by Julie Cleveland
Dr. Debby Tsuang is a staff physician at the Veterans Administration Puget Sound Health Care System and an assistant professor in the Department of Psychiatry at the University of Washington (UW). She joined the UW Alzheimer’s Disease Research Center in 1995. Tsuang has a variety of responsibilities in her work. At least one day a week, she sees patients with a broad range of cognitive and behavioral problems, ranging from people with dementia or Parkinson’s disease to those with schizophrenia. Some days are spent on scholastic activities such as attending scientific meetings, discussing research updates with colleagues as well as planning and conducting clinical research studies. Tsuang is also a principal investigator (P.I.) for several grants related to the genetic risk factors associated with psychosis across the life span. She also spends much time coordinating and overseeing day-to-day functions.
One of these grants on which Tsuang is a P.I. is a pilot study funded by the National Alzheimer’s Coordinating Center (NACC). This project investigates genetic risk factors in subjects diagnosed with dementia with Lewy bodies (DLB) and Alzheimer’s disease (AD). DLB may be the second most common form of dementia in the United Sates after Alzheimer’s disease (AD). Yet, our understanding of DLB is incomplete and the precise distinction of DLB from AD remains unclear. Tsuang also serves as the UW site coordinator for a five-year NIH grant on DLB (P.I. – Dr. Thomas Montine; UW ADRC Neuropathology Core Leader). This project is an extension of the above-mentioned NACC project and will examine the hypotheses that DLB can be distinguished from AD through clinical-pathologic, genetic, and biochemical characterizations. Tsuang’s collaborators on this project include UW ADRC investigators Drs. Thomas Montine, James Leverenz (Clinical Core), and Gerard Schellenberg (Genetics Core Leader).
Another area of study that may be related to behavioral disturbances in dementia is schizophrenia. Tsuang is also a PI on another five-year NIH-funded study focusing on the genetics of schizophrenia. Although seemingly unrelated to dementia, she believes that any genetic risk factors associated with schizophrenia may also contribute to the development of psychotic features (hallucinations and/or delusions) in dementia. Tsuang’s hope is that focusing on genetics in her research will contribute to our understanding of the underlying biology of dementia and its associated behavioral disturbances, and ultimately lead to better treatments for patients.
Tsuang moved into this line of work because she’s always been interested in the biology of the brain. She says, "It was just fascinating to me that you could potentially tie behavioral disturbances to specific brain neuro-networks or injuries that are responsible for that disruption.” She continues, "But it is also very interesting how people with the same disease can manifest in so many different ways. It’s that variability that helps fuel a lot of our research."
Tsuang values her work, and the people she works with greatly. "I feel privileged to work with such wonderful faculty and staff at the UW ADRC; everyone is incredibly responsible and helpful.” She continues, "My interactions with patients are also very valuable and helpful to me. I really enjoy interactions with my patients and their families, especially the educational aspects - passing on knowledge that we may have learned from research and trying to help families apply it. For example, we try to help family members understand that their loved one’s behavior (such as forgetfulness) isn’t deliberate; it’s an unfortunate part of the disease.”
"One thing I would like to emphasize," states Tsuang, "is that none of our research is possible without volunteers. The generosity and the altruism of the people who are in our clinical core are really amazing. Participating in research doesn’t necessarily mean it’s going to actually help them, but most of our subjects want to help someone else. Without great people like this in the community, we would never be able to do any of our work."