Dr. Axel Montagne is a chancellor's fellow and group leader at the UK Dementia Research Institute at the University of Edinburgh Centre for Clinical Brain Sciences. His group aims to understand how, when, and where critical components of the blood-brain barrier become dysfunctional preceding dementia and in the earliest stages of age-related cognitive decline. With this knowledge, they hope to develop precise treatments targeting brain vasculature to protect brain function.

More importantly his work, and that of his colleagues, provide a critical lens through which to view the contributions of vascular dysfunction (or, conversely, vascular health – if we choose to preserve it) as a critical common thread in dementia and neurodegeneration.

In this episode, we discuss:

• (00:00) Introduction to Dr. Axel Montagne
• (11:44) What dementias have in common
• (12:42) The importance of preserving small blood vessels (in the brain)
• (13:38) Changes in the blood-brain barrier in aging that cause "leaking"
• (15:11) Predicting cognitive decline early with biomarkers – an opportunity for intervention?
• (16:32) Why targeting amyloid isn't enough
• (18:54) The impact of the APOE4 genotype on brain vasculature
• (24:19) The cause of white matter damage in the brain
• (33:47) Why the loss of omega-3 transport affects pericytes
• (35:25) The role of exercise in prevention of blood-brain barrier dysfunction
• (35:45) Why high heart rates during exercise preserve brain function
• (36:49) The role of exercise in preserving vision health
• (40:17) Why leaky vessels damage myelin and the brain
• (45:31) Can you have more than one type of dementia?
• (47:54) Does the breakdown of the blood-brain barrier cause "type 3 diabetes"?
• (54:03) Why omega-3 may prevent detachment of pericytes
• (1:14:35) Why a hepatitis drug restored cognition in APOE4 mice
• (1:19:39) Why blood-brain barrier disruption results in the accumulation of amyloid-beta
• (1:25:14) Why lifetime hypertension increases dementia risk
• (1:37:13) Effects of obesity on blood-brain barrier leakage

Watch this episode on YouTube

Show notes are available by clicking here

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