There is no lack of brains in Ireland but there is a decided shortage of brain tissue samples.
These are the tissues used by neuropathologists and microbiologists to study neurological disorders such as Alzheimer's Disease, Parkinson's Disease and Multiple Sclerosis. The Republic is one of the very few European states without a facility where brain tissues can be stored - a brain bank - but this is about to change.
Dr Francesca Brett, senior lecturer in neuropathology at Trinity College, and Prof Michael Farrell, associate professor of Clinical Neurological Sciences at the Royal College of Surgeons, will launch the Irish National Brain Bank next Friday. Both are also consultant neuropathologists at Beaumont Hospital and the bank will be established there, explained Prof Farrell.
A great deal of the expertise necessary to operate such a bank is available at Beaumont. The hospital is a national surveillance centre for CJD, a human spongiform encephalopathy similar to the cattle disease, BSE.
Brain banks are nothing new, Prof Farrell said.. Northern Ireland has had one for 20 years, particularly for the study of MS. Los Angeles, California, has had one since the 1920s and brain tissues dating from that time can still be studied by specialists.
There were new pressures for the creation of such a facility, Prof Farrell said. The possibility of direct links between a specific form of CJD and BSE means that patients with dementia require an accurate diagnosis after death. Alzheimer's Disease is also under intensive study because of its growing incidence. Those diseases could not be studied adequately using animal models only, Prof Farrell explained. Human studies were essential. The availability of tissues from a brain bank, linked to the full clinical details of the deceased patient, represented an invaluable resource in the study of these and other neurological disorders.
"Human brain tissue donated at the time of death by people with neurological disease, especially those afflicted with familial neurological disease, is the most precious resource researchers can have. We will be able to compare tissue from affected and unaffected people, to compare different age groups, males and females, and then hopefully we will begin to unravel the mysteries of these neurological diseases," Prof Farrell said.
The bank will hold tissues and will provide a diagnostic service which will be available to neurologists and geriatricians who need definitive post-mortem results. The service will also provide information to the patient's relatives. "With most of the CJD cases, the families have been anxious to have an autopsy." This post-mortem service has been available for some time on an informal basis, Prof Farrell said. Patients would be transferred to Beaumont soon after death for diagnosis of the neurological disease before release to the family and the undertakers. Now the family will be asked if tissues could be retained in the bank.
"There would be no connection with industry," Prof Farrell stressed, and tissues would only be made available after independently reviewed requests were made by recognised researchers.
For this reason, he could never "see a situation where you would dispose of tissues". The Los Angeles facility had shown over the past 70 years that stored tissues were a valuable research resource.
There was no cost to the families and taking the tissues would not involve disfigurement of the remains so there was no barrier to having an open coffin, Prof Farrell explained. As the procedure involved took no more than an hour, willingness to donate a patient's tissues to the bank would not delay funeral arrangements.
It was desirable to retain the entire brain to allow comprehensive post-mortem study and for future research, but if the family preferred, a sample could be taken instead. All donor information would remain totally anonymous, Prof Farrell added.
New discoveries relating to MS, Alzheimer's and Parkinson's were occurring all of the time, he said. Researchers are delving into the complex biochemical processes which allow health but can break down to cause illness. Having a brain tissue bank would help Irish researchers in this important work.
Families wishing to consider registering with the brain bank should discuss a potential donation with the neurologist or geriatrician caring for the patient. The doctor will then either contact the brain bank on the patient's behalf or put the patient or family members in direct contact.
Further information is also available from the neuropathology department at Beaumont.