The Israel National Brain Repository .The establishment and uniqueness of the first brain bank in Israel

Abstract

AbstractBackgroundPost‐mortem human brain tissue is the gold‐standard for neurodegenerative disease diagnosis and is invaluable for elucidating cellular and molecular mechanisms. Therefore, neurodegenerative disease brain banks are a critical component of research to advance diagnosis and develop effective disease modifying therapies. The Israel National Brain Repository (INBR) was established in 2018 at the Sheba Medical Center via a collaboration with the Mount Sinai Neuropathology Brain Bank in New York. Israel is a unique country with a diverse population including substantial populations of individuals of European descent, Middle‐Eastern North African (MENA) descent, and combinations of both.MethodINBR predominantly recruits from two prospective longitudinal cohort studies whose participants are at high dementia risk: older adults with type 2 diabetes (the Israel Diabetes and Cognitive Decline study) and middle‐aged offspring of people with Alzheimer’s Disease (The Israel Registry for Alzheimer’s Prevention). Participants in both cohorts are phenotyped for cognition, lifestyle, brain imaging, blood biomarkers, and genetics. Biospecimen collection and processing protocols are aligned with other Neurobiobanks in the USA (see flowchart). Additionally, all participants in both cohorts are members of the second largest healthcare provider in Israel, the Maccabi Healthcare Services, permitting linkage to longitudinal medical records dating from 1998.ResultN = 450 participants have signed intent to autopsy. Among the N = 285 with race/ethnicity data available, 30% are MENA. 14 brain and 6 spinal cord donations have been completed. At time of death, donors had an average age of 81.1 years, 10 had normal cognition, 3 had dementia, and one had amyotrophic lateral sclerosis.ConclusionThe potential strengths of the INBR is in the population characteristics of Israel, the ethnic diversity and admixture, the linkage to 25‐years of medical records data, and the small size of the country allowing donations to be received from anywhere in the country. The main challenge we face is cultural barriers to brain donation that exist among some segments of Israeli society. The ultimate goal is to capitalize on the strengths and uniqueness of INBR to develop novel therapies for dementia.