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Turner MR. We need to talk about brain donation. Pract Neurol 2024; 24:183-184. [PMID: 38499333 DOI: 10.1136/pn-2024-004102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2024] [Indexed: 03/20/2024]
Affiliation(s)
- Martin R Turner
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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2
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Griffin CP, Bowen JR, Walker MM, Lynam J, Paul CL. Understanding the value of brain donation for research to donors, next-of-kin and clinicians: A systematic review. PLoS One 2023; 18:e0295438. [PMID: 38117774 PMCID: PMC10732432 DOI: 10.1371/journal.pone.0295438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 12/22/2023] Open
Abstract
PURPOSE Post-mortem brain donation affords the opportunity to characterise disease by exploring global neuropathological changes. Such opportunities are essential to progress knowledge of CNS tumours such as Glioblastoma. A comprehensive understanding of the experience of consenting to brain donation is crucial to maximising consent rates while providing patient-centred care. This review aimed to synthesise the reported facilitators and barriers according to potential donors, next-of-kin (NOK) and clinician respondents. DESIGN Database searches included Embase, Medline, PsycINFO, Psychology and Behavioural Science and Scopus. Search terms focused on motivations, attitudes and psychosocial experiences of brain donation. Exclusions included organ transplantation and brain death. All studies were assessed for quality and validity using tools from the Joanna Briggs Institute. To determine perceptions of benefit and harm, a method guided by the thematic analysis of Braun and Clarke was employed to reflexively assess and identify common themes and experiences. RESULTS 40 studies (15 qualitative, 25 quantitative) were included involving participants with paediatric cancer, neurodegenerative and psychological diseases. Perceptions of benefit included benefit to future generations, aiding scientific research, avoidance of waste, improved treatments and the belief that donation will bring consolation or aid in the grieving process. Perceptions of harm included a perceived conflict with religious beliefs, disfigurement to the donor, emotional distress at the time of autopsy and discord or objections within the family. CONCLUSION Brain donation can afford a sense of purpose, meaning and empowerment for donors and their loved ones. Careful strategies are required to mitigate or reduce potential harms during the consent process.
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Affiliation(s)
- Cassandra P. Griffin
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Jenna R. Bowen
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Marjorie M. Walker
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
| | - James Lynam
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Department of Medical Oncology, Calvary Mater, Newcastle, NSW, Australia
| | - Christine L. Paul
- College of Health, Medicine and Wellbeing University of Newcastle, Tamworth, NSW, Australia
- Hunter Medical Research Institute, Newcastle, NSW, Australia
- Priority Research Centre Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, Australia
- Priority Research Centre Health Behaviour, University of Newcastle, Callaghan, Australia
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3
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Cattaneo C, Urakcheeva I, Giacomini G, Stazi MA, Lana S, Arnofi A, Salemi M, Toccaceli V. Attitude and concerns of healthy individuals regarding post-mortem brain donation. A qualitative study on a nation-wide sample in Italy. BMC Med Ethics 2023; 24:104. [PMID: 38012766 PMCID: PMC10683267 DOI: 10.1186/s12910-023-00980-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Collecting post-mortem brain tissue is essential, especially from healthy "control" individuals, to advance knowledge on increasingly common neurological and mental disorders. Yet, healthy individuals, on which this study is focused, are still understudied. The aim of the study was to explore, among healthy potential brain donors and/or donors' relatives, attitude, concerns and opinion about post-mortem brain donation (PMBD). METHODS A convenience sampling of the general population (twins and their non-twin contacts) was adopted. From June 2018 to February 2019, 12 focus groups were conducted in four Italian cities: Milan, Turin, Rome and Naples, stratified according to twin and non-twin status. A qualitative content analysis was performed with both deductive and inductive approaches. Emotional interactions analysis corroborated results. RESULTS One hundred and three individuals (49-91 yrs of age) participated. Female were 60%. Participants had scarse knowledge regarding PMBD. Factors affecting attitude towards donation were: concerns, emotions, and misconceptions about donation and research. Religion, spirituality and secular attitude were implied, as well as trust towards research and medical institutions and a high degree of uncertainty about brain death ascertainment. Family had a very multifaceted central role in decision making. A previous experience with neurodegenerative diseases seems among factors able to favour brain donation. CONCLUSIONS The study sheds light on healthy individuals' attitudes about PMBD. Brain had a special significance for participants, and the ascertainment of brain death was a source of debate and doubt. Our findings emphasise the importance of targeted communication and thorough information to promote this kind of donation, within an ethical framework of conduct. Trust in research and health professionals emerged as an essential factor for a collaborative attitude towards donation and informed decision making in PMBD.
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Affiliation(s)
- Chiara Cattaneo
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
| | | | - Gianmarco Giacomini
- Centre of Reference for Mental Health and Behavioural Sciences, Istituto Superiore di Sanità, Rome, Italy
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Maria Antonietta Stazi
- Centre of Reference for Mental Health and Behavioural Sciences, Istituto Superiore di Sanità, Rome, Italy
| | - Susanna Lana
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità, Rome, Italy
| | - Antonio Arnofi
- Centre of Reference for Mental Health and Behavioural Sciences, Istituto Superiore di Sanità, Rome, Italy
| | - Miriam Salemi
- Centre of Reference for Mental Health and Behavioural Sciences, Istituto Superiore di Sanità, Rome, Italy
| | - Virgilia Toccaceli
- Centre of Reference for Mental Health and Behavioural Sciences, Istituto Superiore di Sanità, Rome, Italy.
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4
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Siminoff LA, Mash D, Wilson-Genderson M, Gardiner HM, Mosavel M, Barker L. Making a family decision to donate the brain for genomic research: lessons from the genotype-tissue expression project (GTEx). Cell Tissue Bank 2021; 22:431-441. [PMID: 33386465 PMCID: PMC9040537 DOI: 10.1007/s10561-020-09890-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 12/04/2020] [Indexed: 01/15/2023]
Abstract
This study sheds light on the attitudes and circumstances that influence decisions by families to donate the brain of a deceased family member for research. This study, a part of the Genotype-Tissue Expression (GTEx) project, interviewed families of patients who had authorized organ and/or tissue donation for transplantation. A total of 384 family decision makers (FDMs) who decided to donate organs and/or tissues for transplantation were also asked to donate to GTEx. Of these, 297 families were asked to donate their loved one's whole brain and 87 families responded to a hypothetical request for brain donation. The decision to donate the brain to GTEx, actually or hypothetically, was the major outcome measure. The majority of the FDMs would choose to donate the brain, 78%. Unwillingness to donate the brain was associated with four attitudes: (1) the FDM unwillingness to donate their own tissues for research (OR 1.91, 95% CI .67 to 2.96; p = .05), (2) concern with potential for-profit use of tissues (OR 2.12, 95% CI 1.2 to 3.7; p = .008), (3) reported squeamishness about tissue donation (OR 1.34, 95% CI 1.1 to 1.7; p = .006), and (4) belief that FDMs should have a say in how the donated tissues are used (OR 1.36, 95% CI 1.13 to 1.5; p = .01). Organ and tissue donors may present a plenteous source of brains for research. Family concerns about tissue use and collection should be addressed by requesters.
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Affiliation(s)
- Laura A Siminoff
- College of Public Health, Temple University, 1700 N. Broad Street Suite 202 - 2nd Floor, Philadelphia, PA, 19121, USA.
| | - Deborah Mash
- Neurology and Molecular and Cellular Pharmacology, Miller School of Medicine, University of Miami, Miami, USA
| | | | - Heather M Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, USA
| | - Maghboeba Mosavel
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, USA
| | - Laura Barker
- College of Public Health, Temple University, Philadelphia, USA
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5
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Reyes-Pablo AE, Campa-Córdoba BB, Luna-Viramontes NI, Ontiveros-Torres MÁ, Villanueva-Fierro I, Bravo-Muñoz M, Sáenz-Ibarra B, Barbosa O, Guadarrama-Ortíz P, Garcés-Ramírez L, de la Cruz F, Harrington CR, Martínez-Robles S, González-Ballesteros E, Perry G, Pacheco-Herrero M, Luna-Muñoz J. National Dementia BioBank: A Strategy for the Diagnosis and Study of Neurodegenerative Diseases in México. J Alzheimers Dis 2021; 76:853-862. [PMID: 32568191 DOI: 10.3233/jad-191015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We recently developed the National Dementia Biobank in México (BioBanco Nacional de Demencias, BND) as a unit for diagnosis, research, and tissue transfer for research purposes. BND is associated with the Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de Mexico (UNAM), Mexico. The donation of fluids, brain, and other organs of deceased donors is crucial for understanding the underlying mechanisms of neurodegenerative diseases and for the development of successful treatment. Our laboratory research focuses on 1) analysis of the molecular processing of the proteins involved in those neurodegenerative diseases termed tauopathies and 2) the search for biomarkers for the non-invasive and early diagnosis of Alzheimer's disease.
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Affiliation(s)
- Aldelmo Emmanuel Reyes-Pablo
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México.,Escuela Nacional de Ciencias Biológicas, Depto. Fisiología, Instituto Politécnico Nacional, CDMX, México
| | - B Berenice Campa-Córdoba
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México.,Escuela Nacional de Ciencias Biológicas, Depto. Fisiología, Instituto Politécnico Nacional, CDMX, México
| | - Nabil Itzi Luna-Viramontes
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México.,Escuela Nacional de Ciencias Biológicas, Depto. Fisiología, Instituto Politécnico Nacional, CDMX, México
| | | | | | - Marely Bravo-Muñoz
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México
| | - Bárbara Sáenz-Ibarra
- Depto. de Patología, Facultad de medicina de la Universidad Autónoma de Nuevo León, Nuevo León, México
| | - Oralia Barbosa
- Jefa del Servicio de Anatomía Patológicay Citopatología del Hospital Universitario "Dr. José E. González de la UANL, Nuevo León, México
| | | | - Linda Garcés-Ramírez
- Escuela Nacional de Ciencias Biológicas, Depto. Fisiología, Instituto Politécnico Nacional, CDMX, México
| | - Fidel de la Cruz
- Escuela Nacional de Ciencias Biológicas, Depto. Fisiología, Instituto Politécnico Nacional, CDMX, México
| | - Charles R Harrington
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Sandra Martínez-Robles
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México
| | - Erik González-Ballesteros
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México
| | - George Perry
- Department of Biology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Mar Pacheco-Herrero
- School of Medicine, Faculty of Health Sciences, Pontificia Universidad Catolica Madre y Maestra, Dominican Republic
| | - José Luna-Muñoz
- National Dementia BioBank, Ciencias Biológicas, Facultad de Estudios Superiores, Cuautitlán campo 1, UNAM Estado de México, México
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6
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Chan RJW, Seah S, Foo JYJ, Yong ACW, Chia NSY, Agustin SJU, Neo SXM, Tay KY, Au WL, Tan LCS, Ng ASL. Patient attitudes towards brain donation across both neurodegenerative and non-neurodegenerative neurological disorders. Cell Tissue Bank 2020; 21:265-277. [PMID: 32140800 DOI: 10.1007/s10561-020-09819-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/24/2020] [Indexed: 02/07/2023]
Abstract
Brain donations are imperative for research; understanding possible barriers to entry is required to improve brain donation rates. While a few surveys have studied attitudes towards brain banking in patients with neurodegenerative disorders, none have surveyed patients with chronic neurological disorders but without neurodegeneration. This cross-sectional study was conducted on 187 participants, with both neurodegenerative (n = 122) and non-neurodegenerative disorders (n = 65), to compare their attitudes and preferences towards brain donation. Encouragingly, patients with non-neurodegenerative disorders were just as likely to consider brain donation as those with neurodegenerative diseases. Approximately half of each group were willing to consider brain donation, and majority of participants across both groups would not be offended if asked to participate in brain donation (71%). Across both groups, altruistic reasons such as desire to advance medical knowledge and benefit to other patients were the main motivating factors for brain donation, while perceived stress for family members, fears of body disfigurement and religious reasons were the main reasons against brain donation. Of note, nearly two-thirds of all participants were agreeable to allow their family to decide on their behalf. Overall, participants with non-neurodegenerative disorders appeared equally likely to consider brain donation as participants with neurodegenerative disorders. This is an important finding as they represent a significant population seen in specialist neurology clinics who may be overlooked in brain donor recruitment and awareness efforts. Healthcare professionals involved in brain banking should consider actively approaching these potential donors and involving their family members in these discussions.
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Affiliation(s)
- Reudi J W Chan
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Sherilyn Seah
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore
| | - Joel Y J Foo
- Department of Research, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Alisa C W Yong
- Department of Research, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Nicole S Y Chia
- Department of Research, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Sherwin J U Agustin
- Department of Research, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Shermyn X M Neo
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Kay-Yaw Tay
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Wing-Lok Au
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Louis C S Tan
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Adeline S L Ng
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
- Neuroscience and Behavioural Disorders Program, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
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7
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Zhang Q, Deng J, Li YN, Gou Y, Yan XX, Li F, Pan AH. Perceptions and Attitudes toward Brain Donation among the Chinese People. ANATOMICAL SCIENCES EDUCATION 2020; 13:80-90. [PMID: 31022327 DOI: 10.1002/ase.1886] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 06/09/2023]
Abstract
Postmortem human brain donation is crucial to both anatomy education and research. The China Human Brain Banking Consortium was established recently to foster brain donation in China. The purpose of this study was to gain information about the public perception of and attitudes toward brain donation and to identify factors that may impact the willingness to participate in brain donation among the Chinese people. A specifically designed questionnaire was delivered to community residents in Changsha (the capital city of Hunan province) with a total of 1,249 completed forms returned and statistically analyzed. The majority of the participants considered that brain donation would help medical research and education, and 32.0% of respondents agreed that the brain donation would help change the traditional Chinese funeral belief in keeping the body intact after death. However, participants aged over 60 years old were less supportive of this concept. Among all participants, 63.7% stated that they were not knowledgeable about brain donation, while 26.4% explicitly expressed a willingness to participate in brain donation. Age, gender, monthly household income, and knowledge about brain donation significantly affected the willingness. Compared with other age groups, a higher proportion of participants aged over 60 years old preferred to be informed by a medical college. To promote brain donation in China, especially among the elderly, better communication of its medical benefits and a reinterpretation of the Confucius view of the human body should be provided. Efforts are also needed to provide appropriate forums and sources of brain donation information to targeted communities and society in general.
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Affiliation(s)
- Qi Zhang
- Xiangya Brain Bank, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
- Department of Human Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, Hunan, People's Republic of China
| | - Ya-Nan Li
- Xiangya Brain Bank, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
- Department of Human Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
| | - Yue Gou
- Department of Human Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
| | - Xiao-Xin Yan
- Xiangya Brain Bank, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
- Department of Human Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
| | - Fang Li
- Department of Human Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
| | - Ai-Hua Pan
- Xiangya Brain Bank, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
- Department of Human Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, Hunan, People's Republic of China
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8
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Lin MJP, Jowsey T, Curtis MA. Why people donate their brain to science: a systematic review. Cell Tissue Bank 2019; 20:447-466. [PMID: 31538265 PMCID: PMC6863784 DOI: 10.1007/s10561-019-09786-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 09/05/2019] [Indexed: 11/24/2022]
Abstract
The acquisition of brain tissue for research purposes is an important endeavour in research on ageing, pathological diagnosis, and the advancement of treatment of neurological or neurodegenerative diseases. While some tissue samples can be obtained from a living patient, the procurement of a whole brain requires the donation from people after their death. In order to promote positive attitudes towards brain donation, it is essential to understand why people do or do not donate their brain to medical research. In 2018 we undertook a systematic review of the international literature concerning people's attitudes, motivations, and feelings about brain donation. Five electronic databases were searched: Scopus, PsycINFO, Embase, Medline, and Google Scholar. Search terms included: ("brain donor*" OR "brain donation" OR "brain banking" OR "banking on brain") AND (attitude* OR motivation* OR decision*") AND (LIMIT-TO "human") AND (LIMIT-TO (LANGUAGE, "English")). Articles were analysed using the Framework for Assessing Qualitative Evaluations and a meta-ethnographic approach. Fourteen articles were included for review. The findings suggest four universal factors informing a person's decision to donate their brain: (1) contextual knowledge, (2) conceptual understandings, (3) family/friends matter, and (4) personal experience, time and process. The findings also indicate that the way healthcare professionals present themselves can influence people's feelings and attitudes towards brain donation. Healthcare and research professionals who are involved in brain donation processes must be mindful of the complex and multiple factors that influence donation outcomes. Effective and sensitive communication with potential donors and their family/friends is paramount.
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Affiliation(s)
- Meng-Jiun Penny Lin
- School of Curriculum and Pedagogy, Faculty of Education and Social Work, The University of Auckland, Auckland, New Zealand
| | - Tanisha Jowsey
- Faculty of Medical and Health Sciences, Centre for Medical and Health Sciences Education, The University of Auckland, Auckland, New Zealand
| | - Maurice A. Curtis
- Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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9
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African-American and Caucasian participation in postmortem human brain donation for neuropsychiatric research. PLoS One 2019; 14:e0222565. [PMID: 31644530 PMCID: PMC6808324 DOI: 10.1371/journal.pone.0222565] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 09/03/2019] [Indexed: 01/15/2023] Open
Abstract
Increased African-American research participation is critical to the applicability and generalizability of biomedical research, as population diversity continues to increase both domestically and abroad. Yet numerous studies document historical origins of mistrust, as well as other barriers that may contribute to resistance in the African-American community towards participation in biomedical research. However, a growing body of more recent scientific evidence suggests that African-Americans value research and are willing to participate when asked. In the present study, we set out to determine factors associated with research participation of African-American families in postmortem human brain tissue donation for neuropsychiatric disorders as compared with Caucasian families, from same-day medical examiner autopsy referrals. We retrospectively reviewed brain donation rates, as well as demographic and clinical factors associated with donation in 1,421 consecutive referrals to three medical examiner’s offices from 2010–2015. Overall, 69.7% of all next-of-kin contacted agreed to brain donation. While Caucasian families consented to donate brain tissue at a significantly higher rate (74.1%) than African-American families (57.0%) (p<0.001), African-American brain donation rates were as high as 60.5% in referrals from Maryland. Neither African-American nor Caucasian donors differed significantly from non-donors on any demographic or clinical factors ascertained, including age, sex, diagnosis of the donor, or in the relationship of the next-of-kin being contacted (p>0.05). However, Caucasian donors were significantly older, had more years of education, were more likely to be referred for study due to a psychiatric diagnosis, more likely to have comorbid substance abuse, and more likely to have died via suicide, as compared with African-American donors (p<0.05). When African-American participants are identified and approached, African-American families as well as Caucasian families are indeed willing to donate brain tissue on the spot for neuropsychiatric research, which supports the belief that African-American attitudes towards biomedical research may be more favorable than previously thought.
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10
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Striley CW, Milani SA, Kwiatkowski E, DeKosky ST, Cottler LB. Community perceptions related to brain donation: Evidence for intervention. Alzheimers Dement 2019; 15:267-272. [PMID: 30365929 PMCID: PMC7224447 DOI: 10.1016/j.jalz.2018.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/01/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Research progress on neurocognitive disorders requires donation of both healthy and diseased brains. Here, we describe attitudes toward brain donation among a large community sample in Florida. METHODS HealthStreet, a community engagement program at the University of Florida, used community health workers to assess community attitudes toward research participation, including brain donation. RESULTS Over 60% of people, primarily Caucasian and employed, indicated that they would be likely or somewhat likely to donate their brain for research. Those who would be willing to donate were also more likely to be willing to participate in other research studies and to have participated in research. DISCUSSION Brain donation will add to the science of disorders of aging, including accurate diagnoses and validation of in vivo biomarkers. Increasing willingness to donate is a first step toward donation. Community populations are willing; community health workers can educate others about the need for this initiative in communities.
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11
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Zhang H, Chen K, Wang N, Zhang D, Yang Q, Zhang Q, Liu P, Wan M, Gong C, Hong X, Qiu W, Qian X, Chen Y, Ma C. Analysis of Brain Donors’ Demographic and Medical Characteristics to Facilitate the Construction of a Human Brain Bank in China. J Alzheimers Dis 2018; 66:1245-1254. [DOI: 10.3233/jad-180779] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Hanlin Zhang
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Eight-year MD Program, Peking Union Medical College, Beijing, China
| | - Kang Chen
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Eight-year MD Program, Peking Union Medical College, Beijing, China
| | - Naili Wang
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- National Experimental Demonstration Center of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Di Zhang
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- National Experimental Demonstration Center of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Qian Yang
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, China
| | - Qing Zhang
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, China
| | - Pan Liu
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, China
| | - Mengyao Wan
- Eight-year MD Program, Peking Union Medical College, Beijing, China
| | - Changlin Gong
- Eight-year MD Program, Peking Union Medical College, Beijing, China
| | - Xinyu Hong
- Eight-year MD Program, Peking Union Medical College, Beijing, China
| | - Wenying Qiu
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiaojing Qian
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Yongmei Chen
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Chao Ma
- Department of Human Anatomy, Institute of Basic Medical Sciences, Histology and Embryology, Neuroscience Center, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
- Joint Laboratory of Anesthesia and Pain, Peking Union Medical College, Beijing, China
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12
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Trujillo Diaz D, Hernandez NC, Cortes EP, Faust PL, Vonsattel JPG, Louis ED. Banking brains: a pre-mortem "how to" guide to successful donation. Cell Tissue Bank 2018; 19:473-488. [PMID: 30220002 DOI: 10.1007/s10561-018-9720-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/13/2018] [Indexed: 11/29/2022]
Abstract
A review of the brain banking literature reveals a primary focus either on the factors that influence the decision to become a future donor or on the brain tissue processing that takes place after the individual has died (i.e., the front-end or back-end processes). What has not been sufficiently detailed, however, is the complex and involved process that takes place after this decision to become a future donor is made yet before post-mortem processing occurs (i.e., the large middle-ground). This generally represents a period of many years during which the brain bank is actively engaged with donors to ensure that valuable clinical information is prospectively collected and that their donation is eventually completed. For the past 15 years, the Essential Tremor Centralized Brain Repository has been actively involved in brain banking, and our experience has provided us valuable insights that may be useful for researchers interested in establishing their own brain banking efforts. In this piece, we fill a gap in the literature by detailing the processes of enrolling participants, creating individualized brain donation plans, collecting clinical information and regularly following-up with donors to update that information, and efficiently coordinating the brain harvest when death finally arrives.
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Affiliation(s)
- Daniel Trujillo Diaz
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Nora C Hernandez
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Etty P Cortes
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Phyllis L Faust
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, NY, USA
| | - Jean Paul G Vonsattel
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Elan D Louis
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA. .,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA. .,Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA.
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13
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de Lange GM, Rademaker M, Boks MP, Palmen SJMC. Brain donation in psychiatry: results of a Dutch prospective donor program among psychiatric cohort participants. BMC Psychiatry 2017; 17:347. [PMID: 29058593 PMCID: PMC5651614 DOI: 10.1186/s12888-017-1513-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 10/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human brain tissue is crucial to study the molecular and cellular basis of psychiatric disorders. However, the current availability of human brain tissue is inadequate. Therefore, the Netherlands Brain Bank initiated a program in which almost 4.000 participants of 15 large Dutch psychiatric research cohorts were asked to register as prospective brain donors. METHODS We approached patients with schizophrenia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, post-traumatic stress disorder, families with a child with autism or Attention Deficit Hyperactivity Disorder, healthy relatives and healthy unrelated controls, either face-to-face or by post. We investigated whether diagnosis, method of approach, age, and gender were related to the likelihood of brain-donor registration. RESULTS We found a striking difference in registration efficiency between the diagnosis groups. Patients with bipolar disorder and healthy relatives registered most often (25% respectively 17%), followed by unrelated controls (8%) and patients with major depressive disorder, post-traumatic stress disorder, and obsessive-compulsive disorder (9%, 6% resp. 5%). A face-to-face approach was 1.3 times more effective than a postal approach and the likelihood of registering as brain donor significantly increased with age. Gender did not make a difference. CONCLUSIONS Between 2013 and 2016, our prospective brain-donor program for psychiatry resulted in an almost eightfold increase (from 149 to 1149) in the number of registered psychiatric patients at the Netherlands Brain Bank. Based on our results we recommend, when starting a prospective brain donor program in psychiatric patients, to focus on face to face recruitment of people in their sixties or older.
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Affiliation(s)
- Geertje M. de Lange
- 0000 0001 2171 8263grid.419918.cNetherlands Brain Bank, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, the Netherlands ,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, the Netherlands
| | - Marleen Rademaker
- 0000 0001 2171 8263grid.419918.cNetherlands Brain Bank, Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, the Netherlands
| | - Marco P. Boks
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, the Netherlands
| | - Saskia J. M. C. Palmen
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, PO Box 85500, 3508 GA Utrecht, the Netherlands
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14
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"Why throw away something useful?": Attitudes and opinions of people treated for bipolar disorder and their relatives on organ and tissue donation. Cell Tissue Bank 2016; 18:105-117. [PMID: 27900507 DOI: 10.1007/s10561-016-9601-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 11/12/2016] [Indexed: 10/20/2022]
Abstract
In regard to mental illness, brain donation is essential for the biological investigation of central pathology. Nevertheless, little is known about the thoughts of people with mental disorders on tissue donation for research. Here, our objective was to understand the attitudes and opinions of people treated for bipolar disorder and their relatives regarding donation in general, and particularly donation for research. This is a qualitative study that used in-depth interviews to determine the thoughts of participants regarding tissue donation for research. Theoretical sampling was used as a recruitment method. Grounded theory was used as a framework for content analyses of the interviews. A semi-structured interview guide was applied with the topics: donation in general; donation for research; mental health and body organs; opinion regarding donation; feelings aroused by the topic. Although all participants were aware of organ donation for transplant, they were surprised that tissue could be donated for research. Nevertheless, once they understood the concept they were usually in favor of the idea. Although participants demonstrated a general lack of knowledge on donation for research, they were willing to learn more and viewed it as a good thing, with altruistic reasons often cited as a motive for donation. We speculate that bridging this knowledge gap may be a fundamental step towards a more ethical postmortem tissue donation process.
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15
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Martin MM, Rothwell EW, Venne VL, Foster NL. Perceptions of Tissue Storage in a Dementia Population Among Spouses and Offspring. J Genet Couns 2015; 24:503-11. [DOI: 10.1007/s10897-015-9818-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 01/02/2015] [Indexed: 11/24/2022]
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16
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Toledo JB, Van Deerlin VM, Lee EB, Suh E, Baek Y, Robinson JL, Xie SX, McBride J, Wood EM, Schuck T, Irwin DJ, Gross RG, Hurtig H, McCluskey L, Elman L, Karlawish J, Schellenberg G, Chen-Plotkin A, Wolk D, Grossman M, Arnold SE, Shaw LM, Lee VMY, Trojanowski JQ. A platform for discovery: The University of Pennsylvania Integrated Neurodegenerative Disease Biobank. Alzheimers Dement 2013; 10:477-484.e1. [PMID: 23978324 DOI: 10.1016/j.jalz.2013.06.003] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 05/10/2013] [Accepted: 06/03/2013] [Indexed: 12/12/2022]
Abstract
Neurodegenerative diseases (NDs) are defined by the accumulation of abnormal protein deposits in the central nervous system (CNS), and only neuropathological examination enables a definitive diagnosis. Brain banks and their associated scientific programs have shaped the actual knowledge of NDs, identifying and characterizing the CNS deposits that define new diseases, formulating staging schemes, and establishing correlations between neuropathological changes and clinical features. However, brain banks have evolved to accommodate the banking of biofluids as well as DNA and RNA samples. Moreover, the value of biobanks is greatly enhanced if they link all the multidimensional clinical and laboratory information of each case, which is accomplished, optimally, using systematic and standardized operating procedures, and in the framework of multidisciplinary teams with the support of a flexible and user-friendly database system that facilitates the sharing of information of all the teams in the network. We describe a biobanking system that is a platform for discovery research at the Center for Neurodegenerative Disease Research at the University of Pennsylvania.
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Affiliation(s)
- Jon B Toledo
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Vivianna M Van Deerlin
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Edward B Lee
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - EunRan Suh
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Young Baek
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - John L Robinson
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Sharon X Xie
- Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jennifer McBride
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Elisabeth M Wood
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Theresa Schuck
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - David J Irwin
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Rachel G Gross
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Howard Hurtig
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leo McCluskey
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lauren Elman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jason Karlawish
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gerard Schellenberg
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Alice Chen-Plotkin
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David Wolk
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Murray Grossman
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven E Arnold
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leslie M Shaw
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - Virginia M-Y Lee
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA
| | - John Q Trojanowski
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, Philadelphia, Pennsylvania, USA.
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17
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Harris C, Kiger A, Counsell C. Attitudes to brain donation for Parkinson's research and how to ask: a qualitative study with suggested guidelines for practice. J Adv Nurs 2012; 69:1096-108. [PMID: 22823003 DOI: 10.1111/j.1365-2648.2012.06099.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2012] [Indexed: 11/28/2022]
Abstract
AIM To describe factors people consider important in deciding whether or not to donate their brain for research after death. BACKGROUND Brain tissue retrieved at post-mortem is needed to further research into neurological conditions such as Parkinson's disease. Previous research has focussed mainly on attitudes to organ donation for transplantation. DESIGN Data were gathered and analysed using a qualitative approach based on grounded theory. METHODS Nineteen people who had made a decision about brain donation, five people with Parkinson's and 14 unaffected individuals, were identified through theoretical sampling. Interviews conducted between September 2007-January 2008 were analysed to identify themes representing the concerns of participants, when making a decision. FINDINGS The three main themes identified were views and beliefs about post-mortem, the importance of family and the things people do not talk about. Although participants were more familiar with the concept of organ donation for transplantation, unanimous support was expressed for brain donation for research. However, beliefs about death and post-mortem, influence of family and the difficulty in talking and thinking about things to do with death all posed barriers to consent when actually asked to make a decision. For some, however, being asked had acted as a catalyst, transforming previously held positive attitudes into a decision to consent. CONCLUSION Guidelines for asking developed from these findings highlight the importance of discussing the issue to raise awareness in potential donors, involving family members, and giving accurate and appropriate information to inform, reassure and to dispel misconceptions.
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Affiliation(s)
- Clare Harris
- Division of Applied Health Sciences, University of Aberdeen, UK.
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18
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Eatough V, Shaw K, Lees A. Banking on brains: insights of brain donor relatives and friends from an experiential perspective. Psychol Health 2012; 27:1271-90. [PMID: 22452631 DOI: 10.1080/08870446.2012.669480] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Brain donation is critical to understand the pathological causes of neurodegenerative diseases. Increasing levels of donation requires an understanding of those factors that both encourage and deter donation. At present, there are few studies of how people understand, feel and decide about brain donation for scientific research. This qualitative experiential study contributes to the growing literature on brain donation through its specific focus on how the donation process is experienced from the perspectives of family members and friends. Nineteen semi-structured interviews were analysed using a phenomenologically informed thematic analysis. Four themes were derived from the analysis, three of which are described in detail: Making the decision to donate; a personal perspective on the donation process; the significance of the brain; beliefs about brain donation. In particular, the thematic analysis highlights the variation of individual decision making and the emotions and reasons underpinning such decisions. Key conclusions include the importance of integrated practice amongst relevant healthcare professionals as well as the need for supportive and informed communication. Also, in light of the finding that the brain assumed no special significance for most participants, the value of the distinction between brain donation for research purposes and organ transplantation is questioned.
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Affiliation(s)
- Virginia Eatough
- Department of Psychological Sciences, Birkbeck University of London, London WC1E 7HX, UK.
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19
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Austrom MG, Dickinson SLJ, Denny SS, Matthews BR, Gao S, Lu Y. Frontotemporal dementia caregivers and researchers: partnering for brain donation. Am J Alzheimers Dis Other Demen 2011; 26:477-83. [PMID: 22021861 DOI: 10.1177/1533317511424278] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study utilized a community-based, participatory research model between the Association for Frontotemporal Degeneration (AFTD) and the Education Core of the Indiana Alzheimer Disease Center. A total of 30 caregivers of persons with frontotemporal dementia (FTD) participated in 6 focus groups in 3 cities. The majority of participants were spouses of the person with FTD and had been providing care for an average of 6 years. Transcript analysis revealed 7 prominent themes: willingness to participate, when/how the issue of brain donation is raised, who initiates discussion about brain donation, who is involved in decisions about brain donation, motivation for participating in brain donation, lack of effective communication, and barriers to research participation. Caregivers demonstrated a strong desire to participate in research and contribute to advancing knowledge. The lack of effective communication between the clinicians and caregivers was a barrier to developing positive rapport, detrimentally impacting research participation.
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Affiliation(s)
- Mary Guerriero Austrom
- Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, 46202, USA.
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20
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Angelini P, Hawkins C, Laperriere N, Bouffet E, Bartels U. Post mortem examinations in diffuse intrinsic pontine glioma: challenges and chances. J Neurooncol 2010; 101:75-81. [DOI: 10.1007/s11060-010-0224-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Accepted: 05/04/2010] [Indexed: 10/19/2022]
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21
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Weickert CS, Sheedy D, Rothmond DA, Dedova I, Fung S, Garrick T, Wong J, Harding AJ, Sivagnanansundaram S, Hunt C, Duncan C, Sundqvist N, Tsai SY, Anand J, Draganic D, Harper C. Selection of Reference Gene Expression in a Schizophrenia Brain Cohort. Aust N Z J Psychiatry 2010; 44:59-70. [PMID: 20073568 PMCID: PMC2950262 DOI: 10.3109/00048670903393662] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE In order to conduct postmortem human brain research into the neuropatho-logical basis of schizophrenia, it is critical to establish cohorts that are well-characterized and well-matched. The aim of the present study was therefore to determine if specimen characteristics including: diagnosis, age, postmortem interval (PMI), brain acidity (pH), and/or the agonal state of the subject at death related to RNA quality, and to determine the most appropriate reference gene mRNAs. METHODS A matched cohort was selected of 74 subjects (schizophrenia/schizoaffective disorder, n = 37; controls, n = 37). Middle frontal gyrus tissue was pulverized, tissue pH was measured, RNA isolated for cDNA from each case, and RNA integrity number (RIN) measurements were assessed. Using quantitative reverse transcription-polymerase chain reaction, nine housekeeper genes were measured and a geomean calculated per case in each diagnostic group. RESULTS The RINs were very good (mean = 7.3) and all nine housekeeper control genes were significantly correlated with RIN. Seven of nine housekeeper genes were also correlated with pH; two clinical variables, agonal state and duration of illness, did have an effect on some control mRNAs. No major impact of PMI or freezer time on housekeeper mRNAs was detected. The results show that people with schizophrenia had significantly less PPIA and SDHA mRNA and tended to have less GUSB and B2M mRNA, suggesting that these control genes may not be good candidates for normalization. CONCLUSIONS In the present cohort <10% variability in RINs was detected and the diagnostic groups were well matched overall. The cohort was adequately powered (0.80-0.90) to detect mRNA differences (25%) due to disease. The study suggests that multiple factors should be considered in mRNA expression studies of human brain tissues. When schizophrenia cases are adequately matched to control cases subtle differences in gene expression can be reliably detected.
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Affiliation(s)
- Cynthia Shannon Weickert
- Schizophrenia Research Institute, Sydney, AU,School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU
| | - Donna Sheedy
- New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | - Debora A. Rothmond
- Schizophrenia Research Institute, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU
| | - Irina Dedova
- Schizophrenia Research Institute, Sydney, AU,New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | - Samantha Fung
- Schizophrenia Research Institute, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, AU
| | - Therese Garrick
- New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | - Jenny Wong
- Schizophrenia Research Institute, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU,School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, AU
| | - Antony J. Harding
- New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | - Sinthuja Sivagnanansundaram
- Schizophrenia Research Institute, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU
| | - Clare Hunt
- New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | - Carlotta Duncan
- Schizophrenia Research Institute, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU
| | - Nina Sundqvist
- Schizophrenia Research Institute, Sydney, AU,New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | - Shan-Yuan Tsai
- Schizophrenia Research Institute, Sydney, AU,Schizophrenia Research Laboratory, Prince of Wales Medical Research Institute, Randwick, AU
| | - Jasna Anand
- New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
| | | | - Clive Harper
- New South Wales Tissue Resource Centre, Department of Pathology, School of Medical Sciences, University of Sydney, AU
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22
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Factors that influence decisions by families to donate brain tissue for medical research. Cell Tissue Bank 2009; 10:309-15. [PMID: 19517269 DOI: 10.1007/s10561-009-9136-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Accepted: 05/18/2009] [Indexed: 10/20/2022]
Abstract
Whilst mainstream transplant literature provides valuable insights into the influences on families to donate organs and tissues for transplant, the relevance of these findings in relation to organ donation for research remain speculative. The present study aims to expand the research donation literature, by exploring factors that influence a family's decision to donate brain tissue to neuroscience research. The verbal responses of the senior available next-of-kin (NOK), to the question of brain donation for research, are analysed. The donation rate was high (54%) over the 5-year-period. NOK relationship to the deceased, and post mortem interval were the main factors associated with a positive donation. Parents were most likely to donate and this may result from a lifetime of decision-making on behalf of the deceased. Also, the longer the interval between death of the potential donor and the question being asked, the greater the likelihood of donation.
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23
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Abstract
Understanding what influences people to donate, or not donate, body organs and tissues is very important for the future of transplant surgery and medical research (Garrick in J Clin Neurosci 13:524-528, 2006). A previous web-based motivation survey coordinated by the New South Wales Tissue Resource Centre found that most people who participated in brain donation were young, female, educated Australians, not affiliated with any particular religion, and with a higher prevalence of medical illness than the general Australian population. It discussed the main motivating factors for brain donation to be "the benefits of the research to medicine and science". This study has been replicated in a paper-based version to capture a broader cross-section of the general population, to find out who they are and what motivates them to donate. All consented and registered brain donors (n = 1,323) were sent a questionnaire via the post and recipients were given 3 months to complete the questionnaire and return it in a reply paid envelope. Results were entered into the original web-based survey and analyzed using SPSS version 10. Six hundred and fifty-eight questionnaires were returned completed, a response rate of 53%. The results show that people from all age groups are interested in brain donation. The over 65's are the largest of the groups (30.7%). The majority of the participants were female (60.6%), married (49.2%) with children (65.8%), employed (52.9%) and have a tertiary education (73.3%). They were either non-religious (48.2%) or Christian (41.6%) and were mostly Australian (65.4%). Most (81%) had pledged to donate other organs and tissues for transplantation. The most commonly cited reasons for the donation were to benefit science (27.6%), to benefit medicine (23.9%), a family illness (17.5%) and to benefit the community (16.6%). This study demonstrates that people across all age groups are interested in brain donation. Recruitment of new brain donors could target the over 65 female Australians, who are not religious or Christian and who have also donated other organs and tissues for transplant purposes. It also indicates the need to make donation for research part of the national transplant donation program.
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24
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Sheedy D, Garrick T, Dedova I, Hunt C, Miller R, Sundqvist N, Harper C. An Australian Brain Bank: a critical investment with a high return! Cell Tissue Bank 2008; 9:205-16. [PMID: 18543078 PMCID: PMC3391553 DOI: 10.1007/s10561-008-9076-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2008] [Accepted: 05/18/2008] [Indexed: 11/26/2022]
Abstract
Research into neuropsychiatric disorders, including alcohol-related problems, is limited in part by the lack of appropriate animal models. However, the development of new technologies in pathology and molecular biology means that many more questions can be addressed using appropriately stored human brain tissues. The New South Wales Tissue Resource Centre (TRC) in the University of Sydney (Australia) is a human brain bank that can provide tissues to the neuroscience research community studying alcohol-related brain disorders, schizophrenia, depression and bipolar disorders. Carefully standardised operational protocols and integrated information systems means that the TRC can provide high quality, accurately characterised, tissues for research. A recent initiative, the pre-mortem donor program called "Using our Brains", encourages individuals without neuropsychiatric illness to register as control donors, a critical group for all research. Community support for this program is strong with over 2,000 people registering their interest. Discussed herein are the protocols pertaining to this multifaceted facility and the benefits of investment, both scientific and financial, to neuroscience researchers and the community at large.
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Affiliation(s)
- D Sheedy
- Discipline of Pathology, University of Sydney, Sydney, NSW 2006, Australia.
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25
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Bell JE, Alafuzoff I, Al-Sarraj S, Arzberger T, Bogdanovic N, Budka H, Dexter DT, Falkai P, Ferrer I, Gelpi E, Gentleman SM, Giaccone G, Huitinga I, Ironside JW, Klioueva N, Kovacs GG, Meyronet D, Palkovits M, Parchi P, Patsouris E, Reynolds R, Riederer P, Roggendorf W, Seilhean D, Schmitt A, Schmitz P, Streichenberger N, Schwalber A, Kretzschmar H. Management of a twenty-first century brain bank: experience in the BrainNet Europe consortium. Acta Neuropathol 2008; 115:497-507. [PMID: 18365220 DOI: 10.1007/s00401-008-0360-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 02/28/2008] [Accepted: 02/28/2008] [Indexed: 10/22/2022]
Abstract
Collections of human postmortem brains gathered in brain banks have underpinned many significant developments in the understanding of central nervous system (CNS) disorders and continue to support current research. Unfortunately, the worldwide decline in postmortem examinations has had an adverse effect on research tissue procurement, particularly from control cases (non-diseased brains). Recruitment to brain donor programmes partially addresses this problem and has been successful for dementing and neurodegenerative conditions. However, the collection of brains from control subjects, particularly from younger individuals, and from CNS disorders of sudden onset, remains a problem. Brain banks need to adopt additional strategies to circumvent such shortages. The establishment of brain bank networks allows data on, and access to, control cases and unusual CNS disorders to be shared, providing a larger resource for potential users. For the brain banks themselves, inclusion in a network fosters the sharing of protocols and development of best practice and quality control. One aspect of this collective experience concerns brain bank management, excellence in which is a prerequisite not only for gaining the trust of potential donors and of society in general, but also for ensuring equitable distribution to researchers of high quality tissue samples. This review addresses the legal, ethical and governance issues, tissue quality, and health and safety aspects of brain bank management and data management in a network, as well as the needs of users, brain bank staffing, donor programs, funding issues and public relations. Recent developments in research methodology present new opportunities for researchers who use brain tissue samples, but will require brain banks to adopt more complex protocols for tissue collection, preparation and storage, with inevitable cost implications for the future.
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Banco de tejidos neurológicos de Sant Joan de Déu-Serveis de Salut Mental para la investigación de las enfermedades mentales. La importancia de un programa de donación en vida. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s1134-5934(08)71126-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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