Harvard Medical Student: THIS is the future of brain disease [Part 2]

Meg Majumder lays out the future of brain health in Part 2 of our interview

Written by Alex Reid
Posted December 6, 2018

harvard interview part II

Meg Majumder is a Harvard Medical student who researches neurodegenerative disorders like Alzheimer's and Parkinson's. Her research started as an undergraduate at UC Berkeley and includes the use of artificial intelligence to diagnose and treat these diseases, plus the ethical implications that follow. You can follow Meg on Twitter here.

We were fortunate to grab Meg for an exclusive interview. The original transcript has been edited for clarity and ease of reading. This is Part 2, so if you missed Part 1, check that out here.

This is part of our ongoing series with doctors and researchers at the cutting edge of medical science and theory. You can find the last installment, an interview with orthopedic surgeon and diet advocate Dr. Shawn Baker, right here.

When this part of the interview started, we were talking about both the advantages and pitfalls of pharmaceutical medicine.

Meg Majumder: In my opinion, pharma is generally problematic in nature because... Big Pharma, especially, has a tendency to exacerbate disparities and worsen the issue of access to medicine.

I'm not going to name any specifics here, but I think it's kind of understood that Big Pharma is almost nobody's friend.

Based on what I know — and it's nothing conclusive or comprehensive at all, given my intake of the studies — is that there's a lot more research to be done to confirm and validate the promises that new therapies are putting out there, for the general public.

CHN: And what about natural remedies?

Meg Majumder: I am somebody who swears by natural remedies and what nature has to offer. If there's no harm, I don't see the harm in trying it out. You know?

I'm Indian, so my background is also in Ayurveda.

Ayurveda is an Indian type of medicine rooted in religious texts. Ashwagandha comes from that, and it's something that I definitely see promise in.

It's this small evergreen, perennial herb. You might know it as winter cherry or Indian ginseng. It's not a cure for Alzheimer's or anything, but it is something that I have noted, in the patients that I've worked with, to reduce amyloid plaques over time, and emerging research suggests it could even improve cognitive abilities.

Whether or not that's a placebo, we don't often know because it's almost impossible to conduct a perfect experiment. But there are remarkable therapeutic effects of Ashwagandha.

This is just one in a very many cases, but I've seen it overcome behavioral deficits and pathologies that you can see in Alzheimer's disease models. So that's interesting.

I've seen neuronal networks be reconstructed. It's incredible. And that's absolutely necessary if you want to treat neurodegenerative diseases. 

CHN: How about Lion's mane mushroom? Have you heard of this being a neuroprotective against dementia?

Meg Majumder: Yeah, there's a lot of people who say it could work as protection against dementia. I think it totally depends on the patient and how much they actually believe in any of these natural remedies.

There does appear to be plenty of research to justify mushroom intake in general.

As long as it's nothing that could hurt you, right, why not? Why not take a crazy chance? They have plenty of antioxidants.

And antioxidants, they just have a cascading-type mechanism in your body, where neuroprotection could very well, depending on your genome, be one of the effects.

CHN: And what about protecting your brain with lifestyle changes like improved sleep or exercise?

Meg Majumder: Yeah, definitely. Of course sleep is imperative, but physical activity is just so critical to cognitive function, it's almost crazy.

Our brain size was even known to increase, evolutionarily speaking, as a direct result of physical activity.

And even though it's like a chicken or the egg kind of problem, I can kind of almost positively say based on the research I surveyed, as a direct result of increased activity, physical activity, brain health will improve.

Cognitive function and physical activity are very much interdependent and intercorrelative. In whatever way you can figure to have an hour a day being on your feet, running around, playing ping pong, that kind of... That'll do a world of good.

And anything that integrates hand-eye coordination or builds together cognitive function and memory recall and integration of limb movements, all of that would be definitely beneficial.

CHN: You mentioned earlier that you're working with VR right now.

Meg Majumder: That's what's underway for the clinical trials. We're integrating VR, eye-tracking, gait, all these different technologies into one paradigm that can effectively diagnose or prefer early diagnoses to neurodegenerative patients. Very, very multifaceted, to say the least.

CHN: And you said the VR could also be part of the prevention or treatment?

Meg Majumder: Yeah, so it could be part of the treatment, but right now, we're just using it diagnostically.

So when people have rapid eye movements, we're using VR to assess whether or not those movements compare normatively to our data sets.

So the data sets would be composed of people who have normal rapid eye movement and people who have abnormal rapid eye movement. People with more abnormal rapid eye movement might have an increased risk of a certain neurodegenerative disease.

CHN: That's fascinating.

Meg Majumder: But yeah, you're definitely right with regards to treatment. It could be used as a treatment therapy. There's a lab that's using it in real-time. I think they've even deployed it at UCSS as treatment, for neurodegenerative patients, though I think they're still in clinical trials.

CHN: Is it possible that playing video games now, like commercially available video games, VR games, could help people suffering from neurodegenerative issues?

Meg Majumder: I don't know anything that's on the market that you can purchase right now, but there's definitely a very significant potential for virtual reality in both diagnoses AND treatment.

CHN: To bring this back to what you can do right now, it sounds like the very first thing is to have a conversation with your doctor and get an accurate diagnosis as soon as possible. And, among other things, that can actually save you money in the long run?

Meg Majumder: Oh, yeah. Lot of money. And it might even allow others to care for you, as a patient or future patient. Let's say you have kids and they're planning on moving away. If a parent is diagnosed with an increased risk of a certain neurodegenerative disease, they might feel the need to stay and that would be great because then you'll have the care that you need in the event that you're diagnosed.

CHN: And what would you tell someone who is concerned about a loved one, maybe a parent or even a spouse?

Meg Majumder: Yeah, so that's a big one. So most of the parents and daughters, sons, and husbands, wives that I've talked to of current patients, all of them unanimously have stated that they wish that they'd known earlier on.

So what that means is for you to interpret, for the reader of this post to interpret. But, to me, it means that, I have an obligation as a scientist and a future physician, to provide them with the tools to fulfill their wishes.

CHN: Here's a difficult question for you. Do you have any advice for someone who wants their spouse, their parent, or other family member to go and get tested, but is afraid to broach the subject?

Meg Majumder: Oh. For how somebody might go about getting their spouse to get tested or at least have the conversation?

CHN: Yeah, exactly. Which we know can be very difficult.

Meg Majumder: So, people care about a lot of things, and if you can correctly identify or find some way to find out what people care about, whether it comes to finances or their children or their living wills — by incentivizing them with something they care about, they'll be much more likely to open up to having this kind of conversation, because it's almost an impossible reality to be faced with. Especially in this day and age, where there are no cures for most neurodegenerative diseases.

The way that I see it play out most effectively, is when a woman came up to me, and she advised that her husband was forgetting a lot of things and he refused to acknowledge that he had something wrong with him. She was almost sure, because she'd seen it in her own mom, that it was a form of dementia. And she consulted me. I was a young kid then, but she opened up about it, and I couldn't do anything but console her and ask her what her daughter would do. Like what would her daughter do? Would they care? Would this change things? Because her daughter was about to get married and stuff.

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And she said, "Yeah, you're right. This would affect my daughter." And then she brought that up to her husband and by portraying it in a light that it had... Like him getting diagnosed or him at least having the conversation about the possibility that he has dementia or could have dementia, that that would have cascading implications for their daughter. That's what brought him to the doctor, TCSS, the neurology clinic.

So, I think it's all about framing it in a light that affects what the patient in question would actually care about. Because if it's sometimes people just don't care enough about themselves, but they care a lot about other people. Or they care a lot about their insurance, or their family insurance, you know?

CHN: And you could even take that a degree further. You could then frame that in terms of some of the optimism you've shown about the technology side. Not only do this for our daughter, but solve this for your daughter, in the sense that—

Meg Majumder: Exactly.

CHN: Are there any sort of positive results you've seen in your own research that you can talk about?

Meg Majumder: Yeah. We're pretty successful with that. But we're currently pretty bad at... Our department is kind of bad at, is treating. Stuff like Alzheimer's and treating stuff like Parkinson's and Huntington's. We're pretty good on MS, as of right now, just because you see it.

But the other, the entire, the remaining [inaudible 00:44:59] of neurodegenerative issues, we're not that great. We're not that great at preventing them, we're not that great at treating them, we're not that great at palliative care when it comes to late stages of Alzheimer's and stuff. So, yeah.

What we are good on is early diagnosing. But all of that, it needs to be complemented. There's a huge need right now for complementary forms of therapy, whether it comes to pharmaceuticals or whether it comes to palliative care.

CHN: It sounds like you see the most promise maybe in some of these large technology companies, and private money?

Meg Majumder: Definitely. Yeah. Definitely private money combined with academic institutions for research. That's pretty much the future of treatment and diagnoses and rehabilitation.

CHN: And if there's any way our readers want to support this, what can they do?

Meg Majumder: In my opinion, the best way to support this research is to acquire knowledge about what's going on. Like what are the latest therapies and to inquire with your doctor about what's coming out, so that doctors are incentivized to actually be aware of these treatments and to be aware of the technologies that allow for early diagnosis. Because otherwise, this could very well get lost in a paper stack on a provider's desk, right? The more awareness you build, the better you're doing for both yourself, your family, your community, and the entirety of your population.

CHN: So to return to the very practical, the biggest thing is diagnosis and having that conversation with loved ones and doctors. And then the lifestyle and supplemental things are worth considering as well?

Meg Majumder: I would say the Ashwagandha. Curcumin has a whole suite of benefits that are proven. A lot of them are unproven by any kind of peer reviews studies, but oftentimes...

It depends on the body, of course, because everyone's genome is susceptible to different kinds of interventions and things manifest differently dependent on your body. So, most all of the effects that I've seen with regard to curcumin and curcumin studies have been positive and it's a whole array...

It's not necessarily a cure for anything, but I would supplement as a complement. It can't do anything bad for you.

CHN: Okay. So you confidently say that curcumin and the Ashwagandha? And then, physical activity?

Meg Majumder: Definitely physical activity, yes.

CHN: And ping pong is great, because it sounds like someone with impaired mobility could play sitting down?

Meg Majumder: Exactly. I recommend it to so many people. They love it. It's fun, it's exciting, it's like a bonding experience and it eases both the mental faculty and the physical.

CHN: And then yeah, I guess just to wrap up, what would you like to tell our audience, specifically? What would you like to tell everyone who reads the article?

Meg Majumder: Honestly, if you're living a happy, healthy lifestyle, then you're doing right by you, your family, and your community. And you could even do more by intervening in a way that's productive and kind to all these people that you care about by simply being aware of what's out there and caring about science, in general. I know it might... It often goes over people's heads, like all this kind of crazy research that's going on, but at the end of the day, it's just like the folks that want to help. And what we're doing to help is not that complicated if we're good enough at having the conversation. That's it.

CHN: Yeah, I think that's a great note to end on. Thanks again for being generous with your time.