Q&A: Jessica Alber, Ph.D.

Her inspiration, the biggest challenges in her work, and what makes her feel hopeful.

Assistant Professor Jessica Alber investigates the potential to use retinal imaging as a screening tool for early-stage Alzheimer’s disease. Performed during a routine eye exam, the screening technique could help provide a low-cost, minimally invasive way to detect Alzheimer’s disease before symptoms appear. Last fall, she received a $10.3 million NIH grant to further her work.

How did you become interested in neurodegenerative disease?
When I was in fourth grade, I did a science fair project, “How Does Your Brain Work?,” and I made a 3-D model of the brain. From that point on, I was sold on brain science.

Then, when I was 10, my grandfather was diagnosed with Alzheimer’s disease. Three of my four grandparents died with Alzheimer’s disease. I was really close with my grandparents, and I wanted to devote my life to making things better for people and families affected by this disease.

What led to your focus on identifying retinal biomarkers for AD?
It was a happy accident. I was working on a project as a postdoc and ran into someone I knew at a conference, who had gotten a job with a retinal imaging company. They talked to me about including a study I was running at the time. Our pilot work showed that the retina, which is an extension of the brain, could be a screener for neurodegenerative disease. The results interested me, and so I began following up on them.

What are some of the biggest challenges in your work?
Alzheimer’s is a very multifactorial disease. It’s like solving a puzzle. If there was one cure, someone would have found it by now. I think we have seen so many failures because we’ve treated it as if it were a single disease, and pathologically we know that’s not what’s happening. It will probably require a menu of treatments and very targeted biomarker tests, where you tailor the treatment to each patient. But that requires a tremendous amount of funding and coordinated effort.

Another challenge is that you can’t control people as well as you can control animal models. Most people don’t come to our clinic with just Alzheimer’s disease. They have comorbidities like heart disease or diabetes. So, there’s a lot more noise in your data.

How does working directly with patients influence your work? [Alber leads a clinical site at Butler Hospital Memory and Aging Program.]
It grounds you. Sometimes you can get stuck on how difficult research can be, or the bureaucratic aspects of it or paperwork, but working with the patients is very motivational. You get to see every day the disease you’re trying to impact, and it brings home why you do what you do.

It’s also wonderful to sit down with someone and hear their story. I still remember in graduate school [in Edinburgh, Scotland], I had one research participant who cracked Morse code in World War II. She cracked the code that [located] the Bismarck. Our society tends to write off older people, when they’ve made a tremendous contribution. I love hearing about their lives and what they’ve done.

What is next for your work?
We’ll take the biomarkers we’ve found and validate them to see whether they’re related to pathology in the brain. After that, I’ll be working on developing an algorithm for clinical use and piloting it to see if optometrists and ophthalmologists can actually use it in their practices. We’ve already had interest from a few eye clinics in the community, and they’ve been very collaborative.

I am hopeful there will be a preventative intervention for Alzheimer’s disease in my lifetime. There are so many really smart people working on this disease, and more money going toward research than there has ever been. It gives me hope that we will see some breakthroughs.

Jessica Alber, Ph.D. completed her Ph.D. in human cognitive neuroscience at the University of Edinburgh and her post-doctoral fellowship as part of the Clinical Psychology Training Consortium at the Alpert Medical School of Brown University, followed by a year as assistant professor of psychiatry and human behavior at Brown. She has received numerous awards, including the University of Edinburgh Principal’s Career Development Award and the University of Edinburgh Medal for Academic Distinction.

Alber spent the early years of her career conducting neuropsychological assessments in memory clinic and building a foundation in neurodegenerative disease research, with a focus on preclinical biomarkers of Alzheimer’s disease (AD). During her post-doctoral fellowship, she studied under Stephen Salloway and Peter Snyder, developing expertise in AD clinical trials and biomarkers for the early detection of AD. She is currently engaged in research examining potential retinal biomarkers for the detection and prevention of Alzheimer’s disease. Other projects include examination of the effect of cardiac rehabilitation on long-term cognitive decline, and the effect of the APOE E4 gene on cognitive, lifestyle, and biomarker outcomes in preclinical AD. She has published extensively on the early detection and prevention of AD, and looks forward to expanding her burgeoning career in neurodegenerative disease research.