In Context

212 www.thelancet.com/neurology Vol 11 March 2012

Reisa Sperling was killing time up on the 40th fl oor of the New York Academy of Sciences building when The Lancet Neurology caught up with her. You would think that the phone reception would be crystal clear so high up. It isn’t. But even after the umpteenth dropped call there wasn’t the merest hint of irritation in Sperling’s voice when she picked up again, laughing down the crackling line. Nor was there a trace of nerves, which there might have been, because Sperling was about to deliver the academy audience a lecture billed as Biomarkers and Brain Imaging of Presymptomatic Alzheimer’s Disease: Exploring the Silent Years. Even when you are as sure of your subject as Sperling clearly is—being a leading light in the push to redefi ne Alzheimer’s Disease (AD) as having a long pre-symptomatic phase—having to expound on it in front of an auditorium full of New Yorkers might still cause a few last-minute butterfl ies. But Sperling, it turns out, has a distinct edge over her peers when it comes to taking the stage.

“Reisa was a Broadway performer”, volunteers Randy Buckner, a colleague of Sperling’s at Harvard Uni-versity (Boston, MA, USA). And although Sperling is ever so slightly coy about her theatrical past, Buckner has no such reservations. “You can fi nd a remnant of her life before medicine in the internet movie database”, he divulges with glee, but The Lancet Neurology will exercise its discretion and say no more, because for Sperling it is all about the science now. According to her long-time Harvard collaborator, Dennis Selkoe, Sperling represents the “wave of the future in translational research on age-related cognitive decline”, a remarkable metamorphosis from Broadway actress to trail-blazing clinician-scientist that should be a beacon of hope for anyone considering a radical career change.

“Ever since I was young I’ve been fascinated by thinking and cognition, but I really had a one-track mind for theatre until I was kind of in my late 20s”, Sperling recalls. The daughter of two scientists, Sperling left home in Pennsylvania and travelled to New York City at the age of 17 to get her taste of the limelight, working “mostly in musical theatre in New York and all around the country for 7 years”. But, she explains, “I then started to realise that although I loved theatre and had an incredible time, I really wanted, and this might sound very trite, to do something more meaningful with my life”. On top of acting, Sperling enrolled at Columbia University to study psychology, despite realising midway through the entrance exam that stage school hadn’t taught her to add fractions. All of her fascination with neuroscience, and with memory in particular came fl ooding back, but it was a profoundly personal experience that would put Sperling fi rmly on the path to research into AD.

“At the time when I was going back to school and studying neuroscience and psychology, my grandfather developed

memory problems and dementia. And that was diffi cult for me because he’d always been the intellectual giant in our family, and I really saw this process destroy him over the course of just a few years”, Sperling recalls. “So the two of those things together made me think I wanted to go to medical school, and I decided AD in particular was a very fascinating model of how memory fails, and also hopefully that we could fi nd a way to prevent memory failure.”

So, after 11 years in New York, Sperling made the trip to Boston, where she had secured herself a place at the medical school “because Harvard are very serious about their second year show, so they bring in some ringers”, she jokes. 23 years later, Sperling says, “and this is very sad to say, my offi ce is literally 200 feet away from where I walked in the door to go to medical school. I have not moved anywhere.” Nor, it seems, would she want to. “Boston is an amazing opportunity for neuroscience”, she enthuses. “And it’s terrifi c because I’m really blessed to be able to work with people who are working on the molecular biology of AD, like Dennis Selkoe and Brad Hyman, doing amazing imaging, in a really dedicated place that’s working on treatment.”

The feeling is more than mutual: it’s hard not to suspect that one reason for Sperling’s long association with Harvard is that her colleagues wouldn’t let her leave even if she wanted to. “To sum up in a word, Reisa Sperling is a visionary”, says Dorene Rentz. “She has a talent for being on the ‘cutting edge’, and inspires the best in all those around her. I have never known anyone with the kind of energy and passion that she has.” It’s a sentiment echoed by everyone that The Lancet Neurology spoke to, and Sperling’s energy and passion are in abundance when she speaks about her plans for the future, a large secondary prevention study in which, she explains, “we take amyloid-positive older individuals and try to treat them with an anti-amyloid drug, to see if by lowering amyloid accumulation before symptoms occur we can slow the rate of decline”.

Although the approach is controversial, “I think we must try, we can’t keep trying these therapies at the end stage of the disease”, Sperling explains. “I fervently hope and pray that we do hit a home run”, she says, but two decades in the fi eld have tempered her optimism slightly, if not her steely determination. “Maybe 5 years ago I remember saying ‘I’m going to have to fi nd another disease to study because we’re going to fi x AD’. And now I’m a little less clear that we’re going to fi x it before my own brain gives out”, she laughs. “But I feel like we have a way forward now to really test a hypothesis. It may be that we’re not on the right track, but that at least gives me hope that we can make progress.”

David Holmes

Profi leReisa Sperling: acting out, Alzheimer’s in

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