Saturday, Jun. 13, 2009

Scott Air Force Base helps deliver MRI equipment to South America

Device to be used for schizophrenia tests

SCOTT AIR FORCE BASE -- Dr. Gabriel de Erausquin has a theory on how schizophrenia begins and how it can be prevented.

On Friday, Scott Air Force Base provided an important assist to Erausquin, a Harvard Medical School neuro-psychiatrist, in his quest to test it out.

Early on Friday afternoon, a K-Loader crew from the 375th Airlift Wing cradled a 12.5-ton electro-magnet into the hold of a U.S. Air Force C-17 cargo plane.

The electro-magnet's eventual destination: Salta, Argentina, in the foothills of the Andes mountains.

When it arrives, the giant magnet will be hooked up to another 7.5 tons worth of wires, circuit boards and computers shipped there last year. Together, they will form a completed magnetic resonance imagining machine, or MRI, which uses radio waves to generate detailed pictures of a patient's anatomy.

Along with providing routine medical care, the MRI will be used to conduct brain scans of indigenous peoples as part of an ambitious research project into the origins of schizophrenia, a mental illness that afflicts an estimated 1 percent of the world's population.

The native population living in the Andean foothills makes for perfect test subjects. That's because since they have never been treated for this mental illness before, they have never taken the medicines that could cloud test results, said Erausquin, himself a native of Argentina.

The project could one day pay off in new ways to cure or even prevent schizophrenia. Its symptoms include hallucinations and bizarre behavior, said Erausquin, who until two weeks ago taught at the medical school at Washington University in St. Louis, which donated the MRI.

At least 30 indigenous people will take part in the $1 million study, which is being funded in large part by U.S. taxpayers in the form of National Institutes of Health grants.

The volunteers who take part will include both those with obvious symptoms of schizophrenia and close relatives who are not showing symptoms, Erausquin said.

Erausquin's team will use the brain scans to test a theory that holds that schizophrenia is associated with problems in the production and flow of a chemical called dopamine inside the brain.

Dopamine is a neurotransmitter that enables the brain to send messages to itself and the rest of the body. It plays a major role in cognition, movement and learning.

The brain abnormalities that cause dopamine problems in a schizophrenic patient might also show up in the brains of a close relative, Erausquin said.

"The trick is we'll look at not just the patients, but also at the normal relatives that have the chance of developing schizophrenia, but not have developed the disease," he said.

If a pattern of abnormalities emerges linking the brains of schizophrenic patients with their normal relatives, "then we can map the risk" for the development of schizophrenia in families, Erausquin said.

"We can tell where in that slope, if you will, that goes from being completely normal to having a full blown sickness, where you are," he said. "We think the imaging data will add significantly to our ability to predict correctly."

The story of how the MRI came to Scott Air Force Base began when a nonprofit charity called FULTRA, which provides mental health care to patients in South America, contacted Erausquin about promising work on schizophrenia he was performing in his laboratory at Washington University.

Meanwhile, the university had bought a new MRI and notified Erausquin he could use the old one for research purposes. Erausquin decided to turn it over to FULTRA.

Right away he confronted a big problem: How to get a machine weighing 20 tons from St. Louis to the tip of South America?

"I had to start trying to figure out how to transport this monster to Argentina. It was a nightmare actually," he said. "There were no commercial planes big enough to carry that monster down there."

Enter the federal government, in the form of the U.S. Agency for International Development.

It runs the Denton Program, which allows private groups to use space available on U.S. military cargo planes to transport humanitarian items, such as medical and educational supplies, food and farm equipment to nations in need. This year, the program expects to coordinate the shipment of 500 tons of equipment to 17 nations.

Because of the MRI's immense size and complexity, it had to be taken down to South America in two trips more than 10 months apart, along with an airlift certification letter, said Ken Hundemer, operations manager for the Denton Program, which is based at the Charleston Air Force Base, in Charleston, S.C.

"This is the last piece of the puzzle," Hundemer said. "Everyone will be extremely happy."

Erausquin wants to test a theory on how schizophrenia begins in the first place.

Research shows that a patient with schizophrenia must inherit a genetic predisposition toward the disease. But something must occur in the environment to "push" the patient toward manifesting its symptoms -- which can begin showing up during the patient's first six months of life.

The proposed environmental factors span a wide range, from a virus that causes influenza to a traumatic birth.

And then there is the biggest question of all: Why does humanity pass on the genes for this disease from one generation to the next, with its prevalence at 1 percent of the population regardless of race, geography or culture?

"One of the arguments is that it may have to do with the development of language," Erausquin said. "The same mechanism by which we develop language is what made us prone to schizophrenia."