Watching brain surgery raises a profound question: is Alzheimer’s disease an unsolvable puzzle, or can science eventually defeat it?
At the Edinburgh Royal Infirmary, cutting-edge dementia research begins inside an operating theatre. A patient lies sedated as surgeons prepare to remove a brain tumour that spread from colon cancer. On large screens, MRI images reveal the mass deep within the brain, far from the surface.
To reach it, neurosurgeons must pass through the cortex, the brain’s outer layer responsible for memory, language and thought. Using extreme precision, Professor Paul Brennan drills a small opening in the skull and carefully removes a tiny section of cortex. In most hospitals, this tissue would be discarded. Here, with the patient’s consent, it becomes a valuable resource for Alzheimer’s research.
That small piece of living brain tissue is placed immediately into ice-cold artificial cerebrospinal fluid to keep it alive. It is then rushed across the city to the University of Edinburgh, where Dr Claire Durrant and her team begin their work.
Dr Durrant’s laboratory is among a handful worldwide studying living adult human brain tissue. For her, each sample represents both a scientific opportunity and a deeply human moment. The tissue once formed part of a person’s thoughts, memories and fears.
In the lab, the sample is embedded in a jelly-like substance, then sliced into sections thinner than a human hair. These living brain slices are kept alive in incubators and exposed to toxic proteins known as amyloid and tau, which accumulate in the brains of people with Alzheimer’s disease.
By observing how these proteins damage synapses — the connections between brain cells — researchers hope to understand why memory and thinking decline, and how that process might be stopped.
Alzheimer’s remains the most common cause of dementia, affecting around one million people in the UK alone. While there is still no cure, recent developments have renewed optimism. New drugs such as lecanemab and donanemab have shown the ability to slow the disease, even if their impact is currently limited and they are not funded by the NHS.
According to Professor Tara Spires-Jones, director of the Centre for Discovery Brain Science, these treatments mark a turning point. They demonstrate that Alzheimer’s can be altered biologically, opening the door to more effective therapies.
Researchers are now exploring multiple angles at once: targeting amyloid and tau, understanding brain inflammation, examining immune cells like astrocytes, and studying how genetics, blood vessels and environmental factors contribute to the disease.
Experts believe progress will come in stages — first treatments that slow or halt decline, then tools to prevent dementia, and eventually therapies that could reverse symptoms in those already affected. While curing Alzheimer’s remains the most difficult goal, many scientists believe it is no longer out of reach.
The human brain is extraordinarily complex, and only continued research and clinical trials will reveal what is truly possible. But for the scientists working with living brain tissue today, hope has never been stronger.
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