Washington People: Randall Bateman

Innovations advance Alzheimer’s research
By Michael C. Purdy

Robert Boston

Randall Bateman, MD (left), and Justyna Dobrowolska, a doctoral student, look at specimens in the lab. “Randy is undaunted by challenges,” says Bateman’s frequent collaborator David Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor and chair of Neurology. “I think growing up on a farm gave him a very practical perspective on life, and his intellect and his curiosity allow him to explore ideas others would never even try.”

Randall Bateman, MD, had no intention of becoming a doctor when he enrolled as an undergraduate at Washington University in St. Louis.

“I thought a doctor was someone who only treated people with colds, coughing and sneezing up phlegm,” he says. “That was not an interesting job to me.”

Bateman, associate professor of neurology, who grew up in small farm towns in Georgia and Missouri, was interested in computers and artificial intelligence, so he decided to major in electrical engineering. But his degree required him to take a biology course.

“I wasn’t so enthralled by biology in high school, but the brilliant biology teachers here at Washington University changed that for good,” he says. “The faculty members who inspired me included Barbara Pickard, PhD, who is professor emerita of biology.”

Bateman began taking biology electives and became active in the Emergency Support Team, a student-staffed group of medical first responders on the Danforth Campus. He served as treasurer and president of the group.

Bateman realized that he liked working with a wide variety of people, and medicine offered more opportunities to do that than engineering. He applied to medical school at Case Western Reserve University and was accepted.

“After I earned my MD, I took six months off to backpack around the world,” he says. “One of the things that I came to believe from that trip and my time at Washington University is that all people are fundamentally alike: They’re good people.

“Societies, cultures and practices around the world are so different,” he says. “But the vast majority of people from any country are all alike in that they wish well, are caring and will help you.”

Answering a question

As a faculty member at the School of Medicine since 2006, Bateman focuses his research on Alzheimer’s disease. He led the development of a technique known as stable isotope-linked kinetics (SILK) that made it possible to resolve a critical question about the disease.

That question centered on amyloid beta. High levels of amyloid beta, which is a normal product of brain metabolism, are one of the hallmarks of Alzheimer’s. But scientists had no way of knowing whether patients had more amyloid beta in their brains because they were making more of it, because they were clearing less of it from the brain, or because both production and clearance rates were changing.

SILK involves giving subjects an infusion of a labeled form of an amino acid, leucine, one of the building blocks of amyloid beta. Scientists take periodic samples of the subjects’ cerebrospinal fluid through a lumbar catheter and determine how much of the amyloid beta includes labeled leucine. Tracking the rise and fall of amyloid beta with labeled leucine gives scientists the subject’s amyloid beta production and clearance rates.

In 2010, Bateman and his colleagues reported in an initial study of 24 subjects that clearance was the problem. Healthy individuals and patients recently diagnosed with Alzheimer’s made amyloid beta at the same rate, but the amyloid beta clearance rate had dropped by 30 percent in Alzheimer’s patients.

“Randy is undaunted by challenges,” says Bateman’s frequent collaborator David Holtzman, MD, the Andrew B. and Gretchen P. Jones Professor and chair of Neurology. “I think growing up on a farm gave him a very practical perspective on life, and his intellect and his curiosity allow him to explore ideas others would never even try.”

Preparing for an important trial

In follow-up studies, Bateman and his colleagues are determining whether a drop in amyloid beta clearance levels can be used to predict Alzheimer’s disease years before symptoms become apparent.

Identifying Alzheimer’s in its earliest stages is a top priority for researchers. Many think that by the time symptoms become apparent, Alzheimer’s disease has already damaged the brain extensively, making it difficult or impossible to restore memory and other mental abilities.

"We want to prevent damage and loss of brain cells by intervening early in the disease process — even before outward symptoms are evident because by then, it may be too late,” Bateman says.

Bateman is associate director of the Dominantly Inherited Alzheimer’s Network (DIAN), an international collaborative dedicated to studying the inherited forms of Alzheimer’s.

Inherited forms of Alzheimer’s are much less common, involve mutations in one of three genes and typically cause symptoms earlier than sporadic forms of the disease. When a son or daughter in these families inherits the mutated form of the gene, they typically develop symptoms at about the same point in life as their parents did.

Bateman and his colleagues in the DIAN study reported in the summer of 2011 that they can detect changes in the brain related to Alzheimer’s disease 20 years before the estimated age of onset. Bateman now is leading the design of a first-of-its-kind trial of preventive treatments for these individuals that he hopes will begin this year.

“It’s very exciting research, both from the perspective of what we may be able to do for the family members in the DIAN study and what that may teach us about stopping sporadic forms of the disease,” Bateman says.

Enjoying family life

Bateman calls his wife, Crystal, and their three children — Nicholas, 12; Emma, 8; and Alexander, 4 — the “greatest things in my life.’

Courtesy photo

Randall Bateman, MD (right), and his wife, Crystal, pose in an area park with children (from left) Nicholas, Alexander and Emma.

“I was in sixth grade, and Crystal was in fourth grade when she and I first met, and she served me mashed potatoes at a summer fundraising event for someone whose house had burned down,” he rsays. “She doesn’t remember this, but I smiled sweetly at her. We didn’t make much of a connection until years later in marching band.”

Bateman appreciates the variety of family activities available in St. Louis. He and his family are fans of the Saint Louis Zoo, Grant’s Farm, the Saint Louis Science Center, the Missouri Botanical Garden, Six Flags St. Louis and other community activities and events.

“We have amazingly good kids, and I credit that to their mother,” he says. “I know all parents think this, but I truly believe they’re outstanding. They’re kind, caring, and always take care of each other.”

Fast facts about Randall Bateman 

Title: Associate professor of neurology
Grew up in: Iberia, Mo., and Acworth, Ga.
Lives in: Wildwood, Mo.
Hobbies: Reading about particle physics, astrophysics and artificial intelligence, camping
Favorite restaurants: “Crystal finds out what the good ones are, and I go with her,” he says.
Michael C. Purdy
Senior Medical Sciences Writer
(314) 286-0122