My CUH Story - Kieren Allinson

As a consultant neuropathologist I have examined hundreds of brains. My interest in neuropathology, the study of diseases of the brain, started as a medical student in Edinburgh where I worked with James Ironside on prion disease. I started neuropathology training at CUH in 2010 and became clinical lead for the Brain Bank around seven years ago. The Bank was established in the 70s and more than 2,000 brains have been donated since then.

There are many reasons why a patient may wish to donate their brain after their death. Many build a strong relationship with their neurologist and want to help research, to improve the lives of future patients with a similar disease to them. Brain donation is a selfless gift to science and we are hugely grateful to the donors and their families. We have funding for around 40 new brains a year so unfortunately we have to be selective about which ones are donated to the Brain Bank. We have a great relationship with the neurologists and we receive many valuable brain donations from patients that are well known to neurologists such as Roger Barker and James Rowe. In the future, with better funding and more staff, I would love to increase the number of donations we can take.

The process of donation starts in the mortuary and we are incredibly grateful for the part they play. The process is a huge team effort that involves several people. As a neuropathologist, I will examine the tissue in detail, freezing some to preserve nuclei acid, proteins and other molecules.

The effect of these diseases on a brain is visible to the naked eye. Anyone can appreciate this. The brain of someone with Alzheimer’s is physically lighter and smaller. There can be a loss of a few hundred grams of brain tissue and it is easy to understand why it leads to such profound changes in a patient. As neurons die in different areas of the brain, the disease can progress from memory loss to behavioural changes and involve other cognitive domains. They are cruel diseases that rob people of their personality and sense of self and place a huge burden on their loved ones.

There is still a lot we don’t understand about dementia and it only gets a fraction of the funding that cancer research does. But research is helping. Cambridge Brain Bank has been involved in increasing are understanding of the link between inflammation and brain degeneration, the way which the abnormal proteins spread throughout the brain and the nature of the abnormal protein build-up seen in Parkinson’s disease.

We are beginning to understand risk factors for dementia. The risk of repeated head injuries, even a single moderate head injury, has led to concerns with sports including rugby, football and boxing. However, the biggest risk factor is age – about two in 100 people between 65 to 69 have dementia, but one in 6 people over 80 will. That is a huge rise in those 10-20 years but it is by no means an inevitability of aging. With an increasingly older population, we will see more people with diseases such as Alzheimer’s, Parkinson’s and Lewy body dementia.