Netherlands Brain Bank
The Netherlands Brain Bank (NBB) isolates and stores human brain tissue. People living in the Netherlands can register as a brain donor during life, thereby giving the NBB informed consent to perform brain autopsy after they die. Both healthy controls and people diagnosed with various psychiatric or neurological disorders are welcomed as brain donors. Due to close collaboration with the VU medical center in Amsterdam, the autopsy can be performed shortly after death. Because of the short post mortem delay (the time between death and autopsy), the brain tissue is of high quality. The NBB supplies human brain tissue to researchers worldwide, together with accurate clinical and neuropathological data on the donor’s life.
By investigating human brain tissue, researchers gain insight in human brain functioning on a cellular and molecular level. Better understanding of the human brain helps to further develop treatment for neurological and psychiatric brain diseases.
The NBB acts according to national legislation and its procedures support human rights (right of self-determination, dignity and integrity). Brain tissue is supplied to researchers anonymously. The ethical principles to which the NBB is committed, and the legal foundation for these procedures, are summarized in the ethical and legal statement of the NBB.
Organisation
In 1978, Professor Dick Swaab (1944) was installed as director of the Netherlands Institute for Brain Research, nowadays called the Netherlands Institute for Neuroscience. In collaboration with neuropathologists Prof. Frans Stam (VU medical center or VUmc) and Dr. Wouter Kamphorst (VUmc) he founded the NBB in 1985, aiming to facilitate scientific research on brain pathology, by stimulating human brain research after death (called postmortem research). Currently, the NBB is led by Dr. Inge Huitinga.
The NBB is a department of the Netherlands Institute of Neuroscience (NIN), an institute of The Royal Netherlands Academy of Arts and Sciences. The NBB is located in Amsterdam and collaborates closely with the department of Pathology of VUmc.
Donor program
Over 3.750 people have registered as prospective brain donors up until January 2016. Some donors are diagnosed with one or multiple psychiatric or neurological disorders, while approximately half of the donors are healthy controls. To compare healthy and diseased brain tissue, similar tissue from both healthy and diseased brains is required. Tissue is matched on brain region, donor sex and age. To enable this match, healthy control donors are essential for postmortem research.
Neurological diseases in the scope of NBB are for example Parkinson’s Disease, Multiple Sclerosis (MS), Frontotemporal Dementia and Alzheimer’s Disease. To optimize the contribution to postmortem brain research, the NBB can adjust its registration policy to answer to the needs of science.
Besides neurological disorders, the NBB also focuses on prospective donors diagnosed with psychiatric disorders. Worldwide, brain tissue from donors with a psychiatric history is highly scarce. The amount of available tissue does not meet researcher’s needs by far. To overcome this deficit and to establish a resource of psychiatric brain tissue, the NBB started the NBB-Psy project. With this project, potential donors are actively informed about brain donation and postmortem research. For more information on NBB-Psy, see below.
People can sign up voluntarily as brain donor at the NBB. Registration is realized by signing the Informed Consent (in Dutch: ‘Toestemmingsverklaring Nederlandse Hersenbank’). People can register as brain donor at the NBB and organ donor at the Dutch Donor Register simultaneously. However, execution of both donations is not feasible for timing reasons. In case of simultaneous registration, it is policy to give organ donation –if still possible- priority over brain donation.
Preservation of brain tissue
After removal of the brain, approximately seventy regions of the brain are isolated, fixated and preserved. The brain tissue is frozen at -196 °C immediately and either preserved at -80 °C or chemically treated to prepare it for research techniques. Subsequently, the tissue is stored anonymously. The neuropathologist will determine the final diagnosis in an English report, based on microscopical findings and the medical record. This report will concentrate on neurological deviations which can be observed with a microscope.
Scientific research with brain tissue
The average period of time between passing of the donor and the autopsy lies around six hours. Because of the short postmortem delay, the brain tissue is of very high quality and therefore highly useful for immunohistochemical staining and RNA- DNA-, sugar-, fat- and protein analyses. Medical data of the donor are collected, summarized and anonymized by the NBB in a report. The NBB receives and processes many requests for brain tissue from scientific researchers worldwide. After a review of the request by the scientific committee, brain tissue will be sent to the researcher together with the report with anonymized information about the donor. The research projects executed with NBB tissue apply various histological, cellular and molecular techniques. The goal of this kind of research is to gain insight in both the normal functioning of the brain and the disease processes underlying different neurological and psychiatric disorders. Each two years a project overview is published including research projects conducted with brain tissue from the NBB. Those overviews can be found on the NBB website.
NHB-Psy
At the end of 2012 the Netherlands Brain Bank for Psychiatry (NBB-Psy) started, a donor program of the NBB. Aim of this project is to establish a resource of brain tissue of 7 major psychiatric disorders: schizophrenia and/or psychoses, severe depression, bipolar disorder, autism spectrum disorders, ADHD, obsessive compulsive disorder and post-traumatic stress disorder. NBB-Psy focuses on informing people with psychiatric disorders about brain donation at the NBB, to stimulate postmortem research on psychiatric disorders. Goal of NBB-Psy is to increase understanding of psychiatric disorders and to develop and optimize therapies that will improve quality of life. Currently, it is not clear how the brains of people diagnosed with one of the mentioned disorders differ in functioning compared to healthy control brains. Besides imaging studies (MRI), animal and genetic studies, postmortem research is an important addition in learning more about the pathways underlying psychiatric disorders. Postmortem research on the human brain is the only research that supports techniques on the smallest cellular and molecular level. NBB-Psy collaborates with several cohort studies. Participants of existing cohorts are approached by a research assistant which actively informs the participant on NBB-Psy and brain donation. If participants choose to register as a brain donor, additional data on the donor can be collected later on. This data is a highly valued addition to data collected during the cohort study. Another source of data on registered brain donors is the MINI+ interview: a psychiatric interview that maps psychiatric symptoms. All new brain donors (except cohort participants) are invited to participate in this interview.