It was 13 years ago that University of Manitoba Prof. Zahra Moussavi first suspected something was wrong with her mother, Soroor.
The normally sharp and composed woman was visiting Winnipeg from Iran at the time. But while in the car with Moussavi, shear would often become anxious -- worried she and her daughter were lost.
"It was more an expression of anxiety, paying too much attention to the landmarks, the cues. That was odd to me," says Moussavi, a biomedical engineer, who, at the time, couldn't figure out exactly what was off-kilter about her beloved mother.
A trip to a physician came up with nothing.
During Soroor's visit to Winnipeg a year later, Moussavi took her to a neurologist. She passed dementia tests. Meanwhile, Moussavi noticed her mother was depressed and her vocabulary dwindled.
A few years later, Soroor got lost only a short distance from her home. That was the first definitive sign: She showed symptoms of Alzheimer's disease.
She and her family were heartbroken -- almost in disbelief.
After all, Soroor was an intelligent and determined woman who had survived so much. In Iran, she married at the young age of 15, dropped out of school and went on to have four children -- Moussavi being the youngest.
That didn't stop her innate hunger for learning; she eventually went to night school, earned a high school diploma and, at age 46, graduated from university with honours.
"It was extremely devastating. It's sad to see such a talented woman decline cognitively, says Moussavi. The professor's voice trails off when talking about her mother, who passed away earlier this year.
It's her personal experiences with her mother's battle with Alzheimer's disease that prompted the Canada Research Chair in biomedical engineering -- who is best known for her work in sleep apnea -- to turn her attention to the disease that destroyed her mother's cognitive skills.
In 2011, 747,000 Canadians were living with dementia. By 2031, this figure will reach more than 1.4 million, according to the Alzheimer Society of Canada.
Moussavi's goal: To detect the earliest signs of Alzheimer's before it's too late.
Her mother wasn't so lucky. Moussavi guesses the steadfast woman had the beginnings of either dementia or Alzheimer's for four years before she was finally diagnosed.
"Our diagnostic system is lacking a lot," says Moussavi, noting that diagnostic tests for dementia aren't adequate to detect the intricate changes going on the in the brain at the onset. "It is so easy to ace those tests, for somebody as intelligent as my mother was."
Alzheimer's patients have the best chance to slow or prevent further decline of their minds if their disease is caught early, she says.
That idea prompted Moussavi to think like a research detective: She wondered if there was an early warning sign of Alzheimer's in her mother -- a detail that might be common in all patients.
The professor came up with a theory. Thirteen years ago, her mother got anxious when Moussavi drove home using different routes. She seemed to pay a lot of attention to coffee shops, banks and other markers she would pass on the way to a destination. Perhaps Soroor was losing her "egocentric orientation" skills, the way humans find directions and get their spatial bearings using their "internal compass," explains Moussavi.
"When that starts to deteriorate, we have to rely more on the landmarks and the cues," says the professor. "I saw mom paying too much attention to landmarks."
Her theories make her the first in the world to hypothesize that egocentric orientation may be one of the first cognitive skills to deteriorate in the initial stages of dementia.
Moussavi and her team have developed a video game that tests this hypothesis.
It depicts a virtual house that looks the same from everywhere.
"In this house, I show a target room from outside the building and ask the subject to go inside the building and find that room," she says.
Moussavi -- who has labs at University of Manitoba and at Riverview Health Centre -- is trying to test the egocentric orientation in as many people as possible; healthy or not, young or old. Her goal is to gather data to determine what levels of egocentric orientation is normal for certain age groups. She also wants to prove it declines in people as they age, particularly at the onset of dementia.
She says her current tests of patients who appear to be at the onset of Alzheimer's prove just that -- they don't do well at her video game.
She is seeking test subjects of all ages to participate in her research.
"The only reason that I'm accepting publicity on my Alzheimer's research is because I need people to volunteer themselves," says Moussavi, candidly.
She admits it's unusual for a researcher to have such a personal connection to the subject she is researching.
Her passion for medicine started in her birthplace, Iran, in 1979, during the throes of the Iranian revolution. A year later, the war between Iran and Iraq broke out and Moussavi, just 19, helped the wounded in surrounding villages. Since her father was a pharmacologist, Moussavi says she had some knowledge of medicine. "I was anxious to do whatever I could."
Eventually, she started her academic studies in Iran and completed them in Canada.
Egocentric orientation isn't Moussavi's only area of interest: She has also developed and tested a series of brain exercises that have been shown to strengthen associative memory in patients at the earliest stages of dementia. "That has shown remarkable results. I'm so happy about it."
Her third area of Alzheimer's research uses repetitive Transcranial Magnetic Stimulus (rTMS), a cutting-edge technology that sends electromagnetic pulses to the brain and fires up neurons.
Carlo Miniussi, a physiology professor at the University of Brescia, Italy, says Moussavi is one of the few Alzheimer's researchers in the world studying rTMS. The researcher met Moussavi recently during a visit to Winnipeg and says it is rare for a researcher to be uncovering clues to a disease that has affected her family so intimately.
"I must say that I would consider this vital for her activity. It is indeed unusual for a scientist to be inspired by such a personal connections," Miniussi wrote in an email.
Moussavi, a mother of two, says she worries about her own genetic risk of dementia. To lessen her chances of developing the disease, she regularly performs the brain exercises she invented.
But her main motivation has nothing to do with preventing her own cognitive demise. It's her mother, Soroor.
Moussavi thinks about her every day.
"For sure. When I see these patients, they remind me of my mother. Perhaps that's why I desperately want to find a way for them to improve."
Are you or a family member interested in participating in Zahra Moussavi's studies? Contact her at firstname.lastname@example.org.
To see her brain exercises, log onto: http://bme.ee.umanitoba.ca/BrainExercises/
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