ISTAART Relay Podcast – The Eye As A Biomarker For AD PIA

Voice Over:

Hello and thank you for listening to the fourth season of the ISTAART PIA Relay Podcast, brought to you by Dementia Researcher. ISTAART is a professional society and part of the Alzheimer’s Association representing scientists, physicians, and other dementia professionals active in researching and understanding the causes and potential treatments of Alzheimer’s disease and other dementias. In this five-part series, we’ve asked members of the ISTAART professional interest areas to take turns interviewing their colleagues and being interviewed themselves, with the interviewee going on to be the next episode’s interviewer.

I’m sure you’ve listened to these before, so you’ll know what to expect. We’ll be releasing one of these podcasts each day in the buildup to the Alzheimer’s Association International Conference, which this year takes place online and in Amsterdam. So, sit back, turn up the volume, and be ready to hear about these individuals’ amazing research fields, the work of their peers, and just what you can expect at this year’s conference. Thank you for listening.

Dr Shana Stites:

Hello and thanks for tuning in. I’m Shana Stites. I’m an assistant professor at the University of Pennsylvania in Philadelphia. I am co-chair of the Diversity and Disparities PIA. And today, I’m delighted to be talking with Dr. Imre Lengyel. The topic of our conversation will be The Eye as a Biomarker for Alzheimer’s Disease PIA. Hi Imre. Can you start by-

Dr Imre Lengyel:

Hi, Shana.

Dr Shana Stites:

Can you start by … I’m going to start by asking you to introduce yourself and tell us with which PIA you are involved.

Dr Imre Lengyel:

Hi, Shana. Hi, everybody. My name is Imre Lengyel. I’m an associate professor at Queen’s University Belfast in the United Kingdom, and I am the communication chair for the Eye as a Biomarker for Alzheimer’s Disease Special Interest Group. And it’s a great pleasure to introduce or tell you a little bit more about what we are doing within this PIA.

Dr Shana Stites:

That’s wonderful. Would you like to tell us a little bit about your own work, and then maybe how that connects over to what the PIA is up to?

Dr Imre Lengyel:

So, I’m originally started to work on the brain. And as a biochemist, I was interested in how learning and memory processes work. And it naturally segues me into how problems with learning and memory affect the biochemical and physiological processes in the brain. Then, suddenly, I made a change, and the change was to start looking at signs and similarities between what happens in the eye in Alzheimer’s disease.

The reason this became quite interesting, because at that time, which was about 2002, 2004, that was the area when, suddenly, ideas started to emerge. There is a potential that the events taking place in the eye and the events taking place in the brain might be reflecting on each other in one way or the other. So, my background from Alzheimer’s disease in the brain, especially studying the hippocampus, led me to start investigating what we can see in the eye. And that basically why I joined the PIA.

We had a few publications that were through the ISTAART, and the journal associated with it, so the Alzheimer’s Association papers. So that’s the reason why I joined the PIA. And it’s a great thing to do. The opportunity to exchange ideas with people who are interested in the eye, but they may not necessarily be working in the eye domain was a very exciting opportunity for me.

Dr Shana Stites:

So, you are in a … I want to make sure. So, this is a work involving the eye as a biomarker in Alzheimer’s disease. Sounds like it’s been being built for about a decade now. Maybe a little bit more?

Dr Imre Lengyel:

I agree with you. It’s probably a little bit more. We probably started to formulate ideas around this 20 years ago and we weren’t the first ones. There are many-

Dr Shana Stites:

So, over the [inaudible 00:04:41] about a decade ago.

Dr Imre Lengyel:

Yeah. But it’s a very interesting transition from the brain to the eye and all that background. I have to say at the beginning, when we started to talk to neurologists about looking at the eye as a potential surrogate for the brain, we weren’t very popular. But of course, at that time we didn’t necessarily have the right methodologies and technologies available to make that transition quite smooth. As soon as imaging with the so-called optical coherence tomography, which can identify the different layers of the retina, we started to see atrophy happening in the eye, then the transitions became much easier.

Dr Shana Stites:

I actually have a bunch of questions. I’m very curious about the technology you’re using to study the eye and study this phenomenon. Before we get there, can I back you up a little bit to make sure I’m clear on how your working group that you’re a part of is part the PIA and what parts, whether it’s the PIA, the working group, are all studying the eye or how those organizations are positioned relative to the study of the eye as a biomarker. And then, of course, your position within the working group.

Dr Imre Lengyel:

So, it actually was a very interesting way the PIA came about. Femke Bouwman, who used to be our chair of this PIA, and some other colleagues organized a meeting in, I think it was in Washington, where they tried to pull together people who had some interest in the eye and brain connection. And I think everyone got very surprised how many people turned up at that meeting and not just from-

Dr Shana Stites:

What year?

Dr Imre Lengyel:

That’s a very good question. Probably I have Alzheimer’s disease myself, so I don’t necessarily remember. But it was like within the last 10 years. And when this meeting realized itself and we had a lot of discussion around the table and in the rows, some heated discussions and some disagreement, it was very clear that there is quite a need to bring together the different expertise from neuropathology to neuroimaging and neurology and try to understand really how we can link the different type of information together.

So, that was a hotbed for our PIA. And I was lucky enough that I was invited to join this group first as a member and later on a steering committee member, and eventually, I took over the communication chair for the time being trying to disseminate some of these ideas that we are formulating. And the committee is actually made up of very different disciplines.

So, our chair is interested in the brain but more on the basic science translational domain, Robert Rissman in San Diego. And then, our vice chair is a card-carrying pathologist. So, Dietmar Thal did a lot of very important work on how pathological information can be translated, especially in relationship to the eye. Our program chair is Jessica Alber. And we have a junior chair who is Lies De Groef. And another steering committee member is Maya Koronyo.

And the people are coming from … some from the United States, some from Europe, so it’s a very nice mixture. And currently, we have 316 members. So, it’s a very good group which is trying to bring together the different ideas around eye and vision.

Dr Shana Stites:

If you could comment on what are the top two or three topics, like hot topics, in the PIA right now?

Dr Imre Lengyel:

So, what we are really doing quite a lot of work around is trying to discuss why some labs do not find exactly the same in pathological sections, for example, on clinical imaging. So, there is some disparity between the labs, but thankfully, all these labs are very, very willing to discuss how to harmonize these things. So, the whole topic, there are many, but really a very important topic that the PIA is making a lot of work on is trying to understand how we could use the histopathology that we can use on cadaver tissues, how can we harmonize that every lab will get the same results. The reason why this is important is because there are some disparities between detecting amyloid-beta or phospho-tau in the eye versus the brain. And it seems that there are some significant methodological diversities and that might explain why one lab finds something different than others.

This harmonization is one of the hot topics which we are covering. There are regular pathological meetings where people from different labs share images, and then there is a very strong, very clean and open discussion about why you might have found this or is that feature which we identified on the image is the same or not. So, this is on the pathological side, but of course, with the ever-developing ophthalmic imaging technologies, there are better and better methods to find the fine details, to identify fine details on retinal images. And that is another area where we work a lot to try to harmonize how people in the different institutions would generate retinal images so we would be able to analyze those images in a very consistent way. So, with the different laboratories, we have different clinics because, really, this is now a clinical domain when we are imaging people directly with different imaging modalities that are actually used on a clinic on the everyday level because that’s a key element.

And the two, of course, this harmonization of imaging technologies in vivo and in vitro comes together because the two, as we learn from ophthalmology, comes together very strongly. So, despite the fact that we have fantastic technologies like high resolution optical coherence tomography images, for example, we don’t necessarily know which layer is what. So, identifying these features from the clinic to the pathological sections is a very important element of it. And then on top of that, one of the things that we are identifying as a lot of discussion is going on that we have very good cross-sectional studies, but we don’t really have longitudinal studies. And the identification of the need for these longitudinal studies and thinking about what features one study find so we could actually, within this harmonization, make sure that these longitudinal images is generated in a way that it will enrich the rest of the community. That’s a very, very important direction we take.

Dr Shana Stites:

That’s fabulous. So it sounds like the PIA is a working group that’s instrumental in facilitating harmonization across all of these groups that are interested in the topic, both for purposes of developing the methods that seem quite divergent in ways that might be even problematic, but then also it sounds like there’s resource or capacity building, and that you might be able to harmonize these various cohorts in order to develop longitudinal data. That’s absolutely outstanding.

Dr Imre Lengyel:

Well, thank you very much. It’s a great group. We don’t always agree, but that’s science for you. But it’s a very important step forward. And of course, we pay a lot of attention to what else is going on in the world. So, for example, in the United Kingdom, they started the so-called DEMON Network, which is looking at how data science could be used for enhancing our capabilities. And there within the DEMON Network, we have an eye imaging network there as well. And some of the members are part of both groups. One is really thinking about the computational side, the other one is more the everyday life for the patient involvement. And the two work extremely well. Some common and some divergent reviews are being worked out, white papers that will actually help to build that kind of community that we’ll be able to share these images with each other, share the data with each other, and enhance the numbers that, of course, with dementia research, we don’t always have for clinical trial.

Dr Shana Stites:

That’s fabulous. Moving over just a little bit, I’m curious to know how your work fits into the work that’s being done by the PIA and how the PIA is supporting your work as well as how you’re contributing within the PIA.

Dr Imre Lengyel:

So, for our work, I think we have a really fabulous synergy with what’s going on in the PIA and that helps a lot. So, when I started to work on the eye, everyone was concentrating on the central vision, so the so-called macula. This is what every optometrist and ophthalmologist look first, the side of central vision. But someone who is coming from not the ophthalmology field, like me, I immediately asked the question, hold on, that’s about 10, 15, 20%, maybe, the whole back of the eye. Is it possible that we are missing something? And so, my work started out to ask this question, what happens on the peripheral retina? And this is a very … It might sound a mundane thing that, well, peripheral retina is not that important, but of course, for patients who are losing some of their complexions, navigating your environment is very important.

Seeing with your peripheral vision that there is not necessarily a lion coming from this side but could be a bus or there is a sofa, and you bump into that, making your life much more complicated is potentially a very important issue. And so, my group established a contact with a company, which was starting to make a camera called Optos PLC, who can image the whole back of the eye, or at least a much bigger version than what we could see before. That suddenly opened up the opportunity to look at what happens in the peripheral retina. And my research really in Alzheimer’s took off from there because we identified vascular changes that are more visible on the periphery than would be in the central areas of the retina. Also, we saw extracellular deficit formation, which, in the eye, they call drusen. They’re not identical but not dissimilar from amyloid plaques. You can see that more on the periphery.

And how this came together with other members of the PIA, Maya Koronyo’s group was studying the whole back of the eye postmortem. And actually, they found also that it seems that the features they are identifying as amyloid deposition is actually more on those peripheral areas than necessarily in the central one. And given that now there is a camera that is proposed to be detecting amyloid-beta in a live patient, and there is a special technology but also a so-called hyperspectral imaging, now we have the opportunity to follow this up, these original observations pathologically as well as clinically that the peripheral retina might be a better indicator together with the macula, but the inclusion is an important part that is now bringing up new technologies and new ideas.

Dr Shana Stites:

So, it sounds like your science is an exemplar for the … you just don’t know until you look and that you were in the position to be able to look.

Dr Imre Lengyel:

I like that, I like that. And you are right, absolutely, that if we put a little blinker, we will see what we are allowed to see. If we are allowed to view with a wider scope, we might find things. Maybe we have no idea what we are seeing, but the appearance of features, but more importantly, the progression of these features is going to be very important indicators for the disease. And this is, actually, one of the strengths of using the eye as a biomarker for Alzheimer’s disease, because pharmaceutical companies “doomed” the idea that if you can generate an image in a couple of seconds for a few dollars or pounds as opposed to have a brain imaging for every single time point of a clinical trial and that could indicate the progression or regression of a disease, that is a very powerful tool for clinical studies and clinical trials.

And then of course, which is, I think, quite important potentially for the research you are doing is that not only inexpensive and quick, but also extremely well tolerated by the patient. So, generating eye images, if we get to the point that the eye images could reflect disease progression and the efficacy of drugs, which will make all those clinical trials significantly simpler.

Dr Shana Stites:

That’s wonderful in terms of being able to expand our clinical trials and make them better tolerated, hopefully, for those individuals who volunteer to be part. And I don’t want to get too far ahead of myself here or ahead of you, but as I understand it, another one of these big downstream markers that you might be heading for or outcomes would be that this is a technology that could roll out to the general public for widespread screening and identification of people who are at risk. Is that something you talk about in the PIA?

Dr Imre Lengyel:

That is absolutely the goal. So, by the time the current medications are used, patients are on their way developing or losing some of their cognitive abilities. If we could use the eye to actually capture a little bit earlier what might be happening and how that changes a little bit earlier, intervention could make a heap of difference not just for the patient but also for their care providers and, of course, society because it’s not really a cheap process to support people with declining cognitive function.

Dr Shana Stites:

Wonderful. All right. Let’s hope we get there and get there quickly, or we’ll probably get there. Just how fast, right? You picked it up when I did my introduction that I’m from the Diversity and Disparities PIA. And so, if I could just shift the conversation just a little bit to ask, sort of coming from that direct, ask a question that you may or may not have the answer to, but if you’d explore it with me, I’d appreciate it. As I understand it, there are sex and age and race differences in the eye, believe it or not.

Dr Imre Lengyel:

Yes.

Dr Shana Stites:

And I’d like to hear if you are aware of anything that your PIA is doing to address those differences, that natural variation that occurs in the technology or in the methods and how that comes up in your PIA?

Dr Imre Lengyel:

So, it’s absolutely true. In many eye diseases, we know that there are sex imbalance and we definitely, with all these studies we are doing, including pathological studies, we are very consciously looking at male-female combination, because we don’t yet fully understand the ramification of sex differences, for example. So definitely, it’s a very important part of our harmonization that we try to encourage people to make sure that there is male-female comparison, for example.

One of the difficulties which we find, and we generally find that with other eye diseases as well, is that racial differences are much more complex to capture. Whether that’s because of cultural differences or what drives that, it’s much more difficult to see people with color in these studies and trials and, especially, it’s much more difficult to capture postmortem material from these populations. So, we are very strongly … There’s a lot of discussion about whether anyone has access to material that has different genetics and factors that we could study. So, I think there are things that are easier to address like male-female, but-

Dr Shana Stites:

So, it does sound like a lot of your efforts around diversity and natural variance within the PIA is focused or counting on issues of representation. You need to have people in these studies that represent a very wide segment, if not as wide as possible, of the populations that these technologies and advances might be benefiting. Do you think with some of the advances in the retinal technologies that you’re talking about, you are going to make those technologies more accessible, they’ll become more accessible, to cohorts where there may be higher representation of sexual and gender minorities and racial minorities?

Dr Imre Lengyel:

One of the difficulties with high end technologies to detect changes is that the machinery is expensive. Very often used, very highly precision, engineered parts, and therefore, it’s more difficult to travel. But times are changing. Now, we have a lot of handheld cameras which we can take to the patients rather than asking the patients to come to us. And I think that is going to make a difference. Patients really like to see what the outcome of the procedure is.

So, we had a feasibility study, this so-called Deep and Frequent Phenotyping study, which is running right now in the UK, and I lead the ophthalmology side of it, is that when patients came in, we generated the pictures, and they could come around and we could show them the different layers. They could understand what we were looking for. We could point out features like the optic nerve had, the vessels and maybe a deposit here, deposit there, which is not necessarily disease but just part of aging. So, this actually, I believe, will make a big difference. The patients did appreciate that and liked that. And I think that opens to … Sorry.

Dr Shana Stites:

Sorry. I’m just curious. Since you have this unique experience of being able to have shown people pictures of their eyes in the context of this study, what were some of the most common reactions you were hearing? And how do you think it facilitated their engagement in the study?

Dr Imre Lengyel:

I think they’re quite amazed how beautiful the back of the eye is. It’s extremely well organized. It’s very pretty. Lots of colors from red, orange, green, blue, all that comes together. So, it’s visually impressive. And when you look at some other modalities like the optical coherence tomography, which shows you every single layer, then people are developing an appreciation of the complexity we are faced with, but also, they understand how we … So, it’s relatively easy to make them understand how we analyze images. And I think that’s a great advantage to build trust and interest in participating in studies.

Dr Shana Stites:

Do you hear people react, sort of acknowledging, well, this was different than I thought it was, or confirming, this was exactly what I thought it was?

Dr Imre Lengyel:

No, I have to say we do hear that fairly often because, often, we still delete the eye, okay? Because you can generate much better images if your pupils are wide open. So, that’s not very comfortable, but it’s comfortable. And the fact that within, let’s say, half an hour, we can do a fairly thorough imaging of the patients with the inclusion of giving them a little tour of the back of their eye, that makes them quite positive about the experience, and the feedback was very, very positive. And I’m sure it’s not because we gave them a biscuit and a cup of tea, but because of what they went through. And there is one very important element of this is that because we have to delete their eyes, we have these absolutely amazing throwaway sunglasses which we give people because we want to make sure that the strong sunlight doesn’t bother them too much. And we keep telling them that now they can go out to the wide world and either the boys or the girls will be falling over to get their attention with this funky eyeglass.

Dr Shana Stites:

So, like a study giveaway if you will.

Dr Imre Lengyel:

Yes.

Dr Shana Stites:

That’s wonderful. Do you ever … One more question before we move on. I’m just curious, do you have any concerns with talking patients through their images or do you think it’s really been just all positives?

Dr Imre Lengyel:

So, we are not clinicians. So, I’m a basic scientist and most of my team are not basic scientists. So, we are not analyzing the images on the spot. So, we are not giving them any indication whether there is anything bad or wrong because we are just not qualified to do that. But of course, immediately, we have a clinician on board who is leading the clinical side of these studies, and we have an obligation to look at the images very quickly in case of incident of findings and we report that very quickly. So, unless we see something very, very obvious, none of these changes are jumping at you that, oh, there is something that is so obvious. But if there is a problem, we immediately alert the clinicians.

So, for that reason, we haven’t had a negative experience so far. We have been in the situation where we found something that had to be reported and acted upon. In fact, it happened to one of the neurologists who were involved in this study that when we got together, this is just an interesting anecdote, how it works, we sat down around the table discussing this study and this clinician said to the ophthalmologist that “There is some funny feeling in the back of the eye. Maybe at lunch break, if you don’t mind, just having a look because I’m flying to the United States in the evening and just making sure that everything is fine.” And then an hour later, the ophthalmologist came back but not the neurologist because he was already in the operating theater with a retinal detachment which happened in the far periphery, which we could detect with our technologies.

And basically, what it meant is that if he had flown to the United States, probably by the time he landed, he has lost the vision on that time. So, this kind of thing can happen, rarely happens, but we are prepared to do that. But we’re certainly not qualified to give a clinical diagnosis to the patient, so we would refer them straight away to their clinician.

Dr Shana Stites:

So, it sounds like you’ve put together these studies in a very thoughtful way, as I would expect, that you have protocols in place to deal with incidental findings or unexpected findings that might come up, and to even deal with what might be emergent situations.

Dr Imre Lengyel:

Yes. Thankfully, eye is very, very, very rare as such an emergency. So, we don’t have bleeding eyes and that kind of thing. So, it is possible to do eye imaging in this way, so you don’t need to immediately react. But as I said, as soon as we identify some kind of abnormalities that requires a specialist’s idea or specialist’s review, we immediately refer them.

Dr Shana Stites:

I have to say I’m excited. I can’t wait to see some of these images about which you’ve been talking. Is there any chance these images or other work from your PIA is going to be at AAIC this year?

Dr Imre Lengyel:

There will be. So, we will have an eye PIA Day, where there will be reports. There are a number of talks as well as posters from the PIA. We are collating this information right now and we are very excited about that because it’s really going to be really the first sort of real presence of our PIA at the meeting. So, it’s going to be fantastic to hear and see what people who haven’t necessarily been engaged with eye imaging will think of these findings.

Dr Shana Stites:

Congratulations on the arrival of the PIA on the … for PIA for the first AAIC. Do you have a program planned for PIA Day that you’d want to share with the audience?

Dr Imre Lengyel:

We have a program. I think it’s just about to be populated on the ISTAART website. So, I would direct anyone to the ISTAART website and look for the eye PIA, The Eye as a Biomarker for AD PIA, to look for the most up to date one. We just recently had the steering committee meeting, and we were discussing this. So, this is definitely within days, it will be part of the website.

Dr Shana Stites:

You also said, I heard you sneak it in there, that you’re collating information for presentations and posters that will be happening at AAIC. Do you know where that information will be posted or how people can get a copy of it?

Dr Imre Lengyel:

Yeah, again, we will be disseminating all that information through the different channels. We are present on Twitter, on LinkedIn, and every form which we can reach out to people. And again, this information will be on the ISTAART website very soon. But we will be continuously monitoring the program. And as the communication chair, I will be disseminating the idea how to gain the best access to it, and we will be alerting people regularly of any new information coming out.

Dr Shana Stites:

That’s right. As communication chair, I couldn’t be asking for a better person.

Dr Imre Lengyel:

Well, I’m not sure about that. You are the better judge than me that the information I’m giving is useful.

Dr Shana Stites:

It’s been fabulous. I am curious, you mentioned way back earlier, as we just started talking, that the PIA has about 300 people in it. Is that right?

Dr Imre Lengyel:

Yes. We have 316 members right now and I imagine that this number will gradually increase because, as I said, ophthalmology is really coming of age and 20 years ago, it was difficult to have a conversation with a neurologist about the eye and the brain. Of course, we had the neuro-ophthalmologist for very specific conditions, but then with the new technologies, this conversation became very fluent. And thankfully, now we are the ones who are being asked to be part of clinical studies as a potential surrogate. Unfortunately, we are not yet at the point that we can, with absolute certainty, say what are the connections. But I think we are very close to that tipping point where the value of eye imaging and eye pathology for detecting and rather monitoring the progression of the disease is becoming reality.

Dr Shana Stites:

That’s so exciting. I have to, I’m going to guess here, so please correct me if I’m wrong, but within that group of PIA members, you probably have a fair amount of diversity in terms of you’ve got students, postdocs, senior scientists, is that right to be-

Dr Imre Lengyel:

That’s absolutely right. And we are very, very strongly encouraging everyone to join because I think it’s a new territory. Undoubtedly, there is an evolutionary similarity between the eye and the brain, so they are from the same embryonic origin. Same similar type of cells is forming both the retina and the brain structure. So, there is every reason to think that we can connect the two. And I’m not thinking about whether the eye happens first or the brain or the brain happens first and then the eye. It’s just the same things seem to happen. Whether there is a causality, that’s going to be an interesting question to examine in the future.

So, I think there is a lot of interest in the younger people because it’s actually really beautiful to work on the retina. Obviously, I’m biased, but it’s such a nice structure when you are doing staining or trying to look for features, you can find them.

Dr Shana Stites:

So, I have two questions for you. As someone, you look at me, consider me somewhat interested in being part of your PIA, and before I get to the nuts and bolts of how could I reach out to become involved, but two questions is, as an individual who’s from outside of this work, very much from another area of a shared science, would there be a place to get involved? Or how, as a total newbie, could I get involved in the PIA? And would it be a safe and welcoming and okay place for me to do that? Or is really the level of sophistication that’s happening here, I’m going to get in the way, and it wouldn’t be as helpful?

Dr Imre Lengyel:

No, I’m very confident to say that anybody who has an interest in exploring what’s happening in the eye would be welcome. That’s absolutely certain. And joining is very simple. As an ISTAART member, you just navigate to our page, The Eye as a Biomarker for AD page, and there is a simple click on become a member and you sign up there and you will start automatically getting the basic information.

We also organize regular meetings and that every year, basically, starts with a summary of what happened last year. Seminar, one of our young colleagues is tasked with the job of giving us an overview of what happened the year before. And that’s actually a wonderful place for people like yourself who don’t necessarily have the breadth of knowledge on ophthalmology because that’s where you can really learn how the field moves forward compared to the year before.

So, you would be very, very welcome to join. And there are lots of interesting questions that, of course, come up about the vision or the eyesight is one of our most precious sensors for people and, therefore, losing sight is a very important issue financially, psychologically, and every other aspect of life. So, getting people involved from different areas and thinking together about what the ramification of a finding is we have is actually a very important aspect which we’d like to explore.

Dr Shana Stites:

Fabulous. I’d be happy to have those conversations. In our PIA, again, the Diversity and Disparities. PIA, we have representation in our membership from all over the world. And one of the things that I hear is that it’s hard for people to make meetings. If for no other reason than time zones alone, not to get to the busy schedules and all of the other work demands, but does your PIA, and it’s okay if not, I guess. Does your PIA have ways for people to participate if they can’t make the meetings? Or do you make any adjustments to your meetings to try to deal with that issue of time zones and schedules?

Dr Imre Lengyel:

So, we have some issues already, given that our chair is in San Diego. So, for him to wake up, we are ready to drink our first beer in the pub. So, we need to find time, but it’s basically almost impossible to cover all time zones. There is quite a bit of discussion amongst the steering committee, how could we cover this, and we try to record meetings. So, making it sure that those who are unable to participate, they can. So yes, absolutely, we are trying to find different days and times when it’s more suitable for people to join, and we are keeping a keen eye on the membership. So, the members who are signing up to PIA that so we understand what their geographical location is and how could we make inclusion as seamless as possible.

Dr Shana Stites:

Wonderful. So, it does sound like this is one of the challenges that we deal with in this field, especially as a global community. But the PIA is willing to … is welcome to everybody and there’s ways to get in touch and to have access to the content and maybe even contribute even with some of those challenges. And I have got to tell you, this is our first meeting and it’s been a pleasure to have this opportunity to sit and talk with you and get to know you a little bit. And thank you for sharing the work that’s going on in the PIA, that’s amazing and your own work. I’ve really appreciated it.

Dr Imre Lengyel:

Thank you very much, Shana. It’s always amazing to talk to people who are not immediately on the field because you asked some really interesting questions. And I hope that the listeners will enjoy a little bit of different insight than what we usually talk about, hardcore science for example.

Dr Shana Stites:

Thank you for listening over the past week. ISTAART PIAs are a great way to expand your network and find new collaborators. We hope these podcasts have inspired you to become involved. You can find profiles of myself and my wonderful guest and information on how to become involved in the ISTAART on our website at dementiaresearcher.nihr.ac.uk, and also at www.alz.org/istaart.

We are looking forward to next week’s AAIC conference. So, if you haven’t already registered, visit alz.org for more information. Finally, please remember to like, subscribe, and leave a review of this podcast through our website, iTunes, Spotify, and SoundCloud, and all the other places you can find podcasts. I’m Shana Stites. Thank you so much for listening.

Voice Over:

Brought to you by dementiaresearcher.nihr.ac.uk, in association with Alzheimer’s Research UK, Alzheimer’s Society, Race Against Dementia, and the Alzheimer’s Association, bringing new research, news, career tips and support.

END