36,781
WHAT'S GOING ON.

6000
04:39:36,781 --> 04:39:38,149
AGAIN, GETTING THE WORD OUT IS 

6001
04:39:38,149 --> 04:39:38,883
EVERYTHING AND THANK YOU SO MUCH

6002
04:39:38,883 --> 04:39:40,651
AND THANK YOU FOR GIVING ME SOME

6003
04:39:40,651 --> 04:39:49,293
TIME TO SPEAK.

6004
04:39:49,293 --> 04:39:55,199
>> THANK YOU, DEIDRE, IN
THE 

6005
04:39:55,199 --> 04:40:00,004
ADDITION OF DIAGNOSIS THERE'S 

6006
04:40:00,004 --> 04:40:03,174
DEMYSTIFYING THE CONDITION AND 

6007
04:40:03,174 --> 04:40:08,179
THE ABILITY TO DESCRIBE LATE IS 

6008
04:40:08,179 --> 04:40:18,556
CRITICALLY IMPORTANT.

6009
04:40:23,861 --> 04:40:27,265
>> I HAVE MANY QUESTIONS
BUT IN 

6010
04:40:27,265 --> 04:40:30,468
THE INTEREST OF TIME I HAVE ONE 

6011
04:40:30,468 --> 04:40:32,570
FOR THE HIPPOCAMPAL SCLEROSIS 

6012
04:40:32,570 --> 04:40:34,839
THE ELEPHANT IN THE ROOM AND 

6013
04:40:34,839 --> 04:40:38,142
WHEN IT COMES TO THIS DIAGNOSIS 

6014
04:40:38,142 --> 04:40:41,546
THERE'S A LOT OF INCONSISTENCY 

6015
04:40:41,546 --> 04:40:42,480
LEADING TO AGREEMENT BETWEEN 

6016
04:40:42,480 --> 04:40:44,182
DIFFERENT GROUPS.

6017
04:40:44,182 --> 04:40:46,884
I DON'T SEE A LOT OF EFFORT IN 

6018
04:40:46,884 --> 04:40:49,153
TRYING TO UNIFY THE DIAGNOSIS OR

6019
04:40:49,153 --> 04:40:51,689
SET OF RECOMMENDATIONS TO HELP 

6020
04:40:51,689 --> 04:40:54,392
US TALK THE SAME LANGUAGE WHEN 

6021
04:40:54,392 --> 04:40:58,329
WE SAY HIPPOCAMPUS SCLEROSIS OF 

6022
04:40:58,329 --> 04:40:59,597
AGING AND THE OTHER DOWN THE 

6023
04:40:59,597 --> 04:41:01,265
LINE IS MOVING AWAY FROM A 

6024
04:41:01,265 --> 04:41:04,635
BINARY DIAGNOSIS AND COMING UP 

6025
04:41:04,635 --> 04:41:09,473
WITH AT LEAST AN ORGANAL 

6026
04:41:09,473 --> 04:41:10,007
CRITERIA LIKE WITH OTHER 

6027
04:41:10,007 --> 04:41:20,218
PATHOLOGIES.

6028
04:41:21,085 --> 04:41:23,187
>> YOUR POINT IS WELL
TAKEN.

6029
04:41:23,187 --> 04:41:24,922
WE NEED BETTER CRITERIA FOR HOW 

6030
04:41:24,922 --> 04:41:28,659
WE THRESHOLD OUR DIAGNOSES IN 

6031
04:41:28,659 --> 04:41:32,663
THE PATHOLOGICAL AND STRUCTURAL 

6032
04:41:32,663 --> 04:41:34,332
IMAGING CONTEXT.

6033
04:41:34,332 --> 04:41:36,400
WE NEED THAT AND ONE OF THE 

6034
04:41:36,400 --> 04:41:39,337
STRONG RECOMMENDATIONS THAT WE 

6035
04:41:39,337 --> 04:41:44,008
MADE IS THAT BOTH FOR IS THE 

6036
04:41:44,008 --> 04:41:54,485
BIOMARKER OF OPATHY WE NEED 

6037
04:41:56,921 --> 04:42:00,825
GROUPS TO COME TOGETHER AND MAKE

6038
04:42:00,825 --> 04:42:05,796
THE CALLS.

6039
04:42:05,796 --> 04:42:08,633
>> AND COME UP WITH
HARMONIZED 

6040
04:42:08,633 --> 04:42:14,138
PROTOCOLS WITH HOW PATHOLOGISTS 

6041
04:42:14,138 --> 04:42:15,306
SPEAK ABOUT HIPPOCAMPAL 

6042
04:42:15,306 --> 04:42:25,850
SCLEROSIS AND MOVE IT TO CLINIC.

6043
04:42:27,685 --> 04:42:31,756
>> I WANT TO RAISE UP WHEN
IT 

6044
04:42:31,756 --> 04:42:33,991
COMES TO ALZHEIMER'S 

6045
04:42:33,991 --> 04:42:34,725
DISEASE-RELATED DIMENTIAS ARE 

6046
04:42:34,725 --> 04:42:36,227
DIFFERENT THAN LATE NC EVEN TO 

6047
04:42:36,227 --> 04:42:38,229
THIS DAY PEOPLE WILL THINK 

6048
04:42:38,229 --> 04:42:39,931
THEY'RE BEING IMPACTED BY 

6049
04:42:39,931 --> 04:42:40,598
ALZHEIMER'S DISEASE AND IN YEARS

6050
04:42:40,598 --> 04:42:44,235
PAST BEFORE ALL THE WORK YOU 

6051
04:42:44,235 --> 04:42:47,471
GUYS HAVE DONE SO NEATLY HAS 

6052
04:42:47,471 --> 04:42:49,407
SHOWN MORE WHAT THE DISEASE IS.

6053
04:42:49,407 --> 04:42:56,647
AND TO THAT END, TDP43 HAS BEEN 

6054
04:42:56,647 --> 04:42:59,150
ON THE BACK FOOT AND HOW CAN WE 

6055
04:42:59,150 --> 04:43:00,651
OVERCOME THE INJUSTICE OF THAT 

6056
04:43:00,651 --> 04:43:02,420
VERY IMPORTANT THING AND 

6057
04:43:02,420 --> 04:43:05,389
FAMILIES EVEN SAYING IT'S 

6058
04:43:05,389 --> 04:43:08,259
ALZHEIMER'S DISEASE AND TALKING 

6059
04:43:08,259 --> 04:43:12,029
TO PEOPLE BUILT AND NOT KNOWING 

6060
04:43:12,029 --> 04:43:14,565
IT'S AMYLOID AND TAU IMPLICATED 

6061
04:43:14,565 --> 04:43:18,202
AND THAT'S A BIG PICTURE 

6062
04:43:18,202 --> 04:43:19,303
QUESTION AND THERE'S WORK 

6063
04:43:19,303 --> 04:43:25,209
SHOWING TDP43 IS SHOWN 

6064
04:43:25,209 --> 04:43:26,444
DYSFUNCTIONALLY IN OTHER BODY 

6065
04:43:26,444 --> 04:43:28,079
PARTS AND THE GUT WHICH COULD BE

6066
04:43:28,079 --> 04:43:32,249
A WAY THAT IT'S TRANSMITTED I 

6067
04:43:32,249 --> 04:43:32,650
GATHER.

6068
04:43:32,650 --> 04:43:35,686
SO, ARE YOU LOOKING AT THAT OR 

6069
04:43:35,686 --> 04:43:36,320
ANY THOUGHTS ABOUT IT?

6070
04:43:36,320 --> 04:43:42,460
THANK YOU SO MUCH.

6071
04:43:42,460 --> 04:43:45,262
>> I'LL TAKE THE FIRST
PART OF 

6072
04:43:45,262 --> 04:43:47,999
OF THAT QUESTION AND TURN TO 

6073
04:43:47,999 --> 04:43:50,267
OTHERS IF YOU WANT TO TALK MORE 

6074
04:43:50,267 --> 04:43:53,270
ABOUT OUTSIDE THE BRAIN.

6075
04:43:53,270 --> 04:43:58,275
I THINK WE NOW KNOW ALZHEIMER'S 

6076
04:43:58,275 --> 04:44:02,446
DISEASE HAS MULTIPLE PATHOLOGIES

6077
04:44:02,446 --> 04:44:04,415
AND THERE'S THE IMPORTANCE OF 

6078
04:44:04,415 --> 04:44:06,684
UNDERSTANDING THE ROLE OF TDP 

6079
04:44:06,684 --> 04:44:12,656
AND LATE WITHIN THE CONTEXT OF 

6080
04:44:12,656 --> 04:44:15,192
ALZHEIMER'S DISEASE AND ABLE TO 

6081
04:44:15,192 --> 04:44:17,495
IDENTIFY THE INDIVIDUALS WITH 

6082
04:44:17,495 --> 04:44:19,463
ALZHEIMER'S DISEASE WHO HAVE THE

6083
04:44:19,463 --> 04:44:20,264
CO-PATHOLOGY BECAUSE IT'S ALMOST

6084
04:44:20,264 --> 04:44:22,500
CERTAIN THERE'S MECHANISTIC 

6085
04:44:22,500 --> 04:44:25,469
DIFFERENCES THAT CAUSE ONE 

6086
04:44:25,469 --> 04:44:31,108
INDIVIDUAL TO HAVE CON COMBINANT

6087
04:44:31,108 --> 04:44:34,011
TDB AND WHEN WE'RE ENGAGED WITH 

6088
04:44:34,011 --> 04:44:34,612
THERAPEUTICS FOR ALZHEIMER'S 

6089
04:44:34,612 --> 04:44:35,646
DISEASE WE'RE GOING TO BE 

6090
04:44:35,646 --> 04:44:38,983
NEEDING TO FIGURE OUT WHO HAVE 

6091
04:44:38,983 --> 04:44:43,521
THE CO-PATHOLOGIES AND HOW IT 

6092
04:44:43,521 --> 04:44:47,024
AFFECTS OUTCOMES AND OF WHAT 

6093
04:44:47,024 --> 04:44:48,359
OTHERS STRESSED AND WE NEED GOOD

6094
04:44:48,359 --> 04:44:52,663
BIOMARKERS TO TELL US MORE 

6095
04:44:52,663 --> 04:44:56,300
DEFINITIVELY ABOUT THE PRESENCE 

6096
04:44:56,300 --> 04:45:06,844
OF DETERMINING AND HAVING BETTER

6097
04:45:10,014 --> 04:45:11,348
BIOMARKERS IS IMPORTANT AND YOU 

6098
04:45:11,348 --> 04:45:12,883
MENTIONED THE IMPORTANCE OF 

6099
04:45:12,883 --> 04:45:13,651
EDUCATING THE COMMUNITY ABOUT 

6100
04:45:13,651 --> 04:45:21,025
THAT AND A -- THERE'S STATEMENTS

6101
04:45:21,025 --> 04:45:23,227
OF MORE COMMUNITY OUTREACH IN 

6102
04:45:23,227 --> 04:45:24,228
UNDERSTANDING THE CONDITION 

6103
04:45:24,228 --> 04:45:27,898
WHICH IS KEY BECAUSE MANY 

6104
04:45:27,898 --> 04:45:31,535
NEUROLOGISTS LET ALONE PRIMARY 

6105
04:45:31,535 --> 04:45:33,237
CARE DOCTORS HAVE NEVER HEARD OF

6106
04:45:33,237 --> 04:45:34,672
THE DIAGNOSTIC ENTITY.

6107
04:45:34,672 --> 04:45:37,408
I DON'T KNOW IF ANYONE WANTS TO 

6108
04:45:37,408 --> 04:45:39,777
COMMENT OUT SIDE THE BRAIN IN 

6109
04:45:39,777 --> 04:45:50,321
TERMS OF TDP43 FUNCTION AT ALL.

6110
04:45:54,492 --> 04:45:55,793
NO TAKERS?

6111
04:45:55,793 --> 04:45:57,895
ONE THING WE STRESSED IN THE 

6112
04:45:57,895 --> 04:45:58,629
RECOMMENDATIONS IS TO 

6113
04:45:58,629 --> 04:45:59,897
COLLABORATE AND WORK WELL WITH 

6114
04:45:59,897 --> 04:46:04,635
THE BROADER TDP43 COMMUNITY AND 

6115
04:46:04,635 --> 04:46:07,404
ALS AND IF FTD WAS THERE'S LOTS 

6116
04:46:07,404 --> 04:46:10,407
OF WISDOM FROM MANY YEARS OF 

6117
04:46:10,407 --> 04:46:12,676
WORK THIS FIELD CAN GAIN FROM 

6118
04:46:12,676 --> 04:46:13,477
AND CERTAINLY I THINK 

6119
04:46:13,477 --> 04:46:18,182
COLLABORATION IS CRITICAL.

6120
04:46:18,182 --> 04:46:23,320
>> I HAVE TWO QUESTIONS ON
THE 

6121
04:46:23,320 --> 04:46:28,626
VIDEOCAST.

6122
04:46:28,626 --> 04:46:31,028
THEY'RE ABOUT DETECTING TDP43 IN

6123
04:46:31,028 --> 04:46:34,999
LATE AND IF YOU HAVE THE ABILITY

6124
04:46:34,999 --> 04:46:36,667
TO DISTINGUISH IT FROM 

6125
04:46:36,667 --> 04:46:37,768
ALZHEIMER'S DISEASE.

6126
04:46:37,768 --> 04:46:40,404
WHAT IS THE IMPACT ON TREATMENTS

6127
04:46:40,404 --> 04:46:42,173
AND CLINICAL BIOMARKERS AND THE 

6128
04:46:42,173 --> 04:46:44,708
OTHER IS A MORE TECHNICAL 

6129
04:46:44,708 --> 04:46:48,646
QUESTION ABOUT WHAT IS NEEDED TO

6130
04:46:48,646 --> 04:46:51,815
DETECT TDP43 DEPOSITS.

6131
04:46:51,815 --> 04:46:56,287
DO WE NEED DEVELOPMENT OF 

6132
04:46:56,287 --> 04:46:58,422
NON-AMINO HISTOCHEMISTRY METHODS

6133
04:46:58,422 --> 04:47:00,124
TO BE ADVANTAGEOUS TO DETECT OR 

6134
04:47:00,124 --> 04:47:04,662
IS IT DIFFERENT SPECIES OF TDP43

6135
04:47:04,662 --> 04:47:08,332
BOTH ON THE TECHNICAL DETECTION 

6136
04:47:08,332 --> 04:47:09,633
AND THE IMPACT.

6137
04:47:09,633 --> 04:47:12,670
>> THOSE ARE GREAT
QUESTIONS.

6138
04:47:12,670 --> 04:47:18,075
I DON'T KNOW, KONSTATINOS DID 

6139
04:47:18,075 --> 04:47:22,846
YOU WANT TO SAY A FEW WORDS?

6140
04:47:22,846 --> 04:47:25,549
>> WE KNOW LATE NC IS
MIXED WITH

6141
04:47:25,549 --> 04:47:28,152
OTHER PATHOLOGIES COMMONLY.

6142
04:47:28,152 --> 04:47:30,721
THIS MEANS IF WE HAVE A MARKER 

6143
04:47:30,721 --> 04:47:32,723
FOR LATE NC WE'RE NOT GOING TO 

6144
04:47:32,723 --> 04:47:35,125
BE ONLY HELPING CLINICAL TRIALS 

6145
04:47:35,125 --> 04:47:36,260
IN THE DIAGNOSIS OF LATE BUT 

6146
04:47:36,260 --> 04:47:38,896
ALSO GOING TO BE HELPING 

6147
04:47:38,896 --> 04:47:42,933
CLINICAL TRIALS IN TREATMENT FOR

6148
04:47:42,933 --> 04:47:44,301
OTHER PATHOLOGIES FOR THE SIMPLE

6149
04:47:44,301 --> 04:47:46,904
REASON IF YOU HAVE THE 

6150
04:47:46,904 --> 04:47:49,840
SUCCESSFUL ALZHEIMER'S DRUG BUT 

6151
04:47:49,840 --> 04:47:51,809
TESTING ON PEOPLE THAT HAVE 

6152
04:47:51,809 --> 04:47:55,379
LATE, THESE PEOPLE MAY PROGRESS 

6153
04:47:55,379 --> 04:47:58,515
AND HAVE DEMENTIA AT SOME POINT.

6154
04:47:58,515 --> 04:47:59,316
IT DOESN'T MEAN THE ALZHEIMER'S 

6155
04:47:59,316 --> 04:48:00,184
DRUG DID NOT WORK.

6156
04:48:00,184 --> 04:48:03,320
IT'S VERY IMPORTANT TO BE ABLE 

6157
04:48:03,320 --> 04:48:09,326
TO IDENTIFY NOT ONLY FOR 

6158
04:48:09,326 --> 04:48:12,630
DIAGNOSING AND TREATING BUT 

6159
04:48:12,630 --> 04:48:14,164
ATTACKING ADRD.

6160
04:48:14,164 --> 04:48:18,736
THEN THE SECOND QUESTION WAS YOU

6161
04:48:18,736 --> 04:48:20,204
SAID -- 

6162
04:48:20,204 --> 04:48:23,307
>> MORE AROUND THE
QUESTION 

6163
04:48:23,307 --> 04:48:24,642
ABOUT DETECTION OF -- TECHNICAL 

6164
04:48:24,642 --> 04:48:26,310
BARRIERS.

6165
04:48:26,310 --> 04:48:30,014
>> AT THIS POINT I THINK
IT'S 

6166
04:48:30,014 --> 04:48:31,382
WISE WE DO IT THIS WAY AND 

6167
04:48:31,382 --> 04:48:36,654
ATTACK IT FROM ALL ASPECTS.

6168
04:48:36,654 --> 04:48:42,259
THERE BLOOD BASED MARKERS AND 

6169
04:48:42,259 --> 04:48:51,769
TRACERS TO DETECT THE PATHOLOGY 

6170
04:48:51,769 --> 04:48:54,305
AND SPECIFIC MARKERS AND EVERY 

6171
04:48:54,305 --> 04:48:54,638
ASPECT.

6172
04:48:54,638 --> 04:48:56,307
I THINK THERE ARE VERY HOPEFUL 

6173
04:48:56,307 --> 04:49:00,477
SIGNS FROM EACH ONE OF THEM EVEN

6174
04:49:00,477 --> 04:49:02,313
THE CLINICAL CRITERIA ALREADY 

6175
04:49:02,313 --> 04:49:07,384
INCLUDES INFORMATION WITH KNEW 

6176
04:49:07,384 --> 04:49:09,186
KNOWLEDGE GENERATED FROM THE 

6177
04:49:09,186 --> 04:49:09,720
BIOMARKER POINT OF VIEW.

6178
04:49:09,720 --> 04:49:13,190
I FEEL THE CLINICAL CRITERIA 

6179
04:49:13,190 --> 04:49:15,526
WILL ABSORB THE INFORMATION AND 

6180
04:49:15,526 --> 04:49:16,660
INCORPORATE THEM.

6181
04:49:16,660 --> 04:49:20,297
I THINK WE'RE SEEING VERSION ONE

6182
04:49:20,297 --> 04:49:22,132
OF THE CLINICAL CRITERIA RIGHT 

6183
04:49:22,132 --> 04:49:23,567
NOW WHICH IS A HUGE STEP FORWARD

6184
04:49:23,567 --> 04:49:25,269
BUT WE NEED TO GO TO VERSION 

6185
04:49:25,269 --> 04:49:26,303
TWO.

6186
04:49:26,303 --> 04:49:34,244
>> A QUICK POINT.

6187
04:49:34,244 --> 04:49:37,014
THE POINTS MADE BY THE PATIENT'S

6188
04:49:37,014 --> 04:49:40,150
DAUGHTER WERE IMPORTANT TO ME 

6189
04:49:40,150 --> 04:49:42,419
AND THIS PERVADES TO EVERYTHING 

6190
04:49:42,419 --> 04:49:45,656
WE HEARD TODAY AND NOT JUST WITH

6191
04:49:45,656 --> 04:49:47,658
LATE OR AD BUT THE DEMENTIA 

6192
04:49:47,658 --> 04:49:49,793
FIELD NEEDS TO LEARN FROM THE 

6193
04:49:49,793 --> 04:49:52,629
CANCER FIELD SOME OF THE 

6194
04:49:52,629 --> 04:49:54,164
CULTURAL ADVANCES THEY HAVE 

6195
04:49:54,164 --> 04:50:00,637
ACHIEVED THAT HAVE BEEN 

6196
04:50:00,637 --> 04:50:01,872
TRANSLATED TO SCIENTIFIC 

6197
04:50:01,872 --> 04:50:04,241
ADVANCES AND NOT BE AFRAID OF 

6198
04:50:04,241 --> 04:50:05,642
COMPLEXITY.

6199
04:50:05,642 --> 04:50:06,577
CANCER GRAPPLES WITH DEEP 

6200
04:50:06,577 --> 04:50:07,544
COMPLEXITY AND HAS COME UP WITH 

6201
04:50:07,544 --> 04:50:08,212
IT ON THE UPPER HAND IN MANY 

6202
04:50:08,212 --> 04:50:10,214
WAYS.

6203
04:50:10,214 --> 04:50:12,649
WE HAVE BEEN VERY AVERSE TO IT 

6204
04:50:12,649 --> 04:50:14,585
AND WE TEND TO DICHOTOMIZE 

6205
04:50:14,585 --> 04:50:16,920
THINGS AS YES, NO, YES, NO.

6206
04:50:16,920 --> 04:50:20,391
IT'S NOT A YES, NO SITUATION.

6207
04:50:20,391 --> 04:50:28,665
THERE'S FACTORS AND GENETIC AND 

6208
04:50:28,665 --> 04:50:29,133
ENVIRONMENTAL.

6209
04:50:29,133 --> 04:50:32,636
THE COMPLEXITY, NUMBER ONE, 

6210
04:50:32,636 --> 04:50:35,072
NUMBER TWO, WE NEED TO GET TO 

6211
04:50:35,072 --> 04:50:36,540
THEIR ASSESSMENTS.

6212
04:50:36,540 --> 04:50:37,341
THE BIOMARKERS WORK AND THERE 

6213
04:50:37,341 --> 04:50:39,109
USED TO BE A CULTURE WHERE THERE

6214
04:50:39,109 --> 04:50:40,611
IS IN CANCER AND NOT CURRENTLY 

6215
04:50:40,611 --> 04:50:42,346
IN DEMENTIA TREATMENT AND CARE.

6216
04:50:42,346 --> 04:50:44,882
AND WE NEED TO GET PEOPLE TO 

6217
04:50:44,882 --> 04:50:46,383
KNOW WHAT TO SCREEN THEM FOR AND

6218
04:50:46,383 --> 04:50:48,318
WHAT THEY'RE AT RISK FOR AND TO 

6219
04:50:48,318 --> 04:50:50,154
THEN GIVE THEM OPTIONS.

6220
04:50:50,154 --> 04:50:51,422
IT'S NOT TELLING THEM THEY HAVE 

6221
04:50:51,422 --> 04:50:53,390
TO DO THIS OR THAT BUT PEOPLE 

6222
04:50:53,390 --> 04:50:55,692
ARE SCARED OF DEMENTIA AS MUCH 

6223
04:50:55,692 --> 04:50:59,029
AS THEY'RE SCARED AS CANCER AND 

6224
04:50:59,029 --> 04:51:01,865
WE'VE ACTED AS THOUGH BEING 

6225
04:51:01,865 --> 04:51:03,467
INTERVENTIONISTS ARE BAD AND 

6226
04:51:03,467 --> 04:51:04,768
IT'S NOT IT'S GIVING PEOPLE 

6227
04:51:04,768 --> 04:51:05,969
CHOICES AND DECISIONS ON THEIR 

6228
04:51:05,969 --> 04:51:10,441
OWN AND THOSE ELEMENTS OF CANCER

6229
04:51:10,441 --> 04:51:15,412
CULTURE WE CAN LEARN A LOT FROM.

6230
04:51:15,412 --> 04:51:18,081
>> AND THERE'S A MORE
PRECISION 

6231
04:51:18,081 --> 04:51:19,416
MEDICINE APPROACH AND IN THE 

6232
04:51:19,416 --> 04:51:22,419
CONTEXT OF ALZHEIMER'S BUT IN 

6233
04:51:22,419 --> 04:51:24,655
THE CONTEXT OF OTHER 

6234
04:51:24,655 --> 04:51:26,089
NEURODEGENERATIVE CONDITIONS IN 

6235
04:51:26,089 --> 04:51:27,758
ITS OWN RIGHT.

6236
04:51:27,758 --> 04:51:30,227
DEVELOPING BIOMARKERS WILL HAVE 

6237
04:51:30,227 --> 04:51:30,727
THAT IMPACT.

6238
04:51:30,727 --> 04:51:36,533
>> IF I CAN ADD TO THE
ANSWER.

6239
04:51:36,533 --> 04:51:39,870
SPEAKING SPECIFICALLY ABOUT THE 

6240
04:51:39,870 --> 04:51:42,372
TDP43 PATHOLOGY DETECTION WITHIN

6241
04:51:42,372 --> 04:51:44,508
THE LDP SPACE THERE'S MULTIPLE 

6242
04:51:44,508 --> 04:51:48,245
PATHOLOGY.

6243
04:51:48,245 --> 04:51:49,513
WITHIN THE ALS SPACE AND FTD 

6244
04:51:49,513 --> 04:51:53,650
SPACE AND LATE SPACE, THERE'S A 

6245
04:51:53,650 --> 04:51:58,121
SENSE WHERE THE DIRECTION OF 

6246
04:51:58,121 --> 04:51:58,655
PATHOPHYSIOLOGY HAS BEEN 

6247
04:51:58,655 --> 04:52:00,190
DIFFICULT AND HARDER TO DETECT 

6248
04:52:00,190 --> 04:52:02,860
COMPARED TO OTHER FORMS OF 

6249
04:52:02,860 --> 04:52:07,598
PATHOLOGY BUT THE ABSENCE OF 

6250
04:52:07,598 --> 04:52:12,536
TDP43 ACTION THROUGH THE KRY

6251
04:52:12,536 --> 04:52:14,271
KRYPTONS MAY BE EASIER TO DETECT

6252
04:52:14,271 --> 04:52:16,273
AND AS DR. NELSON SAID EXTREMELY

6253
04:52:16,273 --> 04:52:18,008
WELL, WE ALSO NEED TO THINK OF 

6254
04:52:18,008 --> 04:52:19,009
OPPORTUNITIES TO COME UP WITH 

6255
04:52:19,009 --> 04:52:24,648
TOOLS THAT WILL NOT END UP 

6256
04:52:24,648 --> 04:52:28,519
HAVING BANKRUPT OUR SOCIETY TO 

6257
04:52:28,519 --> 04:52:29,386
BE BLUNT AND BE AT THE 

6258
04:52:29,386 --> 04:52:33,156
INTERSECTION AND NOT LOOKING FOR

6259
04:52:33,156 --> 04:52:35,859
EACH INDIVIDUAL FORM OF 

6260
04:52:35,859 --> 04:52:37,694
PHOSPHORYLATED TDP43 BUT LOSS OF

6261
04:52:37,694 --> 04:52:40,531
FUNCTION THAT COULD BE 

6262
04:52:40,531 --> 04:52:41,498
APPLICABLE ACROSS BECAUSE IT 

6263
04:52:41,498 --> 04:52:43,100
WILL BE A LOT LESS EXPENSIVE FOR

6264
04:52:43,100 --> 04:52:45,536
OUR SOCIETY.

6265
04:52:45,536 --> 04:52:46,970
>> THOSE ARE ALL EXCELLENT

6266
04:52:46,970 --> 04:52:48,238
POINTS.

6267
04:52:48,238 --> 04:52:50,674
I THINK TRYING TO SEE WHERE OUR 

6268
04:52:50,674 --> 04:52:53,911
BIOMARKERS OVERLAP VERSUS WHERE 

6269
04:52:53,911 --> 04:52:56,380
THEY'RE DISTINCTIVE.

6270
04:52:56,380 --> 04:53:00,651
PET TRACERS MAY DIFFERENTIALLY 

6271
04:53:00,651 --> 04:53:03,987
BIND TO AGGREGATE FORMS OF TDP43

6272
04:53:03,987 --> 04:53:07,324
AND THE CONTEXT OF LATE VERSUS 

6273
04:53:07,324 --> 04:53:08,292
OTHER CONDITIONS.

6274
04:53:08,292 --> 04:53:12,663
I SEE ANOTHER HAND UP.

6275
04:53:12,663 --> 04:53:14,097
I THINK IT'S MITCH.

6276
04:53:14,097 --> 04:53:15,165
>> HI.

6277
04:53:15,165 --> 04:53:16,633
THANK YOU VERY MUCH.

6278
04:53:16,633 --> 04:53:23,240
I WANTED TO AMPLIFY SOME RECENT 

6279
04:53:23,240 --> 04:53:33,750
COMMENTS ABOUT COMPLEXITY AND 

6280
04:53:42,693 --> 04:53:44,528
BUT IN STUDIES WITH TESTING OF 

6281
04:53:44,528 --> 04:53:46,530
COGNITION IN TERMS OF THAT TYPE 

6282
04:53:46,530 --> 04:53:49,800
OF BIOMARKER TO LOOK AT WEATHER 

6283
04:53:49,800 --> 04:53:58,442
THERE IS A CHARACTERISTIC OF 

6284
04:53:58,442 --> 04:54:00,844
CO-OCCURRING AD PATHOLOGY WITH 

6285
04:54:00,844 --> 04:54:01,878
MULTI-DOMAIN TESTING AND SEE 

6286
04:54:01,878 --> 04:54:10,887
WHAT HAPPENS FIRST AND LATER ON.

6287
04:54:10,887 --> 04:54:12,956
A CORRELATION TO THAT IS 

6288
04:54:12,956 --> 04:54:14,291
ASSOCIATION OF COGNITION IMPROVE

6289
04:54:14,291 --> 04:54:16,994
THE PRECISION OF THAT TYPE OF 

6290
04:54:16,994 --> 04:54:17,527
COGNITIVE BIOMARKER GOING 

6291
04:54:17,527 --> 04:54:22,466
FORWARD.

6292
04:54:22,466 --> 04:54:24,968
>> I'LL JUST -- THOSE ARE
GREAT 

6293
04:54:24,968 --> 04:54:26,370
QUESTIONS, MITCH.

6294
04:54:26,370 --> 04:54:32,309
THERE HAVE BEEN A NUMBER OF 

6295
04:54:32,309 --> 04:54:33,343
ANTI-MORTEM, POSTMORTEM STUDIES 

6296
04:54:33,343 --> 04:54:35,646
LOOKING AT COGNITION OVER TIME.

6297
04:54:35,646 --> 04:54:38,115
THERE'S BEEN A RUSH GROUP THAT'S

6298
04:54:38,115 --> 04:54:40,651
DONE BEAUTIFUL WORK LOOKING AT 

6299
04:54:40,651 --> 04:54:42,386
COGNITIVE CHANGES AND THE 

6300
04:54:42,386 --> 04:54:52,929
SEQUENCES OVER TIME BUT I ARGUE 

6301
04:54:54,464 --> 04:54:55,532
DEFINING PEOPLE IN VIVO IS 

6302
04:54:55,532 --> 04:54:58,602
CRITICAL TO GET MORE NUANCED 

6303
04:54:58,602 --> 04:55:00,270
UNDERSTANDING OF COGNITION IS 

6304
04:55:00,270 --> 04:55:03,874
YOUR NOT RELIANT ON PREVIOUSLY 

6305
04:55:03,874 --> 04:55:05,475
COLLECTED STANDARDIZED DATA AND 

6306
04:55:05,475 --> 04:55:07,778
IMPLEMENT DIGITAL BIOMARKERS.

6307
04:55:07,778 --> 04:55:08,512
THAT'S WHY THE FIRST 

6308
04:55:08,512 --> 04:55:11,148
RECOMMENDATION REALLY STRESSES 

6309
04:55:11,148 --> 04:55:14,384
THE IMPORTANCE OF DEEPLY 

6310
04:55:14,384 --> 04:55:16,653
PHENOTYPED COHORTS WHERE WE'RE 

6311
04:55:16,653 --> 04:55:17,788
FOLLOWING INDIVIDUALS AND 

6312
04:55:17,788 --> 04:55:22,559
CLASSIFYING THEM LONGITUDINALLY 

6313
04:55:22,559 --> 04:55:24,628
HOPEFULLY TO AUTOPSY AND LINK 

6314
04:55:24,628 --> 04:55:26,630
WHAT WE SEE PATH LOGICALLY TO 

6315
04:55:26,630 --> 04:55:27,197
WHAT WE'RE SEEING IN VIVO.

6316
04:55:27,197 --> 04:55:28,632
>> I AGREE.

6317
04:55:28,632 --> 04:55:38,809
THANK YOU.

6318
04:56:10,807 --> 04:56:11,775
>> GO AHEAD WITH YOUR
QUESTION.

6319
04:56:11,775 --> 04:56:11,842
 

6320
04:56:17,314 --> 04:56:17,447
OKAY.

6321
04:56:17,447 --> 04:56:20,016
SO WE'LL ALSO HAVE TIME AGAIN AT

6322
04:56:20,016 --> 04:56:23,253
THE END OF DAY TWO TO TAKE 

6323
04:56:23,253 --> 04:56:23,787
ADDITIONAL QUESTIONS AND 

6324
04:56:23,787 --> 04:56:24,354
COMMENTS FROM ANY OF THE 

6325
04:56:24,354 --> 04:56:29,893
SESSIONS FROM THE TWO DAYS.

6326
04:56:29,893 --> 04:56:32,529
>> SOME PEOPLE COULDN'T BE
HERE.

6327
04:56:32,529 --> 04:56:36,733
I WANT TO SAY THANKS FOR JULIE 

6328
04:56:36,733 --> 04:56:40,637
SNYDER A LEADER HERE AND 

6329
04:56:40,637 --> 04:56:42,672
DRDR

6330
04:56:42,672 --> 04:56:44,508
DR. GIFFIN AND HAS BEEN A TREAT 

6331
04:56:44,508 --> 04:56:47,978
TO WORK WITH ALL OF YOU.

6332
04:56:47,978 --> 04:56:48,411
>> THANK YOU, PETE.

6333
04:56:48,411 --> 04:56:51,181
>> THANK YOU SO MUCH.

6334
04:56:51,181 --> 04:56:52,649
AND GREAT JOB.

6335
04:56:52,649 --> 04:56:55,919
SORRY FOR RUNNING A LITTLE BIT 

6336
04:56:55,919 --> 04:57:00,223
OVER BUT WE HAVE AFTER MEETING 

6337
04:57:00,223 --> 04:57:02,259
SLIDES THAT WILL COME UP AND 

6338
04:57:02,259 --> 04:57:04,661
WE'LL ADJOURN FOR THE DAY.

6339
04:57:04,661 --> 04:57:05,495
>> THANK YOU VERY MUCH.

6340
04:57:05,495 --> 04:57:05,829
THANK YOU ALL.

6341
04:57:05,829 --> 04:57:08,465