This story was published by the San Antonio Express-News on Sept. 10, 2021.
By Lauren Caruba, Staff writer
From an early age, Dr. Sudha Seshadri wanted to understand the human brain, and why its functions sometimes go terribly awry.
Throughout her childhood in India, she watched her mother’s health deteriorate from an unidentified neurological disease that affected her ability to move and speak. By high school, she knew she either wanted to study the brain or treat patients as a physician.
In the years to come, she would do both.
Seshadri is now an internationally prominent researcher on dementia and other neurodegenerative diseases. Since late 2017, she has led the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio, serving as its founding director. In a short amount of time, she has recruited top researchers and advanced studies of drugs that have the potential to treat Alzheimer’s, a disease that for decades has thwarted attempts to cure or effectively treat it.
But she has focused her energies just as much on people currently suffering from the disease, continuing to see patients even as she runs the Biggs Institute and conducts her own research.
“There’s no doubt that Dr. Seshadri is a huge champion for those impacted by dementia broadly,” said Maria Carrillo, chief science officer at the Alzheimer’s Association. “She has been committed to dementia work for decades and is an expert that can address it genetically, epidemiologically, clinically.”
The patient perspective
Seshadri’s experience with her mother — who she now believes had a severe form of multiple sclerosis — has informed her approach as a doctor and researcher. She died when Seshadri was 18 and just beginning her undergraduate studies at Christian Medical College at the University of Madras, along India’s southeastern coast.
“My early experiences have helped me see the patient perspective,” Seshadri said.
While she completed her undergraduate degree, Seshadri served as the guardian of her younger brother, who was finishing high school.
She went on to earn a medical degree in internal medicine and a doctorate in neurobiology at All India Institute of Medical Sciences in New Delhi. There she met her husband, Vasan Ramachandran, a cardiologist interested in heart disease prevention.
The couple moved to Massachusetts in the early 1990s, after Ramachandran secured a position at the Framingham Heart Study, a prestigious research initiative on the outskirts of Boston. Since 1948, Framingham has tracked thousands of people over three generations to identify the progression of and risk factors for heart disease and a host of other medical conditions.
Seshadri took a fellowship with the study’s dementia program, but she always intended to return home.
She did a few years later, taking a position at All India Institute while her husband moved 2,000 miles away to establish a school of public health. The distance was difficult on the couple and their 7-year-old daughter, who would fall asleep in the back of her mother’s academic sessions.
By the time they reunited in the same place, Ramachandran had received recognition for his research. He was offered the opportunity to return to the Framingham study.
Seshadri felt torn about leaving India, where there was a dearth of neurology specialists. But she also knew her work would have greater reach in the U.S., where she would have more resources to pursue her research.
The family decided to emigrate.
One-stop shop for Alzheimer’s
In Boston, Seshadri completed a fellowship in epidemiology and did more neurology work at Framingham, but she was committed to treating patients.
She pursued a neurology residency at Boston University School of Medicine, joining the research faculty in 2005. By 2013, she was leading the neurology arm of Framingham, which is affiliated with the university.
Still, she yearned for more.
There was an Alzheimer’s research center in Boston, but it had a strong emphasis on chronic traumatic encephalopathy, or CTE, the degenerative brain condition that has been identified in football players and others with repeated head injuries.
During her time at Framingham, Seshadri was able to form relationships with the patients behind the data she was collecting. That was not the case at many institutions, where research and treatment were often siloed from each other.
“I had this vision of being able to integrate the clinical care and research,” Seshadri said. “It would be frustrating to me that many Alzheimer’s centers, the research is one part, and the clinical care is another part, and they’re done by different groups of people.”
So when Seshadri was contacted by UT Health San Antonio about leading a new comprehensive center for Alzheimer’s and other neurodegenerative diseases in San Antonio — where she would have the chance to conduct research while also treating patients — she was more than interested.
It sounded like the perfect fit.
Dr. William Henrich was thinking the same thing.
The president of UT Health San Antonio knew he needed someone who could not only think big, but also withstand the challenges and pitfalls of creating something new.
“We were not recruiting to an established institute,” said Henrich, who has led the health care institution since 2009. “This was a greenfield operation. This was a ground-up build, in a portion of a country, in an area of Texas, where there’s great need.”
Henrich was was also under the additional pressure of honoring the person who had inspired the idea for the center in the first place.
A few years earlier, he had been approached by Glenn Biggs, a local business leader who served as the first chairman of what was then called the University of Texas Health Science Center at San Antonio.
He had been diagnosed with Alzheimer’s, and as his condition worsened, he looked for help, to no avail. He refused to accept that nothing could be done for patients like him, his wife said. He met with Henrich and the dean of the medical school, pitching them on the idea that San Antonio could become known for Alzheimer’s research in the same way MD Anderson in Houston was known for advanced cancer care.
“Glenn was a person who would not take no for an answer. He just kept searching,” said Ann Biggs, 87. “He planted the seed. In their mind, I’m sure they had already thought about it, and he pushed them.”
Biggs died in 2015, about two months shy of his 60th wedding anniversary.
Henrich followed through on his promise, raising $50 million toward the establishment of an Alzheimer’s center.
As he considered a pool of distinguished candidates, Seshadri stood out. She had an impeccable résumé, but she also had what Henrich called “sincerity of purpose” — a genuine desire to improve the lives of patients.
“She is indefatigable,” Henrich said. “She is sincerely dedicated to finding a way to mitigate the devastating effects of these neurodegenerative conditions and she will do whatever is required to make the patient better, make the family better.”
In December 2017, the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Disease was unveiled, with Seshadri as its founding director.
For Seshadri, working in San Antonio meant she could shape the center in her vision. But it was also an opportunity to find answers for a underserved community where dementia was extremely prevalent — Latinos are at a 50 percent higher risk of developing the disease.
“The Biggs center, it’s situated in a place where it’s very uniquely positioned to engage a Latin American population that has been not only neglected, ignored, but has also been reluctant to participate in research,” said Carrillo of the Alzheimer’s Association. “That is a bidirectional problem we’ve had not only in dementia research, but in health research broadly.”
Since then, Biggs Institute researchers have advanced three drugs that have shown promise in animals to human studies. The center is also participating in national clinical trials and international research, including a consortium studying the long-term neurological effects of COVID-19.
If her patients can’t have access to a proven treatment, Seshadri said, she at least wants them to have the chance to be part of the solution.
Over the next few years, Seshadri plans to continue growing the Biggs Institute, something she managed to do even as the pandemic disrupted health care systems and research across the globe. Her goal is to identify a meaningful treatment in the next five years, by which time she hopes dementia care will more closely resemble cancer care.
Despite many recent failures to identify effective treatments for Alzheimer’s, Seshadri hasn’t lost hope.
And she still stays in touch with Ann Biggs, who talks with her regularly and has appeared with her at events and informational sessions.
Seshadri arrived too late to help Glenn Biggs. But his wife knows his concerns were for future generations.
She could not think of a better person for the job.
“She’s the kind of person that you feel better after you’ve been around her,” she said. “She’s doing something.”