Ted Huey is the director of the Memory and Aging Program at Butler Hospital, an affiliate of The Warren Alpert Medical School of Brown University, and a research associate in the Department of Psychiatry and Human Behavior
Carney Institute (CI): Tell us about yourself.
Ted Huey (TH): I grew up on the East Coast and went undergraduate to Yale University where I studied cognitive psychology. I did my honors thesis on the cognitive deficits in schizophrenia and found that I really enjoyed working with patients. So, I decided to go to medical school though no one in my family actually is a doctor and it took me a while to get there.
Working as a post bac in an Alzheimer's lab at Columbia University particularly convinced me that this was a path I wanted to take. There was a lot of patient contact as I was doing the cognitive testing with the patients and I thought, “Wow, this is a really fascinating disorder!”
I went to medical school at Stanford and for my adult psychiatry residency. I was torn between psychiatry and neurology. One of my main interests is behavior so I ended up focusing on psychiatry. Interestingly, at Stanford Alzheimer's disease was studied through psychiatry and many of my first mentors, including the creator of the geriatric depression scale, were geriatric psychiatrists.
Following Stanford, I started a fellowship at the National Institute of Mental Health (NIMH) in geriatric psychiatry. My lab was working on Alzheimer's disease but closed midway through my training. There actually wasn't another clinical Alzheimer's lab at NIMH but I was connected with a neuropsychologist at the National Institute of Neurological Disorders and Stroke (NINDS) who was studying a type of non-Alzheimer dementia called frontotemporal dementia. It's another type of dementia where patients have pretty intact memories but their behavior and personality are initially affected. Coming from a psychiatry background, I thought these patients were really interesting and, once I started seeing them, I found that I really loved this area of medicine. I finished my fellowship at NINDS and continued working as an early clinical investigator for a while and saw a lot of this relatively uncommon type of dementia.
For the past 13 years, I’ve been an associate professor of psychiatry and neurology at Columbia University’s College of Physicians and Surgeons. I also served as the director for frontotemporal dementia (FTD), built an FTD center, and was the medical director for the Huntington's disease program, including the genetic testing side of that. I had dual appointments in neurology and psychiatry, but I was really mostly in neurology.
CI: What’s most unique about coming to Brown and Carney?
TH: The Butler Hospital Memory & Aging Program that Steve Salloway and the others there have built is an amazing clinical enterprise. At the same time, I've always been interested in the cognitive science side of things, especially with the frontotemporal dementia patients and Alzheimer's patients, and the paradigms that Carney faculty like David Badre and Michael Frank and others are working on are especially ground-breaking.
One of my two grants is investigating how to use innovative cognitive and emotional neuropsychiatric paradigms to understand Alzheimer’s and FTD symptoms better. I'm particularly interested in non-cognitive symptoms, often called neuropsychiatric symptoms. For example, we know now that most of these disorders present with not just cognitive symptoms but changes in behavior, mood, sleep, and appetite. Apathy is incredibly common in frontotemporal dementia and Alzheimer's as well. So, I'm really interested in learning more about the dimensional commonalities across these modalities.
CI: At times, it seems like there's a gulf between those working on the clinical side of Alzheimer’s/neurodegenerative diseases and those attacking the problem primarily from a research side. How might you be able to bridge the gap?
TH: It's a real challenge. And partly it's all gotten so big that no one really can do it all. I’m a clinical scientist and a lot of what I find exciting about the job is bringing the treatments to people but, I'm not going to come up with a new drug for Alzheimer's. However, if a colleague who's a basic or translational scientist was to produce something interesting, I’m in a position to say, “I can't come up with this, but I can help you see if it's safe and efficacious in people.” A lot of drug development needs a pharmaceutical company. But for early proof of concept, safety, and efficacy studies, we can do that all within Brown. We can take things into the clinic.
CI: Rhode Island is the smallest state in the country, which some people see as a detriment. But many make the point that it's a strength: you have people at Butler Hospital talking to people at Rhode Island Hospital, talking to Miriam Hospital, talking to people at Brown — all creating a tight knit community of researchers and scientists.
TH: It's a unique dynamic. I have a little bit of an outsider point of view coming in from New York where the medical and research landscape is carved up between many systems. In Rhode Island, pretty much everyone has been treated by a Brown affiliated hospital or medical center, and people tend to stay in the state. The head of my search committee said that 95% of the births in Rhode Island happened at that hospital (Women & Infants Hospital of Rhode Island).
This means that we really can get some very interesting population dynamics in a way that I was not able to do in New York. A good example of this is the New England Family Study, a longitudinal investigation initiated in the 1960s. There are now people in the study who are entering their sixties and they're starting to get to the age where we start to look for cognitive and neurodegenerative problems. They have prenatal data on them, they have placental samples. It's incredible data and an incredible cohort. And you can track down and find most of these respondents.
CI: To really tackle Alzheimer’s, a disease that's the sixth leading cause of death in the United States, it would seem to be an “all hands-on deck” affair requiring the expertise of clinicians and researchers from across disciplines.
TH: Yes, it is. I tell this to my trainees too, I don't think I've ever had a research idea of my own that didn't come out of clinic, that didn't come out seeing a patient saying, “that’s interesting.” The other thing I think that sometimes people underestimate is how important it is to involve the patients as the participants in the work and the research. I’m excited to lead the clinical arm of this research at Butler and Brown.