MORGANTOWN -- Judy Polak is a pioneer.\r\n\r\nThe retired WVU NICU \u2013 neonatal intensive care unit \u2013 nurse was diagnosed with Alzheimer\u2019s disease in 2014.\r\n\r\n<img class="alignright size-medium wp-image-26664" src="http:\/\/www.dominionpost.com\/wp-content\/uploads\/2018\/11\/helmet-a-e1541816125427-225x300.jpg" alt="" width="225" height="300" \/>She's the first person in the world to undergo a clinical trial of a new procedure that uses ultrasound waves to perhaps slow or even reverse the effects of early state Alzheimer\u2019s.\r\n\r\n\u201cI think for me it won\u2019t be anything,\u201d she said. \u201cIt\u2019s going to be the future.\u201d\r\n\r\nWVU\u2019s Neuroscience Institute is conducting the trial, overseen by Executive Chair Dr. Ali Rezai, who explained the process.\r\n\r\nIn Alzheimer\u2019s, as brain tissue degenerates, it\u2019s inundated with plaques\u2014 protein deposits and other debris. This make the brain \u201csticky,\u201d so it can\u2019t communicate with the neurons, he said.\r\n\r\n<img class="alignright size-medium wp-image-26665" src="http:\/\/www.dominionpost.com\/wp-content\/uploads\/2018\/11\/helmet1-300x158.jpg" alt="" width="300" height="158" \/>Something called the blood-brain barrier protects the brain by preventing toxins or large molecules from crossing through the blood vessels into the brain.\r\n\r\nBut in Alzheimer\u2019s it\u2019s self-defeating because it also prevents small molecules \u2013 medications, chemotherapy, antibodies \u2013 from crossing in to break up the plaques.\r\n\r\n<img class="alignright size-medium wp-image-26667" src="http:\/\/www.dominionpost.com\/wp-content\/uploads\/2018\/11\/helmet3-300x158.jpg" alt="" width="300" height="158" \/>Rezai\u2019s team is using a new-technology ultrasound helmet with 1,022 probes in it, combined with magnetic resonance imaging (MRI) to deliver focused, low intensity ultrasound waves that converge like a lens to a focal point to target the affected area: the hippocampus.\r\n\r\nThe hippocampus, he said, is involved in memory \u2013 and the plaques in dementia and Alzheimer\u2019s affect new, working memory formation.\r\n\r\nThe helmet is called Exablate Neuro, developed by an Israeli company called Insightec. It and has been used to treat other conditions, such as tremors, with high intensity ultrasound. This is a trail of a new use for the machine.\r\n\r\n\u201cWe\u2019re among the few in this country that has access to this technology,\u2019 Rezai said. Insightec chose WVU to be the first to undertake the Phase II trial after previous, successful Phase I preclinical trials on animals.\r\n\r\nThe process requires no incisions into the brain. As the ultrasound waves enter the brain, the surgical team injects a solution of microbubbles into blood stream.\r\n\r\nThese bubbles circulate through the brain; the ultrasound wave oscillates the microbubbles, which temporarily opens the blood-brain barrier. They believe the immune system is then activated and antibodies can pass into the brain to break up the plaques.\r\n\r\nThis should to some degree restore memory and improve affected behaviors, Rezai said.\r\n\r\nRezai leads a team of about 50 people. \u201cWhat I\u2019ve been stuck by is the dedication, the expertise of the people here, who are really coming together to explore some of these new opportunities, and really make the Rockefeller Neurosciences Institute and West Virginia University a premier place, the go-to place for discovery and innovation.\u201d\r\n\r\nPolak had two treatments in October and will receive one more. \u201cShe is really a very brave lady,\u201d he said.\r\n\r\nMeanwhile, researchers are enrolling more patients for trials at several sites around the country, Rezai said. They will see if there\u2019s impact on plaques and cognitive memory loss.\r\n\r\n\u201cIf we show that over the next two, three years, then there will be another trial, a much larger Phase III trial.\u201d\r\n\r\nJudy\u2019s entire\u00a0procedure takes about five hours. Her head has to be shaved to allow the ultrasound waves to pass. She is lightly sedated because the procedure involves some pain.\r\n\r\nA metal \u201chalo\u201d is attached via screws with sharp points (they don\u2019t go in far) and a silicon membrane is secured over the halo and the scalp. This is all secured to the ultrasound helmet\u2019s specifically designed transcranial transducers.\r\n\r\nThis in turn creates a sealed space, which holds icy cold water. The circulating water provides a medium for smooth ultrasound transmission. Judy is lying on an MRI table for the duration of the procedure.\r\n\r\nJudy\u2019s husband, Mark Polak, is a NICU physician and learned about the trial via some co-workers. They made contact to volunteer in August and were soon approved.\r\n\r\nJudy said she doesn\u2019t feel the screws but does feel the cold. \u201cIt\u2019s like being in a time capsule or something. ... I have warm blankets, so it\u2019s not so uncomfortable with that. It\u2019s not so bad.\u201d\r\n\r\nWhat\u2019s important for her, she said, is future Alzheimer\u2019s patients. \u201cAs more and more people study this and put all the puzzles together, we\u2019re going to find something that will help move forward.\u201d\r\n\r\nTheir daughter, Emily Polak, is an administrative assistant in the pediatric research unit. \u201cShe\u2019s just always been her throughout it,\u201d she said. \u201cShe never looks nervous. She\u2019s sitting up and still smiling.\u201d\r\n\r\nAnd she tries to help the nurses. \u201cShe\u2019s still being a nurse even though she\u2019s the patient. She\u2019s pretty strong. And just seeing go through that without being sorry for herself \u2026 It\u2019s never been about her.\u201d\r\n\r\nThen Emily tears up. \u201cTo me, if this trial can give us another hour where she\u2019ll remember our names in the future, then it\u2019 worked.\u201d\r\n\r\nMark said, \u201cLooking at it as a realist \u2013 we were not looking for cure. But the optimist in me says, why not?\r\n\r\n\u201cMaybe just opening that blood-brain barrier makes a difference. It made a difference in mice.\u201d\r\n\r\nThe immune system may go to work and take care of the plaques. \u201cMaybe people have noticed just a slight, subtle change in her eyes, the way she walks, a more stable gait. Not memory. That\u2019s still is an issue.\u201d\r\n\r\nAlzheimer\u2019s is a disease with 100 percent mortality, Mark said. The brain is protecting itself \u2026 while it destroys itself.\r\n\r\n\u201cNobody gets out of this alive. This [trial] is jumping out of the box. Perhaps immune system will start ramping up in a \u00a0way it never has before.\r\n\r\nHe pondered the use of terms associated with disease. People always suffering from Alzheimer\u2019s. People with cancer are fighting. \u201cWe\u2019ve got to start picking up our weapons and fighting Alzheimer\u2019s rather than just suffering from it.\u201d\r\n\r\nThe Neuroscience Institute will follower Judy closely for five years, he said. They\u2019ll do lab studies, blood tests, spinal taps to see if bad proteins have gotten out of brain, and \u201cscans galore. She\u2019ll have a free pass to the MRI.\r\n\r\nThere will also be neurologic testing \u2013 having her draw a circle, a square. One of her biggest problems is spatial orientation, he said.\r\n\r\n\u201cWe would still be happy doing this if there was no change at all and we knew there was no possibility of improvement, because it has to be done.