By Paul J. Watkins

Sudha Seshadri, MD, a board-certified and fellowship-trained neurologist and founding director of the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio, recalls why she chose a career in medicine. “My mother became ill with a severe form of multiple sclerosis when I was four years old, so I grew up around doctors, many of whom I admired for their knowledge and humanity. My mother had a form of brain and spinal cord disease characterized by recovery and good function for many months, and then, unexpectedly, never-before-seen symptoms would develop. Over time, this very vivacious mother I adored became unable to walk or talk.

“I grew up reading all I could about brain disease to better understand the mysteries of normal and abnormal brain function. I chose to become a physician and neurologist because the intellectual challenge of diagnosis and the deep satisfaction of connecting with patients and families appealed to me.”

Dr. Seshadri adds that, in addition to her personal story, she was attracted to neurology because of the huge amount science still doesn’t know about brain diseases. “On any given day, you might learn something from a patient or from a research study you are doing that will lead to defining a new type of disease or point to a new treatment approach. The clinical and research aspects of neurology interact very closely, and we have so many new diagnostic methods and treatments compared to when I first became a neurologist 30 years ago.”

The neurologist has focused her career on researching and treating Alzheimer’s disease, a form of dementia. Alzheimer’s disease, she explains, can be a devastating illness that attacks a patient’s memory, thinking, and personality, and it affects patients, their families, and society. She says helping these patients and families requires a physician to employ all of his or her knowledge, common sense, and humanity.

“When I started in the Alzheimer’s disease field in 1993, there were many exciting advances that had just been made, like learning that genes such as APP and APOE played an important role in the development of the disease,” Dr. Seshadri remembers. “Since then, we have learned much about Alzheimer’s and related dementias. I do believe we will find treatments in my lifetime that will allow persons at risk of dementia to live long and well.”

Dr. Seshadri says that her research involves working with normal older adults and with Alzheimer’s patients, what is called “clinical and translational research.” She says it directly affects what she is able to offer patients in the form of advice and treatments. If medicine can’t offer an effective treatment, she invites patients and families to enroll in clinical trials to speed up researchers’ ability to find such treatments.

She believes the next significant breakthrough in treating Alzheimer’s disease will be the development of precision diagnosis (based on blood, spinal fluid, and imaging biomarkers) and precision treatments, with several drugs or other interventions targeted to each patient’s genetic and environmental background, disease, and stage of illness.

“This is the personalized approach we already take for most cancers, and it has revolutionized the treatment of diseases like leukemias and melanomas. We are already testing drug combinations in an inherited form of Alzheimer disease and finding biomarkers of various types of brain injury and of resilience. These combinations may be able to treat the disease and to reduce simultaneously the side effects of such treatments. I expect we will find drug and non-drug therapy combinations that work over the next decade.”

As with many medical issues, says Dr. Seshadri, living a healthy lifestyle can play an important role in reducing a person’s risk of developing Alzheimer’s disease. “We neurologists believe people can reduce the risk – or slow the progression – by keeping their blood pressure, blood sugar, and bad cholesterol in a healthy range, not smoking, eating vegetables and fish, staying as physically active and cognitively and socially engaged as possible, getting seven to eight hours of restful sleep each night, avoiding head injury, and correcting any vision or hearing problems.

“I encourage people worried about developing dementia to continue enjoying the things they love to do and to keep learning new skills and making new friends.”

For more information or to join a clinical trial, please call (210) 450-9960 or visit https://biggsinstitute.org/clinical-trials/.